Science.gov

Sample records for non-infectious ischiogluteal bursitis

  1. Bursitis

    MedlinePlus

    ... En Español Making a Change – Your Personal Plan Hot Topics Meningitis Choosing Your Mood Prescription Drug Abuse ... occur with bursitis. Heat: Putting heat (warm, not hot) on the area may reduce pain and stiffness. ...

  2. NON-INFECTIOUS DISORDERS OF WARMWATER FISHES

    EPA Science Inventory

    Compared with infectious diseases and disorders, few non-infectious diseases and disorders in cultured fish have severe biologic or economic impact. Culture practices, however, often establish environments that promote infectious disease by weakening the immune response or by pro...

  3. Bursitis and Tendinitis

    MedlinePlus

    ... tendons, or skin. Bursae are found throughout the body. Bursitis occurs when a bursa becomes inflamed (redness and increased fluid in the bursa). A tendon is a flexible band of fibrous tissue that connects muscles to ...

  4. Non-infectious Pulmonary Diseases and HIV.

    PubMed

    Triplette, M; Crothers, K; Attia, E F

    2016-06-01

    Pulmonary complications remain among the most frequent causes of morbidity and mortality for individuals with HIV despite the advent of antiretroviral therapy (ART) and improvement in its efficacy and availability. The prevalence of non-infectious pulmonary diseases is rising in this population, reflecting both an increase in smoking and the independent risk associated with HIV. The unique mechanisms of pulmonary disease in these patients remain poorly understood, and direct effects of HIV, genetic predisposition, inflammatory pathways, and co-infections have all been implicated. Lung cancer, chronic obstructive pulmonary disease (COPD), and pulmonary hypertension are the most prevalent non-infectious pulmonary diseases in persons with HIV, and the risk of each of these diseases is higher among HIV-infected (HIV+) persons than in the general population. This review discusses the latest advances in the literature on these important complications of HIV infection. PMID:27121734

  5. Endoscopic treatment of prepatellar bursitis.

    PubMed

    Huang, Yu-Chih; Yeh, Wen-Lin

    2011-03-01

    Operative treatment of prepatellar bursitis is indicated in intractable bursitis. The most common complication of surgical treatment for prepatellar bursitis is skin problems. For traumatic prepatellar bursitis, we propose a protocol of outpatient endoscopic surgery under local anaesthesia. From September 1996 to February 2001, 60 cases of failed nonoperative treatment for prepatellar bursitis were included. The average age was 33.5 ± 11.1 years (range 21-55). The average operation duration was 18 minutes. Two to three mini-arthroscopic portals were used in our series. No sutures or a simple suture was needed for the portals after operation. After follow-up for an average of 36.3 months, all patients are were symptom-free and had regained knee function. None of the population had local tenderness or hypo-aesthesia around their wound. Their radiographic and sonographic examinations showed no recurrence of bursitis. Outpatient arthroscopic bursectomy under local anaesthesia is an effective procedure for the treatment of post-traumatic prepatellar bursitis after failed conservative treatments. Both the cosmetic results and functional results were satisfactory. PMID:20521045

  6. Involvement of B cells in non-infectious uveitis

    PubMed Central

    Smith, Justine R; Stempel, Andrew J; Bharadwaj, Arpita; Appukuttan, Binoy

    2016-01-01

    Non-infectious uveitis—or intraocular inflammatory disease—causes substantial visual morbidity and reduced quality of life amongst affected individuals. To date, research of pathogenic mechanisms has largely been focused on processes involving T lymphocyte and/or myeloid leukocyte populations. Involvement of B lymphocytes has received relatively little attention. In contrast, B-cell pathobiology is a major field within general immunological research, and large clinical trials have showed that treatments targeting B cells are highly effective for multiple systemic inflammatory diseases. B cells, including the terminally differentiated plasma cell that produces antibody, are found in the human eye in different forms of non-infectious uveitis; in some cases, these cells outnumber other leukocyte subsets. Recent case reports and small case series suggest that B-cell blockade may be therapeutic for patients with non-infectious uveitis. As well as secretion of antibody, B cells may promote intraocular inflammation by presentation of antigen to T cells, production of multiple inflammatory cytokines and support of T-cell survival. B cells may also perform various immunomodulatory activities within the eye. This translational review summarizes the evidence for B-cell involvement in non-infectious uveitis, and considers the potential contributions of B cells to the development and control of the disease. Manipulations of B cells and/or their products are promising new approaches to the treatment of non-infectious uveitis. PMID:26962453

  7. Reducing Non-Infectious Risks of Blood Transfusion

    PubMed Central

    Gilliss, Brian M.; Looney, Mark R.; Gropper, Michael A.

    2011-01-01

    Summary As screening for transfusion-associated infections has improved, non-infectious complications of transfusion now cause the majority of morbidity and mortality associated with transfusion in the United States. For example, transfusion-related acute lung injury, transfusion-associated circulatory overload, and hemolytic transfusion-reactions are the first, second, and third leading causes of death from transfusion respectively. These complications and others are reviewed here and several controversial methods for prevention of non-infectious complications of transfusion are discussed; universal leukoreduction of red cell units, use of male-only plasma, and restriction of red cell storage age. PMID:21792054

  8. Recent developments in septic bursitis.

    PubMed

    Hanrahan, Jennifer A

    2013-10-01

    Septic bursitis is a disease that can be difficult to distinguish from aseptic bursitis. There are no definitive treatment guidelines. The optimal duration of antibiotic therapy is not defined. Most of the cases are due to infection with Staphylococcus aureus, although many other pathogens can also cause this infection. The optimal management includes early recognition and prompt initiation of appropriate antibiotic therapy. Surgical management may be necessary, and complications can arise from open procedures. Endoscopic bursectomy may be considered for patients requiring surgical debridement. This approach may lead to decreased morbidity in those requiring surgical intervention. PMID:23933823

  9. Exophiala oligosperma Causing Olecranon Bursitis

    PubMed Central

    Bossler, A. D.; Richter, S. S.; Chavez, A. J.; Vogelgesang, S. A.; Sutton, D. A.; Grooters, A. M.; Rinaldi, M. G.; de Hoog, G. S.; Pfaller, M. A

    2003-01-01

    A 62-year-old male with a history of Wegener's granulomatosis and immunosuppressive therapy presented with chronic olecranon bursitis. A black velvety mould with brown septate hyphae and tapered annellides was isolated from a left elbow bursa aspirate and was identified as an Exophiala species. Internal transcribed sequence rRNA sequencing showed the isolate to be identical to Exophiala oligosperma. The patient was successfully treated with aspiration and intrabursal amphotericin B. PMID:14532219

  10. Exophiala oligosperma causing olecranon bursitis.

    PubMed

    Bossler, A D; Richter, S S; Chavez, A J; Vogelgesang, S A; Sutton, D A; Grooters, A M; Rinaldi, M G; de Hoog, G S; Pfaller, M A

    2003-10-01

    A 62-year-old male with a history of Wegener's granulomatosis and immunosuppressive therapy presented with chronic olecranon bursitis. A black velvety mould with brown septate hyphae and tapered annellides was isolated from a left elbow bursa aspirate and was identified as an Exophiala species. Internal transcribed sequence rRNA sequencing showed the isolate to be identical to Exophiala oligosperma. The patient was successfully treated with aspiration and intrabursal amphotericin B. PMID:14532219

  11. Clinicopathological Study of Non-Infectious Erythaematous Papulosquamous Skin Diseases

    PubMed Central

    Pai, Muktha; Philipose, Thoppil Reba; Nayarmoole, Umaru

    2016-01-01

    Introduction Papulosquamous diseases are characterized by scaly papules and plaques with similar clinical picture which amounts to confusion and hence, a definitive histopathological diagnosis goes a long way in treatment of such diseases. Aim The aim of the study was to study the histomorphology of non-infectious, erythaematous, papulosquamous lesions of skin with clinicopathological correlation. Materials and Methods Skin biopsies from 150 clinically diagnosed/suspected non-infectious erythaematous, papulosquamous skin diseases were received in the Department of Pathology. The specimens obtained were subjected to formalin fixation and paraffin embedding, stained with haematoxylin and eosin and studied. The lesions were classified as psoriasis, lichen planus, lichen nitidus, lichen striatus, pityriasis rosea and pityriasis rubra pilaris and clinicopathological correlation was done. Results Papulosquamous lesions were common in the elderly. Males were commonly affected except in pityriasis rosea. Among the 150 cases studied, 72 cases (48%) were histopathologically confirmed to be papulosquamous lesions. Psoriasis was the most common lesion. Conclusion Key histopathological features and clinicopathological correlation gives a conclusive diagnosis. The importance of specific histomorphological diagnosis lies in distinguishing these lesions as the treatment and prognosis varies widely. PMID:27504295

  12. Interspinous bursitis in an athlete.

    PubMed

    DePalma, M J; Slipman, C W; Siegelman, E; Bayruns, T J; Bhargava, A; Frey, M E; Chin, K R

    2004-09-01

    We present a case of L2/3 interspinous bursitis treated with extraspinal injections. No previous investigations have used fluoroscopically guided spinal injections to confirm the clinical relevance of the MRI features of this type of bursae. Autopsy studies have revealed an increased incidence of interspinous lumbar bursal cavities with advancing age. Afflicted patients present with localised, midline lower lumbar pain exacerbated by extension. In young athletes these symptoms can mimic spondylolysis. MRI is useful in detecting soft-tissue injury of the posterior elements. Fluoroscopically guided diagnostic and therapeutic extraspinal injections can be used for confirmation and treatment of pain from such bursae.

  13. [Chronic, non-infectious diarrhea: diagnostics and therapy].

    PubMed

    Ulbricht, Korinna; Layer, Peter; Andresen, Viola

    2016-09-01

    Chronic, non-infectious diarrhea can be caused by a variety of gastrointestinal diseases. In anamnesis, it is important to take accompanying warning symptoms and specific triggers into account. The fecal inflammatory marker calprotectin may help differentiating between organic and functional gastrointestinal disorders, but it is not specific. Among other options, gelling fibres, Loperamide and Cholestyramine as well as probiotics are available for the symptomatic treatment of chronic diarrhea. For long-term treatment of chronic diarrhea with the enkephalinase inhibitor racecadotril, which is approved for acute diarrhea, only limited data are available. Eluxadolin presents a new therapeutic option. It can alleviate abdominal pain and diarrhea by modulation of opioid receptors in the enteric nervous system. Additional approaches in intractable irritable bowel syndrome with diarrhea (IBS-D) include 5-HT3 receptor antagonists, the antibiotic Rifaximin as well as low-dose tricyclic antidepressants. Specific diets such as the low-FODMAP diet can also relieve symptoms in IBS. PMID:27642742

  14. [Non-infectious inflammatory fasciitis: a borderline syndrome].

    PubMed

    Hachulla, E; Janin, A

    1995-01-01

    Inflammatory fasciitis without infection include different entity like eosinophilic fasciitis, the syndrome of eosinophilia-myalgia after tryptophan ingestion, toxic oil syndrome, exposure to trichlorethylene, phenylketonuria skin changes, the syndrome of palmar fasciitis, fasciitis in chronic graft-versus-host disease and fasciitis secondary to an adjacence process. The diagnosis of all these scleroderma-like skin changes is sometimes not easy because the clinical and sometimes the histopathological changes are bordeline manifestations with scleroderma. The most characteristic markers for non infectious fasciitis is eosinophilia and the infiltration of the fascia with eosinophilis, but it may be unremarkable or absent, only frequently present at the onset of the disease. Anamnesis is most important to guide the diagnosis. The eosinophils, but not only, may play a major role in the pathogenesis of this entity.

  15. Olecranon bursitis: a systematic overview

    PubMed Central

    Hay, Bruce A; Bolt, Alexander M; Hay, Stuart M

    2014-01-01

    Background Olecranon bursitis is a common condition where the bursal cavity, superficial to the olecranon, becomes inflamed. This can occur either with or without infection and has been given pseudonyms relating to the repeated minor trauma from external pressure that often predisposes. As a result of the multiple aetiologies, olecranon bursitis can present to any medical specialty with reasonable frequency and, although many therapies are described, a single, evidence-based and standardized treatment pathway is not well described. Methods We summarize the key points within the literature and subsequently propose an evidence-based treatment pathway. Results Relevant evidence is presented from appropriate publications to add rational to existing decision-making processes, together with personal experience and suggested operative bursectomy techniques from an established upper limb surgeon. The common and significant aetiologies are summarized and, in particular, red flag symptoms are highlighted by way of warning to the unsuspecting investigator. Conclusions The conclusion is provided in diagrammatic form, providing a suggested treatment pathway from history and examination through to operative intervention. PMID:27582935

  16. Primary immunodeficiency update II: Syndromes associated with mucocutaneous candidiasis and non-infectious cutaneous manifestations

    PubMed Central

    Pichard, Dominique C.; Freeman, Alexandra F.; Cowen, Edward W.

    2015-01-01

    Several primary immunodeficiencies (PID) have recently been described which confer elevated risk of fungal infections as well as non-infectious cutaneous manifestations. In addition, immunological advances have provided new insights into our understanding of the pathophysiology of fungal infections in established PID. We reviewed PID that present with an eczematous dermatitis in Part I. In Part II, we will discuss updates on PID associated with fungal infections and their biological basis in PID as well as non-infectious cutaneous manifestations. PMID:26282795

  17. Morphological and quantitative comparison between infectious and non-infectious forms of influenza virus.

    PubMed

    WERNER, G H; SCHLESINGER, R W

    1954-08-01

    Electron microscopic study has revealed the morphological entity responsible for the rise in viral hemagglutinin observed in brains of mice after intracerebral inoculation of non-neurotropic strains of influenza virus. This rise in hemagglutinin, although dependent on inoculation of fully infectious virus, is not associated with an increase in infectious titer. The hemagglutinating principle is functionally similar to the "incomplete" influenza virus which can be obtained from chick embryos by serial egg-to-egg transfer of undiluted, infected allantoic fluid according to the method of von Magnus. A method has been described which facilitates selective adsorption of viral particles recovered from organ extracts on saponine-lysed ghosts of fowl erythrocytes. This procedure has been utilized in studying the morphology of non-infectious, hemagglutinating virus from chorio-allantoic membranes or mouse brains and in comparing these two forms with each other and with ordinary, infectious (standard) influenza virus. Standard virus isolated from allantoic fluids or membranes of infected eggs was found to contain uniform particles of predominantly spherical shape with smooth surface and even density, resembling those described by others. The appearance of such particles was not affected by the procedure of extraction and concentration used. In contrast, non-infectious, hemagglutinating virus obtained either from allantoic sacs ("undiluted passages") or from mouse brain was pleomorphic and seemed to consist of disintegrating particles. The majority appeared flattened and bag-like and had a rough, granular surface and reduced, uneven density. 37 per cent of the non-infectious particles isolated from mouse brain infected with the non-neurotropic strain WS had diameters in excess of 170 mmicro, as compared with only 2 per cent of the particles of the parent strain itself. Regardless of whether or not the contrast in appearance of standard and of non-infectious particles was due

  18. Treatment of trochanteric bursitis: our experience

    PubMed Central

    Nurkovic, Jasmin; Jovasevic, Ljubisa; Konicanin, Admira; Bajin, Zoran; Ilic, Katarina Parezanovic; Grbovic, Vesna; Skevin, Aleksandra Jurisic; Dolicanin, Zana

    2016-01-01

    [Purpose] Trochanteric bursitis is a disease for which there are no effective standardized therapy protocols. Very often pain persists in spite of applying all therapeutic treatments. The purpose of this study was to determine whether treatment of trochanteric bursitis with a local injection of bicomponent corticosteroid and 2% lidocaine would improve patients’ conditions and relieve pain symptoms in the trochanteric area. [Subjects and Methods] A retrospective observational study was conducted of 2,217 patients in a 6 year follow-up period at the Special Hospital “Agens”, Mataruska Banja, Serbia. [Results] Of 2,217 examined patients, 58 (2.6%) patients were found to suffer from trochanteritis associated with low back pain, and 157 (7%) were found to suffer from trochanteric pains without low back pains. Local corticosteroid therapy followed by physical therapy was effective in 77 (49%) of these patients, and only corticosteroid injection in 61 (39%) patients. A single injection was given to 47 (29.9%) of the patients. Two injections were given to 9 (5.7%) patients, and from 3 to 5 injections were given repeatedly every 4–6 weeks to 7 (4.5%) patients. [Conclusion] For most patients, local injections of corticosteroids with lidocaine alone or followed by physical therapy gave satisfactory results. PMID:27512268

  19. Treatment of trochanteric bursitis: our experience.

    PubMed

    Nurkovic, Jasmin; Jovasevic, Ljubisa; Konicanin, Admira; Bajin, Zoran; Ilic, Katarina Parezanovic; Grbovic, Vesna; Skevin, Aleksandra Jurisic; Dolicanin, Zana

    2016-07-01

    [Purpose] Trochanteric bursitis is a disease for which there are no effective standardized therapy protocols. Very often pain persists in spite of applying all therapeutic treatments. The purpose of this study was to determine whether treatment of trochanteric bursitis with a local injection of bicomponent corticosteroid and 2% lidocaine would improve patients' conditions and relieve pain symptoms in the trochanteric area. [Subjects and Methods] A retrospective observational study was conducted of 2,217 patients in a 6 year follow-up period at the Special Hospital "Agens", Mataruska Banja, Serbia. [Results] Of 2,217 examined patients, 58 (2.6%) patients were found to suffer from trochanteritis associated with low back pain, and 157 (7%) were found to suffer from trochanteric pains without low back pains. Local corticosteroid therapy followed by physical therapy was effective in 77 (49%) of these patients, and only corticosteroid injection in 61 (39%) patients. A single injection was given to 47 (29.9%) of the patients. Two injections were given to 9 (5.7%) patients, and from 3 to 5 injections were given repeatedly every 4-6 weeks to 7 (4.5%) patients. [Conclusion] For most patients, local injections of corticosteroids with lidocaine alone or followed by physical therapy gave satisfactory results. PMID:27512268

  20. Candida glabrata olecranon bursitis treated with bursectomy and intravenous caspofungin.

    PubMed

    Skedros, John G; Keenan, Kendra E; Trachtenberg, Joel D

    2013-01-01

    Orthopedic surgeons are becoming more involved in the care of patients with septic arthritis and bursitis caused by yeast species. This case report involves a middle-aged immunocompromised female who developed a Candida glabrata septic olecranon bursitis that developed after she received a corticosteroid injection in the olecranon bursa for presumed aseptic bursitis. Candida (Torulopsis) glabrata is the second most frequently isolated Candida species from the bloodstream in the United States. Increased use of fluconazole and other azole antifungal agents as a prophylactic treatment for recurrent Candida albicans infections in immunocompromised individuals is one reason why there appears to be increased resistance of C. glabrata and other nonalbicans Candida (NAC) species to fluconazole. In this patient, this infection was treated with surgery (bursectomy) and intravenous caspofungin, an echinocandin. This rare infectious etiology coupled with this intravenous antifungal treatment makes this case novel among cases of olecranon bursitis caused by yeasts. PMID:23628576

  1. The operative treatment of scapulothoracic bursitis in professional pitchers.

    PubMed

    Sisto, D J; Jobe, F W

    1986-01-01

    Four professional pitchers with resistant scapulothoracic bursitis who have required surgical excision of the thickened bursa are reported. The average time duration of symptoms prior to surgery was 18.8 months. Conservative therapy consisting of rest, shoulder exercises, antiinflammatory medications, and cortisone injections failed to resolve the bursitis, and each pitcher was unable to compete secondary to pain. The incision was posterior, just distal to the tip of the scapula. The specimens contained cleft-like spaces lined by synovial tissue consistent with a bursa. All four pitchers returned to professional baseball the year following surgical excision of the bursa. We recommend early, aggressive, conservative therapy for scapulothoracic bursitis in the throwing athlete. Pitchers with a thickened, resistant scapulothoracic bursitis should have the bursa surgically excised.

  2. Therapeutic penetrating keratoplasty for infectious and non-infectious corneal ulcers.

    PubMed

    Yalniz-Akkaya, Zuleyha; Burcu, Ayse; Doğan, Emine; Onat, Mustafa; Ornek, Firdevs

    2015-04-01

    This study reports the outcomes of therapeutic penetrating keratoplasties, defined as keratoplasties performed to eradicate active infectious corneal diseases or to repair a structural defect of the cornea. The records of 24 eyes of 24 patients (17 female and 7 male) treated with therapeutic penetrating keratoplasty between 2002 and 2010 were evaluated retrospectively. Patients were divided into infectious keratitis group and non-infectious keratitis group. The mean age was 52.12 ± 17.91 years. The median follow-up time was 22 months (min-max: 6-96). Therapeutic success was achieved and eyes were preserved in 23 patients and one patient required evisceration for recurrent fungal infection. At the end of the follow-up period, 92.9 % (n = 13) and 77.8 % (n = 7) of grafts remained clear in the infectious and non-infectious groups, respectively (p = 0.538). Visual acuity (VA) improved at least one Snellen line in 23 patients. The mean postoperative decimal VA was 0.2 ± 0.3 and 0.1 ± 0.3 in the infectious and non-infectious groups, respectively (p = 0.12). Amniotic membrane transplantation was performed in two eyes preoperatively and in four eyes postoperatively. Therapeutic penetrating keratoplasty continues to be an effective method in the treatment process of serious perforated and non-perforated corneal infectious and non-infectious diseases resistant to medical and other surgical interventions.

  3. Interplay between innate and adaptive immunity in the development of non infectious uveitis

    PubMed Central

    Willermain, François; Rosenbaum, James T; Bodaghi, Bahram; Rosenzweig, Holly L; Childers, Sarah; Behrend, Travis; Wildner, Gerhild; Dick, Andrew D

    2012-01-01

    In vertebrates, the innate and adaptive immune systems have evolved seamlessly to protect the host by rapidly responding to danger signals, eliminating pathogens and creating immunological memory as well as immunological tolerance to self. The innate immune system harnesses receptors that recognize conserved pathogen patterns and alongside the more specific recognition systems and memory of adaptive immunity, their interplay is evidenced by respective roles during generation and regulation of immune responses. The hallmark of adaptive immunity which requires engagement of innate immunity is an ability to discriminate between self and non-self (and eventually between pathogen and symbiont) as well as peripheral control mechanisms maintaining immunological health and appropriate responses. Loss of control mechanisms and/or regulation of either the adaptive or the innate immune system lead to autoimmunity and autoinflammation respectively. Although autoimmune pathways have been largely studied to date in the context of development of non-infectious intraocular inflammation, the recruitment and activation of innate immunity is required for full expression of the varied phenotypes of non-infectious uveitis. Since autoimmunity and autoinflammation implicate different molecular pathways, even though some convergence occurs, increasing our understanding of their respective roles in the development of uveitis will highlight treatment targets and influence our understanding of immune mechanisms operative in other retinal diseases. Herein, we extrapolate from the basic mechanisms of activation and control of innate and adaptive immunity to how autoinflammatory and autoimmune pathways contribute to disease development in non-infectious uveitis patients. PMID:22120610

  4. Diclofenac Patch for Treatment of Mild to Moderate Tendonitis or Bursitis

    ClinicalTrials.gov

    2008-08-05

    Rotator Cuff Tendonitis; Bicipital Tendonitis; Subdeltoid Bursitis of the Shoulder; Subacromial Bursitis of the Shoulder; Medial Epicondylitis of the Elbow; Lateral Epicondylitis of the Elbow; DeQuervain's Tenosynovitis of the Wrist

  5. Clinical Management of Scapulothoracic Bursitis and the Snapping Scapula

    PubMed Central

    Conduah, Augustine H.; Baker, Champ L.; Baker, Champ L.

    2010-01-01

    Context: Symptomatic scapulothoracic bursitis and crepitus are disorders of the scapulothoracic articulation that are often poorly understood. They can be a source of persistent pain and dysfunction in the active overhead throwing athlete. It is important to distinguish between scapulothoracic bursitis and scapulothoracic crepitus. Scapulothoracic bursitis refers to inflammation of the bursae secondary to trauma or overuse owing to sports activities or work. Scapulothoracic crepitus is defined by a grinding, popping, or thumping sound or sensation secondary to abnormal scapulothoracic motion. Evidence Acquisition: This article presents the causes, diagnosis, and management of these shoulder conditions in a manner that is relevant to clinicians, athletic trainers, and physical therapists, and it reviews relevant studies to determine the consensus on nonoperative treatment, as well as open and arthroscopic surgical treatment. Results: The causes of scapulothoracic bursitis and crepitus include direct or indirect trauma, overuse syndromes, glenohumeral joint dysfunction, osseous abnormalities, muscle atrophy or fibrosis, and idiopathic causes. Scapulothoracic bursitis and crepitus remain primarily clinical diagnoses; however, imaging studies or local injections may also be helpful. The initial treatment of scapulothoracic bursitis and scapulothoracic crepitus should be nonoperative. Surgical treatment options include partial scapulectomy or resection of the superomedial angle of the scapula, open bursal resection, and arthroscopic bursectomy. Despite the lack of agreement among orthopaedic surgeons concerning which procedure is best for treating symptomatic scapulothoracic bursitis and crepitus, most reports have demonstrated good to excellent outcomes in a significantly high percentage of patients. Conclusion: Clearly, the best initial approach to these conditions is a nonoperative treatment plan that combines scapular strengthening, postural reeducation, and core

  6. A Degenerative Retinal Process in HIV-Associated Non-Infectious Retinopathy

    PubMed Central

    Freeman, William R.; Sprague, L. James; Gomez, Maria Laura; Cheng, Lingyun; El-Emam, Sharif; Mojana, Francesca; Bartsch, Dirk-Uwe; Bosten, Jenny; Ayyagari, Radha; Hardiman, Gary

    2013-01-01

    HIV retinopathy is the most common non-infectious complication in the eyes of HIV-positive individuals. Oncotic lesions in the retinal nerve fiber layer, referred to as cotton wool spots (CWS), and intraretinal (IR) hemorrhages are frequently observed but are not unique to this pathology. HIV-positive patients have impaired color vision and contrast sensitivity, which worsens with age. Evidence of inner–retinal lesions and damage have been documented ophthalmoscopically, however their long term structural effect has not been investigated. It has been hypothesized that they may be partially responsible for loss of visual function and visual field. In this study we utilized clinical data, retinal imaging and transcriptomics approaches to comprehensively interrogate non-infectious HIV retinopathy. The methods employed encompassed clinical examinations, fundus photography, indirect ophthalmoscopy, Farmsworth-Munsell 100 hue discrimination testing and Illumina BeadChip analyses. Here we show that changes in the outer retina, specifically in the retinal pigment epithelium (RPE) and photoreceptor outer segments (POS) contribute to vision changes in non-infectious HIV retinopathy. We find that in HIV-positive retinae there is an induction of rhodopsin and other transcripts (including PDE6A, PDE6B, PDE6G, CNGA1, CNGB1, CRX, NRL) involved in visual transduction, as well as structural components of the rod photoreceptors (ABCA4 and ROM1). This is consistent with an increased rate of renewal of rod outer segments induced via increased phagocytosis by HIV-infected RPE previously reported in culture. Cone-specific transcripts (OPN1SW, OPN1LW, PDE6C, PDE6H and GRK7) are uniformly downregulated in HIV positive retina, likely due to a partial loss of cone photoreceptors. Active cotton wool spots and intraretinal hemorrhages (IRH) may not affect photoreceptors directly and the interaction of photoreceptors with the aging RPE may be the key to the progressive vision changes in HIV

  7. Infectious and Non-infectious Etiologies of Cardiovascular Disease in Human Immunodeficiency Virus Infection

    PubMed Central

    Chastain, Daniel B.; King, Travis S.; Stover, Kayla R.

    2016-01-01

    Background: Increasing rates of HIV have been observed in women, African Americans, and Hispanics, particularly those residing in rural areas of the United States. Although cardiovascular (CV) complications in patients infected with human immunodeficiency virus (HIV) have significantly decreased following the introduction of antiretroviral therapy on a global scale, in many rural areas, residents face geographic, social, and cultural barriers that result in decreased access to care. Despite the advancements to combat the disease, many patients in these medically underserved areas are not linked to care, and fewer than half achieve viral suppression. Methods: Databases were systematically searched for peer-reviewed publications reporting infectious and non-infectious etiologies of cardiovascular disease in HIV-infected patients. Relevant articles cited in the retrieved publications were also reviewed for inclusion. Results: A variety of outcomes studies and literature reviews were included in the analysis. Relevant literature discussed the manifestations, diagnosis, treatment, and outcomes of infectious and non-infectious etiologies of cardiovascular disease in HIV-infected patients. Conclusion: In these medically underserved areas, it is vital that clinicians are knowledgeable in the manifestations, diagnosis, and treatment of CV complications in patients with untreated HIV. This review summarizes the epidemiology and causes of CV complications associated with untreated HIV and provide recommendations for management of these complications. PMID:27583063

  8. Arthroscopic bursectomy for recalcitrant trochanteric bursitis after hip arthroplasty.

    PubMed

    Van Hofwegen, Christopher; Baker, Champ L; Savory, Carlton G; Baker, Champ L

    2013-01-01

    This study evaluated the use of arthroscopic bursectomy for pain relief in patients with trochanteric bursitis after hip arthroplasty. In this retrospective case series of 12 patients undergoing arthroscopic treatment of recalcitrant trochanteric bursitis after hip arthroplasty, outcomes were assessed via phone interview with a numeric pain rating scale from 1 to 10 and were compared with preoperative pain ratings. Patients were asked the percentage of time they had painless hip function and whether they would have the surgery again. At an average 36-month follow-up (range, 4-85 months), the average numeric pain scale rating improved from 9.3 to 3.3. At an average of 62% of the time, patients had painless use of the hip. Ten of 12 patients in the study felt the pain relief gained was substantial enough to warrant having procedure again. In these patients, arthroscopic bursectomy was a viable option for patients with recalcitrant bursitis after hip arthroplasty. PMID:23628567

  9. [The main risk factors of chronic non-infectious diseases in students: prevalence and long-term trends].

    PubMed

    Kardangusheva, A M; Él'garova, L V; Él'garov, A A

    2013-01-01

    The study was aimed at elucidating the prevalence and long-term trends of chronic non-infectious diseases among students of Kabardino-Balkarian Republic in the period of socio-economic changes for the elaboration and implementation of scientifically sound recommendations for the improvement of their health status. Four population studies were simultaneously conducted between 1999 and 2001 including 1542 subjects (613 men and 929 women) at risk of chronic non-infectious diseases with the low level of physical activity (76.3%), high personal and reactive anxiety level (41.8 and 28.9%), smoking (15.5%), overweight (10.5%), and arterial hypertension (5.7%). A combination of several risk factors of chronic non-infectious diseases was documented in 32.8% of the students. The prevalence of AH, low physical activity, high personal and reactive anxiety decreased in 2005 compared with 1999 but increased again by 2011. The number of smokers and students with a single risk factor of chronic non-infectious diseases decreased while the number of students with several risk factors increased (p<0. 05-0.0001). High frequency of risk factors of chronic non-infectious diseases suggests the necessity of development and realization of regional prophylactic programs.

  10. Case report: Infrapatellar bursitis caused by Prototheca wickerhamii.

    PubMed

    Van den Bossche, Dorien; de Haan, Roel; Van der Werff Ten Bosch, Jutte; Van Hecke, Wim; Symoens, Françoise; Van den Borre, Ina; Allard, Sabine; De Bel, Annelies

    2012-01-01

    A 54-year-old immunocompetent man presented with an infrapatellar bursitis caused by Prototheca wickerhamii. Because of clinical and microbiological relapse two weeks after bursectomy, six weekly injections of 5 mg of conventional amphotericin B were chosen for intrabursal treatment. Four months after completion of the treatment, the patient remains cured. PMID:24371726

  11. Bursectomy, Curettage, and Chemotherapy in Tuberculous Trochanteric Bursitis.

    PubMed

    Ramos-Pascua, Luis R; Carro-Fernández, José A; Santos-Sánchez, José A; Casas Ramos, Paula; Díez-Romero, Luis J; Izquierdo-García, Francisco M

    2016-03-01

    We presented three patients with trochanteric tuberculosis and described the clinical and imaging findings of the infection. Histology revealed a necrotizing granulomatous bursitis and microbiology confirmed tuberculosis. All cases were successfully treated with bursectomy and curettage of the trochanteric lesion and antituberculous chemotherapy including isoniazid, pyrazinamide, rifampicin, and ethambutol. PMID:26929807

  12. Bursectomy, Curettage, and Chemotherapy in Tuberculous Trochanteric Bursitis

    PubMed Central

    Carro-Fernández, José A.; Santos-Sánchez, José A.; Casas Ramos, Paula; Díez-Romero, Luis J.; Izquierdo-García, Francisco M.

    2016-01-01

    We presented three patients with trochanteric tuberculosis and described the clinical and imaging findings of the infection. Histology revealed a necrotizing granulomatous bursitis and microbiology confirmed tuberculosis. All cases were successfully treated with bursectomy and curettage of the trochanteric lesion and antituberculous chemotherapy including isoniazid, pyrazinamide, rifampicin, and ethambutol. PMID:26929807

  13. Phomopsis bougainvilleicola prepatellar bursitis in a renal transplant recipient

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pre-patellar bursitis is typically a monomicrobial bacterial infection. Rarely is a fungal cause identified. We describe a 61 year-old man who had received a renal transplant 21 months prior to presentation whose synovial fluid and surgical specimens grew Phomopsis bougainvilleicola, a pycnidial coe...

  14. Phomopsis bougainvilleicola Prepatellar Bursitis in a Renal Transplant Recipient

    PubMed Central

    Wickes, Brian L.; Sutton, Deanna A.; Castlebury, Lisa A.; Levitz, Stuart M.; Finberg, Robert W.; Thompson, Elizabeth H.; Daly, Jennifer S.

    2013-01-01

    Prepatellar bursitis is typically a monomicrobial bacterial infection. A fungal cause is rarely identified. We describe a 61-year-old man who had received a renal transplant 21 months prior to presentation whose synovial fluid and surgical specimens grew Phomopsis bougainvilleicola, a pycnidial coelomycete. PMID:23196359

  15. Tuberculosis of the patella masquerading as prepatellar bursitis

    PubMed Central

    Kulkarni, S

    2013-01-01

    Tuberculosis of bone is an uncommon entity in the Western world. We present a case of tuberculosis of the patella mimicking prepatellar bursitis in an otherwise fit and well woman of Bangladeshi origin. We believe tuberculosis of bone should form a differential diagnosis of the swollen knee in high risk patients. PMID:23317718

  16. Results of intravitreal dexamethasone implant 0.7 mg (Ozurdex®) in non-infectious posterior uveitis

    PubMed Central

    Yap, Yew Chong; Papathomas, Thomas; Kamal, Ahmed

    2015-01-01

    AIM To evaluate the safety and efficacy of dexamethasone implant in patients with non-infectious posterior uveitis with cystoid macular edema (CME). METHODS Retrospective analysis of patients reports with CME secondary to non-infectious uveitis treated with dexamethasone implant. Data included type of posterior uveitis, any systemic immunosuppressive therapy, Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography (OCT) and signs of intraocular inflammation at baseline and then at 2wk postoperatively and monthly thereafter. Follow-up is up to 10mo. Any per-operative and post-operative complications were recorded. RESULTS Six eyes of 4 patients with CME due to non-infectious posterior uveitis treated with dexamethasone implant. Diagnosis included idiopathic panuveitis, birdshot chorioretinopathy and idiopathic intermediate uveitis. At baseline mean ETDRS BCVA was 63 letters and mean CMT 556 µm at 2wk postoperatively mean ETDRS BCVA improved to 70 letters and mean CMT decreased to 329 µm. All eyes showed clinical evidence of decreased inflammation. The duration of effect of the implant was 5 to 6mo and retreatment was required in 2 eyes. Two patients required antiglaucoma therapy for increased intraocular pressures. CONCLUSION In patients with non-infectious posterior uveitis dexamethasone implant can be a short-term effective treatment option for controlling intraocular inflammation. PMID:26309888

  17. Differentiating sepsis from non-infectious systemic inflammation based on microvesicle-bacteria aggregation

    NASA Astrophysics Data System (ADS)

    Herrmann, I. K.; Bertazzo, S.; O'Callaghan, D. J. P.; Schlegel, A. A.; Kallepitis, C.; Antcliffe, D. B.; Gordon, A. C.; Stevens, M. M.

    2015-08-01

    Sepsis is a severe medical condition and a leading cause of hospital mortality. Prompt diagnosis and early treatment has a significant, positive impact on patient outcome. However, sepsis is not always easy to diagnose, especially in critically ill patients. Here, we present a conceptionally new approach for the rapid diagnostic differentiation of sepsis from non-septic intensive care unit patients. Using advanced microscopy and spectroscopy techniques, we measure infection-specific changes in the activity of nano-sized cell-derived microvesicles to bind bacteria. We report on the use of a point-of-care-compatible microfluidic chip to measure microvesicle-bacteria aggregation and demonstrate rapid (<=1.5 hour) and reliable diagnostic differentiation of bacterial infection from non-infectious inflammation in a double-blind pilot study. Our study demonstrates the potential of microvesicle activities for sepsis diagnosis and introduces microvesicle-bacteria aggregation as a potentially useful parameter for making early clinical management decisions.Sepsis is a severe medical condition and a leading cause of hospital mortality. Prompt diagnosis and early treatment has a significant, positive impact on patient outcome. However, sepsis is not always easy to diagnose, especially in critically ill patients. Here, we present a conceptionally new approach for the rapid diagnostic differentiation of sepsis from non-septic intensive care unit patients. Using advanced microscopy and spectroscopy techniques, we measure infection-specific changes in the activity of nano-sized cell-derived microvesicles to bind bacteria. We report on the use of a point-of-care-compatible microfluidic chip to measure microvesicle-bacteria aggregation and demonstrate rapid (<=1.5 hour) and reliable diagnostic differentiation of bacterial infection from non-infectious inflammation in a double-blind pilot study. Our study demonstrates the potential of microvesicle activities for sepsis diagnosis and

  18. [Chemical safety as a problem of epidemiology of non-infectious diseases].

    PubMed

    Shestopalov, N V; Shandala, M G

    2013-01-01

    Based on the analysis of adopted in sanitary science methodology for the study and evaluation of the biological action and hygienic significance of environmental factors there was shown the need for the use of laws and methodology of classical epidemiology to ensure the chemical safety in the recognition and elimination of the group of diseases of chemical etiology, outbreaks of similar non infectious diseases. It is stated that individually small "non-toxic" doses of chemicals, but "loading" a large population and forming a large collective dose apparently can be implemented in a stochastic population health damage, detectable only on the basis of large-scale epidemiological studies to assess the risk. These approaches are presented to be especially important for agents in the environment, optimal for which is not absence, but the presence for provision of necessary target effect (pesticides, disinfectants and other household products, etc.). The main task of the epidemiological analysis of local toxic "bursts" and large-scale "epidemics" of this kind is an optimization of the complex of measures implemented by an adequate assessment of their medical, social and economic performance. PMID:24340593

  19. Non-infectious environmental antigens as a trigger for the initiation of an autoimmune skin disease.

    PubMed

    Qian, Ye; Culton, Donna A; Jeong, Joseph S; Trupiano, Nicole; Valenzuela, Jesus G; Diaz, Luis A

    2016-09-01

    Pemphigus represents a group of organ specific autoimmune blistering disorders of the skin mediated by pathogenic autoantibodies with well-defined antigenic targets. While most of these diseases are sporadic, endemic forms of disease do exist. The endemic form of pemphigus foliaceus (also known as fogo selvagem, FS) exhibits epidemiological features that suggest exposure to hematophagous insect bites are a possible precipitating factor of this autoimmune disease, and provides a unique opportunity to study how environmental factors contribute to autoimmune disease development. FS patients and healthy individuals from endemic regions show an autoreactive IgM response that starts in early childhood and becomes restricted to IgG4 autoantibodies in FS patients. In searching for triggering environmental antigens, we have found that IgG4 and IgE autoantibodies from FS patients cross-react with a salivary antigen from sand flies. The presence of these cross-reactive antibodies and antibody genetic analysis confirming that these antibodies evolve from the same naïve B cells provides compelling evidence that this non-infectious environmental antigen could be the initial target of the autoantibody response in FS. Consequently, FS serves as an ideal model to study the impact of environmental antigens in the development of autoimmune disease.

  20. Non-infectious plasmid engineered to simulate multiple viral threat agents.

    PubMed

    Carrera, Monica; Sagripanti, Jose-Luis

    2009-07-01

    The aim of this study was to design and construct a non-virulent simulant to replace several pathogenic viruses in the development of detection and identification methods in biodefense. A non-infectious simulant was designed and engineered to include the nucleic acid signature of VEEV (Venezuelan Equine Encephalitis virus), Influenza virus, Rift Valley Fever virus, Machupo virus, Lassa virus, Yellow Fever virus, Ebola virus, Eastern Equine Encephalitis virus, Junin virus, Marburg virus, Dengue virus, and Crimean-Congo virus, all in a single construct. The nucleic acid sequences of all isolates available for each virus species were aligned using ClustalW software in order to obtain conserved regions of the viral genomes. Specific primers were designed to permit the identification and differentiation between viral threat agents. A chimera of 3143 base pairs was engineered to produce 13 PCR amplicons of different sizes. PCR amplification of the simulant with virus-specific primers revealed products of the predicted length, in bands of similar intensity, and without detectable unspecific products by electrophoresis analysis. The simulant described could reduce the need to use infectious viruses in the development of detection and diagnostic methods, and could also be useful as a non-virulent positive control in nucleic acid-based tests against biological threat agents.

  1. [Identification of the main risk factors for non infectious diseases: method of classification trees].

    PubMed

    Konstantinova, E D; Varaksin, A N; Zhovner, I V

    2013-01-01

    There is presented ideology of the application of one of the methods for assessment of the influence of multi-factor influence of risk factors on population health--the method of classification trees. The method of classification trees is a hierarchical procedure for constructing a decision rule that allows to divide the population into groups with higher and lower morbidity "in the coordinates of" risk factors. The main advantage of the method--the possibility of finding the complex of risk factors having the greatest impact on the health of the population (in contrast to common methods, analyzing only the single-factor effects). In the paper there are presented two possible variants of application of classification trees: 1) the finding of the complex of environmental risk factors (RF), which provides the maximum impact on the prevalence of non infectious diseases in preschool children) in Yekaterinburg (environmental risk factors--the pollution of air drinking water, in the presence of a gas stove in the child's flat, etc.). It is shown that, together with socio-economic risk factors environmental risk factors increase the prevalence of respiratory diseases in preschool children in Ekaterinburg in 2.5-4 times (depending on the list and the number of environmental RF), 2) finding the complex of non-environmental factors that most effectively compensating the negative effect of environmental pollution on human health. This posing of the problem is associated with the fact that pollution environmental factors are (usually) unmodified, while family, behavioral or social factors can be partially or completely eliminated Implementation of the recommendations presented in the paper can reduce the incidence of circulatory diseases in preschool children in Yekaterinburg more than 2 times.

  2. Non Infectious Complications Related to Blood Transfusion: An 11 year Retrospective Analysis in a Tertiary Care Hospital.

    PubMed

    Philip, J; Pawar, A; Chatterjee, T; Mallhi, R S; Biswas, A K; Dimri, U

    2016-09-01

    In India transmission of transfusion transmissible infections (TTI) has shown a relative decrease as a result of mandatory screening of donated blood for TTI's. However, reducing the incidence of non infectious complications poses a major challenge, mainly due to the fact that a number of adverse reactions go unreported. Blood transfusion reaction, can be categorized based on the time interval between transfusion of blood products and the presentation of adverse reactions as acute i.e. those presenting during or within 24 h and as delayed i.e. those presenting anytime after 24 h. Transfusion reactions can further be classified as immune and non immune or infectious and non infectious based on the pathophysiology. In this retrospective study which was undertaken with an aim to determine the type and frequency of non infectious complications due to transfusion of blood and blood products recorded the incidence of febrile non hemolytic transfusion reactions (FNHTR) 51.40 %, allergic reactions 40.14 %, non immune hemolytic reactions 4.22 %, hypothermia 2.81 %, anaphylaxis 0.70 % and iron overload 0.70 %. FNHTR which was found to be the most common complication in this study can certainly be minimized, if not completely eliminated by adopting a policy of universal leucodepletion, the implementation of which solely depends on the financial and infrastructure resources available. This study also reiterates the importance of hemovigilance as a tool to improve the safety of blood transfusion.

  3. FORMATION OF NON-INFECTIOUS INFLUENZA VIRUS IN MOUSE LUNGS: ITS DEPENDENCE UPON EXTENSIVE PULMONARY CONSOLIDATION INITIATED BY THE VIRAL INOCULUM

    PubMed Central

    Ginsberg, Harold S.

    1954-01-01

    Formation of non-infectious virus—particles which hemagglutinate red blood cells and react with antibody to fix complement but do not infect the chick embryo or mouse—occurred when large quantities of certain strains of influenza viruses were inoculated intranasally into mice. Dependent upon the agent employed, 106.5 to 108.5 E.I.D. was essential to elicit this phenomenon. To accomplish this unusual multiplication it was essential to use a strain of virus which effected extensive pulmonary consolidation; strains of virus which did not produce marked lung lesions, even when as much as 108.5 E.I.D. was inoculated, did not form non-infectious virus. The development of this viral form was directly dependent upon the extent of cell damage obtained: consolidation of more than 50 per cent of the lung volume was required. The majority of non-infectious particles developed during the initial cycle of viral multiplication, and concurrently with the formation of non-infectious virus there was a corresponding decrease in the number of infectious viral particles. Non-infectious virus could not be propagated on serial passage in mouse lungs: on second lung passage only fully infectious virus was detectable. The formation of the non-infectious viral form was not the result of interference with synthesis of infectious virus by inactivated virus in the inoculum; for inoculation of heated infected allantoic fluid which contained more than 99 per cent of non-infectious virus did not result in the development of new non-infectious virus. Although inoculation of a large quantity of virus resulted in infection which yielded a relatively low titer of infectious and high titer of non-infectious virus, inoculation of a small quantity of the agent resulted in a high yield of infectious virus and no non-infectious that was detectable. In both instances the total quantity of antigenic viral material synthesized in the mouse lungs was the same. These data do not support the hypothesis that

  4. Giant iliopsoas bursitis: a complication of chronic arthritis.

    PubMed

    Murphy, Claire-Louise; Meaney, James F M; Rana, Haider; McCarthy, Eoghan M; Howard, Donough; Cunnane, Gaye

    2010-03-01

    Iliopsoas bursitis is a poorly recognized cause of hip pain that requires early recognition to avoid potentially serious complications caused by compression of adjacent structures. It can occur in the setting of trauma in athletes or those who engage in heavy labor and is also associated with acute or chronic arthritis. We describe the cases of 2 patients, one of whom developed a femoral neuropathy, while the other had marked venous compression of the lower limb resulting from enlargement of the iliopsoas bursa. Magnetic resonance imaging offers the most accurate information on the extent of the problem. Recalcitrant cases may require bursectomy in addition to treatment of the underlying cause. PMID:20216129

  5. Non Infectious Complications Related to Blood Transfusion: An 11 year Retrospective Analysis in a Tertiary Care Hospital.

    PubMed

    Philip, J; Pawar, A; Chatterjee, T; Mallhi, R S; Biswas, A K; Dimri, U

    2016-09-01

    In India transmission of transfusion transmissible infections (TTI) has shown a relative decrease as a result of mandatory screening of donated blood for TTI's. However, reducing the incidence of non infectious complications poses a major challenge, mainly due to the fact that a number of adverse reactions go unreported. Blood transfusion reaction, can be categorized based on the time interval between transfusion of blood products and the presentation of adverse reactions as acute i.e. those presenting during or within 24 h and as delayed i.e. those presenting anytime after 24 h. Transfusion reactions can further be classified as immune and non immune or infectious and non infectious based on the pathophysiology. In this retrospective study which was undertaken with an aim to determine the type and frequency of non infectious complications due to transfusion of blood and blood products recorded the incidence of febrile non hemolytic transfusion reactions (FNHTR) 51.40 %, allergic reactions 40.14 %, non immune hemolytic reactions 4.22 %, hypothermia 2.81 %, anaphylaxis 0.70 % and iron overload 0.70 %. FNHTR which was found to be the most common complication in this study can certainly be minimized, if not completely eliminated by adopting a policy of universal leucodepletion, the implementation of which solely depends on the financial and infrastructure resources available. This study also reiterates the importance of hemovigilance as a tool to improve the safety of blood transfusion. PMID:27429521

  6. A Structural and Functional Comparison Between Infectious and Non-Infectious Autocatalytic Recombinant PrP Conformers

    PubMed Central

    Noble, Geoffrey P.; Wang, Daphne W.; Walsh, Daniel J.; Barone, Justin R.; Miller, Michael B.; Nishina, Koren A.; Li, Sheng; Supattapone, Surachai

    2015-01-01

    Infectious prions contain a self-propagating, misfolded conformer of the prion protein termed PrPSc. A critical prediction of the protein-only hypothesis is that autocatalytic PrPSc molecules should be infectious. However, some autocatalytic recombinant PrPSc molecules have low or undetectable levels of specific infectivity in bioassays, and the essential determinants of recombinant prion infectivity remain obscure. To identify structural and functional features specifically associated with infectivity, we compared the properties of two autocatalytic recombinant PrP conformers derived from the same original template, which differ by >105-fold in specific infectivity for wild-type mice. Structurally, hydrogen/deuterium exchange mass spectrometry (DXMS) studies revealed that solvent accessibility profiles of infectious and non-infectious autocatalytic recombinant PrP conformers are remarkably similar throughout their protease-resistant cores, except for two domains encompassing residues 91-115 and 144-163. Raman spectroscopy and immunoprecipitation studies confirm that these domains adopt distinct conformations within infectious versus non-infectious autocatalytic recombinant PrP conformers. Functionally, in vitro prion propagation experiments show that the non-infectious conformer is unable to seed mouse PrPC substrates containing a glycosylphosphatidylinositol (GPI) anchor, including native PrPC. Taken together, these results indicate that having a conformation that can be specifically adopted by post-translationally modified PrPC molecules is an essential determinant of biological infectivity for recombinant prions, and suggest that this ability is associated with discrete features of PrPSc structure. PMID:26125623

  7. Bioengineering of Tobacco Mosaic Virus to Create a Non-Infectious Positive Control for Ebola Diagnostic Assays

    PubMed Central

    Lam, Patricia; Gulati, Neetu M.; Stewart, Phoebe L.; Keri, Ruth A.; Steinmetz, Nicole F.

    2016-01-01

    The 2014 Ebola epidemic is the largest to date. There is no cure or treatment for this deadly disease; therefore there is an urgent need to develop new diagnostics to accurately detect Ebola. Current RT-PCR assays lack sensitive and reliable positive controls. To address this critical need, we devised a bio-inspired positive control for use in RT-PCR diagnostics: we encapsulated scrambled Ebola RNA sequences inside of tobacco mosaic virus to create a biomimicry that is non-infectious, but stable, and could therefore serve as a positive control in Ebola diagnostic assays. Here, we report the bioengineering and validation of this probe. PMID:27030058

  8. Bioengineering of Tobacco Mosaic Virus to Create a Non-Infectious Positive Control for Ebola Diagnostic Assays

    NASA Astrophysics Data System (ADS)

    Lam, Patricia; Gulati, Neetu M.; Stewart, Phoebe L.; Keri, Ruth A.; Steinmetz, Nicole F.

    2016-03-01

    The 2014 Ebola epidemic is the largest to date. There is no cure or treatment for this deadly disease; therefore there is an urgent need to develop new diagnostics to accurately detect Ebola. Current RT-PCR assays lack sensitive and reliable positive controls. To address this critical need, we devised a bio-inspired positive control for use in RT-PCR diagnostics: we encapsulated scrambled Ebola RNA sequences inside of tobacco mosaic virus to create a biomimicry that is non-infectious, but stable, and could therefore serve as a positive control in Ebola diagnostic assays. Here, we report the bioengineering and validation of this probe.

  9. Bioengineering of Tobacco Mosaic Virus to Create a Non-Infectious Positive Control for Ebola Diagnostic Assays.

    PubMed

    Lam, Patricia; Gulati, Neetu M; Stewart, Phoebe L; Keri, Ruth A; Steinmetz, Nicole F

    2016-03-31

    The 2014 Ebola epidemic is the largest to date. There is no cure or treatment for this deadly disease; therefore there is an urgent need to develop new diagnostics to accurately detect Ebola. Current RT-PCR assays lack sensitive and reliable positive controls. To address this critical need, we devised a bio-inspired positive control for use in RT-PCR diagnostics: we encapsulated scrambled Ebola RNA sequences inside of tobacco mosaic virus to create a biomimicry that is non-infectious, but stable, and could therefore serve as a positive control in Ebola diagnostic assays. Here, we report the bioengineering and validation of this probe.

  10. Bioengineering of Tobacco Mosaic Virus to Create a Non-Infectious Positive Control for Ebola Diagnostic Assays.

    PubMed

    Lam, Patricia; Gulati, Neetu M; Stewart, Phoebe L; Keri, Ruth A; Steinmetz, Nicole F

    2016-01-01

    The 2014 Ebola epidemic is the largest to date. There is no cure or treatment for this deadly disease; therefore there is an urgent need to develop new diagnostics to accurately detect Ebola. Current RT-PCR assays lack sensitive and reliable positive controls. To address this critical need, we devised a bio-inspired positive control for use in RT-PCR diagnostics: we encapsulated scrambled Ebola RNA sequences inside of tobacco mosaic virus to create a biomimicry that is non-infectious, but stable, and could therefore serve as a positive control in Ebola diagnostic assays. Here, we report the bioengineering and validation of this probe. PMID:27030058

  11. Trochanteric bursitis after total hip arthroplasty: incidence and evaluation of response to treatment.

    PubMed

    Farmer, Kevin W; Jones, Lynne C; Brownson, Kirstyn E; Khanuja, Harpal S; Hungerford, Marc W

    2010-02-01

    We examined the efficacy of corticosteroid injection as treatment for postarthroplasty trochanteric bursitis and the risk factors for failure of nonoperative treatment. There were 32 (4.6%) cases of postsurgical trochanteric bursitis in 689 primary total hip arthroplasties. Of the 25 hips with follow-up, 11 (45%) required multiple injections. Symptoms resolved in 20 (80%) but persisted in 5. We found no statistically significant differences between patients who did and did not develop trochanteric bursitis, or between those who did and did not respond to treatment. There was a trend toward younger age and greater limb-length discrepancy in nonresponders. In conclusion, (1) corticosteroid injection(s) for postoperative trochanteric bursitis is effective; and (2) nonoperative management may be more likely to fail in young patients and those with leg-length discrepancy.

  12. Association between trochanteric bursitis, osteoarthrosis and total hip arthroplasty☆☆☆

    PubMed Central

    Schwartsmann, Carlos Roberto; Loss, Felipe; de Freitas Spinelli, Leandro; Furian, Roque; Silva, Marcelo Faria; Zanatta, Júlia Mazzuchello; Boschin, Leonardo Carbonera; Gonçalves, Ramiro Zilles; Yépez, Anthony Kerbes

    2014-01-01

    Objective this was an epidemiological study on trochanteric bursitis at the time of performing total hip arthroplasty. Methods sixty-two sequential patients who underwent total hip arthroplasty due to osteoarthrosis, without any previous history of trochanteric bursitis, were evaluated. The bursas were collected and evaluated histologically. Results there were 35 female patients (56.5%) and 27 male patients (43.5%), with a mean age of 65 years (±11). Trochanteric bursitis was conformed histologically in nine patients (14.5%), of whom six were female (66.7%) and three were male (33.3%). Conclusions 14.5% of the bursas analyzed presented inflammation at the time that the primary total hip arthroplasty due to osteoarthrosis was performed, and the majority of the cases of bursitis were detected in female patients. PMID:26229811

  13. The clinical utility of ultrasonography for rotator cuff disease, shoulder impingement syndrome and subacromial bursitis.

    PubMed

    Awerbuch, Mark S

    2008-01-01

    Periarticular shoulder disorders are common in clinical practice, and diagnosis is often difficult. Medicare statistics indicate that between 2001 and 2006 the use of diagnostic shoulder ultrasonography increased significantly. Rotator cuff disease, shoulder impingement syndrome and subacromial bursitis are among the most common diagnoses reported on shoulder ultrasonography. Shoulder ultrasonography is useful in the diagnosis of full thickness tears, but its utility for other rotator cuff disorders, shoulder impingement syndrome and subacromial bursitis is less well established. PMID:18205566

  14. Paecilomyces lilacinus septic olecranon bursitis in an immunocompetent host.

    PubMed

    Schweitzer, Karl M; Richard, Marc J; Leversedge, Fraser J; Ruch, David S

    2012-05-01

    Paecilomyces lilacinus is a filamentous fungus that is a rare cause of infection in immunocompromised human hosts. We present a case of lilacinus septic olecranon bursitis in an otherwise healthy 78-year-old male. This patient's case was complicated by wound breakdown after bursectomy and appropriate anti-fungal treatment, requiring a local soft tissue rearrangement. This case demonstrates the need for appropriate and timely medical and surgical treatment in infections involving lilacinus, which are not isolated solely to systemically immunocompromised and medically-ill patient populations. In cases where the patient is systemically immumocompromised or has been rendered locally immunocompromised, it is essential to obtain a full culture work-up, including fungi. PMID:22715445

  15. Non-infectious events under the International Health Regulations (2005) in Europe--a case for syndromic surveillance.

    PubMed

    Rosenkötter, Nicole; Ziemann, Alexandra; Krafft, Thomas; Riesgo, Luis Garcia-Castrillo; Vergeiner, Gernot; Brand, Helmut

    2014-08-01

    The scope of the International Health Regulations of 2005 (IHR (2005)) has been expanded. The IHR (2005) are no longer limited to a specific set of infectious diseases, instead they prescribe detection and assessment of any event of potential public health concern regardless of its source or origin. We examine events of non-infectious origin that might fulfill the criteria of a potential public health emergency of international concern under the IHR (2005). These comprise predominately events related to food safety, but also events related to drug safety or of chemical or industrial origin. We argue that to identify these events and assess health effects related to them, existing disease surveillance systems should be augmented with less specific indicator-based syndromic surveillance strategies that use available routine health-related service data for monitoring purposes.

  16. Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA

    PubMed Central

    2013-01-01

    Background The purpose of this study was to describe comorbidities, healthcare costs, and resource utilization among patients with chronic non-infectious uveitis initiating corticosteroid, immunosuppressants, or biologics. In this retrospective cohort study, patients with a non-infectious uveitis diagnosis and continuous insurance coverage during a 6-month baseline were selected from a privately insured claims database with 80.7 million enrollees. Index dates were defined as the first prescription/administration of a corticosteroid, immunosuppressant, or biologic between 2003 and 2009. Comorbidities, healthcare costs, and utilization were analyzed in a per-member-per-month (PMPM) framework to account for varying between-patient treatment periods, defined as continuous medication use within the same class. Wilcoxon rank-sum and chi-square tests were used for comparisons of costs and categorical outcomes. Results Patients on corticosteroids (N = 4,568), immunosuppressants (N = 5,466), and biologics (N = 1,694) formed the study population. Baseline PMPM inpatient admission rates were 0.029 for patients on corticosteroids, 0.044 for patients on immunosuppressants, and 0.045 for patients on biologics (p < 0.001 immunosuppressants or biologics versus corticosteroids); during treatment, PMPM inpatient admissions increased to 0.044 and 0.048 for patients taking corticosteroids and immunosuppressants, respectively, but decreased to 0.024 for patients taking biologics (p < 0.001 versus corticosteroids and p = 0.003 versus immunosuppressants). Baseline average PMPM costs for patients taking corticosteroids, immunosuppressants, and biologics were US$935, US$1,738, and US$1,439 (p < 0.001 between groups), while on-treatment PMPM costs excluding drug costs increased to US$1,129 for patients taking corticosteroids but lowered to US$1,592 for patients taking immunosuppressants, and US$918 for patients taking biologics (p < 0.001 versus

  17. Tuberculous bursitis of the greater trochanter mimicking ankylosing spondylitis

    PubMed Central

    Tayfur, Öykü; Kılıç, Levent; Karadağ, Ömer; Akdoğan, Ali; Kerimoğlu, Ülkü; Uzun, Ömrüm

    2015-01-01

    Tuberculous trochanteric bursitis (TTB) is a rare condition that accounts for 1% of musculoskeletal tuberculosis cases. Extrapulmonary TB is usually diagnosed late because of reduced diagnostic suspicion, particularly in the absence of signs of systemic infection. Herein, we report a case of right hip pain that was misdiagnosed as ankylosing spondylitis. The patient had a history of inflammatory back pain with morning stiffness. However, HLA-B27 was negative. Sacroiliac magnetic resonance imaging (MRI) revealed a giant multiloculated collection (27×16×10 cm). Percutaneous drainage was performed and Mycobacterium tuberculosis was observed in fluid culture. The patient was treated by drainage along with antituberculosis therapy. After 1 year of antituberculosis therapy, control MRI revealed total resolution of the large fluid collection. It is important to emphasize that fever or general symptoms are absent in patients with TTB, as observed in the present case. In endemic countries, TTB should be kept in mind in the differential diagnosis of a patient presenting with chronic hip pain without fever, weight loss, and constitutional symptoms.

  18. Deletion of the AcMNPV core gene ac109 results in budded virions that are non-infectious

    SciTech Connect

    Fang Minggang; Nie, Yingchao; Theilmann, David A.

    2009-06-20

    Autographa californica multiple nucleopolyhedrovirus (AcMNPV) ac109 is a core gene and its function in the virus life cycle is unknown. To determine its role in the baculovirus life cycle, we used the AcMNPV bacmid system to generate an ac109 deletion virus (vAc{sup 109KO}). Fluorescence and light microscopy showed that transfection of vAc{sup 109KO} results in a single-cell infection phenotype. Viral DNA replication is unaffected and the development of occlusion bodies in vAc{sup 109KO}-transfected cells evidenced progression to the very late phases of viral infection. Western blot and confocal immunofluorescence analysis showed that AC109 is expressed in the cytoplasm and nucleus throughout infection. In addition, AC109 is a structural protein as it was detected in both budded virus (BV) and occlusion derived virus in both the envelope and nucleocapsid fractions. Titration assays by qPCR and TCID{sub 50} showed that vAc{sup 109KO} produced BV but the virions are non-infectious. The vAc{sup 109KO} BV were indistinguishable from the BV of repaired and wild type control viruses as determined by negative staining and electron microscopy.

  19. Deletion of the AcMNPV core gene ac109 results in budded virions that are non-infectious.

    PubMed

    Fang, Minggang; Nie, Yingchao; Theilmann, David A

    2009-06-20

    Autographa californica multiple nucleopolyhedrovirus (AcMNPV) ac109 is a core gene and its function in the virus life cycle is unknown. To determine its role in the baculovirus life cycle, we used the AcMNPV bacmid system to generate an ac109 deletion virus (vAc(109KO)). Fluorescence and light microscopy showed that transfection of vAc(109KO) results in a single-cell infection phenotype. Viral DNA replication is unaffected and the development of occlusion bodies in vAc(109KO)-transfected cells evidenced progression to the very late phases of viral infection. Western blot and confocal immunofluorescence analysis showed that AC109 is expressed in the cytoplasm and nucleus throughout infection. In addition, AC109 is a structural protein as it was detected in both budded virus (BV) and occlusion derived virus in both the envelope and nucleocapsid fractions. Titration assays by qPCR and TCID(50) showed that vAc(109KO) produced BV but the virions are non-infectious. The vAc(109KO) BV were indistinguishable from the BV of repaired and wild type control viruses as determined by negative staining and electron microscopy.

  20. Acute BVDV-2 infection in beef calves delays humoral responses to a non-infectious antigen challenge

    PubMed Central

    McCorkell, Robert; Horsman, Shawn R.; Wynne-Edwards, Katherine; Muench, Greg; van Drunen Littel-van den Hurk, Sylvia; Waeckerlin, Regula; Eschbaumer, Michael; Dardari, Rkia; Chaiyakul, Mark; Gajda, Pawel; Czub, Markus; van der Meer, Frank

    2015-01-01

    Immunosuppressive effects of an intranasal challenge with non-cytopathic bovine viral diarrhea virus (BVDV) 2a (strain 1373) were assessed through acquired and innate immune system responses to ovalbumin (OVA). Concurrent BVDV infection was hypothesized to delay and reduce the humoral response to ovalbumin (administered on days 3 and 15 post-inoculation). Infected animals followed the expected clinical course. BVDV titers, and anti-BVDV antibodies confirmed the course of infection and were not affected by the administration of OVA. Both the T-helper (CD4+) and B-cell (CD20+) compartments were significantly (P < 0.05) reduced in infected animals, while the gamma-delta T-cell population (Workshop cluster 1+, WC1+) decreased slightly in numbers. Infection with BVDV delayed the increase in OVA IgG by approximately 3 d from day 12 through day 21 post-inoculation. Between days 25 and 37 post-inoculation following BVDV infection the IgM concentration in the BVDV− group decreased while the OVA IgM titer still was rising in the BVDV+ animals. Thus, active BVDV infection delays IgM and IgG responses to a novel, non-infectious antigen. PMID:26483584

  1. Ultrasound-Guided 50% Ethyl Alcohol Injection for Patients With Malleolar and Olecranon Bursitis: A Prospective Pilot Study

    PubMed Central

    Hong, Ji Seong; Lee, Jin Hyung

    2016-01-01

    Objective To evaluate the feasibility and effect of ultrasound-guided ethyl alcohol injection on malleolar and olecranon synovial proliferative bursitis. Methods Twenty-four patients received ultrasound-guided 50% diluted ethyl alcohol injection at the site of synovial proliferative bursitis after aspiration of the free fluid. Results Swelling and symptoms significantly decreased in 13 of the 24 patients without any complications. Eleven patients had partial improvement in swelling and symptoms. Conclusion Ultrasound-guided alcohol injection could be an alternative therapeutic option before surgery in patients with chronic intractable malleolar and olecranon synovial proliferative bursitis. PMID:27152282

  2. Septic subacromial bursitis caused by Mycobacterium kansasii in an immunocompromised host.

    PubMed

    Mathew, Stephanie D; Tully, Charla C; Borra, Himabindu; Berven, Michael D; Arroyo, Ramon

    2012-05-01

    Mycobacterium kansasii is a common cause of pulmonary infection as a result of nontuberculous mycobacteria, but is less commonly described as a cause of an orthopedic infection. We present the first case of M. kansasii subacromial septic bursitis in an immunocompromised host. This case demonstrates the diagnostic and treatment challenges associated with orthopedic infections caused by M. kansasii.

  3. Olecranon Bursitis Caused by Candida parapsilosis in a Patient with Rheumatoid Arthritis.

    PubMed

    Gamarra-Hilburn, Carla F; Rios, Grissel; Vilá, Luis M

    2016-01-01

    Septic bursitis is usually caused by bacterial organisms. However, infectious bursitis caused by fungi is very rare. Herein, we present a 68-year-old woman with long-standing rheumatoid arthritis who developed pain, erythema, and swelling of the right olecranon bursa. Aspiration of the olecranon bursa showed a white blood cell count of 3.1 × 10(3)/μL (41% neutrophils, 30% lymphocytes, and 29% monocytes). Fluid culture was positive for Candida parapsilosis. She was treated with caspofungin 50 mg intravenously daily for 13 days followed by fluconazole 200 mg orally daily for one week. She responded well to this treatment but had recurrent swelling of the bursa. Bursectomy was recommended but she declined this option. This case, together with other reports, suggests that the awareness of uncommon pathogens, their presentation, and predisposing risk factors are important to establish an early diagnosis and prevent long-term complications. PMID:27595032

  4. Olecranon Bursitis Caused by Candida parapsilosis in a Patient with Rheumatoid Arthritis

    PubMed Central

    Rios, Grissel

    2016-01-01

    Septic bursitis is usually caused by bacterial organisms. However, infectious bursitis caused by fungi is very rare. Herein, we present a 68-year-old woman with long-standing rheumatoid arthritis who developed pain, erythema, and swelling of the right olecranon bursa. Aspiration of the olecranon bursa showed a white blood cell count of 3.1 × 103/μL (41% neutrophils, 30% lymphocytes, and 29% monocytes). Fluid culture was positive for Candida parapsilosis. She was treated with caspofungin 50 mg intravenously daily for 13 days followed by fluconazole 200 mg orally daily for one week. She responded well to this treatment but had recurrent swelling of the bursa. Bursectomy was recommended but she declined this option. This case, together with other reports, suggests that the awareness of uncommon pathogens, their presentation, and predisposing risk factors are important to establish an early diagnosis and prevent long-term complications. PMID:27595032

  5. Anserina bursitis. A treatable cause of knee pain in patients with degenerative arthritis.

    PubMed

    Brookler, M I; Mongan, E S

    1973-07-01

    The anserina bursa is located on the medial surface of the tibia deep to the tendons of the sartorius, gracilis, and semimembranosus muscles and superficial to the insertion of the tibial collateral ligament. Knee pain, a palpable swelling of the bursa, and tenderness over the medial anterior aspect of the tibia just below the knee are the hallmarks of anserina bursitis. In a three-year period, 24 patients with anserina bursitis were seen in a rheumatology clinic. All but one were women, 18 were obese, and only four were under 50 years old. Knee x-ray studies showed degenerative arthritis in 20 of the 24 patients. In ten, varus knee deformities were present, while three had valgus deformities. Ultrasound or local steroid injections gave dramatic relief in all but one patient.

  6. Citric acid treatment of chronic nonhealing ulcerated tophaceous gout with bursitis.

    PubMed

    Nagoba, Basavaraj S; Punpale, Ajay; Poddar, Ashok; Suryawanshi, Namdev M; Swami, Ganesh A; Selkar, Sohan P

    2013-12-01

    The ulceration associated with gout tophi is very difficult to treat because of impaired and halted local inflammatory response resulting from the gout treatment regimen. We report chronic nonhealing tophaceous gout with bursitis in an 80-year-old male, not responding to conventional treatment modality for months together. This nonhealing ulcer was treated successfully with local application of 3% citric acid ointment for 22 days.

  7. Subscapular bursitis as a rare manifestation of dermatomyositis: a case report

    PubMed Central

    Kim, Kyung Rok; Konig, Maximilian F.; Park, Jin Kyun

    2015-01-01

    Dermatomyositis (DM) is characterized by proximal muscle weakness and characteristic skin rash. Pain is a less common feature and usually indicates inflammation of extramuscular structures such as fascia. Here we report a rare case of subscapular bursitis in a 48-year-old woman with DM. She initially presented with severe, sharp, stabbing pain in her right shoulder that worsened with shoulder movement. Magnetic resonance imaging (MRI) revealed inflammation in the right subscapular bursae. A few months later, the patient developed periungual erythema, Gottron’s papules, and shawl sign with muscle pain in her thighs. DM was diagnosed based on the presence of interface dermatitis on skin biopsy and diffuse muscle inflammation on MRI. Bursitis and myalgia responded incompletely to nonsteroidal anti-inflammatory drugs but promptly to corticosteroids. Here we report a case of subscapular bursitis as a rare manifestation of DM. Pain in patients with DM may warrant physicians to evaluate for the presence of additional inflammatory processes in the perimuscular structures.

  8. Prepatellar bursitis due to Brucella abortus: case report and analysis of the local immune response.

    PubMed

    Wallach, Jorge C; Delpino, M Victoria; Scian, Romina; Deodato, Bettina; Fossati, Carlos A; Baldi, Pablo C

    2010-12-01

    A case of prepatellar bursitis in a man with chronic brucellosis is presented. Brucella abortus biotype 1 was isolated from the abundant yellowish fluid obtained from the bursa. Clinical and epidemiological data did not suggest a direct inoculation of the agent in the bursa. However, the patient mentioned occasional local trauma due to recreational sports, which may have constituted a predisposing factor. As determined by ELISA, there were higher levels of IgG against Brucella LPS and cytosolic proteins detected in the patient's bursal synovial fluid when compared with serum. Levels of proinflammatory cytokines (tumour necrosis factor alpha, interleukin 1 beta, gamma interferon, interleukin 8 and MCP-1) were higher than in synovial fluids obtained from patients with rheumatoid arthritis and a patient with septic arthritis, and a zymographic analysis revealed a gelatinase of about 92 kDa. These findings indicate that it may be possible to diagnose brucellar bursitis by measuring specific antibodies in the bursal synovial fluid. In addition, our findings suggest a role of increased local levels of proinflammatory cytokines and gelatinases in the inflammatory manifestations of brucellar bursitis.

  9. A cross-sectional study of the prevalence and associated risk factors for bursitis in weaner, grower and finisher pigs from 93 commercial farms in England.

    PubMed

    Gillman, C E; Kilbride, A L; Ossent, P; Green, L E

    2008-03-17

    A cross-sectional study of 93 farms in England was carried out to estimate the prevalence and associated risk factors for bursitis. A total of 6250 pigs aged 6-22 weeks were examined for presence and severity of bursitis. Details of pen construction, pen quality and farm management were recorded including floor type, presence of bedding, condition of the floor and floor materials. The prevalence of bursitis was 41.2% and increased with each week of age (OR 1.1). Two-level logistic regression models were developed with the outcome as the proportion of pigs affected with bursitis in a pen. Pigs kept on soil floors with straw bedding were used as the reference level. In comparison with these soil floors, bursitis increased on concrete floors where the bedding was deep throughout (OR 4.6), deep in part (OR 3.7), and sparse throughout (OR 9.0), part slatted floors (OR 8.0), and fully slatted floors (OR 18.8). Slip or skid marks in the dunging area (OR 1.5), pigs observed slipping during the examination of the pen (OR 1.3) and wet floors (OR 3.6) were also associated with an increased risk of bursitis. The results indicate that bursitis is a common condition of growing pigs and that the associated risk factors for bursitis were a lack of bedding in the lying area, presence of voids and pen conditions which increased the likelihood of injury.

  10. A cross-sectional study of the prevalence and associated risk factors for bursitis in weaner, grower and finisher pigs from 93 commercial farms in England.

    PubMed

    Gillman, C E; Kilbride, A L; Ossent, P; Green, L E

    2008-03-17

    A cross-sectional study of 93 farms in England was carried out to estimate the prevalence and associated risk factors for bursitis. A total of 6250 pigs aged 6-22 weeks were examined for presence and severity of bursitis. Details of pen construction, pen quality and farm management were recorded including floor type, presence of bedding, condition of the floor and floor materials. The prevalence of bursitis was 41.2% and increased with each week of age (OR 1.1). Two-level logistic regression models were developed with the outcome as the proportion of pigs affected with bursitis in a pen. Pigs kept on soil floors with straw bedding were used as the reference level. In comparison with these soil floors, bursitis increased on concrete floors where the bedding was deep throughout (OR 4.6), deep in part (OR 3.7), and sparse throughout (OR 9.0), part slatted floors (OR 8.0), and fully slatted floors (OR 18.8). Slip or skid marks in the dunging area (OR 1.5), pigs observed slipping during the examination of the pen (OR 1.3) and wet floors (OR 3.6) were also associated with an increased risk of bursitis. The results indicate that bursitis is a common condition of growing pigs and that the associated risk factors for bursitis were a lack of bedding in the lying area, presence of voids and pen conditions which increased the likelihood of injury. PMID:17942176

  11. Changes of four common non-infectious liver diseases for the hospitalized patients in Beijing 302 hospital from 2002 to 2013.

    PubMed

    Chang, Binxia; Li, Baosen; Huang, Ang; Sun, Ying; Teng, Guangju; Wang, Xiaoxia; Liangpunsakul, Suthat; Li, Jin; Zou, Zhengsheng

    2016-08-01

    The implementation of a hepatitis B vaccination program in China has led to a significant decline in the prevalence and incidence of liver diseases secondary to hepatitis B virus over the past two decades. With recent changes in the economy and increases in average incomes in China during the same period, there has been a rapid rise in per capita alcohol consumption and an epidemic of obesity. We hypothesized that the burden of liver diseases in China has shifted from infectious to non-infectious etiologies. We retrospectively analyzed the data of 20,378 patients who were hospitalized in Beijing 302 hospital between 2002 and 2013. We found that the total admission rate secondary to alcoholic liver disease (ALD), non-alcoholic liver disease (NAFLD), autoimmune liver disease (AILD), and drug-induced liver injury (DILI) was 10.7%. ALD was the leading cause of inpatient hospitalization (3.9% of total admissions). The rate of inpatient admission for ALD, AILD, and DILI increased by 170%, 111%, and 107%, respectively during the study period. Chinese herbal medicine was the primary cause of DILI in our subjects. The burden of non-infectious liver diseases has increased over the last decade among hospitalized patients in a large tertiary hospital in China. The increase in the rate of admission for ALD and DILI from Chinese herbal medicine suggests that strategies to reduce harmful use of alcohol and increase awareness and education on the use of herbal medicine are needed. PMID:27519542

  12. Non-infectious granulomatous diseases of the skin and their associated systemic diseases: an evidence-based update to important clinical questions.

    PubMed

    Hawryluk, Elena Balestreire; Izikson, Leonid; English, Joseph C

    2010-01-01

    Non-infectious granulomatous diseases of the skin are a broad group of distinct reactive inflammatory conditions that share important similarities. As a group, they are relatively difficult to diagnose and distinguish both clinically as well as histologically. Many of these disorders have significant associations with systemic diseases that impact the patient's overall prognosis. In this update, we offer a discussion of emerging concepts and controversies in this field, as presented through evidence-based answers to seven important clinical questions regarding palisading and epithelioid granulomata. These questions offer an opportunity to review ten non-infectious granulomatous conditions that have implications for systemic disease: granuloma annulare, annular elastolytic giant cell granuloma, necrobiosis lipoidica, methotrexate-induced accelerated rheumatoid nodulosis, necrobiotic xanthogranuloma, interstitial granulomatous dermatitis, interstitial granulomatous drug reaction, palisaded neutrophilic granulomatous dermatitis, sarcoidosis, and metastatic Crohn disease. Recent clinical, epidemiologic, and laboratory studies have shed some light on these diseases, the association of these conditions with systemic disorders, and their overall prognoses. PMID:20184390

  13. Acute Calcific Bursitis After Ultrasound-Guided Percutaneous Barbotage of Rotator Cuff Calcific Tendinopathy: A Case Report.

    PubMed

    Kang, Bo-Sung; Lee, Seung Hak; Cho, Yung; Chung, Sun Gun

    2016-08-01

    Ultrasound-guided percutaneous barbotage is an effective treatment for rotator cuff calcific tendinopathy, providing rapid and substantial pain relief. We present the case of a 49-year-old woman with aggravated pain early after ultrasound-guided barbotage of a large calcific deposit in the supraspinatus tendon. Subsequent examination revealed a thick calcification spreading along the subacromial-subdeltoid bursa space, suggesting acute calcific bursitis complicated by barbotage. Additional barbotage alleviated her pain completely. Therefore, a high index of suspicion for acute calcific bursitis is required in patients with unresolved or aggravated pain after barbotage. Repeated barbotage could be effective for this condition. PMID:26902864

  14. [Production and evaluation of immunologic characteristics of mzNLA-3, a non-infectious HIV-1 clone with a large deletion in the pol sequence].

    PubMed

    Aghasadeghi, M R; Zabihollahi, R; Sadat, S M; Salehi, M; Ashtiani, S H; Namazi, R; Kashanizadeh, N; Azadmanesh, K

    2013-01-01

    Inactivation ofintegrase and reverse transcriptase can revoke the replication of HIV virions, and non-infectious HIV particles are desirable virus-like particle (VLP) vaccine candidates. Here, we produced inactive in replication HIV-1 particles fit for vaccine and virological purposes by introducing a mutation into the pol sequence. Proviral DNA (pNLA-3) was cut at two points in the pol region using the Bal I restriction enzyme and then religated. HEK 293T cells were transfected with the resultant plasmid (pmzNL4-3) to produce mutated virions. To confirm a production of VLPs and evaluate their biological activity the p24 load and syncytium formation (MT2 cells) were analyzed. The assay indicated that mzNL4-3 virions were assembled and contained functional envelope glycoproteins (ENV). In addition, mzNL4-3 virions were not able to infect MT2 and HEK 293T cells. Furthermore, the immunogenicity of VLPs was investigated in a mouse model. According to the data on vaccinated mice, the titer of ENV-specific antibodies rose rapidly after a boosting injection. Moreover, lymphoid cells extracted from these mice proliferated after exposure to the antigen. The mzNL4-3 virus particles possessed immunogenic antigens of HIV and can effectively trigger humoral and CD4 immune responses. Non-infectious mzNL4-3 virions may also be used in biomedical experiments to improve the biological safety conditions. Moreover, the mzNL4-3 seems to be a promising candidate for further HIV-1 vaccine investigations. PMID:23808159

  15. Subacromial bursitis with giant rice bodies as initial presentation of rheumatoid arthritis.

    PubMed

    Subramaniam, Ramesh; Tan, Justina Wei Lyn; Chau, Cora Yuk Ping; Lee, Keng Thiam

    2012-10-01

    Rice body formation is a nonspecific response to chronic synovial inflammation associated with tuberculous arthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, seronegative inflammatory arthritis, and even osteoarthritis. Such bodies were termed rice bodies because of their close resemblance to grains of polished white rice. We present a case report of a middle-aged woman with right shoulder subacromial/subdeltoid bursitis with giant rice body formation as her initial presentation of rheumatoid arthritis. Her right shoulder symptoms resolved after subacromial and subdeltoid bursectomy and removal of the rice bodies. She subsequently developed inflammatory arthritis of other joints, met the criteria for rheumatoid arthritis, and has been treated medically. PMID:23013846

  16. Arthroscopic bursectomy with concomitant iliotibial band release for the treatment of recalcitrant trochanteric bursitis.

    PubMed

    Farr, Derek; Selesnick, Harlan; Janecki, Chet; Cordas, Daniel

    2007-08-01

    Trochanteric bursitis with lateral hip pain is a commonly encountered orthopaedic condition. Although most patients respond to corticosteroid injections, rest, physical therapy (PT), stretching, and anti-inflammatory medications, those with recalcitrant symptoms may require operative intervention. Studies have explored the use of the arthroscope in the treatment of these patients. However, these reports have not addressed the underlying pathology in this chronic condition. We believe that the iliotibial band must be addressed and is the main cause of pain, inflammation, and trochanteric impingement leading to the development of bursitis. We report a new technique for arthroscopic trochanteric bursectomy with iliotibial band release. Our technique involves 2 incisions--one 4 cm proximal to the greater trochanter along the anterior border of the iliotibial band, and the other 4 cm distal and along the posterior border. The 30 degrees arthroscope is introduced through the inferior portal, and a cannula is introduced through the superior portal. A 5.5-mm arthroscopic shaver is inserted through the superior cannula to clear off the surface of the iliotibial band, so that it may be adequately visualized. A hooked electrocautery probe is then used to longitudinally incise the iliotibial band until it no longer rubs, causing impingement over the greater trochanter.

  17. Retrocalcaneal Bursitis due to Rare Calcaneal Osteochondroma in Adult Male : Excision and Outcome

    PubMed Central

    Kumar, Rupesh; Anjana; Kundan, Meghraj

    2016-01-01

    Introduction: Osteochondroma is the most common benign tumour of the bone and is considered as developmental lesion of the bone. Common site of osteochondroma presentation is around the knee but calcaneal osteochondroma as such is a rare entity. Osteochondromas grow during childhood through adolescence, but usually the growth of osteochondroma ends when the epiphyseal plates close. In an adult, growth of an osteochondroma suggests the diagnosis of a malignant transformation. However, it can also present as pressure symptom in later phase of life. Here, we presented a case of retrocalcaneal bursitis in late phase of life of a male farmer due to late growth of osteochondroma. Case Presentation: We report a case of calcaneal osteochondroma which is an extremely rare site of occurrence with painful swelling of ankle causing limitation of walking in a 58-year-old male. Surgical excision of tumour followed by a histological confirmation reported negative for any malignant changes. Conclusion: There may be chances of osteochondroma being a reason for retrocalcaneal bursitis. It is possible of late detection of benign osteochondromas which show symptomatic growth and pressure effect in skeletally mature patients without malignant transformation. PMID:27703931

  18. Vaccinia virus temperature-sensitive mutants in the A28 gene produce non-infectious virions that bind to cells but are defective in entry

    SciTech Connect

    Turner, Peter C. Dilling, Bradley P.; Prins, Cindy; Cresawn, Steven G.; Moyer, Richard W.; Condit, Richard C.

    2007-09-15

    The vaccinia virus temperature-sensitive mutations Cts6 and Cts9 were mapped by marker rescue and DNA sequencing to the A28 gene. Cts6 and Cts9 contain an identical 2-bp deletion truncating the A28 protein and removing the fourth conserved cysteine near the C-terminus. Cts9 mutant virions produced at 40 deg. C were non-infectious and unable to cause cytopathic effect. However, the mutant A28 protein localized to purified mature virions (MV) at 31 deg. C and 40 deg. C. MV of Cts9 produced at 40 deg. C bound to cells but did not enter cells. Low pH treatment of Cts9-infected cells at 18 h p.i. failed to produce fusion from within at 40 deg. C, but gave fusion at 31 deg. C. Adsorption of Cts9 mutant virions to cells followed by low pH treatment showed a defect in fusion from without. The Cts9 phenotype suggests that the A28 protein is involved in both virus entry and cell-cell fusion, and supports the linkage between the two processes.

  19. Interaction network and mass spectrometry data of Xanthomonas citri subsp. citri surface proteins from differential proteomic analysis of infectious and non-infectious cells.

    PubMed

    Carnielli, Carolina Moretto; Artier, Juliana; Franco de Oliveira, Julio Cezar; Novo-Mansur, Maria Teresa Marques

    2016-09-01

    Here we provide the mass-spectrometry and in silico interaction network dataset of proteins identified on our research article on surface proteomic analysis from Xanthomonas citri subsp. citri (XAC) cells grown in vivo (infectious) and in vitro (non-infectious, control) by 2D-DIGE approach. Fluorescence labeling of proteins were performed on intact cells followed by cellular lysis and labeled spots from 2D gel differing in abundance between the two conditions (ANOVA, p-value<0.05) were analyzed by a nano-electrospray tandem mass spectrometry Q-Tof Ultima API mass spectrometer (MicroMass/Waters) (LC-ESI-MS/MS). This article contains raw data of proteins detected in the 79 spots analyzed by LC-ESI-MS/MS approach and also an enrichment analysis on the resulting protein-protein interaction network performed with the Integrated Interactome System (IIS) platform and Cytoscape software. The data are supplementary to our original research article, "Xanthomonas citri subsp. citri surface proteome by 2D-DIGE: ferric enterobactin receptor and other outer membrane proteins potentially involved in citric host interaction" (Carnielli et al., 2016) [1], and raw data are available via Peptide Atlas (ftp://PASS00850:ZJ7425v@ftp.peptideatlas.org/). PMID:27595129

  20. Protothecal bursitis after simultaneous kidney/liver transplantation: a case report and review.

    PubMed

    Ramírez, I; Nieto-Ríos, J F; Ocampo-Kohn, C; Aristizábal-Alzate, A; Zuluaga-Valencia, G; Muñoz Maya, O; Pérez, J C

    2016-04-01

    Solid organ transplantation is an accepted therapy for end-stage diseases of the kidneys, liver, heart, and lungs. Unfortunately, transplantation is associated with infectious complications. Here, we present a case report of Prototheca wickerhamii olecranon bursitis and review all of the cases in solid organ transplant (SOT) recipients published in the literature to date. In our patient, the infection resolved with surgical therapy and limited antifungal therapy, and no symptoms have recurred over 24 months of follow-up. A review of the literature suggests that 50% of SOT recipients with Prototheca infection present with disseminated infection, and the overall mortality is 75%. More studies are required to determine the optimal management of protothecosis in this population. PMID:26779785

  1. Complete Achilles tendon rupture after local infiltration of corticosteroids in the treatment of deep retrocalcaneal bursitis.

    PubMed

    Vallone, Ganfranco; Vittorio, Tarallo

    2014-06-01

    Complete rupture of the Achilles tendon is relatively rare, but it is an injury of considerable clinical relevance. A common cause of non-traumatic tendon rupture is local corticosteroid infiltration. Corticosteroid injections may start a degenerative process resulting in partial rupture and subsequent complete rupture of the tendon due to a direct toxic effect, because corticosteroids inhibit production of extracellular matrix collagen and also because of poor local vascularization. This paper describes the case of a patient who presented with complete rupture of the Achilles tendon shortly after administration of local corticosteroid injections in the treatment of deep retrocalcaneal bursitis. This confirms that corticosteroid treatment which is not correctly and accurately administered may be a factor contributing to major injury. It demonstrates that the physician must take all necessary precautions when administering corticosteroid infiltration. It is particularly important that corticosteroid injection is performed under ultrasound guidance which permits visualization of the needle tip and therefore exact identification of the injection site.

  2. Greater trochanteric pain syndrome: more than bursitis and iliotibial tract friction.

    PubMed

    Ho, Garry Wai Keung; Howard, Thomas Michael

    2012-01-01

    Disorders causing lateral hip pain are encountered frequently by physicians. Evaluating these problems can be challenging because of the myriad of potential causes, the complex anatomy of the peritrochanteric structures, and the inconsistently described etiologic factors. Misconceptions about the causes of lateral hip pain and tenderness are common, frequently leading to approaches that only provide temporary solutions rather than address the underlying pathology. Trochanteric bursitis is implicated frequently but is seldom the primary cause of pain in chronic cases. It is important to address hip rotator cuff tendinopathy and pelvic core instability. Treatment options include therapeutic exercise, physical modalities, corticosteroid injections, extracorporeal shock wave therapy, and regenerative injection therapies. For recalcitrant cases, surgery may be appropriate. By understanding the anatomy of the peritrochanteric structures, and the pathologic processes most likely responsible for symptomatology and dysfunction, the physician will be prepared to provide effective long-term solutions for this common problem.

  3. A Rare Case of Femoral Neuropathy Associated with Ilio-Psoas Bursitis After 10 Years of Total Hip Arthroplasty

    PubMed Central

    Singh, Vivek; Shon, Won Yong; Lakhotia, Devendra; Kim, Jong Hoon; Kim, Tae Wan

    2015-01-01

    We describe a case of femoral nerve palsy caused due to non-infective large iliopsoas bursitis after 10 years of cementless ceramic-on-metal THA. Bursectomy and exploration of femoral nerve were done to relieve the compressive symptoms of femoral nerve. Patient neurological symptoms were recovered within six months. Iliopsoas bursitis after THA can lead to anterior hip pain, lump in inguinal area or abdomen, limb swelling due to venous compression or more rarely neurovascular compressive symptoms depending on size and extension. Treating physician should be aware of this rare condition after THA in the absence of any radiographic findings so that prompt diagnosis and treatment can be carried out. PMID:26312109

  4. A Rare Case of Femoral Neuropathy Associated with Ilio-Psoas Bursitis After 10 Years of Total Hip Arthroplasty.

    PubMed

    Singh, Vivek; Shon, Won Yong; Lakhotia, Devendra; Kim, Jong Hoon; Kim, Tae Wan

    2015-01-01

    We describe a case of femoral nerve palsy caused due to non-infective large iliopsoas bursitis after 10 years of cementless ceramic-on-metal THA. Bursectomy and exploration of femoral nerve were done to relieve the compressive symptoms of femoral nerve. Patient neurological symptoms were recovered within six months. Iliopsoas bursitis after THA can lead to anterior hip pain, lump in inguinal area or abdomen, limb swelling due to venous compression or more rarely neurovascular compressive symptoms depending on size and extension. Treating physician should be aware of this rare condition after THA in the absence of any radiographic findings so that prompt diagnosis and treatment can be carried out. PMID:26312109

  5. Development of a non-infectious encapsidated positive control RNA for molecular assays to detect foot-and-mouth disease virus.

    PubMed

    Madi, Mikidache; Mioulet, Valerie; King, Donald P; Lomonossoff, George P; Montague, Nicholas P

    2015-08-01

    Positive controls are an important component of the quality-control of molecular tests used for diagnosis of livestock diseases. For high consequence agents such as foot-and-mouth disease virus (FMDV), the positive controls required to monitor template extraction, reverse transcription and amplification steps usually consist of material derived from infectious viruses. Therefore, their production is dependent upon the use of high containment facilities and their deployment carries the risks associated with inactivation of "live" FMDV. This paper describes the development of a novel non-infectious positive control that encodes FMDV RNA sequences that are encapsidated within Cowpea mosaic virus (CPMV) particles. This surrogate RNA has been engineered to contain sequences from the 5'UTR and 3D regions of FMDV targeted by many molecular assays (conventional RT-PCR, real-time RT-PCR and RT-LAMP). These sequences were inserted into a movement-deficient version of CPMV RNA-2 which is rescued from cowpea plants (Vigna unguiculota) by inoculation with RNA-1. In order to evaluate the performance of these encapsidated RNAs, nucleic acid prepared from a 10-fold dilution series was tested using a range of molecular assays. Results generated by using the molecular assays confirmed RNA-dependent amplification and the suitability of these particles for use in a range of diagnostic tests. Moreover, these CPMV particles were highly stable for periods of up to 46 days at room temperature and 37 °C. Recombinant CPMV can be used to produce high yields of encapsidated RNAs that can be used as positive and negative controls and standards in molecular assays. This approach provides a surrogate that can be potentially used outside of containment laboratories as an alternative to inactivated infectious virus for molecular diagnostic testing.

  6. The mosaic of environment involvement in autoimmunity: the abrogation of viral latency by stress, a non-infectious environmental agent, is an intrinsic prerequisite prelude before viruses can rank as infectious environmental agents that trigger autoimmune diseases.

    PubMed

    Temajo, Norbert O; Howard, Neville

    2014-06-01

    An autoimmune disease (AD), organ-specific or systemic, results from an aberrant response in which the protective immune system normally schooled to recognize and destroy invading infectious agents (viruses, etc.) instead fails to distinguish self-antigens and proceeds to attack and destroy the host's organs. There can be familial aggregation in which a single AD may occur in members of a family, or a single family may be afflicted with multiple ADs. Finally, sometimes multiple ADs co-occur in a single individual: the kaleidoscope of autoimmunity. Autoimmunity is a multifactorial process in which genetic, hormonal, immunological and environmental factors act in concert to materialize the mosaic of autoimmunity phenomenon. A genetically primed individual may yet not develop an AD: the contribution by an environmental factor (non-infectious or infectious) is essential for completion of the act. Of the non-infectious factors, stress plays a determinative step in autoimmunity in that it abrogates viral latency and thereby ordains the viruses to qualify as infectious environmental factors that trigger ADs. This is note-worthy as viruses rank first as the most important environmental triggers of ADs. Furthermore, all these viruses experience going through latency. Hence the hypothesis: "The abrogation of viral latency by stress, a non-infectious environmental agent, is an intrinsic prerequisite prelude before viruses can rank as infectious environmental agents that trigger autoimmune diseases". There is collaboration here between non-infectious- and infectious-agent to achieve the cause of autoimmunity. We say viral latency and stress have a covenant: continued perpetration of autoimmunity is dependent on the intervention by stress to reactivate latent infections.

  7. The value of procalcitonin and the SAPS II and APACHE III scores in the differentiation of infectious and non-infectious fever in the ICU: a prospective, cohort study.

    PubMed

    Jeon, Eun Ju; Jung, Jae Woo; Choi, Jae Chol; Shin, Jong Wook; Park, In Won; Choi, Byoung Whui; Park, Ae Ja; Kim, Jae Yeol

    2010-11-01

    Early and accurate differentiation between infectious and non-infectious fever is vitally important in the intensive care unit (ICU). In the present study, patients admitted to the medical ICU were screened daily from August 2008 to February 2009. Within 24 hr after the development of fever (>38.3℃), serum was collected for the measurement of the procalcitonin (PCT) and high mobility group B 1 levels. Simplified Acute Physiology Score (SAPS) II and Acute Physiology And Chronic Health Evaluation (APACHE) III scores were also analyzed. Sixty-three patients developed fever among 448 consecutive patients (14.1%). Fever was caused by either infectious (84.1%) or non-infectious processes (15.9%). Patients with fever due to infectious causes showed higher values of serum PCT (7.8±10.2 vs 0.5±0.2 ng/mL, P=0.026), SAPS II (12.0±3.8 vs 7.6±2.7, P=0.006), and APACHE III (48±20 vs 28.7±13.3, P=0.039) than those with non-infectious fever. In receiver operating characteristic curve analysis, the area under the curve was 0.726 (95% CI; 0.587-0.865) for PCT, 0.759 (95% CI; 0.597-0.922) for SAPS II, and 0.715 (95% CI; 0.550-0.880) for APACHE III. Serum PCT, SAPS II, and APACHE III are useful in the differentiation between infectious and non-infectious fever in the ICU.

  8. Trochanteric bursitis

    MedlinePlus

    ... walking Joint stiffness Swelling and warmth of the hip joint Catching and clicking sensation You may notice the ... physical therapy if you have trouble moving the joint. Other ... your hip will function just fine without the inflamed bursa. ...

  9. Ankylosis of the distal interphalangeal joint in a horse after septic arthritis and septic navicular bursitis.

    PubMed

    Honnas, C M; Schumacher, J; Kuesis, B S

    1992-04-01

    A 6-month-old 300-kg Quarter Horse filly was treated for septic arthritis of the distal interphalangeal joint and septic navicular bursitis that developed as a result of a deep puncture to the foot. Initial treatment consisted of establishing ventral drainage for the navicular bursa, lavage of the distal interphalangeal joint, and administration of broad-spectrum antimicrobial drugs and non-steroidal anti-inflammatory drugs. Because of continuing sepsis in the distal interphalangeal joint, subsequent treatment included packing the defect in the bottom of the foot with cancellous bone in an attempt to prevent ascending contamination of the joint, placing the limb in a short limb cast, and inserting a Penrose drain into the joint for passive drainage of septic exudate. The goal of treatment was to encourage ankylosis of the distal interphalangeal joint. Because of the filly's persistent lameness and laxity of the lateral collateral ligament in the contralateral carpus, the palmar nerves of the affected foot were injected with a long-acting local anesthetic at the level of the proximal sesamoid bones to encourage weight-bearing. Ankylosis of the distal interphalangeal joint was complete 9 months after the puncture, but a grade-2 lameness remained and the horse had a varus deformity resulting from ligamentous laxity of the lateral collateral ligament in the contralateral carpus.

  10. Mycobacterium avium complex olecranon bursitis resolves without antimicrobials or surgical intervention: A case report and review of the literature

    PubMed Central

    Working, Selene; Tyser, Andrew; Levy, Dana

    2015-01-01

    Introduction Nontuberculous mycobacteria are an uncommon cause of septic olecranon bursitis, though cases have increasingly been described in both immunocompromised and immunocompetent hosts. Guidelines recommend a combination of surgical resection and antimicrobials for treatment. This case is the first reported case of nontuberculous mycobacterial olecranon bursitis that resolved without medical or surgical intervention. Case presentation A 67-year-old female developed a painless, fluctuant swelling of the olecranon bursa following blunt trauma to the elbow. Due to persistent bursal swelling, she underwent three separate therapeutic bursal aspirations, two involving intrabursal steroid injection. After the third aspiration, the bursa became erythematous and severely swollen, and bursal fluid grew Mycobacterium avium complex. Triple-drug antimycobacterial therapy was initiated, but discontinued abruptly due to a rash. Surgery was not performed. The patient was observed off antimicrobials, and gradually clinically improved with a compressive dressing. By 14 months after initial presentation, clinical exam revealed complete resolution of the previously erythematous bursal mass. Discussion This is the first reported case of nontuberculous mycobacterial olecranon bursitis managed successfully without surgery or antimicrobials. Musculoskeletal nontuberculous mycobacterial infections are challenging given the lack of clinical data about optimal duration and choice of antimicrobials or the role of surgery. Additionally, the potential toxicity and drug interactions of antimycobacterials are not insignificant and warrant close monitoring if treatment is pursued. Conclusion This case raises an important clinical question of whether close observation off antimicrobials is appropriate in select cases of immunocompetent patients with localized atypical mycobacterial disease of soft tissue and skeletal structures. PMID:26793457

  11. The Effect of Different Dosing Schedules of Intravitreal Sirolimus, a Mammalian Target of Rapamycin (mTOR) Inhibitor, in the Treatment of Non-Infectious Uveitis (An American Ophthalmological Society Thesis)

    PubMed Central

    Nguyen, Quan Dong; Sadiq, Mohammad Ali; Soliman, Mohamed Kamel; Agarwal, Aniruddha; Do, Diana V.; Sepah, Yasir J.

    2016-01-01

    Purpose: To determine if two different doses of intravitreal sirolimus, an mTOR inhibitor, can decrease inflammation and is safe in eyes with non-infectious posterior, intermediate, or panuveitis in the Sirolimus as a Therapeutic Approach UVEitis: Protocol-2 (SAVE-2) Study. Methods: SAVE-2 is a prospective randomized, phase II, open-label interventional clinical trial conducted at 4 clinical centers in the United States. Eligible subjects were randomized into one of two treatments. Group 1 received 440µg of intravitreal sirolimus in study eyes on days 0, 30, 60, 90, 120, and 150; group 2 received 880µg of intravitreal sirolimus on days 0, 60, and 120. Fellow eyes were also eligible to receive sirolimus (of opposite dose to that of study eye). Primary endpoint of the study was at month 6 (M6). Results: 24 subjects have been randomized in SAVE-2 and are included in the analysis. Vitreous haze decreased by ≥2 steps in 63.6% and 50% of patients in groups 1 and 2, respectively at M6 (p=0.695). Mean change in best-corrected visual acuity for subjects was +3.66 and −2.91 ETDRS letters in group 1 and 2, respectively. Among subjects with macular edema at baseline (n=13), the mean change in foveal thickness was −89.42µm in group 1 and +81.5µm in group 2 at M6. Conclusions: Both low and high doses of intravitreal sirolimus were found to decrease vitreous haze in eyes with non-infectious uveitis. Low dose (440µg) sirolimus administered monthly may be more efficacious in reducing uveitic macular edema than high dose (880µg) administered every 2 months.

  12. Raynaud's phenomenon and bilateral olecranon bursitis co-existing in a patient with chronic hepatitis B and D treated with pegylated interferon.

    PubMed

    Arain, Shafique Rehman; Umer, Tahira Perveen

    2016-06-01

    Pegylated interferon remains the first line treatment for patients with hepatitis D virus and more than one year therapy may be necessary. Interferon a has the most extensive clinical application and is used for the treatment of chronic hepatitis B and D virus as well as HCV infections. The attachment of polyethylene glycol to interferon increases its half-life. Treatment with peg interferon is associated with many troublesome and occasionally with serious or even life-threatening side effects. In this case report, we have described a patient with chronic hepatitis B and D, who developed Raynaud's phenomenon, ischaemic digital necrosis and bilateral olecranon bursitis during Pegylated interferon therapy. The patient underwent a very extensive workup in order to determine the underlying cause of his digital ischaemia and olecranon bursitis, which was finally determined to be secondary to the use of Pegylated interferon.

  13. Evaluation of a Porcine Gastric Mucin and RNase A Assay for the Discrimination of Infectious and Non-infectious GI.1 and GII.4 Norovirus Following Thermal, Ethanol, or Levulinic Acid Plus Sodium Dodecyl Sulfate Treatments.

    PubMed

    Afolayan, Olamide T; Webb, Cathy C; Cannon, Jennifer L

    2016-03-01

    Human noroviruses (NoVs) are a major source of foodborne illnesses worldwide. Since human NoVs cannot be cultured in vitro, methods that discriminate infectious from non-infectious NoVs are needed. The purpose of this study was to evaluate binding of NoV genotypes GI.1 and GII.4 to histo-blood group antigens expressed in porcine gastric mucin (PGM) as a surrogate for detecting infectious virus following thermal (99 °C/5 min), 70% ethanol or 0.5% levulinic acid (LV) plus 0.01 or 0.1% sodium dodecyl sulfate (SDS) sanitizer treatments and to determine the limit of detection of GI.1 and GII.4 binding to PGM. Treated and control virus samples were applied to 96-well plates coated with 1 µg/ml PGM followed by RNase A (5 ng/µl) treatment for degradation of exposed RNA. Average log genome copies per ml (gc/ml) reductions and relative differences (RD) in quantification cycle (Cq) values after thermal treatment were 1.77/5.62 and 1.71/7.25 (RNase A) and 1.73/5.50 and 1.56/6.58 (no RNase A) for GI.1 and GII.4, respectively. Treatment of NoVs with 70% EtOH resulted in 0.05/0.16 (GI.1) and 3.54/10.19 (GII.4) log reductions in gc/ml and average RD in Cq value, respectively. LV (0.5%) combined with 0.1 % SDS provided a greater decrease of GI.1 and GII.4 NoVs with 8.97 and 8.13 average RD in Cq values obtained, respectively than 0.5% LV/0.01 % SDS. Virus recovery after PGM binding was variable with GII.4 > GI.1. PGM binding is a promising surrogate for identifying infectious and non-infectious NoVs after capsid destruction, however, results vary depending on virus strain and inactivation method.

  14. A cross-sectional study of the prevalence and associated risk factors for capped hock and the associations with bursitis in weaner, grower and finisher pigs from 93 commercial farms in England.

    PubMed

    KilBride, A L; Gillman, C E; Ossent, P; Green, L E

    2008-03-17

    The prevalence of capped hock in 5601 post-weaning pigs from 93 pig farms in England was 17.2%. The prevalence increased with age. Once adjusted for age, the lowest prevalence of capped hock was observed in pigs kept on soil floors (usually covered with deep straw bedding). There was no significant increase in the risk of capped hock in pigs kept on solid concrete floors with deep straw bedding. However, pigs kept on solid concrete with some, or the entire pen, sparsely bedded and pigs kept on partially or fully slatted floors had an approximately threefold increased risk of capped hock. This did not vary significantly between these four floor types. This was in contrast to the associated risks for bursitis in the same pigs, where as the floor went from highly resilient (straw and solid floors) to hard and perforated (fully slatted) the risk of bursitis increased in a similar way to a dose response. No other variables that were measured were associated with a change in risk for capped hock, while observation of pigs slipping or slip marks and wet, dirty and worn pens were also associated risks for bursitis. These results indicate that capped hock and bursitis are both affected by exposure to floors, but in different ways. The prevalence of capped hock was associated only with floor hardness, with deep straw protecting the pigs, while bursitis was associated with both changes in bedding depth (hardness), floor material (soil versus concrete) and floor construction (solid versus slatted floors) and in factors associated with locomotion (slipping and slip marks). These results indicate that the aetiology of capped hock and bursitis might differ.

  15. Surgical Correction of Posttraumatic Scapulothoracic Bursitis, Rhomboid Major Muscle Injury, Ipsilateral Glenohumeral Instability, and Headaches Resulting from Circus Acrobatic Maneuvers.

    PubMed

    Skedros, John G; Langston, Tanner D; Phippen, Colton M

    2015-01-01

    We report the case of a 28-year-old transgender (male-to-female) patient that had a partial tear of the rhomboid major tendon, scapulothoracic bursitis, and glenohumeral instability on the same side. These conditions resulted from traumatic events during circus acrobatic maneuvers. Additional aspects of this case that make it unique include (1) the main traumatic event occurred during a flagpole exercise, where the patient's trunk was suspended horizontally while a vertical pole was grasped with both hands, (2) headaches were associated with the periscapular injury and they improved after scapulothoracic bursectomy and rhomboid tendon repair, (3) surgical correction was done during the same operation with an open anterior capsular-labral reconstruction, open scapulothoracic bursectomy without bone resection, and rhomboid tendon repair, (4) a postoperative complication of tearing of the serratus anterior and rhomboid muscle attachments with recurrent scapulothoracic pain occurred from patient noncompliance, and (5) the postoperative complication was surgically corrected and ultimately resulted in an excellent outcome at the one-year final follow-up. PMID:26273484

  16. Comparison of the efficacy of physical therapy and corticosteroid injection in the treatment of pes anserine tendino-bursitis

    PubMed Central

    Sarifakioglu, Banu; Afsar, Sevgi Ikbali; Yalbuzdag, Seniz Akcay; Ustaömer, Kubra; Bayramoğlu, Meral

    2016-01-01

    [Purpose] The aims of this study were twofold. The first was to compare the functional capacity and pain of patients with knee osteoarthritis (KOA), with or without pes anserine tendino-bursitis (PATB). The second is to compare the efficacy of two treatment methods (physical therapy and corticosteroid injection) for patients with PATB. [Subjects and Methods] Sixty patient with KOA and PATB (Group 1) and 57 patients with KOA but without PATB (Group 2) were enrolled in the study. The patients’ visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores and three-meter timed-up and go scores were measured. The PATB group was randomly divided into two groups (Group A and B). Physical therapy (PT) modalities were applied to the first group (Group A), and the second group (Group B) received corticosteroid injections to the pes anserine area. Eight weeks later, patients’ parameters were measured again. [Results] Initial WOMAC scores and timed up-and-go times were significantly higher in Group 1 than in Group 2. Both treatments resulted in significant improvements in all measured parameters, but no significant difference was detected between Group A and B. [Conclusion] Patients with PATB tend to have more severe pain, more altered functionality, and greater disability than those with KOA but without PATB. Both corticosteroid injection and PT are effective methods of treatment for PATB. Injection therapy can be considered an effective, inexpensive and fast therapeutic method. PMID:27512249

  17. Surgical Correction of Posttraumatic Scapulothoracic Bursitis, Rhomboid Major Muscle Injury, Ipsilateral Glenohumeral Instability, and Headaches Resulting from Circus Acrobatic Maneuvers

    PubMed Central

    Skedros, John G.; Langston, Tanner D.; Phippen, Colton M.

    2015-01-01

    We report the case of a 28-year-old transgender (male-to-female) patient that had a partial tear of the rhomboid major tendon, scapulothoracic bursitis, and glenohumeral instability on the same side. These conditions resulted from traumatic events during circus acrobatic maneuvers. Additional aspects of this case that make it unique include (1) the main traumatic event occurred during a flagpole exercise, where the patient's trunk was suspended horizontally while a vertical pole was grasped with both hands, (2) headaches were associated with the periscapular injury and they improved after scapulothoracic bursectomy and rhomboid tendon repair, (3) surgical correction was done during the same operation with an open anterior capsular-labral reconstruction, open scapulothoracic bursectomy without bone resection, and rhomboid tendon repair, (4) a postoperative complication of tearing of the serratus anterior and rhomboid muscle attachments with recurrent scapulothoracic pain occurred from patient noncompliance, and (5) the postoperative complication was surgically corrected and ultimately resulted in an excellent outcome at the one-year final follow-up. PMID:26273484

  18. Comparison of the efficacy of physical therapy and corticosteroid injection in the treatment of pes anserine tendino-bursitis.

    PubMed

    Sarifakioglu, Banu; Afsar, Sevgi Ikbali; Yalbuzdag, Seniz Akcay; Ustaömer, Kubra; Bayramoğlu, Meral

    2016-07-01

    [Purpose] The aims of this study were twofold. The first was to compare the functional capacity and pain of patients with knee osteoarthritis (KOA), with or without pes anserine tendino-bursitis (PATB). The second is to compare the efficacy of two treatment methods (physical therapy and corticosteroid injection) for patients with PATB. [Subjects and Methods] Sixty patient with KOA and PATB (Group 1) and 57 patients with KOA but without PATB (Group 2) were enrolled in the study. The patients' visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores and three-meter timed-up and go scores were measured. The PATB group was randomly divided into two groups (Group A and B). Physical therapy (PT) modalities were applied to the first group (Group A), and the second group (Group B) received corticosteroid injections to the pes anserine area. Eight weeks later, patients' parameters were measured again. [Results] Initial WOMAC scores and timed up-and-go times were significantly higher in Group 1 than in Group 2. Both treatments resulted in significant improvements in all measured parameters, but no significant difference was detected between Group A and B. [Conclusion] Patients with PATB tend to have more severe pain, more altered functionality, and greater disability than those with KOA but without PATB. Both corticosteroid injection and PT are effective methods of treatment for PATB. Injection therapy can be considered an effective, inexpensive and fast therapeutic method. PMID:27512249

  19. [Efficiency evaluation of non-infectious uveitis].

    PubMed

    Krásná, J; Mezerová, V; Krásný, J

    2013-08-01

    Authors compared clinical and economic effeciency of treatment of the classical corticosteroids therapy and modern immunosuppressive treatment or their combination. Retrospective evaluation carried out in 2012, covering 2006-2011, monitored sample of 27 patients, 16 women and 11 men, 45 eyes with disabilities. The average age in the last year of follow-up monitoring was 30.2, ranging from 14 to 76 years. The mean duration of disease for the whole sample is 16.5 years with a range from 6 to 36 years. Three basic diagnoses were included in investigated group: chronic iridocyclitis in 59 % of eyes, intermediate uveitis in 30 % of eyes and sympathetic ophthalmia in 11 % of eyes. The optimal treatment not be determined, however, combined corticosteroid sparing therapy was the most beneficial to maintain in terms of visual acuity with minimal side effects and cost effectiveness. Successful outcomes of treatment were observed for intermediate uveitis, because the visual acuity improved in nine letetters of ETDRS chart in the study. Satisfactory treatment was proved in chronic iridocyclitis and sympathetic ophthalmia in general, because visual acuity improved in a few letters of ETDRS chart, in the same line as in the beginning of the six-year follow-up. Rounded average annual prize for treatment including pharmacotherapy, outpatient and inpatient care and laboratory follow-up was in chronic iridocyclitis € 990, in intermediate uveitis € 310 and sympathetic ophthalmia € 1550. Pharmacotherapy exceeded the financial appraisal of specialized medical and inpatient care in total cost. Key words: uveitis, corticosteorids, immunosuppression, costeffectivness.

  20. Bursitis (Beyond the Basics)

    MedlinePlus

    ... the Licensed Materials from any location via the Internet. b. STANDALONE WORKSTATION: A standalone subscription permits multiple ... computer. A Standalone Workstation license does not include Internet access to the Licensed Materials. c. INSTITUTIONAL SUBSCRIPTION: ...

  1. Tendinitis and Bursitis

    MedlinePlus

    ... American College of Rheumatology Committee on Communications and Marketing. This information is provided for general education only. ... Lists Supporters About Us Leadership Careers at ACR Social Media Newsroom Annual Reports & Financial Statements Policies & Guidelines ...

  2. Bursitis of the Hip

    MedlinePlus

    ... following: Repeated overuse or stress of the hip Rheumatoid arthritis Gout Pseudogout Injury of the hip Infection with bacteria, such as Staphylococcus aureus (or a staph infection) Diabetes Spine problems, such as scoliosis Uneven leg lengths ...

  3. Bursitis of the heel

    MedlinePlus

    ... bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas ... the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone. ...

  4. Nanomedicines for chronic non-infectious arthritis: the clinician's perspective.

    PubMed

    Rubinstein, Israel; Weinberg, Guy L

    2012-09-01

    Rheumatoid arthritis (RA) and osteoarthritis (OA) are prevalent chronic health conditions. However, despite recent advances in medical therapeutics, their treatment still represents an unmet medical need because of safety and efficacy concerns with currently prescribed drugs. Accordingly, there is an urgent need to develop and test new drugs for RA and OA that selectively target inflamed joints thereby mitigating damage to healthy tissues. Conceivably, biocompatible, biodegradable, disease-modifying antirheumatic nanomedicines (DMARNs) could represent a promising therapeutic approach for RA and OA. To this end, the unique physicochemical properties of drug-loaded nanocarriers coupled with pathophysiological characteristics of inflamed joints amplify bioavailability and bioactivity of DMARNs and promote their selective targeting to inflamed joints. This, in turn, minimizes the amount of drug required to control articular inflammation and circumvents collateral damage to healthy tissues. Thus, nanomedicine could provide selective control both in space and time of the inflammatory process in affected joints. However, bringing safe and efficacious DMARNs for RA and OA to the marketplace is challenging because regulatory agencies have no official definition of nanotechnology, and rules and definitions for nanomedicines are still being developed. Although existing toxicology tests may be adequate for most DMARNs, as new toxicity risks and adverse health effects derived from novel nanomaterials with intended use in humans are identified, additional toxicology tests would be required. Hence, we propose that detailed pre-clinical in vivo safety assessment of promising DMARNs leads for RA and OA, including risks to the general population, must be conducted before clinical trials begin. PMID:22640912

  5. Nanomedicines for chronic non-infectious arthritis: the clinician's perspective.

    PubMed

    Rubinstein, Israel; Weinberg, Guy L

    2012-09-01

    Rheumatoid arthritis (RA) and osteoarthritis (OA) are prevalent chronic health conditions. However, despite recent advances in medical therapeutics, their treatment still represents an unmet medical need because of safety and efficacy concerns with currently prescribed drugs. Accordingly, there is an urgent need to develop and test new drugs for RA and OA that selectively target inflamed joints thereby mitigating damage to healthy tissues. Conceivably, biocompatible, biodegradable, disease-modifying antirheumatic nanomedicines (DMARNs) could represent a promising therapeutic approach for RA and OA. To this end, the unique physicochemical properties of drug-loaded nanocarriers coupled with pathophysiological characteristics of inflamed joints amplify bioavailability and bioactivity of DMARNs and promote their selective targeting to inflamed joints. This, in turn, minimizes the amount of drug required to control articular inflammation and circumvents collateral damage to healthy tissues. Thus, nanomedicine could provide selective control both in space and time of the inflammatory process in affected joints. However, bringing safe and efficacious DMARNs for RA and OA to the marketplace is challenging because regulatory agencies have no official definition of nanotechnology, and rules and definitions for nanomedicines are still being developed. Although existing toxicology tests may be adequate for most DMARNs, as new toxicity risks and adverse health effects derived from novel nanomaterials with intended use in humans are identified, additional toxicology tests would be required. Hence, we propose that detailed pre-clinical in vivo safety assessment of promising DMARNs leads for RA and OA, including risks to the general population, must be conducted before clinical trials begin. PMID:22264497

  6. What Are Bursitis and Tendinitis?

    MedlinePlus

    ... long-term cases. When ice is needed, an ice pack can be held on the affected area for 15 to 20 minutes every 4 to 6 hours for 3 to 5 days. A health care provider may suggest longer use of ice and a stretching program. Your health care provider ...

  7. What Are Bursitis and Tendinitis?

    MedlinePlus

    ... happens to young people who play sports like basketball. The overuse of the muscles and force of ... jumping sports. Athletes who play football, tennis, and basketball can all be affected by Achilles tendinitis. An ...

  8. Active Hemovigilance Significantly Improves Reporting of Acute Non-infectious Adverse Reactions to Blood Transfusion.

    PubMed

    Agnihotri, Naveen; Agnihotri, Ajju

    2016-09-01

    One of the key purposes of a hemovigilance program is to improve reporting of transfusion related adverse events and subsequent data-driven improvement in blood transfusion (BT) practices. We conducted a study over 3 years to assess the impact of healthcare worker training and an active feedback programme on reporting of adverse reactions to BTs. All hospitalized patients who required a BT were included in the study. Healthcare workers involved in BT to patients were sensitized and trained in adverse reaction reporting by conducting training sessions and meetings. All the transfused patients were 'actively' monitored for any acute adverse reaction by using a uniquely coded blood issue form. A total of 18,914 blood components transfused to 5785 different patients resulted in 61 adverse reaction episodes. This incidence of 0.32 % in our study was found to be significantly higher (p < 0.005) than that reported from the same region in the past. Red blood cell units were the most frequently transfused component and thus most commonly involved in an adverse reaction (42.6 %), however apheresis platelets had the highest chance of reaction per unit transfused (0.66 %). There was no mortality associated with the BT during the study period. An active surveillance program significantly improves reporting and management of adverse reactions to BTs. PMID:27429527

  9. The Future is Now – Biologics for Non-Infectious Pediatric Anterior Uveitis

    PubMed Central

    Lerman, Melissa A.; Rabinovich, C. Egla

    2015-01-01

    Anterior uveitis (AU), inflammation of the iris, choroid, or ciliary body, can cause significant eye morbidity, including visual loss. In the pediatric age group, the most common underlying diagnosis for AU is juvenile idiopathic associated uveitis and idiopathic AU, which are the focus of this paper. AU is often resistant to medications such as topical corticosteroids and methotrexate. In the past 15 years, biologic agents (biologics) have transformed treatment. In this review, we discuss those in widespread use and those with more theoretical applications for anterior uveitis. Tumor Necrosis Factor alpha inhibitors (anti-TNFα) have been available the longest and are used widely to treat pediatric uveitis. The effects of anti-TNFα in children are described mostly in small retrospective case series. Together, the literature suggests that the majority of children treated with anti-TNFα achieve decreased uveitis activity and reduce corticosteroid burden. However, many will have disease flares even on treatment. Only a few small studies directly compare outcomes between alternate anti-TNFα (infliximab and adalimumab). The use of different uveitis grading systems, inclusion criteria, and outcome measures, makes cross-study comparisons difficult. Whether the achievement and maintenance of inactive disease occurs more frequently with certain anti-TNFα remains controversial. Newer biologics that modulate the immune system differently (e.g., interfere with TH17 activation through IL-17a and IL-6 blockade, limit T lymphocyte costimulation, and deplete B lymphocytes), have shown promise for uveitis. Studies of these agents are small and include mostly adults. Additional biologics are also being explored to treat uveitis. With their advent, we are hopeful that outcomes will ultimately be improved for children with AU. With many biologics available, much work remains to identify the optimal inflammatory pathway to target in AU. PMID:25893479

  10. Visualizing Non Infectious and Infectious Anopheles gambiae Blood Feedings in Naive and Saliva-Immunized Mice

    PubMed Central

    Choumet, Valerie; Attout, Tarik; Chartier, Loïc; Khun, Huot; Sautereau, Jean; Robbe-Vincent, Annie; Brey, Paul; Huerre, Michel; Bain, Odile

    2012-01-01

    Background Anopheles gambiae is a major vector of malaria and lymphatic filariasis. The arthropod-host interactions occurring at the skin interface are complex and dynamic. We used a global approach to describe the interaction between the mosquito (infected or uninfected) and the skin of mammals during blood feeding. Methods Intravital video microscopy was used to characterize several features during blood feeding. The deposition and movement of Plasmodium berghei sporozoites in the dermis were also observed. We also used histological techniques to analyze the impact of infected and uninfected feedings on the skin cell response in naive mice. Results The mouthparts were highly mobile within the skin during the probing phase. Probing time increased with mosquito age, with possible effects on pathogen transmission. Repletion was achieved by capillary feeding. The presence of sporozoites in the salivary glands modified the behavior of the mosquitoes, with infected females tending to probe more than uninfected females (86% versus 44%). A white area around the tip of the proboscis was observed when the mosquitoes fed on blood from the vessels of mice immunized with saliva. Mosquito feedings elicited an acute inflammatory response in naive mice that peaked three hours after the bite. Polynuclear and mast cells were associated with saliva deposits. We describe the first visualization of saliva in the skin by immunohistochemistry (IHC) with antibodies directed against saliva. Both saliva deposits and sporozoites were detected in the skin for up to 18 h after the bite. Conclusion This study, in which we visualized the probing and engorgement phases of Anopheles gambiae blood meals, provides precise information about the behavior of the insect as a function of its infection status and the presence or absence of anti-saliva antibodies. It also provides insight into the possible consequences of the inflammatory reaction for blood feeding and pathogen transmission. PMID:23272060

  11. Depletion of the ozone layer: consequences for non-infectious human diseases.

    PubMed

    Bentham, G

    1993-01-01

    Stratospheric ozone depletion threatens to increase exposure to ultraviolet (UV) radiation which is known to be a factor in a number of diseases. There is little doubt that cumulative exposure to UV radiation is important in the aetiology of non-melanoma skin cancers. Evidence is also strong for a link with cutaneous malignant melanoma, although here it appears to be intermittent intense exposure that is most damaging. More controversial is the view that exposure to solar radiation is a significant factor in ocular damage, particularly in the formation of cataracts. Earlier studies pointing to such an effect have been criticized and alternative aetiological hypotheses have been proposed. However, other studies do show an effect of UV exposure on cortical cataract. Concern is also growing that UV may be capable of activating viruses and have immunological effects that might exacerbate infectious disease. Very worrying is the possibility that UV exposure can activate the human immunodeficiency virus which might accelerate the onset AIDS. Any such health effects that have been observed in human populations are the result of exposure to existing, naturally occurring levels of UV radiation. There is, therefore, great concern about the possible exacerbation of these impacts as a result of increased exposure to UV radiation associated with stratospheric ozone depletion. However, any assessment of the nature and scale of such impacts on human health has to deal with several major problems and these are the focus of this paper. There are uncertainties about recent trends in stratospheric ozone and problems in the prediction of future changes.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Monocytes loaded with indocyanine green as active homing contrast agents permit optical differentiation of infectious and non-infectious inflammation.

    PubMed

    Christensen, Joani M; Brat, Gabriel A; Johnson, Kristine E; Chen, Yongping; Buretta, Kate J; Cooney, Damon S; Brandacher, Gerald; Lee, W P Andrew; Li, Xingde; Sacks, Justin M

    2013-01-01

    Distinguishing cutaneous infection from sterile inflammation is a diagnostic challenge and currently relies upon subjective interpretation of clinical parameters, microbiological data, and nonspecific imaging. Assessing characteristic variations in leukocytic infiltration may provide more specific information. In this study, we demonstrate that homing of systemically administered monocytes tagged using indocyanine green (ICG), an FDA-approved near infrared dye, may be assessed non-invasively using clinically-applicable laser angiography systems to investigate cutaneous inflammatory processes. RAW 264.7 mouse monocytes co-incubated with ICG fluoresce brightly in the near infrared range. In vitro, the loaded cells retained the ability to chemotax toward monocyte chemotactic protein-1. Following intravascular injection of loaded cells into BALB/c mice with induced sterile inflammation (Complete Freund's Adjuvant inoculation) or infection (Group A Streptococcus inoculation) of the hind limb, non-invasive whole animal imaging revealed local fluorescence at the inoculation site. There was significantly higher fluorescence of the inoculation site in the infection model than in the inflammation model as early as 2 hours after injection (p<0.05). Microscopic examination of bacterial inoculation site tissue revealed points of near infrared fluorescence, suggesting the presence of ICG-loaded cells. Development of a non-invasive technique to rapidly image inflammatory states without radiation may lead to new tools to distinguish infectious conditions from sterile inflammatory conditions at the bedside.

  13. Dynamic evaluation of alimentary-dependent risk factors of chronic non-infectious diseases in population survey.

    PubMed

    Agbalyan, E V; Buganov, A A

    2007-01-01

    The aim of the study was to research the incidence of alimentary risk factors (RF) of chronic noninfectious diseases under severe conditions of complex climatoecologic and biogeochemical factors of the Far North. The representative sample of 2,094 Nadym-city non-Natives (Yamalo-Nenets Autonomous Okrug) aged 20-59 was examined. In the first cross-sectional study, 1,093 persons (39.1% of men and 60.9% of women)--and in the last screening 1,001 persons (33.9% of men and 66.1% of women)--were examined. The RF presence was established on the basis of the following criteria: arterial hypertension (WHO, ISAH (1999)) was defined at blood pressure levels > or = 140-90 mmHg. Persons who finished antihypertensive treatment no later than two weeks before examination were also referred to this group. Excessive body mass for both men and women was defined at Quetlet index > or = 29.0 kg/m2, hypercholesterolemia at plasma cholesterol level > or = .5 mmol/l, hypertriglyceridemia at triglyceride level > or = 2.26 mmol/ l, hypoalphacholesterolemia at high density lipoproteins cholesterol level < or = 0.88 mmol/l, and hypercholesterolemia of low density lipoproteids at low density lipoproteids cholesterol level > or = 4.1 mmol/l. The results of research revealed high incidence of alimentary-dependent RF of chronic noninfectious diseases. In six-year dynamics, the increase of dislipoproteidemias for 18.1% (31.3% vs. 26.5%), high incidence of arterial hypertension (31.0% vs. 38.5%), and excessive body mass (33.3% vs. 30.6%) were assessed. High incidence of alimentary-dependent RF of chronic noninfectious diseases is the direct consequence of unsatisfactory, misbalanced nutrition. In programs aimed at prevention of alimentary-dependent diseases the priority should be given to non-pharmacological (or non-medicamentous) methods, and, first of all, to dietologic methods aimed at correcting the nutrition structure in the population.

  14. [The specific features of the development of chronic non-infectious diseases in mechanics at the petrochemical plants].

    PubMed

    Gizatullina, D F; Karimova, L K; Iakhina, R R; Akhmetshina, V T

    2011-01-01

    The present-day petrochemical plant workers, such as 533 process installation repairmen and 332 control instrumentation and automation installation repairmen, were the subjects of the study. The working conditions and the specific features of the formation of non-communicable diseases were examined in the workers of the above occupations. The specific features of the development of musculoskeletal and circulatory diseases and hearing impairments were revealed in the workers depending on the conditions and nature of their work. The data were statistically processed using the correlation coefficient r and the chi2 test at p < 0.05. The parameters were standardized for the examinees' age. During the study, the authors accepted the hypothesis that working conditions affected the prevalence of individual types of chronic non-communicable diseases in process installation repairmen.

  15. DIFFERENTIAL DIAGNOSIS OF DEEP GLUTEAL PAIN IN A FEMALE RUNNER WITH PELVIC INVOLVEMENT: A CASE REPORT

    PubMed Central

    Podschun, Laura; Kolber, Morey J.; Garcia, Ashley; Rothschild, Carey E.

    2013-01-01

    Background: Gluteal injuries, proximal hamstring injuries, and pelvic floor disorders have been reported in the literature among runners. Some suggest that hip, pelvis, and/or groin injuries occur in 3.3% to 11.5% of long distance runners. The purpose of this case report is to describe the differential diagnosis and treatment approach for a patient presenting with combined hip and pelvic pain. Case description: A 45-year-old female distance runner was referred to physical therapy for proximal hamstring pain that had been present for several months. This pain limited her ability to tolerate sitting and caused her to cease running. Examination of the patient's lumbar spine, pelvis, and lower extremity led to the initial differential diagnosis of hamstring syndrome and ischiogluteal bursitis. The patient's primary symptoms improved during the initial four visits, which focused on education, pain management, trunk stabilization and gluteus maximus strengthening, however pelvic pain persisted. Further examination led to a secondary diagnosis of pelvic floor hypertonic disorder. Interventions to address the pelvic floor led to resolution of symptoms and return to running. Outcomes: Pain level on the Visual Analog Scale decreased from 7/10 to 1/10 over the course of treatment. The patient was able to return to full sport activity and improved sitting tolerance to greater then two hours without significant discomfort. Discussion: This case suggests the interdependence of lumbopelvic and lower extremity kinematics in complaints of hamstring, posterior thigh and pelvic floor disorders. This case highlights the importance of a thorough examination as well as the need to consider a regional interdependence of the pelvic floor and lower quarter when treating individuals with proximal hamstring pain. Level of Evidence: Level 4 PMID:24175132

  16. Monocytes Loaded with Indocyanine Green as Active Homing Contrast Agents Permit Optical Differentiation of Infectious and Non-Infectious Inflammation

    PubMed Central

    Christensen, Joani M.; Brat, Gabriel A.; Johnson, Kristine E.; Chen, Yongping; Buretta, Kate J.; Cooney, Damon S.; Brandacher, Gerald; Lee, W. P. Andrew; Li, Xingde; Sacks, Justin M.

    2013-01-01

    Distinguishing cutaneous infection from sterile inflammation is a diagnostic challenge and currently relies upon subjective interpretation of clinical parameters, microbiological data, and nonspecific imaging. Assessing characteristic variations in leukocytic infiltration may provide more specific information. In this study, we demonstrate that homing of systemically administered monocytes tagged using indocyanine green (ICG), an FDA-approved near infrared dye, may be assessed non-invasively using clinically-applicable laser angiography systems to investigate cutaneous inflammatory processes. RAW 264.7 mouse monocytes co-incubated with ICG fluoresce brightly in the near infrared range. In vitro, the loaded cells retained the ability to chemotax toward monocyte chemotactic protein-1. Following intravascular injection of loaded cells into BALB/c mice with induced sterile inflammation (Complete Freund’s Adjuvant inoculation) or infection (Group A Streptococcus inoculation) of the hind limb, non-invasive whole animal imaging revealed local fluorescence at the inoculation site. There was significantly higher fluorescence of the inoculation site in the infection model than in the inflammation model as early as 2 hours after injection (p<0.05). Microscopic examination of bacterial inoculation site tissue revealed points of near infrared fluorescence, suggesting the presence of ICG-loaded cells. Development of a non-invasive technique to rapidly image inflammatory states without radiation may lead to new tools to distinguish infectious conditions from sterile inflammatory conditions at the bedside. PMID:24282595

  17. A universal next generation sequencing protocol to generate non-infectious barcoded cDNA libraries from high containment RNA viruses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Several biosafety level (BSL)-3/4 pathogens are high consequence, single-stranded RNA viruses and their genomes, when introduced into permissive cells, are infectious. Moreover many of these viruses are Select Agents (SAs), and their genomes are also considered SAs. For this reason cDNAs and/or th...

  18. IDENTIFICATION AND CHARACTERIZATION OF INFECTIOUS AND NON-INFECTIOUS SUB-POPULATIONS OF ENCEPHALITIZOON INTESTINALIS SPORES PURIFIED FROM IN VITRO CELL CULTURE

    EPA Science Inventory

    Background: Encephalitizoon intestinalis spores were propagated in rabbit kidney (RK-13) cells and were purified using density gradient (Percoll [registered trademark]) centrifugation. Purified spores were enumeraged and aliquotted using flow cytometry with cell sorting for use...

  19. Medial collateral ligament bursitis in a 12-year-old girl.

    PubMed

    Barclay, Caroline; Springgay, Gemma; van Beek, Edwin J R; Rolf, Christer G

    2005-06-01

    A 12-year-old female athlete, training for an international career in pentathlon, was referred to our clinic because of 2 years of recurrent localized swelling and activity-related pain in the medial aspect of her right knee, since falling from a horse and hitting her knees on the ground. She had been examined by a number of doctors over this period and treated with physiotherapy without a proper diagnosis and with no improvement. She could run only very limited distances before excruciating pain and swelling, and she had to abandon participation in competitions. During rest, the swelling decreased but never disappeared entirely. Clinical examination revealed minor effusion and localized tenderness on palpation around the medial joint line. Magnetic resonance imaging showed fluid between the medial capsule and medial collateral ligament, but could not identify any connection to the joint. Arthroscopy revealed a cleavage in the posterior medial joint capsule, superior and close to the medial meniscus, that was connected to the medial collateral ligament bursa. The cleavage was simply expanded, which emptied the bursa, followed by compression bandage and ice for 2 weeks. An immediate positive effect was observed and she could run pain free without swelling within 3 weeks of surgery. Six months after surgery, there has been no recurrence. To our knowledge, this is the first time this injury has been described in a child.

  20. Blood serum transferrin concentration in cattle in various physiological states, in veal calves fed different amounts of iron, and in cattle affected by infectious and non-infectious diseases.

    PubMed

    Moser, M; Pfister, H; Bruckmaier, R M; Rehage, J; Blum, J W

    1994-08-01

    Transferrin (Tf) concentrations were determined in cattle in various physiological states, in energy-deficient (ketotic) cows, in situations of several acute and chronic infections, after endotoxin administration and in animals with bovine leucocyte adhesion deficiency (BLAD). Tf concentrations varied between 1.5 and 8.5 g/l and in healthy animals were in the range of 2.0 and 6.6 g/l. Tf concentrations in adult animals were smaller than in young animals and increased in veal calves with iron deficiency above 8 g/l, resulting in a negative correlation between Hb and Tf. In veal calves total iron binding capacity (TIBC) and Tf concentration were rather closely correlated (r = 0.63). Chronic infectious diseases (such as paratuberculosis) were characterized by relatively low Tf levels (below 2 g/l), while during acute infections, after endotoxin-administration and during ketosis Tf concentrations were not changed. PMID:7863732

  1. Arm Care. Relief and Prevention for Shoulder Tendonitis, Tennis Elbow, Bursitis and Wrist Sprain in Athletics and Other Activities.

    ERIC Educational Resources Information Center

    Nirschl, Robert P.

    The book provides a practical and meaningful treatment program for athletes involved in sports which injure the arm or shoulder to a high degree, such as tennis, baseball, swimming, raquetball, pole vaulting, javelin throwing, and weight training. The book's chapters present information on: (1) symptoms of injury; (2) the anatomy of injury; (3)…

  2. [Diseases of the extremities of swine in relationship to the floor condition with special reference to bursitis].

    PubMed

    Berner, H; Hermanns, W; Papsthard, E

    1990-02-01

    In 2 pig farms, 102 sows kept in single ranging on plain concrete floor, 168 sows kept in single ranging on cast-iron grates and 27 fattening pigs kept in group penning on concrete slatted floors were repeatedly examined for the incidence of auxiliary synovial bursae (ASB). The clinical examination was completed by radiological, patho-anatomical and histological examinations of the rear legs. In sows, ASB were found on two prominences of the bones: on the latero-plantar area of the calcaneum and the fourth tarsal bone as well as on the plantar tarsal sesamoid bone. ASB on the rear legs were found in 41.2% of the sows kept on plain concrete floor and in 59.5% of the sows kept on cast-iron grates. The ASB of the sows kept on cast-iron grates were larger than those of the sows kept on plain concrete floor. In 49% of the sows kept on plain concrete floor the skin covering the ASB was reddened, in 45% of the sows kept on cast-iron grates it was covered with scab. Injury and necrosis of the skin as well as injury of the ASB themselves were found only in animals kept on cast-iron grates and made up 5% of the cases. In 30% of the cases, palpation of the ASB induced defensive movement. The palpation of ball-shaped, soft bursae more often caused defensive movement than did the palpation of flat-shaped, hard bursae. The occurrence of ASB was combined with kyphosis of the spine, false posture of the rear legs, dystasia, hyperextension of the fetlock, arthrosis of the ankle joint, and anomalies of the claws. In fattening pigs, the ASB were localized at the lateroplantar area of the calcaneum and the fourth tarsal bone as well as at the posterior surface of the calcaneum. At the end of the fattening period, ASB were detected in 26 out of 27 fattening pigs. All of the 48 ASB that were examined histologically showed signs of inflammation. In 30 cases the inflammation was chronic, in 18 cases it turned out to be florid. The results indicate that ASB cause pain during the developing phase and also in the chronic stage.

  3. Factors associated with regional rheumatic pain disorders in a population of Puerto Ricans with diabetes mellitus

    PubMed Central

    Font, Yvonne M.; Castro-Santana, Lesliane E.; Nieves-Plaza, Mariely; Maldonado, Mirna; Mayor, Ángel M.

    2015-01-01

    The aim of the study was to determine the prevalence and factors associated with bursitis/tendonitis disorders in Puerto Ricans with diabetes mellitus (DM). A cross-sectional study was performed in 202 adult Puerto Ricans (100 DM patients and 102 non-diabetic subjects). For each participant, a complete medical history and a musculoskeletal exam were systematically performed. Socio-demographic parameters, health-related behaviors, comorbidities, and pharmacotherapy were determined for all subjects. For DM patients, disease duration, glycemic control, and DM long-term complications were also examined. Multivariate logistic regression analyses were used to determine the factors associated with bursitis/tendonitis disorders. The mean (SD) age for DM patients and non-diabetic controls were 53.3 (12.9) and 50.0 (13.1) years; 64.0 and 64.7 % of DM patients and controls were females, respectively. Overall, the prevalence of bursitis/tendonitis was higher in DM patients than among non-diabetics (59.0 % vs. 29.4 %, p<0.01). In multivariate analyses, DM patients had 2.47 (95 % CI 1.05, 5.84) the odds of having bursitis/tendonitis as compared to non-diabetics. Specifically, DM patients had a higher frequency of flexor tenosynovitis, De Quervain’s tenosynovitis, lateral epicondylitis, medial epicondylitis, trochanteric bursitis, and anserine bursitis than non-diabetic subjects (p<0.05). Among DM patients, multivariate analyses showed that those with bursitis/tendonitis were more likely to be female [OR (95 % CI) 4.55 (1.42, 14.55)] and have peripheral vascular disease [OR (95 % CI) 8.48 (1.71, 41.93)]. In conclusion, bursitis/tendonitis disorders were common in this population of Hispanics with DM. Among DM patients, bursitis/tendonitis disorders were more frequent in women and those with long-term complications such as peripheral vascular disease. PMID:24522480

  4. Subscapular elastofibroma in a young pitcher. A case report.

    PubMed

    Haney, T C

    1990-01-01

    Subscapular elastofibromas and scapulothoracic bursitis can cause symptomatic masses in baseball pitchers. Both processes appear to represent reactive soft tissue responses to repetitive stress at the inferior border of the scapula. It is assumed that most masses in the subscapular area represent scapulothoracic bursitis rather than an elastofibroma. However, it is possible that some of the masses treated conservatively as scapulothoracic bursitis may be elastofibromas. A study is currently under way to evaluate the incidence of subscapular masses in college and professional pitchers in the United States. A follow-up report is anticipated when the study has been completed. The author requests information concerning any confirmed cases of elastofibroma in baseball pitchers.

  5. Integrating Targeted MedlinePlus Health Prescriptions Into Clinic Practice Workflow

    ClinicalTrials.gov

    2016-09-29

    Allergic Rhinitis; Asthma; Back Pain; Benign Prostatic Hypertrophy; Bursitis; Depression; Anxiety; Diabetes Mellitus; Esophageal Reflux; HIV Infections; Hyperlipidemia; Hypertension; Insomnia; Irritable Bowel Syndrome; Obesity; Osteoporosis (Senile); Shoulder Pain; Sinusitis; Symptomatic Menopause; Urinary Incontinence; Urinary Tract Infection; Vaginitis

  6. Elbow pain

    MedlinePlus

    Pain - elbow ... Elbow pain can be caused by many problems. A common cause in adults is tendinitis . This is inflammation and ... a partial dislocation ). Other common causes of elbow pain are: Bursitis -- inflammation of a fluid-filled cushion ...

  7. Shoulder Injuries and Disorders

    MedlinePlus

    ... bursitis, torn rotator cuffs, frozen shoulder, fractures and arthritis. Usually shoulder problems are treated with RICE. This stands for Rest, Ice, Compression and Elevation. Other treatments include exercise, medicines to reduce pain and swelling, and surgery ...

  8. Hip Injuries and Disorders

    MedlinePlus

    ... or falling can all sometimes lead to hip injuries. These include Strains Bursitis Dislocations Fractures Certain diseases also lead to hip injuries or problems. Osteoarthritis can cause pain and limited ...

  9. Arm Injuries and Disorders

    MedlinePlus

    ... of muscles, joints, tendons and other connective tissue. Injuries to any of these parts of the arm ... a fall or an accident. Types of arm injuries include Tendinitis and bursitis Sprains Dislocations Broken bones ...

  10. Sprains

    MedlinePlus

    ... JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: Goldman L, Schafer AI, eds. Goldman's Cecil ... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ...

  11. Ways to Prevent Percussion Overuse Injuries

    ERIC Educational Resources Information Center

    Fidyk, Steve

    2009-01-01

    It is a proven fact that the repetitive nature of percussion playing can cause carpal tunnel syndrome, bursitis, and tendinitis. This paper offers ways to prevent percussion overuse injuries, particularly by developing a healthy warmup routine.

  12. Arthritis and Rheumatic Diseases

    MedlinePlus

    ... Bursitis and Tendinitis, Q&A Fibromyalgia, Q&A Gout, Q&A Juvenile Arthritis, Q&A Childhood Arthritis ( ... Many people also experience fatigue and sleep disturbances. Gout. A type of arthritis resulting from deposits of ...

  13. ARTHROSCOPY OF THE SCAPULOTHORACIC JOINT: CASE REPORTS

    PubMed Central

    Andreoli, Carlos Vicente; Ejnisman, Benno; Pochini, Alberto de Castro; Monteiro, Gustavo Cará; Cohen, Moisés; Faloppa, Flávio

    2015-01-01

    Scapulothoracic arthroscopy is a procedure presenting restricted indications, for resecting free bodies, benign tumors, bursitis, and snaping scapula. The authors report four cases of scapulothoracic joint arthroscopy; in the first case, only a benign tumor (osteochondroma) could be visualized; in the second case, arthroscopic resection of an osteochondroma was found; in the third case, arthroscopic bursectomy due to scapulothoracic bursitis, and; in the fourth case, bursectomy and partial superomedial arthroscopic scapulectomy due to snaping scapula. PMID:27022519

  14. Factors associated with regional rheumatic pain disorders in a population of Puerto Ricans with diabetes mellitus.

    PubMed

    Font, Yvonne M; Castro-Santana, Lesliane E; Nieves-Plaza, Mariely; Maldonado, Mirna; Mayor, Angel M; Vilá, Luis M

    2014-07-01

    The aim of the study was to determine the prevalence and factors associated with bursitis/tendonitis disorders in Puerto Ricans with diabetes mellitus (DM). A cross-sectional study was performed in 202 adult Puerto Ricans (100 DM patients and 102 non-diabetic subjects). For each participant, a complete medical history and a musculoskeletal exam were systematically performed. Socio-demographic parameters, health-related behaviors, comorbidities, and pharmacotherapy were determined for all subjects. For DM patients, disease duration, glycemic control, and DM long-term complications were also examined. Multivariate logistic regression analyses were used to determine the factors associated with bursitis/tendonitis disorders. The mean (SD) age for DM patients and non-diabetic controls were 53.3 (12.9) and 50.0 (13.1) years; 64.0 and 64.7 % of DM patients and controls were females, respectively. Overall, the prevalence of bursitis/tendonitis was higher in DM patients than among non-diabetics (59.0 % vs. 29.4 %, p < 0.01). In multivariate analyses, DM patients had 2.47 (95 % CI 1.05, 5.84) the odds of having bursitis/tendonitis as compared to non-diabetics. Specifically, DM patients had a higher frequency of flexor tenosynovitis, De Quervain's tenosynovitis, lateral epicondylitis, medial epicondylitis, trochanteric bursitis, and anserine bursitis than non-diabetic subjects (p < 0.05). Among DM patients, multivariate analyses showed that those with bursitis/tendonitis were more likely to be female [OR (95 % CI) 4.55 (1.42, 14.55)] and have peripheral vascular disease [OR (95 % CI) 8.48 (1.71, 41.93)]. In conclusion, bursitis/tendonitis disorders were common in this population of Hispanics with DM. Among DM patients, bursitis/tendonitis disorders were more frequent in women and those with long-term complications such as peripheral vascular disease.

  15. The Role of Gender in Uveitis and Ocular Inflammation

    PubMed Central

    Yeung, Ian YL; Popp, Nicholas A; Chan, Chi-Chao

    2015-01-01

    Uveitides can be due to non-infectious and infectious etiologies. It has been observed that there is a gender difference with a greater preponderance of non-infectious uveitis in women than in men. This review will describe both non-infectious and infectious uveitides and describes some of the current autoimmune mechanisms thought to be underlying the gender difference. It will specifically look at non-infectious uveitides with systemic involvement including juvenile idiopathic arthritis, spondyloarthopathies, sarcoidosis, Behçet’s disease, and Vogt-Koyanagi-Harada disease and at uveitides without systemic involvement including sympathetic ophthalmia, birdshot chorioretinitis, and the white dot syndromes. Infectious uveitides like acute retinal necrosis, progressive outer retinal necrosis, and cytomegalovirus mediated uveitis will be mentioned. Different uveitides with female- or male- predominance are presented and discussed. PMID:26035764

  16. Arthroscopic treatment of bilateral snapping scapula syndrome: a case report and review of the literature.

    PubMed

    Freche, Sven; Juch, Franziska; Nusselt, Thomas; Delank, Karl Stefan; Hagel, Alexander

    2015-01-01

    Snapping scapula syndrome represents a rare entity in shoulder surgery. Clinically, it presents as shoulder pain and loud crepitus during shoulder movement. Moreover, glenohumeral bursitis can cause additional pain. Snapping scapula syndrome is caused by an increased angulation of the superomedial part of the scapula combined with bursitis. Other common causes such as subscapular osteochondroma or rib fracture non-unions were excluded. We report a 24-year-old female patient with persisting shoulder pain and disturbing crepitus during movement of the left shoulder. Radiographic examination revealed increased angulation of the superomedial scapula on both sides and MRI, bursitis of the left shoulder. The patient was successfully treated with minimally invasive arthroscopic trimming of the prominent osseous formation at the left scapula combined with bursectomy. Additionally, specific pain-adapted physiotherapeutic exercises of both shoulders were performed. The patient had a pain-free shoulder movement without crepitus on both sides at the 6th month follow-up. PMID:25803260

  17. MR imaging of the elbow in the injured athlete.

    PubMed

    Wenzke, Daniel R

    2013-03-01

    This article summarizes key MR imaging findings in common athletic elbow injuries including little leaguer's elbow, Panner disease, osteochondritis dissecans, olecranon stress fracture, occult fracture, degenerative osteophyte formation, flexor-pronator strain, ulnar collateral ligament tear, lateral ulnar collateral ligament and radial collateral ligament tear, lateral epicondylitis, medial epicondylitis, biceps tear, bicipitoradial bursitis, triceps tear, olecranon bursitis, ulnar neuropathy, posterior interosseous nerve syndrome, and radial tunnel syndrome. The article also summarizes important technical considerations in elbow MR imaging that enhance image quality and contribute to the radiologist's success.

  18. Disseminated protothecosis in a Mexican child.

    PubMed

    Tello-Zavala, María Concepción; Mercado-Lara, Araceli; Gómez-Hernández, Nadia; Recio-Martinez, Veronica

    2013-12-01

    Protothecosis is a rare human infection. There are 3 clinical forms: cutaneous, olecranon bursitis and systemic. Here we present the first case of disseminated protothecosis in Mexico in an immunocompetent girl whose lesions were mostly dermatologic. The patient was successfully treated with amphotericin B colloidal dispersion and gentamicin, followed by itraconazole. PMID:23836139

  19. Indomethacin

    MedlinePlus

    ... the spine). Indomethacin is also used to treat pain in the shoulder caused by bursitis (inflammation of a fluid-filled sac in the shoulder joint) and tendinitis (inflammation of the tissue that connects ... (attacks of severe joint pain and swelling caused by a build-up of ...

  20. Sulindac

    MedlinePlus

    ... the spine). Sulindac also is used to treat pain in the shoulder caused by bursitis (inflammation of a fluid-filled sac in the shoulder joint) and tendinitis (inflammation of the tissue that connects ... (attacks of severe joint pain and swelling caused by a build-up of ...

  1. 21 CFR 522.1881 - Prednisolone acetate.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... days for two or three doses. (2) Indications for use. The drug is indicated in the treatment of dogs... treatment of acute musculoskeletal inflammations such as bursitis, carpitis, and spondylitis. The drug is... used as supportive therapy pre- and postoperatively and for various stress conditions...

  2. Achilles Pain.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Five ailments which can cause pain in the achilles tendon area are: (1) muscular strain, involving the stretching or tearing of muscle or tendon fibers; (2) a contusion, inflammation or infection called tenosynovitis; (3) tendonitis, the inflammation of the tendon; (4) calcaneal bursitis, the inflammation of the bursa between the achilles tendon…

  3. Mycobacterium marinum Infection After Exposure to Coal Mine Water

    PubMed Central

    Huaman, Moises A.; Ribes, Julie A.; Lohr, Kristine M.; Evans, Martin E.

    2016-01-01

    Mycobacterium marinum infection has been historically associated with exposure to aquariums, swimming pools, fish, or other marine fauna. We present a case of M marinum left wrist tenosynovitis and elbow bursitis associated with a puncture injury and exposure to coal mine water in Illinois. PMID:26835478

  4. Mycobacterium marinum Infection After Exposure to Coal Mine Water.

    PubMed

    Huaman, Moises A; Ribes, Julie A; Lohr, Kristine M; Evans, Martin E

    2016-01-01

    Mycobacterium marinum infection has been historically associated with exposure to aquariums, swimming pools, fish, or other marine fauna. We present a case of M marinum left wrist tenosynovitis and elbow bursitis associated with a puncture injury and exposure to coal mine water in Illinois. PMID:26835478

  5. Lower Extremity Overuse Conditions Affecting Figure Skaters During Daily Training

    PubMed Central

    Campanelli, Valentina; Piscitelli, Francesco; Verardi, Luciano; Maillard, Pauline; Sbarbati, Andrea

    2015-01-01

    Background Most ice figure skaters train and compete with ongoing issues in the lower extremities, which are often overlooked by the skaters and considered injuries only when they prevent the athletes from skating. Although not severe, these conditions impair the quality of daily training and compromise the skaters’ state of mind and performances. Purpose (1) To determine the point prevalence of the ongoing lower extremity overuse conditions in a population of ice figure skaters of all ages and levels and (2) to identify the risk factors contributing to the development of the most common ongoing conditions. Study Design Cross-sectional study; Level of evidence, 3. Methods A total of 95 skaters of all ages and skating levels were evaluated in a single examination in the middle of the competitive season. Data collection consisted of a questionnaire, clinical examination, and measurement of the skaters’ characteristics and the equipment used. Results Retrocalcaneal bursitis was the most common problem, affecting at least 1 foot in 34% of the skaters evaluated, followed by posterior heel skin calluses and superficial calcaneal bursitis, which affected 29% and 28% of skaters, respectively. The prevalence of the majority of these conditions was 10% to 32% higher in elite skaters than in nonelite skaters. Higher boot–foot length difference was associated with greater risk of superficial calcaneal bursitis in the landing foot of elite skaters, while higher body weight and greater in-skate ankle flexibility were associated with the development of retrocalcaneal bursitis in nonelite skaters. Only 30 skaters (32%) wore the appropriate boot size, while 57 skaters (51%) could not dorsiflex their ankles properly while wearing skates. Conclusion The heel represents a major area of concern for the high prevalence of calcaneal bursitis and calluses in proximity of the Achilles tendon, suggesting that improvements on the boot heel cup design should take priority. The

  6. Localized Pigmented Villonodular Synovitis of the shoulder: a rare presentation of an uncommon pathology.

    PubMed

    Madruga Dias, João; Costa, Maria Manuela; Duarte, Artur; Pereira da Silva, José A

    2013-01-01

    Pigmented Vilonodular Synovitis is a rare clinical entity characterized as a synovial membrane benign tumour, despite possible aggressive presentation with articular destruction. The localized variant is four times less frequent and the shoulder involvement is uncommon. We present the case of a Caucasian 59 year-old patient, who presented with left shoulder pain, of uncharacteristic quality, with local swelling and marked functional limitation of 1 month duration. Shoulder ultrasonography showed subacromial bursitis. An ultrasound-guided aspiration was performed: synovial fluid was citrine-colored and translucid. One month later, the patient maintained swelling, pain and functional impairment of the left shoulder. New shoulder ultrasound revealed exuberant subacromial bursitis, which was again aspirated using ultrasound guidance. The synovial fluid was haematic, without changes in the cell count or biochemical analysis and cultural exams. We performed an injection with 60 mg of hexacetonide triamcinolone. Two months later there was a relapse, with shoulder ultrasonography once more showing subacromial bursitis with extensive synovial membrane proliferation. Shoulder MRI revealed subacromial bursitis involving the anterior, posterior and medial recesses, with deltoid distension, but without tendinous or intra-articular involvement. In the interior of the bursa hypointense images in T2 were observed, suggesting the diagnosis of Pigmented Vilonodular Synovitis. The patient had surgical bursectomy with success and without complications. The histological exam of the operatory piece confirmed the imaging diagnosis. Pigmented Vilonodular Synovitis is uncommon, rarely affecting the shoulder in a localized variant. It is a diagnosis to be considered in shoulder pain, especially if associated with recurrent subacromial bursitis. PMID:24016657

  7. Psoralen Inactivation of Viruses: A Process for the Safe Manipulation of Viral Antigen and Nucleic Acid.

    PubMed

    Schneider, Katherine; Wronka-Edwards, Loni; Leggett-Embrey, Melissa; Walker, Eric; Sun, Peifang; Ondov, Brian; Wyman, Travis H; Rosovitz, M J; Bohn, Sherry S; Burans, James; Kochel, Tadeusz

    2015-11-12

    High consequence human pathogenic viruses must be handled at biosafety level 2, 3 or 4 and must be rendered non-infectious before they can be utilized for molecular or immunological applications at lower biosafety levels. Here we evaluate psoralen-inactivated Arena-, Bunya-, Corona-, Filo-, Flavi- and Orthomyxoviruses for their suitability as antigen in immunological processes and as template for reverse transcription PCR and sequencing. The method of virus inactivation using a psoralen molecule appears to have broad applicability to RNA viruses and to leave both the particle and RNA of the treated virus intact, while rendering the virus non-infectious.

  8. Scleritis and Peripheral Ulcerative Keratitis

    PubMed Central

    Galor, Anat; Thorne, Jennifer E.

    2008-01-01

    Scleritis and peripheral ulcerative keratitis (PUK) can present as isolated conditions or as part of a systemic inflammatory or infectious disorder. Both are serious ocular conditions that can result in vision loss and therefore require early diagnosis and treatment. Nearly two-thirds of patients with non-infectious scleritis require systemic glucocorticoid therapy, and one fourth need a glucocorticoid-sparing agent, as well. Essentially all patients with non-infectious PUK require systemic glucocorticoids. Detailed clinical history, thorough physical examination, and thoughtful laboratory evaluations are all important in the exclusion of underlying disorders and extraocular involvement. PMID:18037120

  9. Pattern of dermatoses among inmates of district prison--Mangalore.

    PubMed

    Kuruvila, M; Shaikh, Mohammed Ismail; Kumar, Pramod

    2002-01-01

    The present paper studies the pattern of dermatoses among 225 inmates of a jail, over a period of 6 months (Feb- July' 99). 63.6% inmates screened had dermatoses. Among those with dermatoses 63.3% were infectious and 36.4% were non-infectious. Among the infections, fungal infections (51.3%) constituted the maximum. Pediculosis copitis was found in 6.6% of inmates. in the non-infectious group, pigmentary changes (21%) and dandruff (21%) were noted. Overcrowding prevalent in jail (73% excess inmates) could be contributory factor for the high incidence of infections. PMID:17656860

  10. Anserina Bursitis—A Treatable Cause of Knee Pain in Patients with Degenerative Arthritis

    PubMed Central

    Brookler, Morton I.; Mongan, Edward S.

    1973-01-01

    The anserina bursa is located on the medial surface of the tibia deep to the tendons of the sartorius, gracilis, and semimembranosus muscles and superficial to the insertion of the tibial collateral ligament. Knee pain, a palpable swelling of the bursa, and tenderness over the medial anterior aspect of the tibia just below the knee are the hallmarks of anserina bursitis. In a three-year period, 24 patients with anserina bursitis were seen in a rheumatology clinic. All but one were women, 18 were obese, and only four were under 50 years old. Knee x-ray studies showed degenerative arthritis in 20 of the 24 patients. In ten, varus knee deformities were present, while three had valgus deformities. Ultrasound or local steroid injections gave dramatic relief in all but one patient. PMID:4731586

  11. Imaging of the Bursae

    PubMed Central

    Hirji, Zameer; Hunjun, Jaspal S; Choudur, Hema N

    2011-01-01

    When assessing joints with various imaging modalities, it is important to focus on the extraarticular soft tissues that may clinically mimic joint pathology. One such extraarticular structure is the bursa. Bursitis can clinically be misdiagnosed as joint-, tendon- or muscle-related pain. Pathological processes are often a result of inflammation that is secondary to excessive local friction, infection, arthritides or direct trauma. It is therefore important to understand the anatomy and pathology of the common bursae in the appendicular skeleton. The purpose of this pictorial essay is to characterize the clinically relevant bursae in the appendicular skeleton using diagrams and corresponding multimodality images, focusing on normal anatomy and common pathological processes that affect them. The aim is to familiarize radiologists with the radiological features of bursitis. PMID:21966619

  12. Mining Internet search and social media for epidemiology

    EPA Science Inventory

    Many pervasive and multifactorial disorders of modern non-communicable and non-infectious diseases (i.e. obesity, asthma, migraine, autism) need to be better understood and explored. The cost of these disorders to the healthcare system and the general public’s quality of life are...

  13. Sensitization Sessions as the Foundation for Training Transformation Activities

    ERIC Educational Resources Information Center

    Stoloff, Sacha; Boulanger, Maude; Roy, Virginie; Rivard, Marie-Claude

    2015-01-01

    The worldwide rise in obesity makes this the first non-infectious epidemic in human history. The rapid increase is, in fact, influenced more by environment than biology. In an effort to halt the trend, Quebec has launched a major awareness-raising campaign that focuses on healthy environments and targets stakeholders in schools, municipalities,…

  14. Plant Disease Control by the Use of Chemicals. MP-27.

    ERIC Educational Resources Information Center

    Ross, William D.; Bridgmon, George H.

    This document has been prepared as a reference manual providing information regarding plant diseases. The text concerns itself with the identification and development of infectious and non-infectious diseases and associated control measures. An appendix includes a glossary of plant pathological terms and a bibliography. (CS)

  15. Cardio metabolic and immunological impacts of extra virgin olive oil consumption in overweight and obese older adults: a randomized controlled trial

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Both aging and obesity are related to dysregulated immune function which may be responsible for increased risk of infection and also chronic non-infectious diseases. Dietary lipids have been shown to impact immune and inflammatory responses and cardio-metabolic risk factors. No informati...

  16. Propidium monoazide reverse transcription PCR and RT-qPCR for detecting infectious enterovirus and norovirus

    EPA Science Inventory

    Presently there is no established cell line or small animal model that allows for the detection of infectious human norovirus. Current methods based on RT-PCR and RT-qPCR detect both infectious and non-infectious virus and thus the conclusions that may be drawn regarding the publ...

  17. [Pulmonary arterial hypertension associated to human immunodeficiency virus].

    PubMed

    Sandoval-Gutiérrez, José Luis; Santos-Martínez, Luis Efren; Rodríguez-Silverio, Juan; Baranda-Tovar, Francisco Martín; Rivera-Rosales, Rosa María; Flores-Murrieta, Francisco Javier

    2015-01-01

    From the advent of the highly effective antiretroviral treatment, the life expectancy of patients with human immunodeficiency virus has increased significantly. At present, the causes of death are non-infectious complications. Between them, the pulmonary arterial hypertension has a special importance. It is important early detection to establish the therapeutic, with the objective of preventing a fatal outcome to future. PMID:25577549

  18. Bilateral treponema periostitis.

    PubMed

    Bhatti, Anisuddin; Bhatti, Maqsood Ahmed; Mehboob, Ghulam

    2003-12-01

    Symmetrical exuberant periostitis is a rare disease caused by variety of infectious and non-infectious causes. Treponematosis is one of the rare causes of this condition. We report a patient who presented with left arm swelling, secondary to onion peel periostitis of the humerus, which was caused by Treponema species. PMID:15569562

  19. Hepatitis B Vaccination Protection

    MedlinePlus

    ... The hepatitis B vaccination is a non-infectious, vaccine prepared from recombinant yeast cultures, rather than human blood or plasma. There is no risk of contamination from other bloodborne pathogens nor is there any ... from the vaccine. The vaccine must be administered according to the ...

  20. [Pulmonary arterial hypertension associated to human immunodeficiency virus].

    PubMed

    Sandoval-Gutiérrez, José Luis; Santos-Martínez, Luis Efren; Rodríguez-Silverio, Juan; Baranda-Tovar, Francisco Martín; Rivera-Rosales, Rosa María; Flores-Murrieta, Francisco Javier

    2015-01-01

    From the advent of the highly effective antiretroviral treatment, the life expectancy of patients with human immunodeficiency virus has increased significantly. At present, the causes of death are non-infectious complications. Between them, the pulmonary arterial hypertension has a special importance. It is important early detection to establish the therapeutic, with the objective of preventing a fatal outcome to future.

  1. Biomedical solid waste management in an Indian hospital: a case study

    SciTech Connect

    Patil, Gayathri V. . E-mail: patilgayathripatil@rediffmail.com; Pokhrel, Kamala

    2005-07-01

    The objectives of this study were: (i) to assess the waste handling and treatment system of hospital bio-medical solid waste and its mandatory compliance with Regulatory Notifications for Bio-medical Waste (Management and Handling) Rules, 1998, under the Environment (Protection Act 1986), Ministry of Environment and Forestry, Govt. of India, at the chosen KLE Society's J. N. Hospital and Medical Research Center, Belgaum, India and (ii) to quantitatively estimate the amount of non-infectious and infectious waste generated in different wards/sections. During the study, it was observed that: (i) the personnel working under the occupier (who has control over the institution to take all steps to ensure biomedical waste is handled without any adverse effects to human health and the environment) were trained to take adequate precautionary measures in handling these bio-hazardous waste materials, (ii) the process of segregation, collection, transport, storage and final disposal of infectious waste was done in compliance with the Standard Procedures, (iii) the final disposal was by incineration in accordance to EPA Rules 1998 (iv) the non-infectious waste was collected separately in different containers and treated as general waste, and (v) on an average about 520 kg of non-infectious and 101 kg of infectious waste is generated per day (about 2.31 kg per day per bed, gross weight comprising both infectious and non-infectious waste). This hospital also extends its facility to the neighboring clinics and hospitals by treating their produced waste for incineration.

  2. Problem-Solving Skills among Precollege Students in Clinical Immunology and Microbiology: Classifying Strategies with a Rubric and Artificial Neural Network Technology.

    ERIC Educational Resources Information Center

    Kanowith-Klein, Susan; Stave, Mel; Stevens, Ron; Casillas, Adrian M.

    2001-01-01

    Investigates methods for classifying problem solving strategies of high school students who studied infectious and non-infectious diseases by using a software system that can generate a picture of students' strategies in solving problems. (Contains 24 references.) (Author/YDS)

  3. An extraction method for discrimination between infectious and inactive norovirus using RT-PCR

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Human noroviruses (NoVs) are known to bind to human histo-blood group antigens, as well as to chemically-similar porcine gastric mucins. The binding ability of NoV to porcine mucin was assessed as a novel means of distinguishing non-infectious viral particles from potentially infectious viral parti...

  4. Ofuji's disease in an immunocompetent patient successfully treated with dapsone

    PubMed Central

    Anjaneyan, Gopikrishnan; Manne, Sindhura; Panicker, Vinitha Varghese; Eapen, Malini

    2016-01-01

    Eosinophilic pustular folliculitis or Ofuji's disease is a non-infectious eosinophilic infiltration of hair follicles, which usually presents with itchy papules and pustules in a circinate configuration. We report this case of an immunocompetent patient with erythematous papules and plaques without macropustules diagnosed as eosinophilic pustular folliculitis—a rarely reported entity outside Japan. He was successfully treated with oral dapsone. PMID:27730038

  5. Bilateral treponema periostitis.

    PubMed

    Bhatti, Anisuddin; Bhatti, Maqsood Ahmed; Mehboob, Ghulam

    2003-12-01

    Symmetrical exuberant periostitis is a rare disease caused by variety of infectious and non-infectious causes. Treponematosis is one of the rare causes of this condition. We report a patient who presented with left arm swelling, secondary to onion peel periostitis of the humerus, which was caused by Treponema species.

  6. Mutations altering the gammaretrovirus endoproteolytic motif affect glycosylation of the envelope glycoprotein and early events of the virus life cycle

    SciTech Connect

    Argaw, Takele; Wilson, Carolyn A.

    2015-01-15

    Previously, we found that mutation of glutamine to proline in the endoproteolytic cleavage signal of the PERV-C envelope (RQKK to RPKK) resulted in non-infectious vectors. Here, we show that RPKK results in a non-infectious vector when placed in not only a PERV envelope, but also the envelope of a related gammaretrovirus, FeLV-B. The amino acid substitutions do not prevent envelope precursor cleavage, viral core and genome assembly, or receptor binding. Rather, the mutations result in the formation of hyperglycosylated glycoprotein and a reduction in the reverse transcribed minus strand synthesis and undetectable 2-LTR circular DNA in cells exposed to vectors with these mutated envelopes. Our findings suggest novel functions associated with the cleavage signal sequence that may affect trafficking through the glycosylation machinery of the cell. Further, the glycosylation status of the envelope appears to impact post-binding events of the viral life cycle, either membrane fusion, internalization, or reverse transcription. - Highlights: • Env cleavage signal impacts infectivity of gammaretroviruses. • Non-infectious mutants have hyper-glycosylated envelope that bind target cells. • Non-infectious mutants have defects in the formation of the double-stranded DNA. • Env cleavage motif has functions beyond cleavage of the env precursor.

  7. A 2-D guinea pig lung proteome map

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Guinea pigs represent an important model for a number of infectious and non-infectious pulmonary diseases. The guinea pig genome has recently been sequenced to full coverage, opening up new research avenues using genomics, transcriptomics and proteomics techniques in this species. In order to furth...

  8. Endoscopic proximal hamstring repair and ischial bursectomy.

    PubMed

    Dierckman, Brian D; Guanche, Carlos A

    2012-12-01

    With the significant increase in use of the arthroscope around the hip have come several less invasive techniques to manage pathologies around this joint. This technical note with a video details one such technique that allows for the endoscopic management of proximal hamstring tears and chronic ischial bursitis, which until now have been managed exclusively with much larger open approaches. This procedure allows for complete exposure of the posterior aspect of the hip in a safe, minimally invasive fashion. PMID:23766996

  9. Soft tissue problems in older adults.

    PubMed

    Holland, N W; Gonzalez, E B

    1998-08-01

    This article describes common soft tissue problems encountered in older adults, including fibromyalgia, selected bursitis/tendinitis syndromes, nerve entrapment syndromes, and miscellaneous topics such as Dupuytren's contractures, trigger fingers, palmar fasciitis, and reflex-sympathetic dystrophy. Clinical presentations, diagnosis, and treatment are emphasized. These are conditions that are frequently encountered but are generally diagnosed as arthritis or normal age-related problems. This article will hopefully enlighten the reader in distinguishing between these conditions.

  10. MedlinePlus Health Prescriptions: Developing a Pragmatic Approach for Clinic Use

    ClinicalTrials.gov

    2016-09-29

    Acne Vulgaris; Allergic Rhinitis; Anxiety; Asthma; Back Pain; Prostatic Hyperplasia; Bursitis; Chronic Obstructive Pulmonary Disease; Cough; Coronary Artery Disease; Depression; Diabetes Mellitus; Diarrhea; Gastroesophageal Reflux; Fibromyalgia; Headache; HIV Infections; Hypothyroidism; Hyperlipidemia; Hypertension; Influenza; Sleep Initiation and Maintenance Disorders; Irritable Bowel Syndrome; Migraine Disorders; Obesity; Obstructive Sleep Apnea; Osteoarthritis; Senile Osteoporosis; Shoulder Pain; Sinusitis; Smoking Cessation; Tobacco Use Cessation; Menopause; Urinary Incontinence; Urinary Tract Infection; Vaginitis; Vertigo

  11. The ''hot'' patella

    SciTech Connect

    Kipper, M.S.; Alazraki, N.P.; Feiglin, D.H.

    1982-01-01

    Increased patellar uptake on bone scans is seen quite commonly but the possible or probable etiologies of this finding have not been previously well described. A review of 100 consecutive bone scans showed that the incidence of bilateral ''hot'' patellae is 15%. Identified etiologies include osteoarthritic degenerative disease (35%), fracture, possible metastatic disease, bursitis, Paget's disease, and osteomyelitis. The value of careful history, physical examination, and radiographs is stressed.

  12. Soft-tissue rheumatism: diagnosis and treatment.

    PubMed

    Reveille, J D

    1997-01-27

    Soft tissue rheumatism is one of the most common and most misunderstood categories of disorders facing the primary care physician. Among the more common types are subacromial bursitis, epicondylitis, trochanteric bursitis, anserine bursitis, and fibromyalgia. The keys to the diagnosis of soft-tissue rheumatism are the history and, more importantly, the physical examination. Extensive laboratory testing and radiographs are not as helpful in evaluating patients with these complaints. Treatment consists of nonsteroidal anti-inflammatory drugs (NSAIDs) and nonnarcotic analgesics. Especially in patients with localized disorders, intralesional injections of corticosteroids are particularly effective and safe and should be part of the armamentarium of the primary care practitioner. Fibromyalgia is a particularly challenging form of nonarticular rheumatism. The clinical presentation is rather characteristic, with the patient typically being a woman 30-60 years of age who presents with diffuse somatic pain. Patients often give a history of sleep disturbance, may be depressed, and show characteristic tender areas, or trigger points. Laboratory findings are normal. Management includes reassurance, correction of the underlying sleep disturbance with low doses of a tricyclic antidepressant, treatment with muscle relaxants and nonnarcotic analgesics or NSAIDs, and an exercise program with a strong aerobic component.

  13. Markers for sepsis diagnosis in the forensic setting: state of the art

    PubMed Central

    Palmiere, Cristian; Augsburger, Marc

    2014-01-01

    Reliable diagnoses of sepsis remain challenging in forensic pathology routine despite improved methods of sample collection and extensive biochemical and immunohistochemical investigations. Macroscopic findings may be elusive and have an infectious or non-infectious origin. Blood culture results can be difficult to interpret due to postmortem contamination or bacterial translocation. Lastly, peripheral and cardiac blood may be unavailable during autopsy. Procalcitonin, C-reactive protein, and interleukin-6 can be measured in biological fluids collected during autopsy and may be used as in clinical practice for diagnostic purposes. However, concentrations of these parameters may be increased due to etiologies other than bacterial infections, indicating that a combination of biomarkers could more effectively discriminate non-infectious from infectious inflammations. In this article, we propose a review of the literature pertaining to the diagnostic performance of classical and novel biomarkers of inflammation and bacterial infection in the forensic setting. PMID:24778096

  14. [Procalcitonin, a new marker for bacterial infections].

    PubMed

    Ferrière, F

    2000-01-01

    Procalcitonin (PCT), the precursor protein of the hormone calcitonin, appears to be an early marker of the presence of severe systemic infection. High serum concentrations are associated with severe systemic bacterial, parasitic or fungal infections. In contrast, PCT is generally not induced by severe viral infections or inflammatory reactions of non-infectious origin. Hence, PCT can be used for differential diagnosis of bacterial and viral meningitis. PCT may be helpful in the differentiation between infectious and non-infectious origin of systemic inflammatory response syndrome (SIRS) and acute respiratory distress syndrome (ARDS), pancreatitis, cardiogenic shock and acute rejection of organ transplants. PCT monitoring may be useful in patients with high risk of bacterial infection (major surgery, trauma, immunocompromised patients). PCT is a very stable molecule in vitro, and its measurement requires only 20 ml of plasma or serum and can be done within 2 hours.

  15. Mutations altering the gammaretrovirus endoproteolytic motif affect glycosylation of the envelope glycoprotein and early events of the virus life cycle.

    PubMed

    Argaw, Takele; Wilson, Carolyn A

    2015-01-15

    Previously, we found that mutation of glutamine to proline in the endoproteolytic cleavage signal of the PERV-C envelope (RQKK to RPKK) resulted in non-infectious vectors. Here, we show that RPKK results in a non-infectious vector when placed in not only a PERV envelope, but also the envelope of a related gammaretrovirus, FeLV-B. The amino acid substitutions do not prevent envelope precursor cleavage, viral core and genome assembly, or receptor binding. Rather, the mutations result in the formation of hyperglycosylated glycoprotein and a reduction in the reverse transcribed minus strand synthesis and undetectable 2-LTR circular DNA in cells exposed to vectors with these mutated envelopes. Our findings suggest novel functions associated with the cleavage signal sequence that may affect trafficking through the glycosylation machinery of the cell. Further, the glycosylation status of the envelope appears to impact post-binding events of the viral life cycle, either membrane fusion, internalization, or reverse transcription.

  16. What happens to cardiovascular system behind the undetectable level of HIV viremia?

    PubMed

    d'Ettorre, Gabriella; Ceccarelli, Giancarlo; Pavone, Paolo; Vittozzi, Pietro; De Girolamo, Gabriella; Schietroma, Ivan; Serafino, Sara; Giustini, Noemi; Vullo, Vincenzo

    2016-01-01

    Despite the combined antiretroviral therapy has improved the length and quality of life of HIV infected patients, the survival of these patients is always decreased compared with the general population. This is the consequence of non-infectious illnesses including cardio vascular diseases. In fact large studies have indicated an increased risk of coronary atherosclerotic disease, myocardial infarction even in HIV patients on cART. In HIV infected patients several factors may contribute to the pathogenesis of cardiovascular problems: life-style, metabolic parameters, genetic predisposition, viral factors, immune activation, chronic inflammation and side effects of antiretroviral therapy. The same factors may also contribute to complicate the clinical management of these patients. Therefore, treatment of these non-infectious illnesses in HIV infected population is an emerging challenge for physicians. The purpose of this review is to focus on the new insights in non AIDS-related cardiovascular diseases in patients with suppressed HIV viremia. PMID:27127532

  17. What happens to cardiovascular system behind the undetectable level of HIV viremia?

    PubMed

    d'Ettorre, Gabriella; Ceccarelli, Giancarlo; Pavone, Paolo; Vittozzi, Pietro; De Girolamo, Gabriella; Schietroma, Ivan; Serafino, Sara; Giustini, Noemi; Vullo, Vincenzo

    2016-01-01

    Despite the combined antiretroviral therapy has improved the length and quality of life of HIV infected patients, the survival of these patients is always decreased compared with the general population. This is the consequence of non-infectious illnesses including cardio vascular diseases. In fact large studies have indicated an increased risk of coronary atherosclerotic disease, myocardial infarction even in HIV patients on cART. In HIV infected patients several factors may contribute to the pathogenesis of cardiovascular problems: life-style, metabolic parameters, genetic predisposition, viral factors, immune activation, chronic inflammation and side effects of antiretroviral therapy. The same factors may also contribute to complicate the clinical management of these patients. Therefore, treatment of these non-infectious illnesses in HIV infected population is an emerging challenge for physicians. The purpose of this review is to focus on the new insights in non AIDS-related cardiovascular diseases in patients with suppressed HIV viremia.

  18. Gastrointestinal Disorders Associated with Common Variable Immune Deficiency (CVID) and Chronic Granulomatous Disease (CGD)

    PubMed Central

    Uzzan, Mathieu; Ko, Huaibin M.; Mehandru, Saurabh; Cunningham-Rundles, Charlotte

    2016-01-01

    Common Variable Immune Deficiency (CVID) and Chronic Granulomatous Disease (CGD) are two of the well-characterized primary immune defects with distinct pathologic defects. While CVID is predominantly a disorder of the adaptive immune system, in CGD, innate immunity is impaired. In both syndromes, the clinical manifestations include an increased susceptibility to infections and a number of non-infectious, inflammatory conditions including systemic autoimmunity, as well as organ-specific pathology. Among the organ-associated disorders, gastrointestinal (GI) manifestations are one of the most intractable. As such, non-infectious inflammatory disorders of the GI tract are clinically challenging as they have protean manifestations, often resembling inflammatory bowel disease (IBD) or celiac disease, are notoriously difficult to treat, and hence are associated with significant morbidity and mortality. Therefore, assessing the pathogenesis, and defining appropriate therapeutic approaches for GI disease in patients with CVID and CGD is imperative. PMID:26951230

  19. [Pyoderma gangrenosum associated with rheumatoid arthritis: a case report].

    PubMed

    Beber, André Avelino Costa; Knob, Cristiane Faccin; Shons, Karen Regina Rosso; Neumaier, Walter; da Silva, João Carlos Nunes; Monticielo, Odirlei André

    2014-01-01

    Pyoderma gangrenosum is a chronic inflammatory dermatosis, which is associated with non-infectious systemic diseases such as rheumatoid arthritis and inflammatory bowel disease. It is more common in adults and may present with four distinct clinical forms, all leading to ulceration of the skin affected. Its diagnosis is clinical and demands exclusion of other causes. Treatment should be performed with local care and systemic therapy.

  20. Fever and rash in children: important diagnostic considerations.

    PubMed

    Gurion, R; Sabella, C; Zeft, A S

    2013-12-01

    The association of fever with illness has been known for years. A febrile child may have rash, and physicians need to know when this symptom combination is a benign versus a pathologic clinical presentation. In other terms, potential etiologies are either infectious or non-infectious. With scrupulous, methodical history taking and careful, serial physical examination, the treating physician will find hints to assess and solidify an appropriate diagnosis, and chose an appropriate treatment.

  1. Light Microscopy of the Hair: A Simple Tool to “Untangle” Hair Disorders

    PubMed Central

    Adya, Keshavmurthy A; Inamadar, Arun C; Palit, Aparna; Shivanna, Ragunatha; Deshmukh, Niranjan S

    2011-01-01

    Light microscopy of the hair forms an important bedside clinical tool for the diagnosis of various disorders affecting the hair. Hair abnormalities can be seen in the primary diseases affecting the hair or as a secondary involvement of hair in diseases affecting the scalp. Hair abnormalities also form a part of various genodermatoses and syndromes. In this review, we have briefly highlighted the light microscopic appearance of various infectious and non-infectious conditions affecting the hair. PMID:21769242

  2. Propidium monoazide reverse transcriptase PCR and RT-qPCR for detecting infectious enterovirus and norovirus.

    PubMed

    Karim, Mohammad R; Fout, G Shay; Johnson, Clifford H; White, Karen M; Parshionikar, Sandhya U

    2015-07-01

    Presently there is no established cell line or small animal model that allows for the detection of infectious human norovirus. Current methods based on RT-PCR and RT-qPCR detect both infectious and non-infectious virus and thus the conclusions that may be drawn regarding the public health significance of positive findings are limited. In this study, PMA RT-PCR and RT-qPCR assays were evaluated for selective detection of infectious poliovirus, murine norovirus (MNV-1), and Norwalk virus. Viruses were inactivated using heat, chlorine, and ultraviolet light (UV). Infectious and non-infectious viruses were treated with PMA before RT-PCR and RT-qPCR. PMA RT-PCR was able to differentiate selectively between infectious and heat and chlorine inactivated poliovirus. PMA RT-PCR was able to differentiate selectively between infectious and noninfectious murine norovirus only when inactivated by chlorine. However, PMA RT-PCR could not differentiate infectious Norwalk virus from virus particles rendered non-infectious by any treatment. PMA RT-PCR assay was not able to differentiate between infectious and UV inactivated viruses suggesting that viral capsid damage may be necessary for PMA to enter and bind to the viral genome. PMA RT-PCR on naked MNV-1 and Norwalk virus RNA suggest that PMA RT-PCR can be used to detect intact, potentially infectious MNV-1 and Norwalk viruses and can be used to exclude the detection of free viral RNA by PCR assay. PMID:25796356

  3. Innate danger signals in acute injury: From bench to bedside.

    PubMed

    Fontaine, Mathieu; Lepape, Alain; Piriou, Vincent; Venet, Fabienne; Friggeri, Arnaud

    2016-08-01

    The description of the systemic inflammatory response syndrome (SIRS) as a reaction to numerous insults marked a turning point in the understanding of acute critical states, which are intensive care basic cases. This concept highlighted the final inflammatory response features whichever the injury mechanism is: infectious, or non-infectious such as extensive burns, traumas, major surgery or acute pancreatitis. In these cases of severe non-infectious insult, many endogenous mediators are released. Like infectious agents components, they can activate the immune system (via common signaling pathways) and initiate an inflammatory response. They are danger signals or alarmins. These molecules generally play an intracellular physiological role and acquire new functions when released in extracellular space. Many progresses brought new information on these molecules and on their function in infectious and non-infectious inflammation. These danger signals can be used as biomarkers and provide new pathophysiological and therapeutic approaches, particularly for immune dysfunctions occurring after an acute injury. We present herein the danger model, the main danger signals and the clinical consequences.

  4. Frequency of sacroiliitis among patients with low back pain

    PubMed Central

    Owlia, Mohammad Bagher; Danesh-Ardakani, Mitra

    2016-01-01

    Introduction Sacroiliitis is one of the important symptoms in patients attending infectious diseases and rheumatology clinics. Some patients with sacroiliitis are asymptomatic, and some have unspecific symptoms. The aim of this study was to determine the frequency of sacroiliitis causes among patients attending Shahid Sadoughi’s infectious disease and rheumatology clinics. Methods In this study, we evaluated patients attending Shahid Sadoughi rheumatology and infectious diseases clinic in 2014. Patients who had positive findings in favor of sacroiliitis were evaluated by history, physical exam, laboratory tests, and imaging. The patients were divided into infectious, inflammatory non-infectious, and degenerative causes. The data were analyzed by IBM SPSS version 20 using the independent samples t-test, ANOVA, the chi-squared test, and the Fisher’s exact test. Results We studied 136 patients. Among them 64 (47.1%) were male, and 72 (52.9%) were female. The mean age of the participants was 34.28 ± 10.36 years. Among the patients, 12 (8.8%) had infectious causes, 120 (88.2%) had inflammatory non-infectious causes, and four (2.9%) had degenerative causes. Conclusion Based on our results, inflammatory non-infectious causes are at the top of the list of sacroiliitis causes, but we should always consider infectious causes, including brucellosis. PMID:27123217

  5. Intraocular Implants for the Treatment of Autoimmune Uveitis

    PubMed Central

    Lee, Darren J.

    2015-01-01

    Uveitis is the third leading cause of blindness in developed countries. Currently, the most widely used treatment of non-infectious uveitis is corticosteroids. Posterior uveitis and macular edema can be treated with intraocular injection of corticosteroids, however, this is problematic in chronic cases because of the need for repeat injections. Another option is systemic immunosuppressive therapies that have their own undesirable side effects. These systemic therapies result in a widespread suppression of the entire immune system, leaving the patient susceptible to infection. Therefore, an effective localized treatment option is preferred. With the recent advances in bioengineering, biodegradable polymers that allow for a slow sustained-release of a medication. These advances have culminated in drug delivery implants that are food and drug administration (FDA) approved for the treatment of non-infectious uveitis. In this review, we discuss the types of ocular implants available and some of the polymers used, implants used for the treatment of non-infectious uveitis, and bioengineered alternatives that are on the horizon. PMID:26264035

  6. Ultrasound assessment of new onset bilateral painful shoulder in patients with polymyalgia rheumatica and rheumatoid arthritis.

    PubMed

    Ruta, Santiago; Rosa, Javier; Navarta, David A; Saucedo, Carla; Catoggio, Luis J; Monaco, Ricardo García; Soriano, Enrique R

    2012-09-01

    The aim of our study was to investigate by ultrasound (US) the anatomical structures affected during a new episode of bilateral painful shoulder in patients with polymyalgia rheumatica (PMR) and rheumatoid arthritis (RA) and to compare the findings between these two conditions. PMR and RA patients complaining of new onset bilateral painful shoulder were included. Subjects without any known rheumatic condition with a new onset unilateral painful shoulder were assessed as a control group. US evaluation includes the depiction subacromial-subdeltoid (SAD) bursitis, long head biceps (LHB) tenosynovitis and/or gleno-humeral (GH) synovitis. Thirty patients with PMR, 30 with RA, and 60 controls were included for a total of 60 shoulders per group. Unilateral SAD bursitis and LHB tenosynovitis were significantly more frequent in patients with PMR when compared to those with RA (p < 0.0001 and p < 0.01, respectively) and controls (p < 0.001 and p < 0.01, respectively). Unilateral GH synovitis was more common in RA than in PMR and controls (p < 0.05 and p < 0.01, respectively). Bilateral SAD bursitis was significantly more frequent in patients with PMR than in those with RA (p < 0.01) as was bilateral LHB tenosynovitis (p < 0.01). No significant differences were found in bilateral GH synovitis. US-detected periarticular inflammatory involvement more frequently in PMR both unilaterally and bilaterally and intra-articular inflammatory involvement was commonly in RA but only unilaterally.

  7. Human cutaneous protothecosis: report of a case and literature review.

    PubMed

    Seok, Jae Yeon; Lee, Yoonho; Lee, Hyukmin; Yi, Sang Yeop; Oh, Hwa Eun; Song, Ji-Sun

    2013-12-01

    The Prototheca species is achlorophyllic algae and rarely causes human infection. Human protothecosis presents clinically as a cutaneous infection, olecranon bursitis, and disseminated systemic disease. We report a case of human cutaneous protothecosis involving the left wrist. A 68-year-old man presented with an ill-defined erythematous lesion with crust at the dorsal aspect of his left wrist. A punch biopsy was performed to reveal the histologic features of granulomatous inflammation with necrosis at the upper dermis, containing Prototheca organisms, of which, the characteristic features were highlighted by special staining. Through a molecular study, the Prototheca zopfii species was identified. PMID:24421852

  8. Human Cutaneous Protothecosis: Report of a Case and Literature Review

    PubMed Central

    Seok, Jae Yeon; Lee, Yoonho; Lee, Hyukmin; Yi, Sang Yeop; Oh, Hwa Eun

    2013-01-01

    The Prototheca species is achlorophyllic algae and rarely causes human infection. Human protothecosis presents clinically as a cutaneous infection, olecranon bursitis, and disseminated systemic disease. We report a case of human cutaneous protothecosis involving the left wrist. A 68-year-old man presented with an ill-defined erythematous lesion with crust at the dorsal aspect of his left wrist. A punch biopsy was performed to reveal the histologic features of granulomatous inflammation with necrosis at the upper dermis, containing Prototheca organisms, of which, the characteristic features were highlighted by special staining. Through a molecular study, the Prototheca zopfii species was identified. PMID:24421852

  9. Olecranon extrabursal endoscopic bursectomy.

    PubMed

    Tu, Chen G; McGuire, Duncan T; Morse, Levi P; Bain, Gregory I

    2013-09-01

    Olecranon bursitis is a common clinical problem. It is often managed conservatively because of the high rates of wound complications with the conventional open surgical technique. Conventional olecranon bursoscopy utilizes an arthroscope and an arthroscopic shaver, removing the bursa from inside-out. We describe an extrabursal endoscopic technique where the bursa is not entered but excised in its entirety under endoscopic vision. A satisfactory view is obtained with less morbidity than the open method, while still avoiding a wound over the sensitive point of the olecranon. PMID:23970201

  10. Practical US of the forefoot.

    PubMed

    Bianchi, Stefano

    2014-06-01

    Disorders affecting the forefoot are common in the clinical practice. Accurate history and physical examination are the mainstays of diagnosis but imaging modalities are frequently obtained to confirm the clinical suspicion and plan appropriate treatment. In this article we will present the ultrasound (US) technique of examination of the forefoot followed by a brief description of the normal US anatomy and of US appearance of the most frequent forefoot disorders; rheumatoid arthritis, osteoarthritis, overuse arthropathy, Morton neuromas, bursitis, mucoid cysts, foreign bodies, bone disorders.

  11. MR imaging of the forefoot: Morton neuroma and differential diagnoses.

    PubMed

    Zanetti, Marco; Weishaupt, Dominik

    2005-09-01

    Magnetic resonance (MR) imaging of Morton neuromas is highly accurate. Morton neuromas are more conspicuous when the patient is prone positioned and the foot is plantar flexed than in the supine position with the toes pointing upward. MR imaging of Morton neuromas has a large influence on the diagnostic thinking and treatment plan of orthopedic foot surgeons. The most common differential diagnoses include intermetatarsal bursitis, stress fractures, and stress reactions. Some diagnoses (nodules associated with rheumatoid arthritis, synovial cyst, soft tissue chondroma, and plantar fibromatosis) are rare and can be diagnosed with histologic correlation only.

  12. Abductor Reconstruction with Gluteus Maximus Transfer in Primary Abductor Deficiency during Total Hip Arthroplasty

    PubMed Central

    Jang, Se Ang; Byun, Young Soo; Gu, Tae Hoe

    2016-01-01

    Abductor deficiency in native hip joint may cause severe limping and pain. It is more serious situation in case of arthroplasty due to instability and recurrent dislocation. Well-known causes of abductor deficiency are repeated surgery, chronic trochanteric bursitis, superior gluteal nerve injury, failure of repair of abductor tendon insertion to the greater trochanter. Author had experienced primary abductor deficiency during total hip replacement and treated successfully with the transfer of gluteus maximus. We'd like to introduce the operation technique with the review of literature. PMID:27777922

  13. Indoor racquet sports injuries.

    PubMed

    Silko, G J; Cullen, P T

    1994-08-01

    Family physicians can care for most patients injured while participating in indoor racquet sports. However, patients with injuries to the eye usually require ophthalmologic referral. The most common injuries that occur in persons participating in indoor racquet sports include contusions, sprains and strains, lacerations, eye injuries, bursitis and tendinitis. Musculoskeletal injuries that merit special consideration include lateral epicondylitis, DeQuervain's tenosynovitis, wrist intersection syndrome, patellar pain syndrome, meniscal injuries, Achilles tendinitis and plantar fasciitis. The family physician plays a critical role in providing patients with information about preventive measures.

  14. Endoscopic Resection of Lipoma of the Patellar Tendon

    PubMed Central

    Lui, Tun Hing; Lee, Man Wai

    2015-01-01

    Synovial lipoma of the patellar tendon is a very rare entity. It can be associated with rupture of the patellar tendon. We present a case of synovial lipoma that was successfully resected endoscopically. The other indications for patellar tendoscopy include chronic patellar tendinitis and tendinosis, recalcitrant bursitis around the tendon, Osgood-Schlatter disease, and jumper's knee. The major potential danger of this endoscopic procedure is iatrogenic damage to the patellar insertion during endoscopic debridement in patients with jumper's knee or the tibial insertion during endoscopic debridement in patients with Osgood-Schlatter disease. PMID:25973368

  15. Ganglion cyst and olecranon physis nonunion in a baseball pitcher: unique treatment after conservative therapy fails.

    PubMed

    Burman, Mark L; Aljassir, Fawzi; Coughlin, Larry P

    2004-06-01

    Although ganglion cysts and stress fractures occur at many joints, the presence of both disorders at the same joint is rare. In this unusual case, a 30-year-old professional pitcher had been treated conservatively for presumed olecranon bursitis in his right (throwing) arm, but, when therapy failed, he sought additional care. A thorough workup and subsequent surgery revealed a ganglion cyst and nonunion of a stress fracture of the olecranon physis. The ganglion cyst had its origin at the fracture site, and both cyst and bone fragment were excised. The patient had a full recovery and was able to resume pitching as an instructor 18 months after surgery.

  16. Snapping scapula syndrome: current concepts review in conservative and surgical treatment

    PubMed Central

    Merolla, Giovanni; Cerciello, Simone; Paladini, Paolo; Porcellini, Giuseppe

    2013-01-01

    Summary The snapping scapula, also called “washboard syndrome” is a controversial condition attributed to bony and soft tissue abnormalities. The syndrome was understimated for long time and often associated only with specific osseous abnormalities. The nodal point in the overview of the syndrome is that crepitus associated with symptomatic bursitis may be physiologic and is not uncommon a clinical presentation without any form of crepitus or craquement. In the current rewiew we analyzed the current concepts in the conservative and surgical management of snapping scapula syndrome, preceded by a description of scapular anatomy, pathophysiology of scapulothoracic articulation and clinical features of snapping scapula. PMID:23888290

  17. Iliopsoas: Pathology, Diagnosis, and Treatment.

    PubMed

    Anderson, Christian N

    2016-07-01

    Disorders of the iliopsoas can be a significant source of groin pain in the athletic population. Commonly described pathologic conditions include iliopsoas bursitis, tendonitis, impingement, and snapping. The first-line treatment for iliopsoas disorders is typically conservative, including activity modification, physical therapy, nonsteroidal anti-inflammatory drugs, and corticosteroid injections. Surgical treatment can be considered if the patient fails conservative measures and typically involves arthroscopic lengthening of the musculotendinous unit and treatment of concomitant intra-articular abnormality. Tendon release has been described: in the central compartment, in the peripheral compartment, and at the lesser trochanter, with similar outcomes observed between the techniques. PMID:27343394

  18. Retro-trochanteric sciatica-like pain: current concept.

    PubMed

    Meknas, Khaled; Johansen, Oddmund; Kartus, Jüri

    2011-11-01

    The aim of this manuscript is to review the current knowledge in terms of retro-trochanteric pain syndrome, make recommendations for diagnosis and differential diagnosis and offer suggestions for treatment options. The terminology in the literature is confusing and these symptoms can be referred to as 'greater trochanteric pain syndrome', 'trochanteric bursitis' and 'trochanteritis', among other denominations. The authors focus on a special type of sciatica, i.e. retro-trochanteric pain radiating down to the lower extremity. The impact of different radiographic assessments is discussed. The authors recommend excluding pathology in the spine and pelvic area before following their suggested treatment algorithm for sciatica-like retro-trochanteric pain.

  19. A prospective, longitudinal, descriptive study of the effect of a customized wheelchair cushion on clinical variables, satisfaction, and functionality among patients with spinal cord injury.

    PubMed

    Vilchis-Aranguren, Rodrigo; Gayol-Mérida, Diana; Quinzaños-Fresnedo, Jimena; Pérez-Zavala, Ramiro; Galíndez-Novoa, Carmen

    2015-02-01

    The Instituto Nacional de Rehabilitación (Rehabilitation National Institute) (INR) developed a prototype wheelchair cushion (INR cushion) designed to adjust to the anthropometry of the user's ischiogluteal area and prevent pressure ulcer formation while maintaining or promoting functionality. A prospective, longitudinal, descriptive study was conducted from February 2010 to February 2011 to evaluate the effect of using the INR cushion on clinical variables, functionality, and user satisfaction. Sixteen patients were recruited (9 male, 7 female, average age 31.8 [range 22-47] years, average body mass index 25 [range 22-34], average time in a wheelchair 10.1 [range 3-26] years) who met the study protocol inclusion criteria of being pressure ulcer-free for at least 6 months and capable of propulsion and transfer without assistance, chronic spinal cord injury (>2 years), and without chronic-degenerative diseases or cognitive problems. Each participant received the cushion for a 2-month evaluation. Eight clinical variables were assessed: trunk control, posture, spasticity, transfer capacity, comfort, skin reaction, propulsion capacity, and pressure release capacity. The clinical assessment was performed using validated scales and instruments: Modified Ashworth Scale (MAS), Functional Independence Measure™ (FIM), Norton Scale, and assessment of skin reaction. Interface pressures were measured using force sensing array, and participants completed a structured interview to assess user expectation, perceived functionality, perceived quality, and likelihood of recommending the device. Two patients withdrew due to appointment conflicts; of the remaining 14, significant differences between the user's experience with other products and the INR were found with regard to pressure redistribution (P = 0.012); all participants but 1 graded the INR as good in all interview categories. No participants developed a pressure ulcer during the study. The customized cushion was

  20. Rice Body Formation Within a Peri-Articular Shoulder Mass

    PubMed Central

    Caram, Anthony; Flores, Miguel; Scherer, Kurt

    2016-01-01

    Most commonly associated with chronic inflammatory conditions, rice bodies represent an uncommon, nonspecific, often intra-articular inflammatory process. Presumably, rice bodies represent the sequelae of microvascular infarcts of the joint synovium. However, rice bodies have been seen in pleural fluid, in the setting of bursitis, and within the tendon sheath. The etiology and prognostic significance of rice bodies are not clear. MRI is the diagnostic imaging modality of choice for the evaluation of rice body formation. Here we present a case of a 28-year-old female with a history of rheumatoid arthritis (RA) who presented to her primary care physician with a palpable mass around her right shoulder which was presumed to be a lipoma. An initial ultrasound showed a fluid filled structure with internal debris. Subsequent MRI evaluation was confirmatory for subacromial-subdeltoid bursitis with rice body formation. The salient point of this report is to highlight the importance of patient-specific differential diagnosis. While lipomas are a very common benign soft tissue tumor, patients with RA often have disease-specific sequelae that should be included in the diagnostic deliberation. Thus, when ordering diagnostic testing for patients with a palpable mass and rheumatoid arthritis, MRI--possibly preceded by conventional radiography--is the most appropriate diagnostic algorithm. PMID:27625904

  1. [Forefoot pain].

    PubMed

    Damiano, Joël

    2010-03-20

    Forefoot chronic pain is a frequent problem in daily clinical practice. Mechanical pathology of the forefoot, usually called static metatarsalgia, represents the most frequent reason for consultation in pathology of the foot. The cause is a functionnal disorder or anatomic derangement of the forefoot architecture. Metatarsalgia can originate from a wide range of affections. Etiologies of chronic pain are described from medial to lateral with first ray pathologies (hallux valgus, hallux rigidus and sesamoid pathology) and first ray insufficiency, pathologies of the second, third and fourth ray and intermetatarsal spaces (second ray syndrome, Freiberg's disease, Morton neuroma, stress or bone insufficiency metatarsal fractures, intermetatarsal bursitis) and fifth ray pathology (lateral bursitis, quintus varus). Sometimes forefoot pain could also be caused by chronic inflammatory rheumatic diseases (rheumatoid and psoriatic arthritis) with a risk of structural metatarsophalangeal joints alteration. The pathology of the toes can, more rarely, explain a forefoot pain. So, several pathologic conditions can produce forefoot pain and the diagnostic approach must always be based on the anamnesis and clinical examination. In a second time if the cause is difficult to establish based solely on clinical findings, radiography and ultrasonography are today the most usefull auxiliary investigations.

  2. Rice Body Formation Within a Peri-Articular Shoulder Mass.

    PubMed

    Edison, Michele N; Caram, Anthony; Flores, Miguel; Scherer, Kurt

    2016-01-01

    Most commonly associated with chronic inflammatory conditions, rice bodies represent an uncommon, nonspecific, often intra-articular inflammatory process. Presumably, rice bodies represent the sequelae of microvascular infarcts of the joint synovium. However, rice bodies have been seen in pleural fluid, in the setting of bursitis, and within the tendon sheath. The etiology and prognostic significance of rice bodies are not clear. MRI is the diagnostic imaging modality of choice for the evaluation of rice body formation. Here we present a case of a 28-year-old female with a history of rheumatoid arthritis (RA) who presented to her primary care physician with a palpable mass around her right shoulder which was presumed to be a lipoma. An initial ultrasound showed a fluid filled structure with internal debris. Subsequent MRI evaluation was confirmatory for subacromial-subdeltoid bursitis with rice body formation. The salient point of this report is to highlight the importance of patient-specific differential diagnosis. While lipomas are a very common benign soft tissue tumor, patients with RA often have disease-specific sequelae that should be included in the diagnostic deliberation. Thus, when ordering diagnostic testing for patients with a palpable mass and rheumatoid arthritis, MRI--possibly preceded by conventional radiography--is the most appropriate diagnostic algorithm. PMID:27625904

  3. Rice Body Formation Within a Peri-Articular Shoulder Mass

    PubMed Central

    Caram, Anthony; Flores, Miguel; Scherer, Kurt

    2016-01-01

    Most commonly associated with chronic inflammatory conditions, rice bodies represent an uncommon, nonspecific, often intra-articular inflammatory process. Presumably, rice bodies represent the sequelae of microvascular infarcts of the joint synovium. However, rice bodies have been seen in pleural fluid, in the setting of bursitis, and within the tendon sheath. The etiology and prognostic significance of rice bodies are not clear. MRI is the diagnostic imaging modality of choice for the evaluation of rice body formation. Here we present a case of a 28-year-old female with a history of rheumatoid arthritis (RA) who presented to her primary care physician with a palpable mass around her right shoulder which was presumed to be a lipoma. An initial ultrasound showed a fluid filled structure with internal debris. Subsequent MRI evaluation was confirmatory for subacromial-subdeltoid bursitis with rice body formation. The salient point of this report is to highlight the importance of patient-specific differential diagnosis. While lipomas are a very common benign soft tissue tumor, patients with RA often have disease-specific sequelae that should be included in the diagnostic deliberation. Thus, when ordering diagnostic testing for patients with a palpable mass and rheumatoid arthritis, MRI--possibly preceded by conventional radiography--is the most appropriate diagnostic algorithm.

  4. An Abnormal Bone Lesion of the Scapula in a Collegiate Basketball Player: A Case Report

    PubMed Central

    O'Brien, Matthew S.; Donnell, Allison; Miller, Jason; Iven, Val Gene; Pascale, Mark

    2013-01-01

    Objective: To present the case of a bone lesion of the scapula in a collegiate basketball player. Background: A 19-year-old National Collegiate Athletic Association Division I male basketball player presented with pain in the posterior region of the right shoulder. During practice, he was performing a layup when his arm was forced into hyperflexion by a defender. Evaluation revealed a bone lesion involving the scapular spine and base of the acromion. Differential Diagnosis: Acromioclavicular joint sprain, subacromial bursitis, subscapular bursitis, humeral head contusion, acromial fracture. Treatment: The patient was treated for 2 months with therapeutic modalities and rehabilitation exercises. Because of persistent pain and the risk of a pathologic fracture, open surgical biopsy and bone grafting were then undertaken. Uniqueness: Most simple bone cysts affect the proximal humerus and femur, whereas our patient's lesion was in the acromial complex. Conclusions: Athletic trainers should be alert to the unusual possibility of bone cysts, which are usually identified incidentally when radiographs are obtained for other reasons. Most simple bone cysts are asymptomatic, but a pathologic fracture can occur with trauma. PMID:23725460

  5. What Makes a Bacterial Species Pathogenic?:Comparative Genomic Analysis of the Genus Leptospira.

    PubMed

    Fouts, Derrick E; Matthias, Michael A; Adhikarla, Haritha; Adler, Ben; Amorim-Santos, Luciane; Berg, Douglas E; Bulach, Dieter; Buschiazzo, Alejandro; Chang, Yung-Fu; Galloway, Renee L; Haake, David A; Haft, Daniel H; Hartskeerl, Rudy; Ko, Albert I; Levett, Paul N; Matsunaga, James; Mechaly, Ariel E; Monk, Jonathan M; Nascimento, Ana L T; Nelson, Karen E; Palsson, Bernhard; Peacock, Sharon J; Picardeau, Mathieu; Ricaldi, Jessica N; Thaipandungpanit, Janjira; Wunder, Elsio A; Yang, X Frank; Zhang, Jun-Jie; Vinetz, Joseph M

    2016-02-01

    Leptospirosis, caused by spirochetes of the genus Leptospira, is a globally widespread, neglected and emerging zoonotic disease. While whole genome analysis of individual pathogenic, intermediately pathogenic and saprophytic Leptospira species has been reported, comprehensive cross-species genomic comparison of all known species of infectious and non-infectious Leptospira, with the goal of identifying genes related to pathogenesis and mammalian host adaptation, remains a key gap in the field. Infectious Leptospira, comprised of pathogenic and intermediately pathogenic Leptospira, evolutionarily diverged from non-infectious, saprophytic Leptospira, as demonstrated by the following computational biology analyses: 1) the definitive taxonomy and evolutionary relatedness among all known Leptospira species; 2) genomically-predicted metabolic reconstructions that indicate novel adaptation of infectious Leptospira to mammals, including sialic acid biosynthesis, pathogen-specific porphyrin metabolism and the first-time demonstration of cobalamin (B12) autotrophy as a bacterial virulence factor; 3) CRISPR/Cas systems demonstrated only to be present in pathogenic Leptospira, suggesting a potential mechanism for this clade's refractoriness to gene targeting; 4) finding Leptospira pathogen-specific specialized protein secretion systems; 5) novel virulence-related genes/gene families such as the Virulence Modifying (VM) (PF07598 paralogs) proteins and pathogen-specific adhesins; 6) discovery of novel, pathogen-specific protein modification and secretion mechanisms including unique lipoprotein signal peptide motifs, Sec-independent twin arginine protein secretion motifs, and the absence of certain canonical signal recognition particle proteins from all Leptospira; and 7) and demonstration of infectious Leptospira-specific signal-responsive gene expression, motility and chemotaxis systems. By identifying large scale changes in infectious (pathogenic and intermediately pathogenic

  6. Testing fungistatic properties of soil-like substrate for growing plants in bioregenerative life support systems

    NASA Astrophysics Data System (ADS)

    Enzhu, Hu; Nesterenko, Elena; Liu, Professor Hong; Manukovsky, N. S.; Kovalev, Vladimir; Gurevich, Yu.; Kozlov, Vladimir; Khizhnyak, Serge; Xing, Yidong; Hu, Enzhu; Enzhu, Hu

    There are two ways of getting vegetable food in BLSS: in hydroponic culture and on soil substrates. In any case there is a chance that the plants will be affected by plant pathogenic microorganisms. The subject of the research was a soil-like substrate (SLS) for growing plants in a Bioregenerative Life Support System (BLSS). We estimated the fungistatic properties of SLS using test cultures of Bipolaris and Alternaria plant pathogenic fungi. Experiments were made with the samples of SLS, natural soil and sand (as control). We tested 2 samples of SLS produced by way of bioconversion of wheat and rice straw. We measured the disease severity of wheat seedlings and the incidence of common root rot in natural (non-infectious) background and man-made (infectious) conditions. The severity of disease on the SLS was considerably smaller both in non-infectious and infectious background conditions (8 and 12%) than on the natural soil (18 and 32%) and sand. It was the soil-like substrate that had the minimal value among the variants being compared (20% in non-infectious and 40% in infectious background conditions). This index in respect of the soil was 55 and 78%, correspondingly, and in respect of the sand - 60%, regardless of the background. It was found that SLS significantly suppressed conidia germination of Bipolaris soroikiniana (p<0.001). In the presence of SLS germination of conidia decreased to 9.9 - 12.2% of the control value. No significant differences were found between SLS samples obtained from wheat and rice straw.

  7. What Makes a Bacterial Species Pathogenic?:Comparative Genomic Analysis of the Genus Leptospira.

    PubMed

    Fouts, Derrick E; Matthias, Michael A; Adhikarla, Haritha; Adler, Ben; Amorim-Santos, Luciane; Berg, Douglas E; Bulach, Dieter; Buschiazzo, Alejandro; Chang, Yung-Fu; Galloway, Renee L; Haake, David A; Haft, Daniel H; Hartskeerl, Rudy; Ko, Albert I; Levett, Paul N; Matsunaga, James; Mechaly, Ariel E; Monk, Jonathan M; Nascimento, Ana L T; Nelson, Karen E; Palsson, Bernhard; Peacock, Sharon J; Picardeau, Mathieu; Ricaldi, Jessica N; Thaipandungpanit, Janjira; Wunder, Elsio A; Yang, X Frank; Zhang, Jun-Jie; Vinetz, Joseph M

    2016-02-01

    Leptospirosis, caused by spirochetes of the genus Leptospira, is a globally widespread, neglected and emerging zoonotic disease. While whole genome analysis of individual pathogenic, intermediately pathogenic and saprophytic Leptospira species has been reported, comprehensive cross-species genomic comparison of all known species of infectious and non-infectious Leptospira, with the goal of identifying genes related to pathogenesis and mammalian host adaptation, remains a key gap in the field. Infectious Leptospira, comprised of pathogenic and intermediately pathogenic Leptospira, evolutionarily diverged from non-infectious, saprophytic Leptospira, as demonstrated by the following computational biology analyses: 1) the definitive taxonomy and evolutionary relatedness among all known Leptospira species; 2) genomically-predicted metabolic reconstructions that indicate novel adaptation of infectious Leptospira to mammals, including sialic acid biosynthesis, pathogen-specific porphyrin metabolism and the first-time demonstration of cobalamin (B12) autotrophy as a bacterial virulence factor; 3) CRISPR/Cas systems demonstrated only to be present in pathogenic Leptospira, suggesting a potential mechanism for this clade's refractoriness to gene targeting; 4) finding Leptospira pathogen-specific specialized protein secretion systems; 5) novel virulence-related genes/gene families such as the Virulence Modifying (VM) (PF07598 paralogs) proteins and pathogen-specific adhesins; 6) discovery of novel, pathogen-specific protein modification and secretion mechanisms including unique lipoprotein signal peptide motifs, Sec-independent twin arginine protein secretion motifs, and the absence of certain canonical signal recognition particle proteins from all Leptospira; and 7) and demonstration of infectious Leptospira-specific signal-responsive gene expression, motility and chemotaxis systems. By identifying large scale changes in infectious (pathogenic and intermediately pathogenic

  8. What Makes a Bacterial Species Pathogenic?:Comparative Genomic Analysis of the Genus Leptospira

    PubMed Central

    Fouts, Derrick E.; Matthias, Michael A.; Adhikarla, Haritha; Adler, Ben; Amorim-Santos, Luciane; Berg, Douglas E.; Bulach, Dieter; Buschiazzo, Alejandro; Chang, Yung-Fu; Galloway, Renee L.; Haake, David A.; Haft, Daniel H.; Hartskeerl, Rudy; Ko, Albert I.; Levett, Paul N.; Matsunaga, James; Mechaly, Ariel E.; Monk, Jonathan M.; Nascimento, Ana L. T.; Nelson, Karen E.; Palsson, Bernhard; Peacock, Sharon J.; Picardeau, Mathieu; Ricaldi, Jessica N.; Thaipandungpanit, Janjira; Wunder, Elsio A.; Yang, X. Frank; Zhang, Jun-Jie; Vinetz, Joseph M.

    2016-01-01

    Leptospirosis, caused by spirochetes of the genus Leptospira, is a globally widespread, neglected and emerging zoonotic disease. While whole genome analysis of individual pathogenic, intermediately pathogenic and saprophytic Leptospira species has been reported, comprehensive cross-species genomic comparison of all known species of infectious and non-infectious Leptospira, with the goal of identifying genes related to pathogenesis and mammalian host adaptation, remains a key gap in the field. Infectious Leptospira, comprised of pathogenic and intermediately pathogenic Leptospira, evolutionarily diverged from non-infectious, saprophytic Leptospira, as demonstrated by the following computational biology analyses: 1) the definitive taxonomy and evolutionary relatedness among all known Leptospira species; 2) genomically-predicted metabolic reconstructions that indicate novel adaptation of infectious Leptospira to mammals, including sialic acid biosynthesis, pathogen-specific porphyrin metabolism and the first-time demonstration of cobalamin (B12) autotrophy as a bacterial virulence factor; 3) CRISPR/Cas systems demonstrated only to be present in pathogenic Leptospira, suggesting a potential mechanism for this clade’s refractoriness to gene targeting; 4) finding Leptospira pathogen-specific specialized protein secretion systems; 5) novel virulence-related genes/gene families such as the Virulence Modifying (VM) (PF07598 paralogs) proteins and pathogen-specific adhesins; 6) discovery of novel, pathogen-specific protein modification and secretion mechanisms including unique lipoprotein signal peptide motifs, Sec-independent twin arginine protein secretion motifs, and the absence of certain canonical signal recognition particle proteins from all Leptospira; and 7) and demonstration of infectious Leptospira-specific signal-responsive gene expression, motility and chemotaxis systems. By identifying large scale changes in infectious (pathogenic and intermediately pathogenic

  9. [Usefulness of the passive hemagglutination micromethod in the diagnosis of whooping cough].

    PubMed

    Kuklińska, D A; Baszak, M A

    1989-01-01

    Studies on modification of diagnostic test for pertussis have been continued, they were practically restricted to an application of passive haemagglutination micromethod. Six hundred and twenty eight sera from children suspected to be infected with Bordetella and 38 sera of control children suffering from non-infectious diseases were tested. Despite of the fact that higher titers were obtained with method using red blood cells preserved in Alsevier solution, the passive haemagglutination micromethod may be used in field studies especially during pertussis epidemics what was confirmed by statistical analysis. PMID:2561809

  10. Post splenectomy related pulmonary hypertension

    PubMed Central

    Palkar, Atul V; Agrawal, Abhinav; Verma, Sameer; Iftikhar, Asma; Miller, Edmund J; Talwar, Arunabh

    2015-01-01

    Splenectomy predisposes patients to a slew of infectious and non-infectious complications including pulmonary vascular disease. Patients are at increased risk for venous thromboembolic events due to various mechanisms that may lead to chronic thromboembolic pulmonary hypertension (CTEPH). The development of CTEPH and pulmonary vasculopathy after splenectomy involves complex pathophysiologic mechanisms, some of which remain unclear. This review attempts congregate the current evidence behind our understanding about the etio-pathogenesis of pulmonary vascular disease related to splenectomy and highlight the controversies that surround its management. PMID:26949600

  11. [The theory of functional systems in medicine: methodological aspects].

    PubMed

    Khrutskiĭ, K S

    2009-01-01

    P.K. Anokhin's theory of functional systems (TFS) is a unique scientific development extending an original field of biomedical research initiated in this country by I.M. Sechenov, I.P. Pavlov, and A.A. Ukhtomsky. Unique methodology of TFS is based on the integrated approach to the study of human vital activity including psychic and somatic processes. The main results of the studies in the framework of TFS methodology and prospects for its further development are reviewed with special reference to the key mechanisms of eitiopathogenesis of chronic non-infectious diseases. PMID:19799208

  12. Effect of environmental contaminants on nasal lysozyme secretions.

    PubMed

    Noble, Rudolf E

    2002-02-01

    Human nasal secretions are comprised of lysozyme and albumin as their main protein components. Lysozyme, an anti-microbial substance, is produced by nasal serous cells while albumin is obtained, primarily, from increased nasal vasculature permeability. We measured lysozyme levels in nasal secretions following challenge by a variety of non-infectious environmental contaminants. The methodology given presents a simple and rapid method of collecting nasal secretions and determining their lysozyme content, a technique which can be used for a host of environmental irritants.

  13. Testicular infarction and rupture: an uncommon complication of epididymo-orchitis

    PubMed Central

    Chia, Daniel; Penkoff, Peter; Stanowski, Matthew; Beattie, Kieran; Wang, Audrey C.

    2016-01-01

    Epididymo-orchitis is a common diagnosis in men presenting with unilateral testicular pain. It can be of an infectious or non-infectious aetiology. Clinical examination and laboratory investigations do not reliably differentiate testicular infarction secondary to epididymo-orchitis from uncomplicated epididymo-orchitis. Definitive diagnosis is usually made by ultrasound. Misdiagnosis and under-treatment can lead to poor outcome, such as infarction and loss of the affected testis. We present an uncommon case of epididymo-orchitis resulting in testicular infarction and rupture despite normal initial investigations. PMID:27165751

  14. Cutaneous Manifestations of Human Immunodeficiency Virus: a Clinical Update

    PubMed Central

    Altman, Kirstin; Vanness, Erin

    2015-01-01

    Dermatologic diseases are common in the HIV-infected population. Many of the cutaneous diseases are not unique to this group, but the presentation can be more severe. Although the introduction of antiretroviral therapy has been followed by a decline in many of the skin diseases associated with HIV, drug reactions and other non-infectious skin conditions have increased. This article reviews the current spectrum of HIV-associated skin conditions, focusing on common complaints, infections, drug-associated toxicity and malignancies. PMID:25821188

  15. Prion-like Mechanisms in Neurodegenerative Diseases

    PubMed Central

    Frost, Bess; Diamond, Marc I.

    2013-01-01

    Many non-infectious neurodegenerative diseases are associated with the accumulation of fibrillar protein. These diseases all exhibit phenotypic diversity and propagation of pathology that is reminiscent of prionopathies. Furthermore, emerging studies of amyloid-β, α–synuclein, and tau proteins suggest that they share key biophysical and biochemical characteristics with prions. Propagation of protein misfolding in these diseases may therefore occur via mechanisms similar to those underlying prion pathogenesis. If verified in vivo, this will suggest new therapeutic strategies to block propagation of protein misfolding throughout the brain. PMID:20029438

  16. Gender Disparities in Ocular Inflammatory Disorders*

    PubMed Central

    Sen, Hatice Nida; Davis, Janet; Ucar, Didar; Fox, Austin; Chan, Chi Chao; Goldstein, Debra A.

    2014-01-01

    Ocular inflammatory disorders disproportionately affect women, and the majority of affected women are of childbearing age. The role of sex or reproductive hormones has been proposed in many other inflammatory or autoimmune disorders, and findings from non-ocular autoimmune diseases suggest a complex interaction between sex hormones, genetic factors and the immune system. However, despite the age and sex bias, factors that influence this disparity are complicated and unclear. This review aims to evaluate the gender disparities in prevalence, incidence and severity of the most common infectious and non-infectious ocular inflammatory disorders. PMID:24987987

  17. Severe Adverse Events Related to Tattooing: An Retrospective Analysis of 11 Years

    PubMed Central

    Wollina, Uwe

    2012-01-01

    Background: The incidence of tattoos has been increased markedly during the last 20 years. Aims: To analyze the patient files for severe adverse medical reactions related to tattooing. Settings: Academic Teaching Hospital in South-East Germany. Materials and Methods: Retrospective investigation from March 2001 to May 2012. Results: The incidence of severe adverse medical reactions has been estimated as 0.02%. Infectious and non-infectious severe reactions have been observed. The consequences were medical drug therapies and surgery. Conclusions: Tattooing may be associated with severe adverse medical reactions with significant morbidity. Regulations, education and at least hygienic controls are tools to increase consumer safety. PMID:23248361

  18. Norovirus Gastroenteritis Successfully Treated with Nitazoxanide

    PubMed Central

    Siddiq, Danish M.; Koo, Hoonmo L.; Adachi, Javier A.; Viola, George M.

    2012-01-01

    Infectious and non-infectious diarrhea is a common occurrence in the immunosuppressed population. We present a 43-year-old individual with large-volume stool output Norovirus acute gastroenteritis in the setting of relapsed refractory acute myelogenous leukemia, hematopoietic stem cell transplantation, and biopsy-proven cutaneous and pulmonary graft-versus-host disease. Therapeutic options such as intravenous immunoglobulin or reduction of oral immunosuppressants were not a feasible choice. A prompt clinical cure was achieved with nitazoxanide, a broad spectrum antimicrobial agent. Nitazoxanide may be a safe therapeutic alternative, in which a reduction in immunosuppression is not a viable option. PMID:21839773

  19. Hyperferritinemia in pulmonary tuberculosis.

    PubMed

    D'Souza, Benedicta; Sinha, Sulekha; Manjrekar, Poornima; D'Souza, Vivian

    2013-07-01

    High ferritin levels have been found to be associated with non infectious as well as infectious causes including tuberculosis. This is one case report of 41 year old male who presented with cough with expectoration. The patient had Multi drug resistant tuberculosis (MDRTB) and type 2 diabetes mellitus. The laboratory findings showed Iron 280 μg/dl, Total iron binding capacity (TIBC) 61 μg/dl, and ferritin 92,945 ng/ml which indicates that iron is an essential nutrient for the survival of the pathogen Mycobacterium tuberculosis.

  20. [Madagascar: public health situation on the "Big Island" at the beginning of the 21st century].

    PubMed

    Andrianarisoa, A C E; Rakotoson, J; Randretsa, M; Rakotondravelo, S; Rakotoarimanana, R D; Rakotomizao, J; Aubry, P

    2007-02-01

    The main public health issue in Madagascar at the beginning of the 21st century still involves transmissible infectious diseases including re-emerging diseases such as bubonic plague and emerging diseases such as HIV/AIDS, dengue fever and Chikungunya virus infection. Health and hygiene especially access to clean water is still poor especially in rural areas. No improvement in the public health situation with regard to malaria, schistomosomiais or cysticercosis as well as non-infectious diseases such as protein-energy malnutrition is expected within the next decade.

  1. Multisystem involvement in neuromyelitis optica

    PubMed Central

    Langille, Megan M.; Desai, Jay

    2015-01-01

    We describe a case of pediatric neuromyelitis optica (NMO) with muscle and lung involvement in addition to central nervous system disease. Our patient initially presented with features of area postrema syndrome, then subsequently with optic neuritis. The patient also had recurrent hyperCKemia that responded to corticosteroids. Finally, axillary and hilar adenopathy with pulmonary consolidation were noted as well and responded to immunomodulation. Our case highlights multisystem involvement in NMO including non-infectious pulmonary findings which have not been described in the pediatric population previously. PMID:26538850

  2. [Clinical and bacteriological characteristic of infectious purulent complications in patients after related renal transplantation].

    PubMed

    Volynchik, E P; Bol'shakov, L V; Bogomolova, N S; Kuznetsova, S M

    2014-01-01

    We investigated the frequency and characteristics of infectious purulent and non-infectious complications in living related renal transplant recipients in early postoperative period. It was identified the prevalent microorganisms in urinary tract infections and its antibiotic sensitivity: Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Citrobacter freundii, Staphylococcus epidermidis, Enterococcus faecalis, Candida albicans. 182 strains of bacteria and Candida were isolated from urine of renal graft patients in early postoperative period (from 2 days to 3 months). The prevention and treatment schemes, antimicrobial drugs dosing regimen were developed. It leads to decrease the infectious complications rate. PMID:25327674

  3. Tracheobronchitis in a Patient With Crohn's Disease

    PubMed Central

    Yeung, Vincent; Govind, Anusha G.; Arastu, Sanaa

    2016-01-01

    We report a 63-year-old woman who presented with 1 month of non-productive cough and non-bloody diarrhea. She was on maintenance therapy for a 15-year history of Crohn's disease. Treatment with systemic corticosteroids resulted in rapid improvement of both her diarrhea and respiratory symptoms. Our patient is unique in that she presented with tracheobronchitis during an acute flare of her Crohn's without obvious lung pathology on chest imaging. Tracheobronchitis is a rare manifestation of inflammatory bowel disease that should be considered in Crohn's disease patients presenting with persistent non-infectious cough. PMID:27144198

  4. Advances in prevention and therapy of neonatal dairy calf diarrhoea: a systematical review with emphasis on colostrum management and fluid therapy.

    PubMed

    Meganck, Vanessa; Hoflack, Geert; Opsomer, Geert

    2014-01-01

    Neonatal calf diarrhoea remains the most common cause of morbidity and mortality in preweaned dairy calves worldwide. This complex disease can be triggered by both infectious and non-infectious causes. The four most important enteropathogens leading to neonatal dairy calf diarrhoea are Escherichia coli, rota- and coronavirus, and Cryptosporidium parvum. Besides treating diarrhoeic neonatal dairy calves, the veterinarian is the most obvious person to advise the dairy farmer on prevention and treatment of this disease. This review deals with prevention and treatment of neonatal dairy calf diarrhoea focusing on the importance of a good colostrum management and a correct fluid therapy. PMID:25431305

  5. Interobserver reliability of the 'Welfare Quality(®) Animal Welfare Assessment Protocol for Growing Pigs'.

    PubMed

    Czycholl, I; Kniese, C; Büttner, K; Beilage, E Grosse; Schrader, L; Krieter, J

    2016-01-01

    The present paper focuses on evaluating the interobserver reliability of the 'Welfare Quality(®) Animal Welfare Assessment Protocol for Growing Pigs'. The protocol for growing pigs mainly consists of a Qualitative Behaviour Assessment (QBA), direct behaviour observations (BO) carried out by instantaneous scan sampling and checks for different individual parameters (IP), e.g. presence of tail biting, wounds and bursitis. Three trained observers collected the data by performing 29 combined assessments, which were done at the same time and on the same animals; but they were carried out completely independent of each other. The findings were compared by the calculation of Spearman Rank Correlation Coefficients (RS), Intraclass Correlation Coefficients (ICC), Smallest Detectable Changes (SDC) and Limits of Agreements (LoA). There was no agreement found concerning the adjectives belonging to the QBA (e.g. active: RS: 0.50, ICC: 0.30, SDC: 0.38, LoA: -0.05 to 0.45; fearful: RS: 0.06, ICC: 0.0, SDC: 0.26, LoA: -0.20 to 0.30). In contrast, the BO showed good agreement (e.g. social behaviour: RS: 0.45, ICC: 0.50, SDC: 0.09, LoA: -0.09 to 0.03 use of enrichment material: RS: 0.75, ICC: 0.68, SDC: 0.06, LoA: -0.03 to 0.03). Overall, observers agreed well in the IP, e.g. tail biting (RS: 0.52, ICC: 0.88; SDC: 0.05, LoA: -0.01 to 0.02) and wounds (RS: 0.43, ICC: 0.59, SDC: 0.10, LoA: -0.09 to 0.10). The parameter bursitis showed great differences (RS: 0.10, ICC: 0.0, SDC: 0.35, LoA: -0.37 to 0.40), which can be explained by difficulties in the assessment when the animals moved around quickly or their legs were soiled. In conclusion, the interobserver reliability was good in the BO and most IP, but not for the parameter bursitis and the QBA. PMID:27478731

  6. Interobserver reliability of the 'Welfare Quality(®) Animal Welfare Assessment Protocol for Growing Pigs'.

    PubMed

    Czycholl, I; Kniese, C; Büttner, K; Beilage, E Grosse; Schrader, L; Krieter, J

    2016-01-01

    The present paper focuses on evaluating the interobserver reliability of the 'Welfare Quality(®) Animal Welfare Assessment Protocol for Growing Pigs'. The protocol for growing pigs mainly consists of a Qualitative Behaviour Assessment (QBA), direct behaviour observations (BO) carried out by instantaneous scan sampling and checks for different individual parameters (IP), e.g. presence of tail biting, wounds and bursitis. Three trained observers collected the data by performing 29 combined assessments, which were done at the same time and on the same animals; but they were carried out completely independent of each other. The findings were compared by the calculation of Spearman Rank Correlation Coefficients (RS), Intraclass Correlation Coefficients (ICC), Smallest Detectable Changes (SDC) and Limits of Agreements (LoA). There was no agreement found concerning the adjectives belonging to the QBA (e.g. active: RS: 0.50, ICC: 0.30, SDC: 0.38, LoA: -0.05 to 0.45; fearful: RS: 0.06, ICC: 0.0, SDC: 0.26, LoA: -0.20 to 0.30). In contrast, the BO showed good agreement (e.g. social behaviour: RS: 0.45, ICC: 0.50, SDC: 0.09, LoA: -0.09 to 0.03 use of enrichment material: RS: 0.75, ICC: 0.68, SDC: 0.06, LoA: -0.03 to 0.03). Overall, observers agreed well in the IP, e.g. tail biting (RS: 0.52, ICC: 0.88; SDC: 0.05, LoA: -0.01 to 0.02) and wounds (RS: 0.43, ICC: 0.59, SDC: 0.10, LoA: -0.09 to 0.10). The parameter bursitis showed great differences (RS: 0.10, ICC: 0.0, SDC: 0.35, LoA: -0.37 to 0.40), which can be explained by difficulties in the assessment when the animals moved around quickly or their legs were soiled. In conclusion, the interobserver reliability was good in the BO and most IP, but not for the parameter bursitis and the QBA.

  7. Protothecosis.

    PubMed

    Mayorga, Jorge; Barba-Gómez, José Fernando; Verduzco-Martínez, Ana Paula; Muñoz-Estrada, Víctor Fernando; Welsh, Oliverio

    2012-01-01

    Protothecosis is a rare infection caused by achlorophyllic algae that are members of the genus Prototheca. They are ubiquitous in nature in organic material. The clinical manifestations can be acute or chronic and local or disseminated. The disease is classified as cutaneous, causing bursitis or disseminated/systemic, affecting both immunocompetent and immunosuppressed patients, with more severe and disseminated infections occurring in immunocompromised individuals. Prototheca wickerhamii and Prototheca zopfii are the most frequent organisms reported in humans. Diagnosis is made by observing asexual sporangia (thecas) on histopathological examination of tissue. Medical and surgical treatment should be considered. Ketoconazole, itraconazole, fluconazole, voriconazole, posaconazole, and amphotericin B are the most commonly used antifungals. Voriconazole and amphotericin B are highly effective against Prototheca spp. Treatment failure is not uncommon because of the comorbidities that limit the therapeutic outcome. PMID:22682193

  8. Protothecosis in hematopoietic stem cell transplantation: case report and review of previous cases.

    PubMed

    Macesic, N; Fleming, S; Kidd, S; Madigan, V; Chean, R; Ritchie, D; Slavin, M

    2014-06-01

    Prototheca species are achlorophyllus algae. Prototheca wickerhamii and Prototheca zopfii cause human disease. In immunocompetent individuals, they cause soft tissue infections and olecranon bursitis, but in transplant recipients, these organisms can cause disseminated disease. We report a fatal case of disseminated P. zopfii infection in an hematopoietic stem cell transplant (HSCT) recipient with bloodstream infection and involvement of multiple soft tissue sites. We review all previous cases of protothecosis in HSCT reported in the literature. Protothecosis is uncommon after HSCT, but has a disseminated presentation that is frequently fatal. It is commonly misidentified as a yeast. Tumor necrosis factor-alpha inhibitors and contamination of central venous catheters may contribute to development of protothecosis. Optimal treatment approaches are yet to be defined. New agents such as miltefosine may be possible future therapies. PMID:24797402

  9. [Greater trochanteric pain syndrome of the hip].

    PubMed

    Haviv, Barak; Bronak, Shlomo; Thein, Rafael

    2014-02-01

    Lateral pain of the hip with point tenderness at the Greater Trochanter is a common musculoskeletal complaint. It is frequently diagnosed as trochanteric bursitis; however, this term is inaccurate because of evident non-inflammatory pathologies, particularly of the abductor tendons of the hip. It is important to differentiate this extra-articular source from an intra-articular or a lower back source of pain. Imaging is useful in cases of trauma, prolonged pain or uncertain diagnosis. Non-operative treatment that involves modifying activities, physiotherapy, analgesics, steroid injections and shock wave therapy is usually helpful. Nevertheless, despite the above treatments, about one third of the patients suffer from chronic pain and disability. These patients may be candidates for operative intervention. Currently, there are endoscopic surgical techniques for local decompression, bursectomy and suture of torn tendons similar to surgery used in the shoulder. PMID:24716427

  10. Corticosteroid Injections for Common Musculoskeletal Conditions.

    PubMed

    Foster, Zoë J; Voss, Tyler T; Hatch, Jacquelynn; Frimodig, Adam

    2015-10-15

    Family physicians considering corticosteroid injections as part of a comprehensive treatment plan for musculoskeletal diagnoses will find few high-quality studies to assist with evidence-based decision making. Most studies of corticosteroid injections for the treatment of osteoarthritis, tendinopathy, bursitis, or neuropathy include only small numbers of patients and have inconsistent long-term follow-up. Corticosteroid injections for the treatment of adhesive capsulitis result in short-term improvements in pain and range of motion. For subacromial impingement syndrome, corticosteroid injections provide short-term pain relief and improvement in function. In medial and lateral epicondylitis, corticosteroid injections offer only short-term improvement of symptoms and have a high rate of symptom recurrence. Corticosteroid injections for carpal tunnel syndrome may help patients avoid or delay surgery. Trigger finger and de Quervain tenosynovitis may be treated effectively with corticosteroid injections. Patients with hip or knee osteoarthritis may have short-term symptom relief with corticosteroid injections.

  11. Osteomyelitis Infection of Mycobacterium marinum: A Case Report and Literature Review

    PubMed Central

    Nguyen, Hao H.; Fadul, Nada; Ashraf, Muhammad S.; Siraj, Dawd S.

    2015-01-01

    Mycobacterium marinum (M. marinum) is a ubiquitous waterborne organism that grows optimally at temperatures around 30°C. It is a nontuberculous Mycobacterium found in nonchlorinated water with worldwide prevalence. It is the most common atypical Mycobacterium that causes opportunistic infection in humans. M. marinum can cause superficial infections and localized invasive infections in humans, with the hands being the sites most frequently affected. It can cause skin lesions, which are either single, papulonodular lesions, confined to an extremity, or may resemble cutaneous sporotrichosis. This infection can also cause deeper infections including tenosynovitis, bursitis, arthritis, and osteomyelitis. Disseminated infections and visceral involvements have been reported in immunocompromised patients. We here report a case of severe deep soft tissue infection with necrotizing fasciitis and osteomyelitis of the left upper extremity (LUE) caused by M. marinum in an immunocompromised patient. PMID:25664190

  12. [Hyperuricemia and gout].

    PubMed

    Gröbner, Wolfgang

    2015-10-01

    In most cases (98-99 %) primary hyperuricemia is caused by impaired renal excretion of uric acid. Overproduction of uric acid is rare. Secondary hyperuricemia has to be differentiated from primary forms. Clinical manifestations of hyperuricemia are acute inflammatory arthritis, tenosynovitis, bursitis, chronic arthropathy and accumulation of urate crystals in the form of tophaceous deposits. In addition renal complications can occur. Pathophysiology and diagnosis of gout were described. Treatment of gout has two goals: Treatment of the acute gout attack, to terminate pain and disability and treatment of hyperuricemia by lifestyle modification and with urate lowering drugs. A serum uric acid value below 6 mg/dl (360 µmol/L) should be achieved.

  13. Disorders of the Peritrochanteric and Deep Gluteal Space: New Frontiers for Arthroscopy.

    PubMed

    Byrd, John W Thomas

    2015-12-01

    Arthroscopic techniques for the hip joint have evolved into endoscopic methods for extra-articular disorders. These endoscopic strategies provide a less invasive alternative to open procedures for traditionally recognized forms of pathology. Endoscopy has defined new disorders amenable to surgical correction and has redefined some of these existing disorders. The peritrochanteric and deep gluteal regions represent 2 of the most currently active areas of exploration. Peritrochanteric problems include trochanteric bursitis, full-thickness and partial-thickness tears of the abductors including the gluteus medius and minimus, and external coxa saltans (snapping iliotibial band). Deep gluteal disorders include piriformis syndrome, and other variations of deep gluteal syndrome, and ischiofemoral impingement. Each of these evolving areas is highlighted in this chapter. PMID:26524558

  14. Hamstring injuries

    PubMed Central

    Guanche, Carlos A.

    2015-01-01

    There is a continuum of hamstring injuries that can range from musculotendinous strains to avulsion injuries. Although the proximal hamstring complex has a strong bony attachment on the ischial tuberosity, hamstring injuries are common in athletic population and can affect all levels of athletes. Nonoperative treatment is mostly recommended in the setting of low-grade partial tears and insertional tendinosis. However, failure of nonoperative treatment of partial tears may benefit from surgical debridement and repair. The technique presented on this article allows for the endoscopic management of proximal hamstring tears and chronic ischial bursitis, which until now has been managed exclusively with much larger open approaches. The procedure allows for complete exposure of the posterior aspect of the hip in a safe, minimally invasive fashion. PMID:27011828

  15. Hallux valgus and hallux rigidus: MRI findings.

    PubMed

    Schweitzer, M E; Maheshwari, S; Shabshin, N

    1999-01-01

    The purpose of this article is to describe the MR findings of Hallux Valgus (HV) and Hallux Rigidus (HR). Twenty-four patients (11 with HV, 4 with HR, and 9 with both HV and HR) were studied at 1.5 Tesla MRI. Two separate observers evaluated the first ray blindly for the following signs: sesamoid position, sesamoid proliferation, hypertrophy of the median eminence, presence of a lateral facet, presence of an adventitial bursa, shape of the first metatarsal head, relative length of the first metatarsal, joint space loss, osteophytes (dorsalor lateral), marrow edema, geodes, subchondral sclerosis, intra-articular ossicle, and pes planus. The most common findings observed in HV were a hypertrophic medial eminence (95%), sesamoid proliferation (90%) and adventitial bursitis (70%). The most common findings observed in HR were osteophytes (77% and 69%), geodes, and marrow edema. We conclude that traditional routine radiograph signs of HV and HR may be applied to MR images.

  16. Disorders of the Peritrochanteric and Deep Gluteal Space: New Frontiers for Arthroscopy.

    PubMed

    Byrd, John W Thomas

    2015-12-01

    Arthroscopic techniques for the hip joint have evolved into endoscopic methods for extra-articular disorders. These endoscopic strategies provide a less invasive alternative to open procedures for traditionally recognized forms of pathology. Endoscopy has defined new disorders amenable to surgical correction and has redefined some of these existing disorders. The peritrochanteric and deep gluteal regions represent 2 of the most currently active areas of exploration. Peritrochanteric problems include trochanteric bursitis, full-thickness and partial-thickness tears of the abductors including the gluteus medius and minimus, and external coxa saltans (snapping iliotibial band). Deep gluteal disorders include piriformis syndrome, and other variations of deep gluteal syndrome, and ischiofemoral impingement. Each of these evolving areas is highlighted in this chapter.

  17. Carpal boss in chronic wrist pain and its association with partial osseous coalition and osteoarthritis - A case report with focus on MRI findings.

    PubMed

    Poh, Feng

    2015-01-01

    The carpal boss is a bony prominence at the dorsal aspect of the 2(nd) and/or 3(rd) carpometacarpal joint, which has been linked to various etiologies, including trauma, os styloideum, osteophyte formation, and partial osseous coalition. It may result in symptoms through secondary degeneration, ganglion formation, bursitis, or extensor tendon abnormalities by altered biomechanics of wrist motion. We present a case of symptomatic carpal boss with the finding of a partial osseous coalition at the 2(nd) carpometacarpal (metacarpal-trapezoid) joint and highlight the magnetic resonance imaging (MRI) findings of carpal boss impingement and secondary osteoarthritis. To the best of our knowledge, there is no report in the literature describing the imaging findings of partial osseous coalition and degenerative osteoarthritis in relation to carpal boss.

  18. Arthroscopy of the shoulder joint--a cadaver and clinical study. Part 2: Clinical study.

    PubMed

    Rojvanit, V

    1984-10-01

    Shoulder arthroscopy was carried out 56 times on 50 patients. Different types of arthroscopes were employed. Anterior and posterior approaches were used. Diagnoses were 21 cases of glenohumeral instability including 17 of recurrent anterior dislocation and subluxation; 2 of voluntary anterior subluxation and 2 of habitual posterior dislocation, 13 of rotator cuff tear, 6 of chronic subacromial bursitis, 2 of fracture-dislocation, 2 of frozen shoulder, 2 of baseball shoulder, one of rheumatoid arthritis, and 3 miscellaneous. The arthroscopic findings in the instability group and rotator cuff tear group were verified. Bankart lesion and Hill-Sachs lesion were identified arthroscopically. The indications for shoulder arthroscopy are outlined. There was no significant morbidity with this procedure.

  19. Migration of calcium deposits into subacromial-subdeltoid bursa and into humeral head as a rare complication of calcifying tendinitis: sonography and imaging.

    PubMed

    Della Valle, Valeria; Bassi, Emilio Maria; Calliada, Fabrizio

    2015-09-01

    Calcifying tendinitis of the shoulder is a common condition characterized by the deposition of calcium, predominantly hydroxyapatite crystals, in the rotator cuff. A rare complication of this condition is the migration of calcium deposits from tendons, usually the supraspinatus, into the subacromial-subdeltoid bursa or into the humeral greater tuberosity. These complications are responsible for intense acute shoulder pain and functional disability. Patient anamnesis and clinical symptoms must be considered to make the diagnosis, but imaging, particularly sonography, is often necessary, showing a typical presentation related to the locations of calcium deposits. We present sonographic and other imaging features of subacromial-subdeltoid bursitis and humeral osteitis related to the migration of calcium.

  20. Presumed prepatellar fibrosis in collegiate wrestlers: imaging findings and clinical correlation.

    PubMed

    Northam, Meredith C; Gaskin, Cree M

    2015-02-01

    Knee pain and injury are common complaints of athletes presenting to the orthopedic clinic. Wrestlers are no exception, and may present more commonly with anterior knee pain because of the nature of their sport. Morel-Lavallée lesions and prepatellar bursitis have been described in the prepatellar region of wrestlers. We report a distinctly different prepatellar finding on MRI, focally prominent and discrete fibrosis in three collegiate wrestlers. This characteristic appearance and clinical setting have already been repeated in our clinical practice; thus, other MRI readers are also likely to encounter this finding, which in our experience can be considered a "don't touch" lesion of no clinical significance. PMID:24997159

  1. [Electroroentgenography in the diagnosis of soft tissue tumors].

    PubMed

    Vintergal'ter, S F; Vishevnik, B I

    1989-01-01

    Clinical, electroroentgenographic and X-ray studies of soft tissues were carried out in 425 patients with malignant (75), benign (246) soft tissue tumors and in cases of such soft tissue pathologies of the extremities and body (104) as bursitis, hematoma, cyst and ganglia which may clinically simulate tumors. The paper discusses the technicalities of electroroentgenography which produces on one roentgenogram separate images of all components of soft tissues and bones in a given segment. A comparison of image quality assured by electroroentgeno- and roentgenography did not establish any significant difference in soft tissue tumor semiotics. Electroroentgenography of soft tissues is relatively less sophisticated, time-consuming and cheaper; it does not require special medical facilities for examining patients bearing soft tissue tumor or suspect lesions.

  2. Immunomodulatory and anti-inflammatory action of Nigella sativa and thymoquinone: A comprehensive review.

    PubMed

    Majdalawieh, Amin F; Fayyad, Muneera W

    2015-09-01

    Many herbal products are now used as remedies to treat various infectious and non-infectious conditions. Even though the use of herbs and natural products is much more evident in the Eastern world, their use in Western cultures is continuously increasing. Although the immunomodulatory effects of some herbs have been extensively studied, research related to possible immunomodulatory effects of many herbs and various spices is relatively scarce. Here, we provide a comprehensive review of the immunomodulatory and anti-inflammatory properties of Nigella sativa, also known as black seed or black cumin, and its major active ingredient, thymoquinone (TQ). This review article focuses on analyzing in vitro and in vivo experimental findings that were reported with regard to the ability of N. sativa and TQ to modulate inflammation, cellular and humoral adaptive immune responses, and Th1/Th2 paradigm. The reported capability of N. sativa to augment the cytotoxic activity of natural killer (NK) cells against cancer cells is also emphasized. The molecular and cellular mechanisms underlying such immunomodulatory and anti-inflammatory effects of N. sativa and TQ are highlighted. Moreover, the signal transduction pathways implicated in the immunoregulatory functions of N. sativa and TQ are underscored. Experimental evidence suggests that N. sativa extracts and TQ can potentially be employed in the development of effective therapeutic agents towards the regulation of immune reactions implicated in various infectious and non-infectious conditions including different types of allergy, autoimmunity, and cancer.

  3. Activity of bleach, ethanol and two commercial disinfectants against spores of Encephalitozoon cuniculi.

    PubMed

    Jordan, Carly N; Dicristina, Jennifer A; Lindsay, David S

    2006-03-31

    Encephalitozoon cuniculi is a small protist parasite in the phylum Microspora. Hosts are infected by ingestion or inhalation of spores passed in the urine or feces. Infection with E. cuniculi is usually asymptomatic, except in young or immunocompromised hosts. This study examined the effects of various disinfectants on in vitro infectivity of E. cuniculi spores. Spores of E. cuniculi were exposed to several dilutions of commercial bleach, 70% ethanol and dilutions of commercial disinfectants HiTor and Roccal for 10 min and then loaded onto human fibroblast cells (Hs68 cells). Ten minutes of exposure to these disinfectants was lethal to E. cuniculi spores. Additional exposure time studies were done using dilutions of bleach at 0.1, 1 and 10%, and 70% ethanol. Exposure of E. cuniculi spores to 1 or 10% bleach for 30s rendered them non-infectious for Hs68 cells. Growth of E. cuniculi was observed in Hs68 cells inoculated with spores treated with 0.1% bleach for 30s or 1, 3 and 5 min, but not with spores treated for 7 min or longer. Exposure of E. cuniculi spores to 70% ethanol for 30s rendered them non-infectious for Hs68 cells. Spores of E. cuniculi are more sensitive to disinfectants than are coccidial oocysts and other parasite cysts. The relatively short contact time needed to kill spores indicates that disinfection of animal housing may be a viable means to reduce exposure of animals to E. cuniculi spores. PMID:16368193

  4. A Systematic Review of Methodology: Time Series Regression Analysis for Environmental Factors and Infectious Diseases

    PubMed Central

    Imai, Chisato; Hashizume, Masahiro

    2015-01-01

    Background: Time series analysis is suitable for investigations of relatively direct and short-term effects of exposures on outcomes. In environmental epidemiology studies, this method has been one of the standard approaches to assess impacts of environmental factors on acute non-infectious diseases (e.g. cardiovascular deaths), with conventionally generalized linear or additive models (GLM and GAM). However, the same analysis practices are often observed with infectious diseases despite of the substantial differences from non-infectious diseases that may result in analytical challenges. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, systematic review was conducted to elucidate important issues in assessing the associations between environmental factors and infectious diseases using time series analysis with GLM and GAM. Published studies on the associations between weather factors and malaria, cholera, dengue, and influenza were targeted. Findings: Our review raised issues regarding the estimation of susceptible population and exposure lag times, the adequacy of seasonal adjustments, the presence of strong autocorrelations, and the lack of a smaller observation time unit of outcomes (i.e. daily data). These concerns may be attributable to features specific to infectious diseases, such as transmission among individuals and complicated causal mechanisms. Conclusion: The consequence of not taking adequate measures to address these issues is distortion of the appropriate risk quantifications of exposures factors. Future studies should pay careful attention to details and examine alternative models or methods that improve studies using time series regression analysis for environmental determinants of infectious diseases. PMID:25859149

  5. Discrimination of infectious bacteriophage T4 virus by propidium monoazide real-time PCR.

    PubMed

    Fittipaldi, Mariana; Rodriguez, Nancy J Pino; Codony, Francesc; Adrados, Bárbara; Peñuela, Gustavo A; Morató, Jordi

    2010-09-01

    The advent of quantitative PCR has improved the detection of human viral pathogens in the environment. However, a serious limitation of this method may arise from the inability to discriminate between viruses that are infectious and viruses that have been inactivated and do not represent a human health hazard. To assess whether propidium monoazide (PMA) pre-treatment is a good approach to inhibiting DNA amplification from non-infectious viruses, bacteriophage T4 survival was measured using cell culture titration and real-time PCR with and without PMA pre-treatment. Heat (85 degrees C) and proteolysis methods were carried out. After these inactivation treatments, the results indicated that the PMA pre-treatment approach is not appropriate for differentiating infectious viruses. However, when a heat treatment at 110 degrees C was undertaken, PMA pre-treatment did allow differentiation of non-infectious from infectious viruses. In this case, effective binding of PMA to bacteriophage T4 DNA could be taken to indicate capsid damage. Therefore, PMA pre-treatment may be appropriate for assessing effective disinfection treatments and for a more reliable understanding of the factors that contribute to viral inactivation through capsid damage monitoring. The PMA-PCR approach could be useful as a rapid and inexpensive analytical tool for screening and evaluation of the efficacy of disinfectants.

  6. A Unique Report: Development of Super Anti-Human IgG Monoclone with Optical Density Over Than 3

    PubMed Central

    Aghebati Maleki, Leili; Baradaran, Behzad; Abdolalizadeh, Jalal; Ezzatifar, Fatemeh; Majidi, Jafar

    2013-01-01

    Purpose: Monoclonal antibodies and related conjugates are key reagents used in biomedical researches as well as, in treatment, purification and diagnosis of infectious and non- infectious diseases. Methods: Balb/c mice were immunized with purified human IgG. Spleen cells of the most immune mouse were fused with SP2/0 in the presence of Poly Ethylene Glycol (PEG). Supernatant of hybridoma cells was screened for detection of antibody by ELISA. Then, the sample was assessed for cross-reactivity with IgM & IgA by ELISA and confirmed by immunoblotting. The subclasses of the selected mAbs were determined. The best clone was injected intraperitoneally to some pristane-injected mice. Anti-IgG mAb was purified from the animals' ascitic fluid by Ion exchange chromatography and then, mAb was conjugated with HRP. Results: In the present study, over than 50 clones were obtained that 1 clone had optical density over than 3. We named this clone as supermonoclone which was selected for limiting dilution. The result of the immunoblotting, showed sharp band in IgG position and did not show any band in IgM&IgA position. Conclusion: Based on the findings of this study, the conjugated monoclonal antibody could have application in diagnosis of infectious diseases like Toxoplasmosis, Rubella and IgG class of other infectious and non- infectious diseases. PMID:24312857

  7. Neutrophil-specific deletion of the CARD9 gene expression regulator suppresses autoantibody-induced inflammation in vivo

    PubMed Central

    Németh, Tamás; Futosi, Krisztina; Sitaru, Cassian; Ruland, Jürgen; Mócsai, Attila

    2016-01-01

    Neutrophils are terminally differentiated cells with limited transcriptional activity. The biological function of their gene expression changes is poorly understood. CARD9 regulates transcription during antifungal immunity but its role in sterile inflammation is unclear. Here we show that neutrophil CARD9 mediates pro-inflammatory chemokine/cytokine but not lipid mediator release during non-infectious inflammation. Genetic deficiency of CARD9 suppresses autoantibody-induced arthritis and dermatitis in mice. Neutrophil-specific deletion of CARD9 is sufficient to induce that phenotype. Card9−/− neutrophils show defective immune complex-induced gene expression changes and pro-inflammatory chemokine/cytokine release but normal LTB4 production and other short-term responses. In vivo deletion of CARD9 reduces tissue levels of pro-inflammatory chemokines and cytokines but not LTB4. The CARD9-mediated signalling pathway involves Src-family kinases, Syk, PLCγ2, Bcl10/Malt1 and NFκB. Collectively, CARD9-mediated gene expression changes within neutrophils play important roles during non-infectious inflammation in vivo and CARD9 acts as a divergence point between chemokine/cytokine and lipid mediator release. PMID:27032818

  8. Activity of bleach, ethanol and two commercial disinfectants against spores of Encephalitozoon cuniculi.

    PubMed

    Jordan, Carly N; Dicristina, Jennifer A; Lindsay, David S

    2006-03-31

    Encephalitozoon cuniculi is a small protist parasite in the phylum Microspora. Hosts are infected by ingestion or inhalation of spores passed in the urine or feces. Infection with E. cuniculi is usually asymptomatic, except in young or immunocompromised hosts. This study examined the effects of various disinfectants on in vitro infectivity of E. cuniculi spores. Spores of E. cuniculi were exposed to several dilutions of commercial bleach, 70% ethanol and dilutions of commercial disinfectants HiTor and Roccal for 10 min and then loaded onto human fibroblast cells (Hs68 cells). Ten minutes of exposure to these disinfectants was lethal to E. cuniculi spores. Additional exposure time studies were done using dilutions of bleach at 0.1, 1 and 10%, and 70% ethanol. Exposure of E. cuniculi spores to 1 or 10% bleach for 30s rendered them non-infectious for Hs68 cells. Growth of E. cuniculi was observed in Hs68 cells inoculated with spores treated with 0.1% bleach for 30s or 1, 3 and 5 min, but not with spores treated for 7 min or longer. Exposure of E. cuniculi spores to 70% ethanol for 30s rendered them non-infectious for Hs68 cells. Spores of E. cuniculi are more sensitive to disinfectants than are coccidial oocysts and other parasite cysts. The relatively short contact time needed to kill spores indicates that disinfection of animal housing may be a viable means to reduce exposure of animals to E. cuniculi spores.

  9. The Reasons of Renal Transplant Recipients’ Admission to the Emergency Department; a Case Series Study

    PubMed Central

    Uysal, Erdal; Dokur, Mehmet; Bakir, Hasan; Ikidag, Mehmet Ali; Kirdak, Turkay; Kazimoglu, Hatem

    2016-01-01

    Introduction: Renal transplantation are admitted to emergency department (ED) more than normal population. The present brief report aimed to determine the reasons of renal transplant patients’ ED visits. Methods: This retrospective case series study analyzed the reasons of renal transplant recipients’ admission to one ED between 2011 and 2014. The patient data were collected via a checklist and presented using descriptive statistics tools. Results: 41 patients with the mean age of 40.63 ± 10.95 years were studied (60.9% male). The most common ED presenting complaints were fever (36.6%) and abdominal pain (26.8%). Infections were the most common final diagnosis (68.3%). Among non-infectious causes, the most common was acute renal failure (9.7 %). 73.2% of the patients were hospitalized and no cases of graft loss and mortality were seen. Conclusion: The most common reason for ED admission was fever, and infections were the most common diagnosis. Acute gastroenteritis being the most frequent infection and among non-infectious problems, acute renal failure was the most frequent one. PMID:27800542

  10. Suppressor of Cytokine Signaling 1 (SOCS1) Mitigates Anterior Uveitis and Confers Protection Against Ocular HSV-1 Infection

    PubMed Central

    Yu, Cheng-Rong; Hayashi, Kozaburo; Lee, Yun Sang; Mahdi, Rashid M.; Shen, De Fen; Chan, Chi-Chao; Egwuagu, Charles E.

    2014-01-01

    Immunological responses to pathogens are stringently regulated in the eye to prevent excessive inflammation that damage ocular tissues and compromise vision. Suppressors of cytokine signaling (SOCS) regulate intensity/duration of inflammatory responses. We have used SOCS1-deficient mice and retina-specific SOCS1 transgenic rats to investigate roles of SOCS1 in ocular herpes simplex virus (HSV-1) infection and non-infectious uveitis. We also genetically engineered cell-penetrating SOCS proteins (membrane-translocating sequence (MTS)-SOCS1, MTS-SOCS3) and examined whether they can be used to inhibit inflammatory cytokines. Overexpression of SOCS1 in transgenic rat eyes attenuated ocular HSV-1 infection while SOCS1-deficient mice developed severe non-infectious anterior uveitis, suggesting that SOCS1 may contribute to mechanism of ocular immune privilege by regulating trafficking of inflammatory cells into ocular tissues. Furthermore, MTS-SOCS1 inhibited IFN-γ-induced signal transducers and activators of transcription 1 (STAT1) activation by macrophages while MTS-SOCS3 suppressed expansion of pathogenic Th17 cells that mediate uveitis, indicating that MTS-SOCS proteins maybe used to treat ocular inflammatory diseases of infectious or autoimmune etiology. PMID:24993154

  11. AUTOINFLAMMATORY PUSTULAR NEUTROPHILIC DISEASES

    PubMed Central

    Naik, Haley B.; Cowen, Edward W.

    2013-01-01

    SYNOPSIS The inflammatory pustular dermatoses constitute a spectrum of non-infectious conditions ranging from localized involvement to generalized disease with associated acute systemic inflammation and multi-organ involvement. Despite the variability in extent and severity of cutaneous presentation, each of these diseases is characterized by non-infectious neutrophilic intra-epidermal microabscesses. Many share systemic findings including fever, elevated inflammatory markers, inflammatory bowel disease and/or osteoarticular involvement, suggesting potential common pathogenic links (Figure 1). The recent discoveries of several genes responsible for heritable pustular diseases have revealed a distinct link between pustular skin disease and regulation of innate immunity. These genetic advances have led to a deeper exploration of common pathways in pustular skin disease and offer the potential for a new era of biologic therapy which targets these shared pathways. This chapter provides a new categorization of inflammatory pustular dermatoses in the context of recent genetic and biologic insights. We will discuss recently-described monogenic diseases with pustular phenotypes, including deficiency of IL-1 receptor antagonist (DIRA), deficiency of the IL-36 receptor antagonist (DITRA), CARD14-associated pustular psoriasis (CAMPS), and pyogenic arthritis, pyoderma gangrenosum, acne (PAPA). We will then discuss how these new genetic advancements may inform how we view previously described pustular diseases, including pustular psoriasis and its clinical variants, with a focus on historical classification by clinical phenotype. PMID:23827244

  12. The "mystery" of cutaneous sarcoidosis: facts and controversies.

    PubMed

    Tchernev, G; Cardoso, J C; Chokoeva, A A; Verma, S B; Tana, C; Ananiev, J; Gulubova, M; Philipov, S; Kanazawa, N; Nenoff, P; Lotti, T; Wollina, U

    2014-01-01

    The reason why the cutaneous form of sarcoidosis is well known in the literature is because of its spectrum of manifestations granting it the fame of a Great Imitator. The mystery shrouding the pathogenesis of this rare cutaneous disease is still there (in spite of the fundamental progress of the various diagnostic methods in current day medicine). The production of the morphological substrate - the epithelioid cell granuloma - which is considered to be characteristic of skin sarcoidosis, could, however, also be the end result of a reaction to i) various specific infectious agents such as Leishmaniasis cutis, coccidioidomycosis, etc., ii) certain residual bacterial or other mycobacterial antigens which, at the moment of setting the diagnosis are - by definition - non-infectious but still immunogenic, as well as iii) different tumor antigens in lesional tissue or other location. Often, differentiating between sarcodiosis and a sarcoid-like reaction, based on the updated criteria for cutaneous sarcoidosis, is problematic to downright impossible. A future characterization of the genetic signature of the two conditions, as well as the implementation of additional mandatory panels for i) the identification of certain infectious or ii) non-infectious but immunogenic and iii) tumor antigens in the epithelioid cell granuloma (or in another location in the organism), could be a considerable contribution to the process of differentiating between the two above-mentioned conditions. This will create conditions for greater accuracy when setting the subsequent therapeutic approaches.

  13. Dissociation of recombinant prion autocatalysis from infectivity.

    PubMed

    Noble, Geoffrey P; Supattapone, Surachai

    2015-01-01

    Within the mammalian prion field, the existence of recombinant prion protein (PrP) conformers with self-replicating (ie. autocatalytic) activity in vitro but little to no infectious activity in vivo challenges a key prediction of the protein-only hypothesis of prion replication--that autocatalytic PrP conformers should be infectious. To understand this dissociation of autocatalysis from infectivity, we recently performed a structural and functional comparison between a highly infectious and non-infectious pair of autocatalytic recombinant PrP conformers derived from the same initial prion strain. (1) We identified restricted, C-terminal structural differences between these 2 conformers and provided evidence that these relatively subtle differences prevent the non-infectious conformer from templating the conversion of native PrP(C) substrates containing a glycosylphosphatidylinositol (GPI) anchor. (1) In this article we discuss a model, consistent with these findings, in which recombinant PrP, lacking post-translational modifications and associated folding constraints, is capable of adopting a wide variety of autocatalytic conformations. Only a subset of these recombinant conformers can be adopted by post-translationally modified native PrP(C), and this subset represents the recombinant conformers with high specific infectivity. We examine this model's implications for the generation of highly infectious recombinant prions and the protein-only hypothesis of prion replication.

  14. Immunomodulatory and anti-inflammatory action of Nigella sativa and thymoquinone: A comprehensive review.

    PubMed

    Majdalawieh, Amin F; Fayyad, Muneera W

    2015-09-01

    Many herbal products are now used as remedies to treat various infectious and non-infectious conditions. Even though the use of herbs and natural products is much more evident in the Eastern world, their use in Western cultures is continuously increasing. Although the immunomodulatory effects of some herbs have been extensively studied, research related to possible immunomodulatory effects of many herbs and various spices is relatively scarce. Here, we provide a comprehensive review of the immunomodulatory and anti-inflammatory properties of Nigella sativa, also known as black seed or black cumin, and its major active ingredient, thymoquinone (TQ). This review article focuses on analyzing in vitro and in vivo experimental findings that were reported with regard to the ability of N. sativa and TQ to modulate inflammation, cellular and humoral adaptive immune responses, and Th1/Th2 paradigm. The reported capability of N. sativa to augment the cytotoxic activity of natural killer (NK) cells against cancer cells is also emphasized. The molecular and cellular mechanisms underlying such immunomodulatory and anti-inflammatory effects of N. sativa and TQ are highlighted. Moreover, the signal transduction pathways implicated in the immunoregulatory functions of N. sativa and TQ are underscored. Experimental evidence suggests that N. sativa extracts and TQ can potentially be employed in the development of effective therapeutic agents towards the regulation of immune reactions implicated in various infectious and non-infectious conditions including different types of allergy, autoimmunity, and cancer. PMID:26117430

  15. On the Dark Side of Therapies with Immunoglobulin Concentrates: The Adverse Events

    PubMed Central

    Späth, Peter J.; Granata, Guido; La Marra, Fabiola; Kuijpers, Taco W.; Quinti, Isabella

    2015-01-01

    Therapy by human immunoglobulin G (IgG) concentrates is a success story ongoing for decades with an ever increasing demand for this plasma product. The success of IgG concentrates on a clinical level is documented by the slowly increasing number of registered indication and the more rapid increase of the off-label uses, a topic dealt with in another contribution to this special issue of Frontiers in Immunology. A part of the success is the adverse event (AE) profile of IgG concentrates which is, even at life-long need for therapy, excellent. Transmission of pathogens in the last decade could be entirely controlled through the antecedent introduction by authorities of a regulatory network and installing quality standards by the plasma fractionation industry. The cornerstone of the regulatory network is current good manufacturing practice. Non-infectious AEs occur rarely and mainly are mild to moderate. However, in recent times, the increase in frequency of hemolytic and thrombotic AEs raised worrying questions on the possible background for these AEs. Below, we review elements of non-infectious AEs, and particularly focus on hemolysis and thrombosis. We discuss how the introduction of plasma fractionation by ion-exchange chromatography and polishing by immunoaffinity chromatographic steps might alter repertoire of specificities and influence AE profiles and efficacy of IgG concentrates. PMID:25699039

  16. Incorporation of chimeric HIV-SIV-Env and modified HIV-Env proteins into HIV pseudovirions

    SciTech Connect

    Devitt, Gerard; Emerson, Vanessa; Holtkotte, Denise; Pfeiffer, Tanya; Pisch, Thorsten; Bosch, Valerie . E-mail: v.bosch@dkfz.de

    2007-05-10

    Low level incorporation of the viral glycoprotein (Env) into human immunodeficiency virus (HIV) particles is a major drawback for vaccine strategies against HIV/AIDS in which HIV particles are used as immunogen. Within this study, we have examined two strategies aimed at achieving higher levels of Env incorporation into non-infectious pseudovirions (PVs). First, we have generated chimeric HIV/SIV Env proteins containing the truncated C-terminal tail region of simian immunodeficiency virus (SIV)mac239-Env767{sup stop}, which mediates strongly increased incorporation of SIV-Env into SIV particles. In a second strategy, we have employed a truncated HIV-Env protein (Env-Tr752{sup N750K}) which we have previously demonstrated to be incorporated into HIV virions, generated in infected T-cells, to a higher level than that of Wt-HIV-Env. Although the chimeric HIV/SIV Env proteins were expressed at the cell surface and induced increased levels of cell-cell fusion in comparison to Wt-HIV-Env, they did not exhibit increased incorporation into either HIV-PVs or SIV-PVs. Only Env-Tr752{sup N750K} exhibited significantly higher (threefold) levels of incorporation into HIV-PVs, an improvement, which, although not dramatic, is worthwhile for the large-scale preparation of non-infectious PVs for vaccine studies aimed at inducing Env humoral responses.

  17. Sarcoid reaction: a rare occurrence associated to colon adenocarcinoma (case report and literature review)

    PubMed Central

    Aceñero, M. Jesús Fernández

    2016-01-01

    Granulomatous reactions are related to infectious and non infectious diseases, but more rarely, granulomas may occur in association to malignancies. The presence of sarcoid-like granulomas in lymph nodes draining malignant tumors is an uncommon but well known occurrence. However, their presence in the stroma of malignant tumors is much rarer. We have only found two previous cases reported in the Japanese and English literature. In this study we report a well differentiated adenocarcinoma of the right colon associated to a stromal granulomatous sarcoid-like reaction. Lymph nodes were not involved. The patient had a clinical history of tuberculosis treated 15 years ago, but there was no clinical, histomorphological, immunohistochemical or molecular evidence of disease at the moment of these findings. We have reviewed the literature to find the keys and the diagnostic challenges posed by granulomatous sarcoid-like reaction occurring in lymph nodes draining malignant neoplasms, peritumoral stroma and in other organs far from the primary tumor. The diagnosis of granulomatous sarcoid-like reactions associated to malignancies can be challenging and it can only be made after ruling out specific infectious and non infectious causes of granulomatous inflammation. The mechanisms involved in granuloma formation, their relationship with demographic and histopathological features, their possible association with autoimmune disorders, their cytokine profile and, more importantly, their prognostic significance in each type of tumor are still unclear and require studies with larger number of patients. PMID:27512605

  18. Causes of disease and death from birth to 12 months of age in the Thoroughbred horse in Ireland

    PubMed Central

    2010-01-01

    A retrospective study was carried out to investigate the causes of disease and death in a population of foals in Ireland during their first 12 months post partum. Foaling and veterinary records from 343 foals on four farms born between January 1, 2004 and May 30, 2008 were reviewed. Among 343 foals, 22 did not survive to 12 months of age. Over the five-year period, the incidence of stillbirth was 1.5% (5/343), mortality 5% (17/338) and overall morbidity was 88.5% (299/338). Morbidity was calculated to include all new conditions brought to the attention of the attending veterinary surgeon, no matter how minor. Of foals born alive: congenital abnormalities were the most common cause of death (35.3% 6/17 foals) followed by musculoskeletal trauma (5/17, 29.4%). Of 711 separate incidents of disease, 46.5% (331/711) were due to an infectious process, 25% (178/711) due to non-infectious musculoskeletal issues; and 14.9% (106/711) related to non-infectious gastrointestinal problems. Respiratory infection was the single most common disease accounting for 27.8% (178/711) of all disease incidents in this population. Findings from this study provide information regarding the causes and incidence of death and disease in the young Irish Thoroughbred population. PMID:21851741

  19. Shoulder Disease Patterns of the Wheelchair Athletes of Table-Tennis and Archery: A Pilot Study

    PubMed Central

    2016-01-01

    Objective To investigate the shoulder disease patterns for the table-tennis (TT) and archery (AR) wheelchair athletes via ultrasonographic evaluations. Methods A total of 35 wheelchair athletes were enrolled, made up of groups of TT (n=19) and AR (n=16) athletes. They were all paraplegic patients and were investigated for their wheelchair usage duration, careers as sports players, weekly training times, the Wheelchair User's Shoulder Pain Index (WUSPI) scores and ultrasonographic evaluation. Shoulders were divided into playing arm of TT, non-playing arm of TT, bow-arm of AR, and draw arm of AR athletes. Shoulder diseases were classified into five entities of subscapularis tendinopathy, supraspinatus tendinopathy, infraspinatus tendinopathy, biceps long head tendinopathy, and subacromial-subdeltoid bursitis. The pattern of shoulder diseases were compared between the two groups using the Mann-Whitney and the chi-square tests Results WSUPI did not significantly correlate with age, wheelchair usage duration, career as players or weekly training times for all the wheelchair athletes. For the non-playing arm of TT athletes, there was a high percentage of subscapularis (45.5%) and supraspinatus (40.9%) tendinopathy. The percentage of subacromial-subdeltoid bursitis showed a tendency to be present in the playing arm of TT athletes (20.0%) compared with their non-playing arm (4.5%), even though this was not statistically significant. Biceps long head tendinopathy was the most common disease of the shoulder in the draw arm of AR athletes, and the difference was significant when compared to the non-playing arm of TT athletes (p<0.05). Conclusion There was a high percentage of subscapularis and supraspinatus tendinopathy cases for the non-playing arm of TT wheelchair athletes, and a high percentage of biceps long head tendinopathy for the draw arm for the AR wheelchair athletes. Consideration of the biomechanical properties of each sport may be needed to tailor specific

  20. Shoulder Disease Patterns of the Wheelchair Athletes of Table-Tennis and Archery: A Pilot Study

    PubMed Central

    2016-01-01

    Objective To investigate the shoulder disease patterns for the table-tennis (TT) and archery (AR) wheelchair athletes via ultrasonographic evaluations. Methods A total of 35 wheelchair athletes were enrolled, made up of groups of TT (n=19) and AR (n=16) athletes. They were all paraplegic patients and were investigated for their wheelchair usage duration, careers as sports players, weekly training times, the Wheelchair User's Shoulder Pain Index (WUSPI) scores and ultrasonographic evaluation. Shoulders were divided into playing arm of TT, non-playing arm of TT, bow-arm of AR, and draw arm of AR athletes. Shoulder diseases were classified into five entities of subscapularis tendinopathy, supraspinatus tendinopathy, infraspinatus tendinopathy, biceps long head tendinopathy, and subacromial-subdeltoid bursitis. The pattern of shoulder diseases were compared between the two groups using the Mann-Whitney and the chi-square tests Results WSUPI did not significantly correlate with age, wheelchair usage duration, career as players or weekly training times for all the wheelchair athletes. For the non-playing arm of TT athletes, there was a high percentage of subscapularis (45.5%) and supraspinatus (40.9%) tendinopathy. The percentage of subacromial-subdeltoid bursitis showed a tendency to be present in the playing arm of TT athletes (20.0%) compared with their non-playing arm (4.5%), even though this was not statistically significant. Biceps long head tendinopathy was the most common disease of the shoulder in the draw arm of AR athletes, and the difference was significant when compared to the non-playing arm of TT athletes (p<0.05). Conclusion There was a high percentage of subscapularis and supraspinatus tendinopathy cases for the non-playing arm of TT wheelchair athletes, and a high percentage of biceps long head tendinopathy for the draw arm for the AR wheelchair athletes. Consideration of the biomechanical properties of each sport may be needed to tailor specific

  1. Comparison between ultrasound and plain X-ray in evaluating the cause of shoulder pain.

    PubMed

    Salek, K M; Mannan, M; Chowdhury, A Z; Haque, M A; Kaiser, M S; Nabi, S; Ferdousee, R A; Paul, B K; Ahmed, S M; Khan, M; Begum, M

    2011-01-01

    Painful shoulder is a common painful condition among patients. Apart from acute traumatic lesions such as fractures, dislocations, contusions, sprains and ruptured tendons, 85 to 90% of painful shoulders are due to adhesive capsulitis, acute or chronic calcific tendinitis, bursitis, bicipital tendinitis and lesions of the musculotendinous cuff. Arthritis is the cause of less than 5% of painful shoulders. For evaluating conditions of shoulder joint, X-ray has been regarded as only method of choice for long time. Magnetic resonance imaging (MRI) is an alternative procedure but the cost limits its utilization especially in Bangladesh. Ultrasonography is an effective imaging modality in the evaluation of both rotator and non-rotator cuff disorders. Because of low cost and availability, it can be an alternative procedure for the diagnosis of painful shoulder. The present study was conducted to assess ultrasonography as a useful modality in evaluating cases of shoulder pain and to compare the findings with X-ray findings. Thirty two patients with shoulder pain were evaluated by X-ray and Ultrasonography (USG). Clinical diagnosis was done for correlation. To identify the cause of shoulder pain, 100% patients were found normal in plain X-ray. On Ultrasonography (USG) 12.5% patients had displaced long head of biceps, 21.9% had biceps tendinitis, and 3.1% had bursitis. In the assessment of shoulder pathology, USG had a sensitivity of 73.3%, specificity of 88.2%, Positive predictive value (PPV) of 84.6%, Negative predictive value (NPV) of 78.9% and an accuracy of 81.3%. USG is a useful modality for evaluation the shoulder joint in case of painful shoulder even plain X-ray is non conclusive.

  2. High-resolution ultrasound of rotator cuff and biceps reflection pulley in non-elite junior tennis players: anatomical study

    PubMed Central

    2014-01-01

    Background Tennis is believed to be potentially harmful for the shoulder, therefore the purpose of this study is to evaluate the anatomy of the rotator cuff and the coraco-humeral ligament (CHL) in a-symptomatic non-elite junior tennis players with high-resolution ultrasound (US). Methods From August 2009 to September 2010 n = 90 a-symptomatic non-elite junior tennis players (mean age ± standard deviation: 15 ± 3) and a control group of age- and sex- matched subjects were included. Shoulder assessment with a customized standardized protocol was performed. Body mass index, dominant arm, years of practice, weekly hours of training, racket weight, grip (Eastern, Western and semi-Western), kind of strings were recorded. Results Abnormalities were found at ultrasound in 14/90 (15%) players. Two players had supraspinatus tendinosis, two had subacromial impingement and ten had subacromial bursitis. CHL thickness resulted comparable in the dominant and non-dominant arms (11.3 ± 4.4 mm vs. 13 ± 4.2, p > 0.05). Multivariate analysis demonstrated that no association was present among CHL thickness and the variables evaluated. In the control group, abnormalities were found at ultrasound in 6/60 (10%) subjects (sub-acromial bursitis). No statistically significant differences between players and control group were found (p = 0.71). Conclusion In a-symptomatic non-elite junior tennis players only minor shoulder abnormalities were found. PMID:25034864

  3. Virus quantitation by transmission electron microscopy, TCID₅₀, and the role of timing virus harvesting: a case study of three animal viruses.

    PubMed

    Malenovska, Hana

    2013-08-01

    Quantitation of viruses is practised widely in both basic and applied virology. Infectious titration in cell cultures, the most common approach to it, is quite labour-intensive and alternative protocols are therefore sought. One of the alternatives is transmission electron microscope (TEM) quantitation using latex particles at a known concentration as a reference for counting virus particles. If virus TCID₅₀ is determined in parallel, the ratio of infectious to non-infectious virus particles may be established. This study employs such an approach to compute the number of virus particles and TCID₅₀, and establish their correlation for three viruses: Canine adenovirus 1 (CAdV-1), Feline calicivirus (FCV) and Bovine herpesvirus 1 (BoHV-1). Each of the viruses was grown in five replicates until complete cytopathology was recorded (time 0), then frozen. They were thawed, filter-sterilised and left for additional periods of 16, 32 and 48 h at 37°C. At each time point, the infectious ability of the virus was characterised by TCID50 and the number of virions quantified by TEM, in order to evaluate the influence of timing on virus harvest. The virus particle count determined by TEM did not change for any of the viruses throughout the experiment. The relationship between virus particle counts with TCID₅₀ at time 0 showed good linearity response; their ratio was almost constant. The virus particle-to-TCID₅₀ ratio varied between 146 and 426 (mean±SD: 282±103) for CAdV-1, between 36 and 79 (57±18) for FCV and between 110 and 249 (167±53) for BoHV-1. The proportion of non-infectious particles did not change throughout the experiment for either CAdV-1 or BoHV-1. However, a decrease in virus infectious ability disclosed by TCID₅₀ indicated that the fraction of non-infectious particles in FCV increased 300,000 times when time 0 and 48 h were compared. The quantitation of viruses with TEM is a simple and rapid protocol for virus quantitation but account must

  4. HIV-1 Integrase Binds the Viral RNA Genome and Is Essential during Virion Morphogenesis.

    PubMed

    Kessl, Jacques J; Kutluay, Sebla B; Townsend, Dana; Rebensburg, Stephanie; Slaughter, Alison; Larue, Ross C; Shkriabai, Nikoloz; Bakouche, Nordine; Fuchs, James R; Bieniasz, Paul D; Kvaratskhelia, Mamuka

    2016-08-25

    While an essential role of HIV-1 integrase (IN) for integration of viral cDNA into human chromosome is established, studies with IN mutants and allosteric IN inhibitors (ALLINIs) have suggested that IN can also influence viral particle maturation. However, it has remained enigmatic as to how IN contributes to virion morphogenesis. Here, we demonstrate that IN directly binds the viral RNA genome in virions. These interactions have specificity, as IN exhibits distinct preference for select viral RNA structural elements. We show that IN substitutions that selectively impair its binding to viral RNA result in eccentric, non-infectious virions without affecting nucleocapsid-RNA interactions. Likewise, ALLINIs impair IN binding to viral RNA in virions of wild-type, but not escape mutant, virus. These results reveal an unexpected biological role of IN binding to the viral RNA genome during virion morphogenesis and elucidate the mode of action of ALLINIs. PMID:27565348

  5. Identification of immunodominant proteins of the microalgae Prototheca by proteomic analysis.

    PubMed

    Irrgang, A; Weise, C; Murugaiyan, J; Roesler, U

    2015-01-01

    Prototheca zopfii associated with bovine mastitis and human protothecosis exists as two genotypes, of which genotype 1 is considered as non-infectious and genotype 2 as infectious. The mechanism of infection has not yet been described. The present study was aimed to identify genotype 2-specific immunodominant proteins. Prototheca proteins were separated using two-dimensional gel electrophoresis. Subsequent western blotting with rabbit hyperimmune serum revealed 28 protein spots. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry analysis resulted in the identification of 15 proteins including malate dehydrogenase, elongation factor 1-alpha, heat shock protein 70, and 14-3-3 protein, which were previously described as immunogenic proteins of other eukaryotic pathogens. PMID:25755891

  6. Generalized Lymphadenopathy as Presenting Feature of Systemic Lupus Erythematosus: Case Report and Review of the Literature

    PubMed Central

    Afzal, Wais; Arab, Talal; Ullah, Tofura; Teller, Katerina; Doshi, Kaushik J.

    2016-01-01

    Lymphadenopathy could represent a vast spectrum of etiologies including infectious and non-infectious diseases. Besides proper history taking, physical examination, and laboratory investigations, a tissue diagnosis is often necessary to unmask the cause of generalized lymphadenopathy. Here we present a 23-year-old woman who was admitted for diffuse generalized lymphadenopathy, fatigue, malaise, weight loss, nausea, and bilateral lower extremity edema. She reported a history of seizures as well as stroke 2 years prior with no other medical conditions present. Although malignant and infectious etiologies were initially the primary targets for workup, her history of seizures and stroke remained a dilemma. Extensive workup for malignant and infectious diseases was unrevealing; however, rheumatologic workup was eventually positive for systemic lupus erythematosus (SLE). This case illustrates that extensive generalized diffuse lymphadenopathy may be a presenting feature of SLE and should be considered in the differential diagnosis of patients presenting with diffuse lymphadenopathy and constitutional symptoms. PMID:27738484

  7. Characterization of herpes simplex virus type 1 L-particle assembly and egress in hippocampal neurones by electron cryo-tomography

    PubMed Central

    Ibiricu, Iosune; Maurer, Ulrike E; Grünewald, Kay

    2013-01-01

    Visualizing virus–host interactions in situ inside infected cells by electron cryo-tomography provides unperturbed snapshots of the infection process. Here we focus on the assembly and egress pathway of herpesviruses. Cells infected with herpes simplex virus 1 produce and release not only infective virions but also non-infectious light particles (L-particles). L-particles are devoid of viral capsids and genomes. In this study, we analysed L-particle assembly and egress pathways in cultured dissociated hippocampus neurones by electron cryo-tomography. Virion and L-particle formation occurred in close proximity, suggesting shared assembly and exit pathways. Clathrin-like coats were occasionally associated with L-particle and virion assembly sites. Further, we compared the three-dimensional ultrastructure of intracellular and extracellular L-particles and quantified their diameters and the abundance of inclusion bodies contained. PMID:23253400

  8. An atypical form of cervicofacial actinomycosis treated with short but intensive antibiotic regimen

    PubMed Central

    Shah, Kaushal Mahendra; Karagir, Amol; Kanitkar, Sampada; Koppikar, Rajesh

    2013-01-01

    Human actinomycosis is a rare soft tissue infection caused by Gram-positive, anaerobic bacteria Actinomyces israelii, a commensal of the oral cavity. The major clinical forms of actinomycosis are cervicofacial, thoracic, abdominal and pelvic forms. The cervicofacial region is most commonly affected. Actinomycosis is sometimes difficult to diagnose and it should be borne in mind in the differential diagnosis of numerous infectious and non-infectious diseases. We report a patient who came with tooth pain and extra-oral swelling which later on presented as multiple draining sinuses. Our initial suspicion was dento-alveolar abscess or osteomyelitis. However, a culture of the discharge and subsequent biopsy revealed actinomycetes, confirming cervicofacial actinomycosis, but presenting itself not as the typical ‘lumpy jaw’. The patient was successfully treated conservatively with a short but intensive antibiotic course. PMID:23580677

  9. What we are watching—five top global infectious disease threats, 2012: a perspective from CDC’s Global Disease Detection Operations Center

    PubMed Central

    Christian, Kira A.; Ijaz, Kashef; Dowell, Scott F.; Chow, Catherine C.; Chitale, Rohit A.; Bresee, Joseph S.; Mintz, Eric; Pallansch, Mark A.; Wassilak, Steven; McCray, Eugene; Arthur, Ray R.

    2013-01-01

    Disease outbreaks of international public health importance continue to occur regularly; detecting and tracking significant new public health threats in countries that cannot or might not report such events to the global health community is a challenge. The Centers for Disease Control and Prevention’s (CDC) Global Disease Detection (GDD) Operations Center, established in early 2007, monitors infectious and non-infectious public health events to identify new or unexplained global public health threats and better position CDC to respond, if public health assistance is requested or required. At any one time, the GDD Operations Center actively monitors approximately 30–40 such public health threats; here we provide our perspective on five of the top global infectious disease threats that we were watching in 2012: (1) avian influenza A (H5N1), (2) cholera, (3) wild poliovirus, (4) enterovirus-71, and (5) extensively drug-resistant tuberculosis. PMID:23827387

  10. A unique case of phaeohyphomycosis subretinal abscess in a patient with arthropathy and lung pathology.

    PubMed

    Matthews, Bryan J; Partridge, David; Sheard, Richard M; Rennie, Ian G; Mudhar, Hardeep Singh

    2013-12-01

    A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario.

  11. Physical properties of single- and double-stranded coliphage ribonucleic acid

    PubMed Central

    Bishop, D. H. L.

    1966-01-01

    1. The physical characteristics of single- and double-stranded coliphage RNA with regard to their sedimentation behaviour in gradients of sucrose in high or low ionic conditions were examined. The effect of heat on their sedimentation characteristics was also determined. 2. Single-stranded coliphage RNA was found to exist in three different forms having sedimentation coefficients 28s, 20s and 12s. The latter two were interchangeable, depending on ionic strength. All three were almost equally infectious to spheroplasts. 3. Double-stranded coliphage RNA was found to be non-infectious to spheroplasts and had sedimentation coefficients 15s and 12s. Thermal denaturation gave rise to infectious single-stranded 12s RNA. 4. Four possible hypotheses on the mechanism of replication of coliphage RNA are discussed. PMID:4165511

  12. A Bad Case of Good's Syndrome.

    PubMed

    Tachdjian, Raffi; Keller, Janet J; Pfeffer, Michael

    2014-12-01

    Good's syndrome is a relatively rare immunodeficiency condition that presents in the fourth or fifth decade of life and is defined by hypogammaglobulinemia in the setting of a thymoma. The humoral defect may be severe enough to cause an absence in B cells, with a consequent recurrence of sinopulmonary disease, chronic non-infectious diarrhea and opportunistic infections. The prognosis in patients with Good's syndrome appears to be worse than in those with X-linked agammaglobulinemia (XLA) and common variable immune deficiency (CVID). There have only been three cases of Good's syndrome associated with mycobacterium, and only one case with a cavitary lesion in the lungs. We present here a unique case of Good's syndrome with a non-mycobacterial cavitary lesion.

  13. Primary immunodeficiency update I: Syndromes associated with eczematous dermatitis

    PubMed Central

    Pichard, Dominique C.; Freeman, Alexandra F.; Cowen, Edward W.

    2015-01-01

    In the past decade, the availability of powerful molecular techniques has accelerated the pace of discovery of several new primary immunodeficiencies (PID) and revealed the biologic basis of other established PID. These genetic advances, in turn, have facilitated more precise phenotyping of associated skin and systemic manifestations and provide a unique opportunity to better understand the complex human immunologic response. These continuing medical education articles will provide an update of recent advances about PID that may be encountered by dermatologists through their association with eczematous dermatitis, infectious, and non-infectious cutaneous manifestations. Part I will discuss new primary immunodeficiencies that have an eczematous dermatitis. Part II will focus on primary immunodeficiencies that greatly increase susceptibility to fungal infection and the noninfectious presentations of PID. PMID:26282794

  14. Intra-articular and Peri-articular Tumours and Tumour Mimics- What a Clinician and Onco-imaging Radiologist Should Know

    PubMed Central

    DHANDA, Sunita; QUEK, Swee Tian; BATHLA, Girish; JAGMOHAN, Pooja

    2014-01-01

    Definitive determination of the cause of articular swelling may be difficult based on just the clinical symptoms, physical examinations and laboratory tests. Joint disorders fall under the realms of rheumatology and general orthopaedics; however, patients with joint conditions manifesting primarily as intra-articular and peri-articular soft tissue swelling may at times be referred to an orthopaedic oncology department with suspicion of a tumour. In such a situation, an onco-radiologist needs to think beyond the usual neoplastic lesions and consider the diagnoses of various non-neoplastic arthritic conditions that may be clinically masquerading as masses. Differential diagnoses of articular lesions include infectious and non-infectious synovial proliferative processes, degenerative lesions, deposition diseases, vascular malformations, benign and malignant neoplasms and additional miscellaneous conditions. Many of these diseases have specific imaging findings. Knowledge of these radiological characteristics in an appropriate clinical context will allow for a more confident diagnosis. PMID:24876802

  15. Tropical Skin Infections Among Israeli Travelers

    PubMed Central

    Solomon, Michal; Benenson, Shmuel; Baum, Sharon; Schwartz, Eli

    2011-01-01

    Infectious skin disorders are common dermatologic illnesses in travelers. Knowledge of post-travel–related infectious skin disorders will allow for effective pre- and post-travel counseling. All cases of returning travelers seen in our center seeking care for infectious skin diseases were included in this study. For a comparison, data on returned travelers with non-infectious skin diseases and healthy travelers who had pre-travel consultations in our institution were also analyzed. Altogether, skin-related diagnosis was reported in 540 ill travelers, and among them, 286 (53%) had infectious skin diseases. Tropical skin infection was diagnosed in 64% of the infectious cases. Travelers returning from Latin America were significantly more ill with tropical skin infections than those traveling to Asia and Africa, The most common diagnoses were cutaneous leishmaniasis, myiasis, and cutaneous larva migrans. In conclusion, tropical skin infections are common among Israeli travelers, especially among those who visited Latin America. PMID:22049040

  16. Serostatus Disclosure, Stigma Resistance, and Identity Management Among HIV-Positive Gay Men in Ireland.

    PubMed

    Murphy, Patrick J; Hevey, David; O'Dea, Siobhán; Ní Rathaille, Neans; Mulcahy, Fiona

    2016-09-01

    In this study, we examined how non-infectiousness due to antiretroviral therapy has affected HIV-positive gay men's experience of serostatus disclosure to casual sex partners. Interviews were conducted with 15 seropositive gay men living in Ireland. Using grounded theory, three constructions of non-disclosure were proposed-as self-protection, as a morally permissible act, and as a rejection of the HIV-positive identity. Each construction entailed an aspect related to the sexual exclusion of those living with HIV, and an aspect related to their social exclusion. The extent to which the lives of those interviewed were affected by stigma was starkly revealed, as was the extent to which they stigmatized others living with HIV and rejected the HIV-positive identity. The research highlights the failure to socially normalize HIV and that interventions are needed to reduce the distress associated with seropositivity.

  17. Gastric adenocarcinoma in the context of X-linked agammaglobulinemia: case report and review of the literature.

    PubMed

    Staines Boone, Aidé Tamara; Torres Martínez, María Guadalupe; López Herrera, Gabriela; de Leija Portilla, Julia O; Espinosa Padilla, Sara Elva; Espinosa Rosales, Francisco J; Lugo Reyes, Saúl Oswaldo

    2014-02-01

    The hallmarks of X-linked Agammaglobulinemia (XLA) are panhypogammaglobulinemia, absent B-cells, and recurrent sinopulmonary and gastrointestinal infections starting at an early age, as well as other infections like cellulitis, meningitis, arthritis and sepsis. A number of non-infectious complications have been reported in these patients, including autoimmune diseases and malignancy, especially lymphomas. Here, we report the case of a 30-year old man who developed gastric adenocarcinoma in the context of XLA. Previous reports of, and hypotheses addressing the development of cancer in patients with XLA, are also summarized. Solid cancer in XLA affects mainly the gastrointestinal tract and seems to be related to chronic infection. A natural evolution can be traced back from gastric adenocarcinoma to megaloblastic anemia due to achlorhydria in the context of chronic infection; periodic endoscopy thus seems justified to detect and treat carcinoma in early stages. PMID:24338562

  18. Autophagy in acute brain injury.

    PubMed

    Galluzzi, Lorenzo; Bravo-San Pedro, José Manuel; Blomgren, Klas; Kroemer, Guido

    2016-08-01

    Autophagy is an evolutionarily ancient mechanism that ensures the lysosomal degradation of old, supernumerary or ectopic cytoplasmic entities. Most eukaryotic cells, including neurons, rely on proficient autophagic responses for the maintenance of homeostasis in response to stress. Accordingly, autophagy mediates neuroprotective effects following some forms of acute brain damage, including methamphetamine intoxication, spinal cord injury and subarachnoid haemorrhage. In some other circumstances, however, the autophagic machinery precipitates a peculiar form of cell death (known as autosis) that contributes to the aetiology of other types of acute brain damage, such as neonatal asphyxia. Here, we dissect the context-specific impact of autophagy on non-infectious acute brain injury, emphasizing the possible therapeutic application of pharmacological activators and inhibitors of this catabolic process for neuroprotection. PMID:27256553

  19. [AM and its application in plant disease prevention of Chinese medicinal herbs cultivation].

    PubMed

    Xiao, Wenjuan; Yang, Guang; Chen, Meilan; Guo, Lanpin; Wang, Min

    2011-02-01

    To study the beneficial effect of AMF from the utilization achievement in the agroforestry research, we discuss the application of AM in medicinal plant disease prevention and control. This paper summarized the type of medicinal plant disease, the influence of plant disease and the commonly used prevention method in production. As for the adverse consequences caused by plant's non-infectious and infectious diseases, AM has some improvement function. Something will affect the function of AM in the prevention of medicinal plant disease, for example, the relationship between AMF and the plants, the quantity, the time and the environmental factors about AMF inoculation and so on. In order to achieve the useful effect of AM in the prevention of medicinal plant disease, we should choose the suitable condition during production in practice to carry on the vaccination. PMID:21585020

  20. [Hypoglycemic and hypolipidemic effects of quercetin and its glycosides].

    PubMed

    Yan, Shu-xia; Li, Xian; Sun, Chong-de; Chen, Kun-song

    2015-12-01

    Quercetin and its glycosides are important flavonols in traditional herbal drugs and plant-derived food, and they have diverse hiological activities such as antioxidant, anticarcinogenic, anti-inflammatory, hypoglycemic and hypolipidemic activities. Numerous studies have demonstrated that quercetin and its glycosides were effective in the prevention and treatment of non-infectious chronic disease such as diabetes, obesity, and hyperlipidemia. They can regulate glucose and lipid metaholism through different mechanisms. They can decrease blood glucose via protecting pancreatic/p cells or/and improving insulin sensitivity. Also, they have lipid-lowering effects, which may be the result of regulation of lipid catabolism or/and anabolism. Their distributions, as well as the hypoglycemic and hypolipidemic effects are reviewed in this paper. In addition, further bioactivities as well as their dose-activity relationship, structure-activity relationship, bioavailability, and future clinical application of quercetin and its glycosides are discussed and proposed. PMID:27141664

  1. Proteomic analysis of a matrix stone: a case report.

    PubMed

    Canales, Benjamin K; Anderson, Lorraine; Higgins, LeeAnn; Frethem, Chris; Ressler, Alice; Kim, Il Won; Monga, Manoj

    2009-12-01

    Matrix stones are radiolucent bodies that present as soft muco-proteinaceous material within the renal collecting system. Following wide-angle X-ray diffraction (XRD) and scanning electron microscopy (SEM), we homogenized a surgically removed matrix stone, extracted and purified protein, and analyzed samples using tandem mass spectrometry for proteomic composition. Resulting spectra were searched using ProteinPilot 2.0, and identified proteins were reported with >95% confidence. Primary XRD mineral analysis was a biological apatite, and SEM revealed fibrous, net-like laminations containing bacterial, cellular, and crystalline material. Of the 33 unique proteins identified, 90% have not been previously reported within matrix stones and over 70% may be considered inflammatory or defensive in nature. Characterization of other matrix stone proteomes, in particular from non-infectious populations, may yield insights into the pathogenesis of this rare stone as well as the mineralogical process that occurs within crystalline calculi.

  2. Stromal fibroblast activation and their potential association with uterine fibroids (Review)

    PubMed Central

    ZHENG, LI-HUA; CAI, FENG-FENG; GE, ISABELL; BISKUP, EWELINA; CHENG, ZHONG-PING

    2014-01-01

    Uterine fibroids are the most common type of benign, gynecologic neoplasm and are the primary indication for performance of a hysterectomy, accounting for >200,000 hysterectomies annually in the USA. At present, females are younger and exhibit larger leiomyomas at the time of diagnosis. Cancer-associated fibroblasts in tumor microenvironments have emerged as an important target for cancer therapy. Repeated stimulation by infectious or non-infectious agents in the uterine tissues, including inflammation, mechanical forces or hypoxia, stimulate the resident fibroblasts to undergo specific activation and, thus, are significant in tumorigenesis. Furthermore, complex signaling pathways regulate the mechanisms of fibroblastic activation. The current review focuses on the molecular mechanisms of fibroblastic activation and the potential association with uterine leiomyoma pathogenesis, enabling an integrated pathogenic analysis for review of the therapeutic options. PMID:25013460

  3. Retroviral proteases and their roles in virion maturation.

    PubMed

    Konvalinka, Jan; Kräusslich, Hans-Georg; Müller, Barbara

    2015-05-01

    Proteolytic processing of viral polyproteins is essential for retrovirus infectivity. Retroviral proteases (PR) become activated during or after assembly of the immature, non-infectious virion. They cleave viral polyproteins at specific sites, inducing major structural rearrangements termed maturation. Maturation converts retroviral enzymes into their functional form, transforms the immature shell into a metastable state primed for early replication events, and enhances viral entry competence. Not only cleavage at all PR recognition sites, but also an ordered sequence of cleavages is crucial. Proteolysis is tightly regulated, but the triggering mechanisms and kinetics and pathway of morphological transitions remain enigmatic. Here, we outline PR structures and substrate specificities focusing on HIV PR as a therapeutic target. We discuss design and clinical success of HIV PR inhibitors, as well as resistance development towards these drugs. Finally, we summarize data elucidating the role of proteolysis in maturation and highlight unsolved questions regarding retroviral maturation.

  4. Adverse events related to blood transfusion

    PubMed Central

    Sahu, Sandeep; Hemlata; Verma, Anupam

    2014-01-01

    The acute blood transfusion reactions are responsible for causing most serious adverse events. Awareness about various clinical features of acute and delayed transfusion reactions with an ability to assess the serious reactions on time can lead to a better prognosis. Evidence-based medicine has changed today's scenario of clinical practice to decrease adverse transfusion reactions. New evidence-based algorithms of transfusion and improved haemovigilance lead to avoidance of unnecessary transfusions perioperatively. The recognition of adverse events under anaesthesia is always challenging. The unnecessary blood transfusions can be avoided with better blood conservation techniques during surgery and with anaesthesia techniques that reduce blood loss. Better and newer blood screening methods have decreased the infectious complications to almost negligible levels. With universal leukoreduction of red blood cells (RBCs), selection of potential donors such as use of male donors only plasma and restriction of RBC storage, most of the non-infectious complications can be avoided. PMID:25535415

  5. Anti-NMDA Receptor Encephalitis in the Polar Bear (Ursus maritimus) Knut

    PubMed Central

    Prüss, H.; Leubner, J.; Wenke, N. K.; Czirják, G. Á.; Szentiks, C. A.; Greenwood, A. D.

    2015-01-01

    Knut the polar bear of the Berlin Zoological Garden drowned in 2011 following seizures and was diagnosed as having suffered encephalitis of unknown etiology after exhaustive pathogen screening. Using the diagnostic criteria applied to human patients, we demonstrate that Knut’s encephalitis is almost identical to anti-NMDA receptor encephalitis which is a severe autoimmune disease representing the most common non-infectious encephalitis in humans. High concentrations of antibodies specific against the NR1 subunit of the NMDA receptor were detected in Knut’s cerebrospinal fluid. Histological examination demonstrated very similar patterns of plasma cell infiltration and minimal neuronal loss in affected brain areas. We conclude that Knut suffered anti-NMDA receptor encephalitis making his the first reported non-human case of this treatable disease. The results suggest that anti-NMDA receptor encephalitis may be a disease of broad relevance to mammals that until now has remained undiagnosed. PMID:26313569

  6. Dynamical Systems, Cytokine Storms, and Blood Filtration

    NASA Astrophysics Data System (ADS)

    Foster, Glenn; Hubler, Alfred

    2008-03-01

    Various infections and non-infectious diseases can trigger immune cells and the proteins (cytokines) the cells use to communicate with each other to be caught in a positive feedback loop; this ``cytokine storm'' is frequently fatal. By examining the network of cytokine-immune cell interactions we will illustrate why anti-mediator drugs have been generally ineffective in stopping this feedback. A more effective approach may be to try and reduce interactions by dampening many signals at once by filtering the cytokines out of the blood directly (think dialysis). We will argue that feedback on an out of control nonlinear dynamical system is easier to understand than its normal healthy state and apply filtration to a toy model of immune response.

  7. [Chronic recurrent multifocal osteomyelitis of the spine : Children and adolescent].

    PubMed

    von der Höh, N H; Völker, A; Jeszenszky, D; Heyde, C-E

    2016-06-01

    Chronic non-bacterial osteomyelitis (CNO) in childhood and adolescence is a non-infectious autoinflammatory disease of the bone with partial involvement of adjacent joints and soft tissue. The etiology is unknown. The disease can occur singular or recurrent. Individual bones can be affected and multiple lesions can occur. Chronic recurrent multifocal osteomyelitis (CRMO) shows the whole picture of CNO. Accompanying but temporally independent of the bouts of osteomyelitis, some patients show manifestations in the skin, eyes, lungs and the gastrointestinal tract. The article gives an overview of the clinical manifestations, diagnostic procedures, and treatment options for CRMO involvement of the spine based on the current literature and our own cases. PMID:27221306

  8. A retrospective study of non-suppurative encephalitis in beef cattle from western Canada.

    PubMed

    Sánchez, Sergio; Clark, Edward G; Wobeser, Gary A; Janzen, Eugene D; Philibert, Hélène

    2013-12-01

    Non-suppurative encephalitis occurs sporadically in beef cattle in western Canada, leading to loss of animals. This retrospective study investigated the presence of viral, bacterial, and protozoal antigens or DNA in 37 western Canadian feedlot cattle with non-suppurative encephalitis for which a cause had not been identified. Cases were selected based on the age of the animal (> 7 months), and clinical history of recumbency and depression. The identification of rabies in 1 case stresses the importance of including this viral disease in the list of differential diagnoses. Because there was variation in the severity, distribution, and type of lesions, it is possible that there may be more than 1 cause, but failure to identify an infectious agent might also suggest that non-infectious agents could play a role.

  9. Spectrum of mucocutaneous manifestations in human immunodeficiency virus-infected patients and its correlation with CD4 lymphocyte count.

    PubMed

    Fernandes, Michelle S; Bhat, Ramesh M

    2015-05-01

    In this study, 100 HIV-positive cases (63 men, 37 women) with skin findings were included. The mean CD4 T cell count was 253 cells/mm(3). A total of 235 dermatological manifestations were seen. The common infectious dermatoses were candidiasis (21%), Staphylococcal skin infections (20%), dermatophytoses (14%) and herpes zoster (6%). Among the non-infectious dermatoses were papular pruritic eruptions (20%), xerosis/ichthyosis (20%) and seborrhoeic dermatitis (16%). Statistically significant association (p < 0.05) with CD4 T cell count was seen in pyodermas, dermatophytoses and papular pruritic eruptions. Adverse drug reactions, diffuse hair loss, straightening of hairs and pigmentary changes were also noted. Although there was an absence of Kaposi's sarcoma in our study, a case of verrucous carcinoma of penis was noted.

  10. [Titration of the antibodies to the Crimean hemorrhagic fever virus in a drop of the cell suspension from infected tissue cultures by means of indirect immunofluorescence].

    PubMed

    Zgurskaia, G N; Chumakov, M P

    1977-01-01

    A comparatively simple method has been developed and tested for the detection and titration of antibody to Crimean hemorrhagic fever virus (CHF) by indirect immunofluorescence on slides with previously prepared acetone-inactivated virus in drops of cell suspension from infected BHK-21 and 6619 cell cultures. The antibody titers determined by the indirect immunofluorescence procedures were 4- and 8-fold higher than those determined by the complement-fixation test. This opens the possibility of using non-infectious antigens of cell suspensions for detection or titration by the FA procedure of antibody to CHF virus which may be of importance to diagnostic laboratories which have no conditions for work with live virus.

  11. Hazards of ionising radiation: 100 years of observations on man.

    PubMed Central

    Doll, R.

    1995-01-01

    In November 1895, when Conrad Röntgen serendipitously discovered X-rays, epidemiology was effectively limited to the study of infectious disease. What little epidemiological work was done in other fields was done as part of clinical medicine or under the heading of geographical pathology. The risks from exposure to X-rays and subsequently from other types of ionising radiation were consequently discovered by qualitative association or animal experiment. They did not begin to be quantified in humans until half a century later, when epidemiology emerged as a scientific discipline capable of quantifying risks of non-infectious disease and the scientific world was alerted to the need for assessing the effects of the radiation to which large populations might be exposed by the use of nuclear energy in peace and war. PMID:8519643

  12. Immune Mechanism: A ‘Double-Edged Sword’

    PubMed Central

    Musa, Mustaffa

    2013-01-01

    Immunology has now developed into an independent discipline in medicine which covers not only germ infection which is related to immunity solely but also covers a lot of non-infectious diseases such as autoimmune disease, allergies, and others. Therefore, “The Immune Mechanism: “A Double-Edged Sword” means that the immune mechanism (consisted of antibody mediated mechanism and T cell mediated mechanism), just like one edge playing the role of giving benefit (immunity) as it destroys the agent of infection, and another one can be detrimental as it will cause tissue/cell damages and then give rise to immune diseases (immunopathology). Now, the prevalence of these immune diseases is on the rise and has become a new challenge to our country towards developed country in 2020. Therefore, we have to make ample preparation (laboratory facilities/services, main power, and research) from now on in order to face the problems and challenges. PMID:23966827

  13. Brazilian pemphigus foliaceus anti-desmoglein 1 autoantibodies cross-react with sand fly salivary LJM11 antigen

    PubMed Central

    Qian, Ye; Jeong, Joseph S.; Maldonado, Mike; Valenzuela, Jesus G.; Gomes, Regis; Evangelista, Flor; Qaqish, Bahjat; Aoki, Valeria; Hans, Gunter; Rivitti, Evandro A.; Eaton, Donald; Diaz, Luis A.

    2012-01-01

    The environmental factors that contribute to the development of autoimmune diseases are largely unknown. Endemic pemphigus foliaceus in humans, known as Fogo Selvagem (FS) in Brazil, is mediated by pathogenic IgG4 autoantibodies against desmoglein1 (Dsg1). Clusters of FS overlap with those of leishmaniasis, a disease transmitted by sand fly (Lutzomyia longipalpis) bites. In this study we show that salivary antigens from the sand fly, and specifically the LJM11 salivary protein, are recognized by FS antibodies. Anti-Dsg1 monoclonal autoantibodies derived from FS patients also cross-react with LJM11. Mice immunized with LJM11 generate anti-Dsg1 antibodies. Thus, insect bites may deliver salivary antigens that initiate a cross-reactive IgG4 antibody response in genetically susceptible individuals and lead to subsequent FS. Our findings establish a clear relationship between an environmental, non-infectious antigen and the development of potentially pathogenic autoantibodies in an autoimmune disease. PMID:22798673

  14. Identification of immunodominant proteins of the microalgae Prototheca by proteomic analysis

    PubMed Central

    Irrgang, A.; Weise, C.; Murugaiyan, J.; Roesler, U.

    2014-01-01

    Prototheca zopfii associated with bovine mastitis and human protothecosis exists as two genotypes, of which genotype 1 is considered as non-infectious and genotype 2 as infectious. The mechanism of infection has not yet been described. The present study was aimed to identify genotype 2-specific immunodominant proteins. Prototheca proteins were separated using two-dimensional gel electrophoresis. Subsequent western blotting with rabbit hyperimmune serum revealed 28 protein spots. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry analysis resulted in the identification of 15 proteins including malate dehydrogenase, elongation factor 1-alpha, heat shock protein 70, and 14-3-3 protein, which were previously described as immunogenic proteins of other eukaryotic pathogens. PMID:25755891

  15. Building national public health capacity for managing chemical events: A case study of the development of health protection services in the United Kingdom

    PubMed Central

    Palmer, Stephen; Coleman, Gary

    2013-01-01

    The revised International Health Regulations (2005) require that countries develop plans for chemical threats. In 2012, the World Health Assembly reported that most countries had not yet achieved ‘adequate capacity'. We review the evolution of chemical hazards services in the United Kingdom, the result of 15 years of grass-roots pressure and an accumulating weight of chemical incidents that eventually convinced the UK Department of Health of the need for a new national public health function, culminating, in 2003, in the creation of the Chemical Hazards Division of the new Health Protection Agency. Ten years later, public health services are again being radically reorganized with the creation of Public Health England, potentially destabilizing health protection arrangements and creating confusion among roles in managing chemical emergencies. Incorporating health protection into a broader public health organization, however, offers a new opportunity to broaden the scope of health protection services to embrace prevention of non-infectious environmental diseases. PMID:23447032

  16. Infectious Aortitis.

    PubMed

    Ramirez, F Daniel; Jamison, Bruce M; Hibbert, Benjamin

    2016-09-28

    Aortitis is broadly divided into infectious and non-infectious etiologies, each with distinct treatment implications. We present the case of a patient who sustained a type A aortic dissection during urgent coronary angiography for acute coronary syndrome. Clinical findings and events during the procedure raised suspicion for an underlying vascular disorder; however, the diagnosis of staphylococcal aortitis was not made until pathological examination of resected tissue. Clues to the diagnosis of infectious aortitis noted throughout the patient's clinical course are detailed as are potential consequences of diagnostic delays and treatment decisions, underscoring the difficulties in recognizing and managing the condition. In addition, we describe a previously unreported complication of cardiac catheterization in the setting of an infectious aortopathy.

  17. [Nail diseases in cosmetology].

    PubMed

    Maleszka, Romuald; Ratajczak-Stefańska, Violetta; Boer, Magdalena; Kiedrowicz, Magdalena

    2010-01-01

    Clinical symptoms attributed to the nail apparatus and observed in cosmetology include atrophic or hypertrophic lesions, pathologic nail coloration, abnormalities of the nail surface, and disorders of the nail plate and bed junction. These symptoms may reflect pathologic processes limited to the nail apparatus or may be the consequence of a dermal or systemic disease. Even though the etiology of nail lesions is variegated, diseases of the nails are simply classified as infectious or non-infectious. The aim of this work was to present the most common diseases of the nail apparatus encountered in cosmetology. Often, nail diseases worsen the quality of life of the patient. In addition, the variegated symptomatology demonstrates that nail lesions should be viewed in a wider perspective because they often are important signs of pathologic processes taking place in the organism of the patient. PMID:21427814

  18. Somatic cells count in cow's bulk tank milk.

    PubMed

    Olechnowicz, Jan; Jaśkowski, Jedrzej M

    2012-06-01

    The objective of this study was therefore to present factors affecting somatic cell counts in bovine bulk milk as a result of intramammary infections as well as non-infectious factors. The paper presents also the impact of on-farm management practices on the level of bulk milk somatic cell counts and presents quality indicators in bulk tank milk. At the farm level bulk milk bacterial infection takes place through three main sources: bacterial contamination from the external surface of the udder and teats, from the surface of the milking equipment, and from mastitis microorganisms within the udder. The threshold of 200,000 cells/ml identifies bacteriological negative quarters of the udder. The counts of mammary pathogens in bulk tank milk are relatively low, on average not exceeding 1,000 cfu/ml. Environmental pathogens predominate in bulk tank milk samples with somatic cells count <300 × 10(3) ml. PMID:22230979

  19. An observational study of mortality on bison farms in Saskatchewan with special emphasis on malignant catarrhal fever.

    PubMed

    Epp, Tasha; Waldner, Cheryl; Woodbury, Murray

    2016-01-01

    In December 2011, the Malignant Catarrhal Fever (MCF) Task Force in Saskatchewan recommended that research be conducted on the relationship between the proximity of bison and sheep under typical commercial production settings and bison deaths due to MCF. The objective of this study was to evaluate all causes of death in bison herds and compare the incidence of MCF in herds at varying distances of exposure from sheep operations. Necropsies were completed on 76 of 133 bison reported to have died during the 18-month study period. A total of 7 MCF deaths was reported from 2 large herds within 1.0 km of sheep operations. Although there was a greater risk of MCF deaths in bison herds within 1.0 km of sheep operations than in herds more than 1.0 km away, the overall incidence of MCF deaths within the study period was very low. Most deaths were attributed to non-infectious causes, including copper deficiency.

  20. Nijmegen breakage syndrome and chronic polyarthritis.

    PubMed

    Pasic, Srdjan; Cupic, Maja; Jovanovic, Tanja; Djukic, Slobodanka; Kavaric, Maja; Lazarevic, Ivana

    2013-01-01

    We report on pediatric patient with Nijmegen breakage syndrome (NBS), a rare DNA repair disorder characterized by microcephaly, immunodeficiency and predisposition to malignant lymphomas, who developed juvenile idiopathic arthritis (JIA)-like polyarthritis. In patients with primary immunodeficiencies (PID), septic arthritis due to pyogenic bacteria or mycoplasmal arthritis are the most common osteoarticular manifestations. In certain PID, chronic, non-infectious arthritis resembling rheumatoid arthritis may occur. In our patient microbiologic cultures of synovial fluid including Mycoplasma spp. were negative. At first, because of suspected mycoplasmal arthritis we used macrolides and doxycycline combined with hydroxychloroquine but without therapeutic response. However, the use of rituximab led to remission of her polyarthritis lasting for 9 months. Autoimmune features were rarely reported in NBS. An occurrence of JIA-like, chronic polyarthritis in NBS, a DNA repair disorder characterized by decreased tolerance of immunosuppressive drugs such as methotrexate and a high natural risk for lymphomas, makes therapeutic approach even more complex. PMID:24044622

  1. Nijmegen breakage syndrome and chronic polyarthritis

    PubMed Central

    2013-01-01

    We report on pediatric patient with Nijmegen breakage syndrome (NBS), a rare DNA repair disorder characterized by microcephaly, immunodeficiency and predisposition to malignant lymphomas, who developed juvenile idiopathic arthritis (JIA)-like polyarthritis. In patients with primary immunodeficiencies (PID), septic arthritis due to pyogenic bacteria or mycoplasmal arthritis are the most common osteoarticular manifestations. In certain PID, chronic, non-infectious arthritis resembling rheumatoid arthritis may occur. In our patient microbiologic cultures of synovial fluid including Mycoplasma spp. were negative. At first, because of suspected mycoplasmal arthritis we used macrolides and doxycycline combined with hydroxychloroquine but without therapeutic response. However, the use of rituximab led to remission of her polyarthritis lasting for 9 months. Autoimmune features were rarely reported in NBS. An occurrence of JIA-like, chronic polyarthritis in NBS, a DNA repair disorder characterized by decreased tolerance of immunosuppressive drugs such as methotrexate and a high natural risk for lymphomas, makes therapeutic approach even more complex. PMID:24044622

  2. Transfusion-transmitted parasitic infections.

    PubMed

    Singh, Gagandeep; Sehgal, Rakesh

    2010-07-01

    The transmission of parasitic organisms through transfusion is relatively rare. Of the major transfusion-transmitted diseases, malaria is a major cause of TTIP in tropical countries whereas babesiosis and Chagas' disease pose the greatest threat to donors in the USA In both cases, this is due to the increased number of potentially infected donors. There are no reliable serologic tests available to screen donors for any of these organisms and the focus for prevention remains on adherence to donor screening guidelines that address travel history and previous infection with the etiologic agent. One goal is the development of tests that are able to screen for and identify donors potentially infectious for parasitic infections without causing the deferral of a large number of non-infectious donors or significantly increasing costs. Ideally, methods to inactivate the infectious organism will provide an element of added safety to the blood supply. PMID:20859503

  3. Transfusion-transmitted parasitic infections

    PubMed Central

    Singh, Gagandeep; Sehgal, Rakesh

    2010-01-01

    The transmission of parasitic organisms through transfusion is relatively rare. Of the major transfusion-transmitted diseases, malaria is a major cause of TTIP in tropical countries whereas babesiosis and Chagas’ disease pose the greatest threat to donors in the USA In both cases, this is due to the increased number of potentially infected donors. There are no reliable serologic tests available to screen donors for any of these organisms and the focus for prevention remains on adherence to donor screening guidelines that address travel history and previous infection with the etiologic agent. One goal is the development of tests that are able to screen for and identify donors potentially infectious for parasitic infections without causing the deferral of a large number of non-infectious donors or significantly increasing costs. Ideally, methods to inactivate the infectious organism will provide an element of added safety to the blood supply. PMID:20859503

  4. The emerging role of autophagy in peroxisome dynamics and lipid metabolism of phyllosphere microorganisms.

    PubMed

    Oku, Masahide; Takano, Yoshitaka; Sakai, Yasuyoshi

    2014-01-01

    Eukaryotic microorganisms resident in the phyllosphere (above-ground, plant-surface environments) undergo dynamic changes in nutrient conditions and adapt their metabolic pathways during proliferation or in the course of infection of host plants. Some of these metabolic switches are accomplished by regulation of organelle abundance. Recent studies have shown that autophagy plays a major role in reducing the organelle quantity, thereby contributing to the metabolic switch required for survival or virulence of the microorganisms in the phyllosphere. In this mini review the metabolic pathways in several phytopathogenic fungi and the non-infectious asporogenous yeast Candida boidinii, which involve lipid droplets and peroxisomes, are summarized. The physiological functions of Atg (Autophagy-related) proteins in these organisms are discussed in relation to the dynamics of these two important organelles. PMID:24653730

  5. Sunitinib induced pyoderma gangrenosum-like ulcerations.

    PubMed

    Akanay-Diesel, S; Hoff, N P; Kürle, S; Haes, J; Erhardt, A; Häussinger, D; Schulte, K-W; Bölke, Edwin; Matuschek, C; Budach, W; Gerber, P A; Homey, B

    2011-11-10

    Pyoderma gangrenosum is a non-infectious neutro?philic skin disease commonly associated with underlying systemic diseases. Histopathological and laboratory diagnostics are unspecific in the majority of the cases and the diagnosis is made in accordance with the clinical picture. Here, we report the case of a 69-year old man with progredient pyoderma gangrenosum-like ulcerations under treatment with sunitinib due to hepatocellular carcinoma. A conventional ulcer therapy did not lead to a regression of the lesions. Solely cessation of sunitinib therapy resulted in an improvement of the ulcerations. Sunitinib is a multikinase inhibitor that targets the PDGF-α- and ?β-, VEGF-1-3-, KIT-, FLT3-, CSF-1- and RET-receptor, thereby impairing tumour proliferation, pathological angiogenesis and metastasation. Here, we demonstrate that pyoderma gangrenosum-like ulcers may represent a serious side effect of sunitinib-based anti-cancer treatment. PMID:22027642

  6. [What is a "poison"? Proposal of definition].

    PubMed

    Guitart, Raimon; Giménez, Nuria

    2012-02-18

    We discuss different interpretations of the term poison as well as the need of bringing up to date the changes in this matter according to the science progress. A clear and exact definition is proposed after analysing the factors that affect the relativity of the concept and its boundaries. The proposal for a definition is presented taking into account the most broadly extended concepts concerning its significance. That is to say: "a poison is, for human beings and their non-pathogenic and non-harmful biological environment, an electromagnetic or corpuscular radiation, or a non-infectious chemical agent, structured no larger in size than a small particle or fibre that, after being generated internally or after contact, penetration and/or absorption by a live organism, in sufficiently high dose, can produce or produces a direct or indirect adverse effect unrelated to its temperature or measurable electrical potential difference". The scientific knowledge needs accurate definitions to avoid ambiguities.

  7. Characterization of virus-like particles by atomic force microscopy in ambient conditions

    NASA Astrophysics Data System (ADS)

    Oropesa, Reinier; Ramos, Jorge R.; Falcón, Viviana; Felipe, Ariel

    2013-06-01

    Recombinant virus-like particles (VLPs) are attractive candidates for vaccine design since they resemble native viroids in size and morphology, but they are non-infectious due to the absence of a viral genome. The visualization of surface morphologies and structures can be used to deepen the understanding of physical, chemical, and biological phenomena. Atomic force microscopy (AFM) is a useful tool for the visualization of soft biological samples in a nanoscale resolution. In this work we have investigated the morphology of recombinant surface antigens of hepatitis B (rHBsAg) VLPs from Cuban vaccine against hepatitis B. The rHBsAg VLPs sizes estimated by AFM between 15 and 30 nm are similar to those reported on previous transmission electron microscopy (TEM) studies.

  8. [Exanthema as a main symptom in the febrile child].

    PubMed

    Aebi, C

    2005-08-01

    Distinguishing in febrile children between harmless rashes and those, which require specific action, is a common problem in pediatric primary care. Major exanthematous diseases necessitating emergency hospitalization include invasive meningococcal disease and rarely gram-negative septicaemia caused by other pathogens, staphylococcal and streptococcal toxic shock syndrome, endocarditis, fever and rash in travellers returning from tropical countries and drug hypersensitivity syndrome. Therapeutic intervention is also necessary in patients with scarlet fever, rheumatic fever, varicella in postpuberal and immunocompromised individuals, in Kawasaki's disease, in Still's disease and in other non-infectious, inflammatory diseases (e.g., familial mediterranean fever). Finally, various specific measures need to be taken in reportable diseases, erythema infectiosum (parvovirus B19), primary HIV infection and in Henoch-Schölein purpura.

  9. Approach to Chronic Lymphocytic Meningitis.

    PubMed

    Khadilkar, Satish V; Nadkarni, Nilesh

    2015-09-01

    Chronic meningitis is a common clinical problem. Early diagnosis and appropriate therapy is important in improving the overall outcome and to prevent long-lasting sequels. As many etiological agents lead to the development of chronic lymphocytic meningitis, it is important to develop a systematic approach to the diagnosis; taking clues from history, examination and laboratory tests, to make an accurate diagnosis and institute appropriate therapy. This review focuses on the diagnostic approach towards the commonly encountered situation of chronic lymphocytic meningitis. Chronic meningitis is defined as meningeal inflammation that persists for more than 4 weeks. Chronic meningitis accounts for less than 10% of all the cases of meningitis.1 Causes of chronic lymphocytic meningitis are mainly divided into infectious and non-infectious listed in Table 1.2 Due to advancement in investigations, diseases causing chronic meningitis may be diagnosed earlier than 4 weeks and hence the definition should be considered as a rough guideline. PMID:27608867

  10. Putting endotoxin to work for us: monophosphoryl lipid A as a safe and effective vaccine adjuvant.

    PubMed

    Casella, C R; Mitchell, T C

    2008-10-01

    The development of non-infectious subunit vaccines greatly increases the safety of prophylactic immunization, but also reinforces the need for a new generation of immunostimulatory adjuvants. Because adverse effects are a paramount concern in prophylactic immunization, few new adjuvants have received approval for use anywhere in the developed world. The vaccine adjuvant monophosphoryl lipid A is a detoxified form of the endotoxin lipopolysaccharide, and is among the first of a new generation of Toll-like receptor agonists likely to be used as vaccine adjuvants on a mass scale in human populations. Much remains to be learned about this compound's mechanism of action, but recent developments have made clear that it is unlikely to be simply a weak version of lipopolysaccharide. Instead, monophosphoryl lipid A's structure seems to have fortuitously retained several functions needed for stimulation of adaptive immune responses, while shedding those associated with pro-inflammatory side effects.

  11. Vaccines in Multiple Sclerosis.

    PubMed

    Williamson, Eric M L; Chahin, Salim; Berger, Joseph R

    2016-04-01

    Vaccinations help prevent communicable disease. To be valuable, a vaccine's ability to prevent disease must exceed the risk of adverse effects from administration. Many vaccines present no risk of infection as they are comprised of killed or non-infectious components while other vaccines consist of live attenuated microorganisms which carry a potential risk of infection-particularly, in patients with compromised immunity. There are several unique considerations with respect to vaccination in the multiple sclerosis (MS) population. First, there has been concern that vaccination may trigger or aggravate the disease. Second, disease-modifying therapies (DMTs) employed in the treatment of MS may increase the risk of infectious complications from vaccines or alter their efficacy. Lastly, in some cases, vaccination strategies may be part of the treatment paradigm in attempts to avoid complications of therapy. PMID:26922172

  12. Probiotics for Infectious Diarrhea and Traveler's Diarrhea - What Do We Really Know?

    NASA Astrophysics Data System (ADS)

    Hibberd, Patricia L.

    Worldwide, diarrhea is the sixth leading cause of premature death (Lopez et al., 2006), accounting for more than two million deaths each year. The majority of the burden is borne in lower and middle income countries, and in children under age 5 (Kosek et al., 2003). Even in the United States where there is easy access to “safe” food and water, there are an estimated 211-375 million episodes of acute diarrhea each year, resulting in 900,000 hospitalizations and 6,000 deaths (Herikstad et al., 2002; Mead et al., 1999). While mortality from diarrhea has decreased over the last 30 years, the incidence and morbidity associated with diarrhea has not improved (Kosek et al., 2003). During the same time period an ever increasing number of enteric pathogens as well as non-infectious conditions have been recognized as causes of acute diarrhea (Guerrant et al., 2001).

  13. Synthetic RNAs Mimicking Structural Domains in the Foot-and-Mouth Disease Virus Genome Elicit a Broad Innate Immune Response in Porcine Cells Triggered by RIG-I and TLR Activation.

    PubMed

    Borrego, Belén; Rodríguez-Pulido, Miguel; Revilla, Concepción; Álvarez, Belén; Sobrino, Francisco; Domínguez, Javier; Sáiz, Margarita

    2015-07-17

    The innate immune system is the first line of defense against viral infections. Exploiting innate responses for antiviral, therapeutic and vaccine adjuvation strategies is being extensively explored. We have previously described, the ability of small in vitro RNA transcripts, mimicking the sequence and structure of different domains in the non-coding regions of the foot-and-mouth disease virus (FMDV) genome (ncRNAs), to trigger a potent and rapid innate immune response. These synthetic non-infectious molecules have proved to have a broad-range antiviral activity and to enhance the immunogenicity of an FMD inactivated vaccine in mice. Here, we have studied the involvement of pattern-recognition receptors (PRRs) in the ncRNA-induced innate response and analyzed the antiviral and cytokine profiles elicited in swine cultured cells, as well as peripheral blood mononuclear cells (PBMCs).

  14. Anti-NMDA Receptor Encephalitis in the Polar Bear (Ursus maritimus) Knut.

    PubMed

    Prüss, H; Leubner, J; Wenke, N K; Czirják, G Á; Szentiks, C A; Greenwood, A D

    2015-08-27

    Knut the polar bear of the Berlin Zoological Garden drowned in 2011 following seizures and was diagnosed as having suffered encephalitis of unknown etiology after exhaustive pathogen screening. Using the diagnostic criteria applied to human patients, we demonstrate that Knut's encephalitis is almost identical to anti-NMDA receptor encephalitis which is a severe autoimmune disease representing the most common non-infectious encephalitis in humans. High concentrations of antibodies specific against the NR1 subunit of the NMDA receptor were detected in Knut's cerebrospinal fluid. Histological examination demonstrated very similar patterns of plasma cell infiltration and minimal neuronal loss in affected brain areas. We conclude that Knut suffered anti-NMDA receptor encephalitis making his the first reported non-human case of this treatable disease. The results suggest that anti-NMDA receptor encephalitis may be a disease of broad relevance to mammals that until now has remained undiagnosed.

  15. Carbon monoxide-releasing molecule-A1 (CORM-A1) improves clinical signs of experimental autoimmune uveoretinitis (EAU) in rats.

    PubMed

    Fagone, Paolo; Mangano, Katia; Mammana, Santa; Cavalli, Eugenio; Di Marco, Roberto; Barcellona, Maria Luisa; Salvatorelli, Lucia; Magro, Gaetano; Nicoletti, Ferdinando

    2015-04-01

    Uveitis is a sight-threatening inflammatory disease of the eye which represents the third leading cause of blindness in the developed countries. The conventional pharmacological treatment includes corticosteroids and immunosuppressive agents, which are limited by their side effects. New therapeutic strategies are thus strongly needed. Exogenously-administered carbon monoxide (CO) may represent an effective treatment for conditions characterized by a dysregulated inflammatory response. Carbon monoxide-releasing molecules (CORMs) are a novel group of compounds capable of carrying and liberating controlled quantities of CO. Among CORMs, CORM-A1 represents the first example of water soluble CO releaser. We show here that CORM-A1 under a late prophylactic regime is able to significantly ameliorate the natural course of experimental autoimmune uveoretinitis, a rodent model of immunoinflammatory posterior uveitis. The present study strongly supports the development of CORM-A1 as a potential new drug for treatment of patients with non-infectious posterior uveitis.

  16. Anti-NMDA Receptor Encephalitis in the Polar Bear (Ursus maritimus) Knut.

    PubMed

    Prüss, H; Leubner, J; Wenke, N K; Czirják, G Á; Szentiks, C A; Greenwood, A D

    2015-01-01

    Knut the polar bear of the Berlin Zoological Garden drowned in 2011 following seizures and was diagnosed as having suffered encephalitis of unknown etiology after exhaustive pathogen screening. Using the diagnostic criteria applied to human patients, we demonstrate that Knut's encephalitis is almost identical to anti-NMDA receptor encephalitis which is a severe autoimmune disease representing the most common non-infectious encephalitis in humans. High concentrations of antibodies specific against the NR1 subunit of the NMDA receptor were detected in Knut's cerebrospinal fluid. Histological examination demonstrated very similar patterns of plasma cell infiltration and minimal neuronal loss in affected brain areas. We conclude that Knut suffered anti-NMDA receptor encephalitis making his the first reported non-human case of this treatable disease. The results suggest that anti-NMDA receptor encephalitis may be a disease of broad relevance to mammals that until now has remained undiagnosed. PMID:26313569

  17. Infective Causes of Stroke in Tropical Regions

    PubMed Central

    Moghtaderi, Ali; Alavi-Naini, Roya

    2012-01-01

    Vascular diseases of the brain are the second reason of the death and the first cause of morbidity and disability worldwide. In tropical areas stroke has some particular features related to the nature of torrid zones. There are some special causes of the stroke, mainly infectious, although some of them are non-infectious. The most important etiologies are malaria, tuberculosis, cysticercosis, syphilis, and Chagas’ disease. The mean age of the patients with stroke in tropical areas seems to be less than that in developed countries, and the disease is more prevalent in younger adults. Prevention and/or treatment of the classic risk factors as well as factors related to tropical zones are the mainstays of controlling the disease. It has to be mentioned that lack of human as well as financial resources makes it difficult to control and treat the disease properly. Herein, the etiologies and risk factors of the cerebrovascular diseases in tropical regions will be reviewd. PMID:23115446

  18. Measurements of procalcitonin facilitate targeting of endotoxin adsorption treatment in febrile neutropenic patients suffering from shock.

    PubMed

    Hara, Masaki; Tsuchiya, Ken; Nitta, Kosaku; Ando, Minoru

    2014-01-01

    Immediate initiation of hemoperfusion treatment with polymixin B immobilized fiber (PMX-DHP) is a potent strategy to improve hemodynamics in septic patients with critical circulatory failure. However, it is often difficult to accurately and rapidly differentiate between bacterial infections and non-infectious causes of shock in acutely critically-ill patients. Procalcitonin (PCT) measurements may assist in the early identification of bacterial infection/sepsis and determination of severity in such patients. We present two febrile neutropenic (FN) patients who developed severe shock after chemotherapy for hematological malignancies. PCT levels were markedly elevated in both patients (≥ 10 ng/ml), suggesting a high likelihood of bacterial infectious etiology as the cause of their shock, and thus they were promptly treated with PMX-DHP. Measurements of PCT may facilitate targeting of PMX-DHP treatment among FN patients suffering from shock, which may lead to better prognosis.

  19. Vaccines in Multiple Sclerosis.

    PubMed

    Williamson, Eric M L; Chahin, Salim; Berger, Joseph R

    2016-04-01

    Vaccinations help prevent communicable disease. To be valuable, a vaccine's ability to prevent disease must exceed the risk of adverse effects from administration. Many vaccines present no risk of infection as they are comprised of killed or non-infectious components while other vaccines consist of live attenuated microorganisms which carry a potential risk of infection-particularly, in patients with compromised immunity. There are several unique considerations with respect to vaccination in the multiple sclerosis (MS) population. First, there has been concern that vaccination may trigger or aggravate the disease. Second, disease-modifying therapies (DMTs) employed in the treatment of MS may increase the risk of infectious complications from vaccines or alter their efficacy. Lastly, in some cases, vaccination strategies may be part of the treatment paradigm in attempts to avoid complications of therapy.

  20. Synthetic RNAs Mimicking Structural Domains in the Foot-and-Mouth Disease Virus Genome Elicit a Broad Innate Immune Response in Porcine Cells Triggered by RIG-I and TLR Activation

    PubMed Central

    Borrego, Belén; Rodríguez-Pulido, Miguel; Revilla, Concepción; Álvarez, Belén; Sobrino, Francisco; Domínguez, Javier; Sáiz, Margarita

    2015-01-01

    The innate immune system is the first line of defense against viral infections. Exploiting innate responses for antiviral, therapeutic and vaccine adjuvation strategies is being extensively explored. We have previously described, the ability of small in vitro RNA transcripts, mimicking the sequence and structure of different domains in the non-coding regions of the foot-and-mouth disease virus (FMDV) genome (ncRNAs), to trigger a potent and rapid innate immune response. These synthetic non-infectious molecules have proved to have a broad-range antiviral activity and to enhance the immunogenicity of an FMD inactivated vaccine in mice. Here, we have studied the involvement of pattern-recognition receptors (PRRs) in the ncRNA-induced innate response and analyzed the antiviral and cytokine profiles elicited in swine cultured cells, as well as peripheral blood mononuclear cells (PBMCs). PMID:26193305

  1. Separation of endogenous viral elements from infectious Penaeus stylirostris densovirus using recombinase polymerase amplification.

    PubMed

    Jaroenram, Wansadaj; Owens, Leigh

    2014-01-01

    Non-infectious Penaeus stylirostris densovirus (PstDV)-related sequences in the shrimp genome cause false positive results with current PCR protocols. Here, we examined and mapped PstDV insertion profile in the genome of Australian Penaeus monodon. A DNA sequence which is likely to represent infectious PstDV was also identified and used as a target sequence for recombinase polymerase amplification (RPA)-based approach, developed for specifically detecting PstDV. The RPA protocol at 37 °C for 30 min showed no cross-reaction with other shrimp viruses, and was 10 times more sensitive than the 309F/R PCR protocol currently recommended by the World Organization for Animal Health (OIE) for PstDV diagnosis. These features, together with the simplicity of the protocol, requiring only a heating block for the reaction, offer opportunities for rapid and efficient detection of PstDV.

  2. Diagnostic and vaccine chapter.

    PubMed

    Wolfram, J H; Kokanov, S K; Verkhovsky, O A

    2010-10-01

    The first report in this chapter describes the development of a killed composite vaccine. This killed vaccine is non-infectious to humans, other animals, and the environment. The vaccine has low reactivity, is non-abortive, and does not induce pathomorphological alterations to the organs of vaccinated animals. The second report of this chapter describes the diagnostic value of a competitive enzyme-linked immunosorbent assay for detecting Brucella-specific antibodies and its ability to discriminate vaccinated cattle from infected cattle. The results indicated that the competitive enzyme-linked immunosorbent assay is more sensitive than traditional tests for detecting antibodies to Brucella abortus in naturally and experimentally infected cattle. PMID:20850688

  3. Retrovirus maturation-an extraordinary structural transformation.

    PubMed

    Mattei, Simone; Schur, Florian Km; Briggs, John Ag

    2016-06-01

    Retroviruses such as HIV-1 assemble and bud from infected cells in an immature, non-infectious form. Subsequently, a series of proteolytic cleavages catalysed by the viral protease leads to a spectacular structural rearrangement of the viral particle into a mature form that is competent to fuse with and infect a new cell. Maturation involves changes in the structures of protein domains, in the interactions between protein domains, and in the architecture of the viral components that are assembled by the proteins. Tight control of proteolytic cleavages at different sites is required for successful maturation, and the process is a major target of antiretroviral drugs. Here we will describe what is known about the structures of immature and mature retrovirus particles, and about the maturation process by which one transitions into the other. Despite a wealth of available data, fundamental questions about retroviral maturation remain unanswered. PMID:27010119

  4. A fresh perspective from immunologists and vaccine researchers: Active vaccination strategies to prevent and reverse Alzheimer’s disease

    PubMed Central

    Agadjanyan, M.G.; Petrovsky, N.; Ghochikyan, A.

    2015-01-01

    Traditional vaccination against infectious diseases relies on generation of cellular and humoral immune responses that act to protect the host from overt disease even although they do not induce sterilizing immunity. More recently, attempts have been made with mixed success to generate therapeutic vaccines against a wide range of non-infectious diseases including neurodegenerative disorders. Following the exciting first report of successful vaccine prevention of progression of an AD animal model in 1999, various epitope-based vaccines targeting beta-amyloid (Aβ) have proceeded to human clinical trials, with varied results. More recently, AD vaccines based on tau protein have advanced into clinical testing too. This review seeks to put perspective to the mixed results obtained so far in clinical trials of AD vaccines, and discuss the many pitfalls and misconceptions encountered on the path to a successful AD vaccine, including better standardization of immunological efficacy measures of antibodies, immunogenicity of platform/carrier and adjuvants. PMID:26192465

  5. [Eye and sarcoidosis].

    PubMed

    Weber, M

    1999-11-15

    Sarcoidosis is a multisystem granulomatous disease, of unknown cause, characterised by non-caseating granulomas. The most common organs involved are the lung, thoracic lymph nodes, skin and eyes. Ophthalmic involvement occurred in approximately 30% of the patients and could be the first manifestation of the disease and preceding pulmonary involvement for many years. If anterior uveitis is the most common ocular manifestation, the posterior segment involvement (intermediate uveitis, vasculitis, choroidal granuloma, macular oedema...) is less common but more visually disabling. The non specific ocular manifestations of the disease make it as a difficult diagnosis. The "suspected sarcoidosis" diagnosis is made with regards to clinical, radiological and (or) biological criteria and the "definitive diagnosis" require the demonstration of a non-caseating, granulomatous, non-infectious inflammation process on biopsy.

  6. Biosensors for the detection of bacteria.

    PubMed

    Deisingh, Anil K; Thompson, Michael

    2004-02-01

    This review will consider the role of biosensors towards the detection of infectious bacteria, although non-infectious ones will be considered where necessary. Recently, there has been a heightened interest in developing rapid and reliable methods of detection. This is especially true for detection of organisms involved in bioterrorism, food poisoning, and clinical problems such as antibiotic resistance. Biosensors can assist in achieving these goals, and sensors using several of the different types of transduction modes are discussed: electrochemical, high frequency (surface acoustic wave), and optical. The paper concludes with a discussion of three areas that may make a great impact in the next few years: integrated (lab-on-a-chip) systems, molecular beacons, and aptamers.

  7. [Bacterial genomics and metagenomics: clinical applications and medical relevance].

    PubMed

    Diene, S M; Bertelli, C; Pillonel, T; Schrenzel, J; Greub, G

    2014-11-12

    New sequencing technologies provide in a short time and at low cost high amount of genomic sequences useful for applications such as: a) development of diagnostic PCRs and/or serological tests; b) detection of virulence factors (virulome) or genes/SNPs associated with resistance to antibiotics (resistome) and c) investigation of transmission and dissemination of bacterial pathogens. Thus, bacterial genomics of medical importance is useful to clinical microbiologists, to infectious diseases specialists as well as to epidemiologists. Determining the microbial composition of a sample by metagenomics is another application of new sequencing technologies, useful to understand the impact of bacteria on various non-infectious diseases such as obesity, asthma, or diabetes. Genomics and metagenomics will likely become a specialized diagnostic analysis.

  8. Symmetrical Peripheral Gangrene Following Snake Bite

    PubMed Central

    Shastri, Minal; Parikh, Mital; Patel, Dwijal; Chudasma, Ketan

    2014-01-01

    SPG (Symmetrical peripheral gangrene) is defined as symmetrical distal ischemic damage at two or more sites in the absence of large vessels obstruction. It has been ascribed to a number of infectious and non infectious conditions including connective tissue, cardiovascular, neoplastic and iatrogenic causes. We report a unique case of SPG in a 35-year-old Indian female who developed spontaneous gangrene of the distal phalanges of the right and left index, middle, ring and little fingers and the distal phalanges of all toes of the right and left foot following a snake bite. There have been very few cases of peripheral gangrene and acute renal failure associated with snake bite in literature. PMID:25386476

  9. A novel endogenous betaretrovirus group characterized from polar bears (Ursus maritimus) and giant pandas (Ailuropoda melanoleuca).

    PubMed

    Mayer, Jens; Tsangaras, Kyriakos; Heeger, Felix; Avila-Arcos, María; Stenglein, Mark D; Chen, Wei; Sun, Wei; Mazzoni, Camila J; Osterrieder, Nikolaus; Greenwood, Alex D

    2013-08-15

    Transcriptome analysis of polar bears (Ursus maritimus) yielded sequences with highest similarity to the human endogenous retrovirus group HERV-K(HML-2). Further analysis of the polar bear draft genome identified an endogenous betaretrovirus group comprising 26 proviral copies and 231 solo LTRs. Molecular dating indicates the group originated before the divergence of bears from a common ancestor but is not present in all carnivores. Closely related sequences were identified in the giant panda (Ailuropoda melanoleuca) and characterized from its genome. We have designated the polar bear and giant panda sequences U. maritimus endogenous retrovirus (UmaERV) and A. melanoleuca endogenous retrovirus (AmeERV), respectively. Phylogenetic analysis demonstrated that the bear virus group is nested within the HERV-K supergroup among bovine and bat endogenous retroviruses suggesting a complex evolutionary history within the HERV-K group. All individual remnants of proviral sequences contain numerous frameshifts and stop codons and thus, the virus is likely non-infectious.

  10. Phenol-soluble modulins.

    PubMed

    Otto, Michael

    2014-03-01

    PSMs are a recently discovered family of short, amphipathic, α-helical peptides in staphylococci. Several PSMs are key virulence determinants, particularly in highly virulent Staphylococcus aureus strains. PSMα peptides of S. aureus facilitate neutrophil lysis after phagocytosis, and are key contributors to several infection types, including skin infection and bacteremia. Furthermore, all PSMs contribute to biofilm structuring and the dissemination of biofilm-associated infection. Cytolytic PSMs as produced by S. aureus appear to have evolved from original functions in the non-infectious lifestyle of staphylococci. The surfactant properties of PSMs, which they all share, are believed to facilitate growth on epithelial surfaces. The basic role of PSMs in staphylococcal physiology is underscored, for example, by their exceptionally strict and direct control by quorum-sensing and the presence of a dedicated secretion system. Targeting PSMs for anti-staphylococcal drug development may be a promising approach to overcome the problems associated with widespread antibiotic resistance in staphylococci.

  11. Turning off the tap: stopping tuberculosis transmission through active case-finding and prompt effective treatment.

    PubMed

    Yuen, Courtney M; Amanullah, Farhana; Dharmadhikari, Ashwin; Nardell, Edward A; Seddon, James A; Vasilyeva, Irina; Zhao, Yanlin; Keshavjee, Salmaan; Becerra, Mercedes C

    2015-12-01

    To halt the global tuberculosis epidemic, transmission must be stopped to prevent new infections and new cases. Identification of individuals with tuberculosis and prompt initiation of effective treatment to rapidly render them non-infectious is crucial to this task. However, in settings of high tuberculosis burden, active case-finding is often not implemented, resulting in long delays in diagnosis and treatment. A range of strategies to find cases and ensure prompt and correct treatment have been shown to be effective in high tuberculosis-burden settings. The population-level effect of targeted active case-finding on reducing tuberculosis incidence has been shown by studies and projected by mathematical modelling. The inclusion of targeted active case-finding in a comprehensive epidemic-control strategy for tuberculosis should contribute substantially to a decrease in tuberculosis incidence. PMID:26515675

  12. When amyloids become prions

    PubMed Central

    Sabate, Raimon

    2014-01-01

    The conformational diseases, linked to protein aggregation into amyloid conformations, range from non-infectious neurodegenerative disorders, such as Alzheimer's disease (AD), to highly infectious ones, such as human transmissible spongiform encephalopathies (TSEs). They are commonly known as prion diseases. However, since all amyloids could be considered prions (from those involved in cell-to-cell transmission to those responsible for real neuronal invasion), it is necessary to find an underlying cause of the different capacity to infect that each of the proteins prone to form amyloids has. As proposed here, both the intrinsic cytotoxicity and the number of nuclei of aggregation per cell could be key factors in this transmission capacity of each amyloid. PMID:24831240

  13. Sunitinib induced pyoderma gangrenosum-like ulcerations

    PubMed Central

    2011-01-01

    Pyoderma gangrenosum is a non-infectious neutrophilic skin disease commonly associated with underlying systemic diseases. Histopathological and laboratory diagnostics are unspecific in the majority of the cases and the diagnosis is made in accordance with the clinical picture. Here, we report the case of a 69-year old man with progredient pyoderma gangrenosum-like ulcerations under treatment with sunitinib due to hepatocellular carcinoma. A conventional ulcer therapy did not lead to a regression of the lesions. Solely cessation of sunitinib therapy resulted in an improvement of the ulcerations. Sunitinib is a multikinase inhibitor that targets the PDGF-α - and -β-, VEGF-1-3-, KIT-, FLT3-, CSF-1- and RET-receptor, thereby impairing tumour proliferation, pathological angiogenesis and metastasation. Here, we demonstrate that pyoderma gangrenosum-like ulcers may represent a serious side effect of sunitinib-based anti-cancer treatment. PMID:22027642

  14. Single-particle characterization of oncolytic vaccinia virus by flow virometry.

    PubMed

    Tang, Vera A; Renner, Tyler M; Varette, Oliver; Le Boeuf, Fabrice; Wang, Jiahu; Diallo, Jean-Simon; Bell, John C; Langlois, Marc-André

    2016-09-30

    Vaccinia virus (VV) is an oncolytic virus that is currently being evaluated as a promising cancer vaccine in several phase I, II and III clinical trials. Although several quality control tests are performed on each new batch of virus, these do not routinely include a systematic characterization of virus particle homogeneity, or relate the infectious titer to the total number of submicron sized particles (SSPs) present in the sample. SSPs are comprised of infectious virus and non-infectious viral particles, but also cell contaminants derived from the virus isolation procedures, such as cellular vesicles and debris. Here we have employed flow virometry (FV) analysis and sorting to isolate and characterize distinct SSP populations in therapeutic oncolytic VV preparations. We show that VV preparations contain SSPs heterogeneous in size and include large numbers of non-infectious VV particles. Furthermore, we used FV to illustrate how VV has a propensity to aggregate over time and under various handling and storage procedures. Accordingly, we find that together the infectious titer, the total number of SSPs, the number of viral genomes and the level of particle aggregation in a sample constitute useful parameters that greatly facilitate inter-sample assessment of physical quality, and also provides a means to monitor sample deterioration over time. Additionally, we have successfully employed FV sorting to further isolate virus from other particles by identifying a lipophilic dye that preferentially stains VV over other SSPs in the sample. Overall, we demonstrate that FV is a fast and effective tool that can be used to perform quality, and consistency control assessments of oncolytic VV vaccine preparations.

  15. Inactivated and subunit vaccines against porcine reproductive and respiratory syndrome: Current status and future direction.

    PubMed

    Renukaradhya, Gourapura J; Meng, Xiang-Jin; Calvert, Jay G; Roof, Michael; Lager, Kelly M

    2015-06-17

    Within a few years of its emergence in the late 1980s, the PRRS virus had spread globally to become the foremost infectious disease concern for the pork industry. Since 1994, modified live-attenuated vaccines against porcine reproductive and respiratory syndrome virus (PRRSV-MLV) have been widely used, but have failed to provide complete protection against emerging and heterologous field strains of the virus. Moreover, like many other MLVs, PRRSV-MLVs have safety concerns including vertical and horizontal transmission of the vaccine virus and several documented incidences of reversion to virulence. Thus, the development of efficacious inactivated vaccines is warranted for the control and eradication of PRRS. Since the early 1990s, researchers have been attempting to develop inactivated PRRSV vaccines, but most of the candidates have failed to elicit protective immunity even against homologous virus challenge. Recent research findings relating to both inactivated and subunit candidate PRRSV vaccines have shown promise, but they need to be pursued further to improve their heterologous efficacy and cost-effectiveness before considering commercialization. In this comprehensive review, we provide information on attempts to develop PRRSV inactivated and subunit vaccines. These includes various virus inactivation strategies, adjuvants, nanoparticle-based vaccine delivery systems, DNA vaccines, and recombinant subunit vaccines produced using baculovirus, plant, and replication-deficient viruses as vector vaccines. Finally, future directions for the development of innovative non-infectious PRRSV vaccines are suggested. Undoubtedly there remains a need for novel PRRSV vaccine strategies targeted to deliver cross-protective, non-infectious vaccines for the control and eradication of PRRS.

  16. Impact of Heat and Cold on Total and Cause-Specific Mortality in Vadu HDSS--A Rural Setting in Western India.

    PubMed

    Ingole, Vijendra; Rocklöv, Joacim; Juvekar, Sanjay; Schumann, Barbara

    2015-12-02

    Many diseases are affected by changes in weather. There have been limited studies, however, which have examined the relationship between heat and cold and cause-specific mortality in low and middle-income countries. In this study, we aimed to estimate the effects of heat and cold days on total and cause-specific mortality in the Vadu Health and Demographic Surveillance System (HDSS) area in western India. We used a quasi-Poisson regression model allowing for over-dispersion to examine the association of total and cause-specific mortality with extreme high (98th percentile, >39 °C) and low temperature (2nd percentile, <25 °C) over the period January 2003 to December 2012. Delays of 0 and 0-4 days were considered and relative risks (RR) with 95% confidence intervals (CI) were calculated. Heat was significantly associated with daily deaths by non-infectious diseases (RR = 1.57; CI: 1.18-2.10). There was an increase in the risk of total mortality in the age group 12-59 years on lag 0 day (RR = 1.43; CI: 1.02-1.99). A high increase in total mortality was observed among men at lag 0 day (RR = 1.38; CI: 1.05-1.83). We did not find any short-term association between total and cause-specific mortality and cold days. Deaths from neither infectious nor external causes were associated with heat or cold. Our results showed a strong and rather immediate relationship between high temperatures and non-infectious disease mortality in a rural population located in western India, during 2003-2012. This study may be used to develop targeted interventions such as Heat Early Warning Systems in the area to reduce mortality from extreme temperatures.

  17. Infections, inflammation and epilepsy.

    PubMed

    Vezzani, Annamaria; Fujinami, Robert S; White, H Steve; Preux, Pierre-Marie; Blümcke, Ingmar; Sander, Josemir W; Löscher, Wolfgang

    2016-02-01

    Epilepsy is the tendency to have unprovoked epileptic seizures. Anything causing structural or functional derangement of brain physiology may lead to seizures, and different conditions may express themselves solely by recurrent seizures and thus be labelled "epilepsy." Worldwide, epilepsy is the most common serious neurological condition. The range of risk factors for the development of epilepsy varies with age and geographic location. Congenital, developmental and genetic conditions are mostly associated with the development of epilepsy in childhood, adolescence and early adulthood. Head trauma, infections of the central nervous system (CNS) and tumours may occur at any age and may lead to the development of epilepsy. Infections of the CNS are a major risk factor for epilepsy. The reported risk of unprovoked seizures in population-based cohorts of survivors of CNS infections from developed countries is between 6.8 and 8.3 %, and is much higher in resource-poor countries. In this review, the various viral, bacterial, fungal and parasitic infectious diseases of the CNS which result in seizures and epilepsy are discussed. The pathogenesis of epilepsy due to brain infections, as well as the role of experimental models to study mechanisms of epileptogenesis induced by infectious agents, is reviewed. The sterile (non-infectious) inflammatory response that occurs following brain insults is also discussed, as well as its overlap with inflammation due to infections, and the potential role in epileptogenesis. Furthermore, autoimmune encephalitis as a cause of seizures is reviewed. Potential strategies to prevent epilepsy resulting from brain infections and non-infectious inflammation are also considered.

  18. Single-particle characterization of oncolytic vaccinia virus by flow virometry.

    PubMed

    Tang, Vera A; Renner, Tyler M; Varette, Oliver; Le Boeuf, Fabrice; Wang, Jiahu; Diallo, Jean-Simon; Bell, John C; Langlois, Marc-André

    2016-09-30

    Vaccinia virus (VV) is an oncolytic virus that is currently being evaluated as a promising cancer vaccine in several phase I, II and III clinical trials. Although several quality control tests are performed on each new batch of virus, these do not routinely include a systematic characterization of virus particle homogeneity, or relate the infectious titer to the total number of submicron sized particles (SSPs) present in the sample. SSPs are comprised of infectious virus and non-infectious viral particles, but also cell contaminants derived from the virus isolation procedures, such as cellular vesicles and debris. Here we have employed flow virometry (FV) analysis and sorting to isolate and characterize distinct SSP populations in therapeutic oncolytic VV preparations. We show that VV preparations contain SSPs heterogeneous in size and include large numbers of non-infectious VV particles. Furthermore, we used FV to illustrate how VV has a propensity to aggregate over time and under various handling and storage procedures. Accordingly, we find that together the infectious titer, the total number of SSPs, the number of viral genomes and the level of particle aggregation in a sample constitute useful parameters that greatly facilitate inter-sample assessment of physical quality, and also provides a means to monitor sample deterioration over time. Additionally, we have successfully employed FV sorting to further isolate virus from other particles by identifying a lipophilic dye that preferentially stains VV over other SSPs in the sample. Overall, we demonstrate that FV is a fast and effective tool that can be used to perform quality, and consistency control assessments of oncolytic VV vaccine preparations. PMID:27614781

  19. Prevalence of chronic medical conditions among inmates in the Texas prison system.

    PubMed

    Harzke, Amy J; Baillargeon, Jacques G; Pruitt, Sandi L; Pulvino, John S; Paar, David P; Kelley, Michael F

    2010-05-01

    Given the rapid growth and aging of the US prison population in recent years, the disease profile and health care needs of inmates portend to have far-reaching public health implications. Although numerous studies have examined infectious disease prevalence and treatment in incarcerated populations, little is known about the prevalence of non-infectious chronic medical conditions in US prison populations. The purpose of this study was to estimate the prevalence of selected non-infectious chronic medical conditions among inmates in the Texas prison system. The study population consisted of the total census of inmates who were incarcerated in the Texas Department of Criminal Justice for any duration from September 1, 2006 through August 31, 2007 (N=234,031). Information on medical diagnoses was obtained from a system-wide electronic medical record system. Overall crude prevalence estimates for the selected conditions were as follows: hypertension, 18.8%; asthma, 5.4%; diabetes, 4.2%; ischemic heart disease, 1.7%; chronic obstructive pulmonary disease, 0.96%; and cerebrovascular disease, 0.23%. Nearly one quarter (24.5%) of the study population had at least one of the selected conditions. Except for asthma, crude prevalence estimates of the selected conditions increased monotonically with age. Nearly two thirds (64.6%) of inmates who were >or=55 years of age had at least one of the selected conditions. Except for diabetes, crude prevalence estimates for the selected conditions were lower among Hispanic inmates than among non-Hispanic White inmates and African American inmates. Although age-standardized prevalence estimates for the selected conditions did not appear to exceed age-standardized estimates from the US general population, a large number of inmates were affected by one or more of these conditions. As the prison population continues to grow and to age, the burden of these conditions on correctional and community health care systems can be expected to increase

  20. sTREM-1 in bronchoalveolar lavage fluid in patients with pulmonary sarcoidosis, effect of smoking and inflammation.

    PubMed

    Suchankova, M; Bucova, M; E, Tibenska; Demian, J; Majer, I; Novosadova, H; Tedlova, E; Durmanova, V; Paulovicova, E

    2013-01-01

    Soluble TREM-1 (sTREM-1; Triggering receptor expressed on myelocytes) is a new inflammatory marker indicating the intensity of myeloid cells activation and the presence of infection caused by extracellular bacteria and mould.The aim of our work was to detect and compare the levels of sTREM-1 in bronchoalveolar lavage fluid (BALF) in patients with pulmonary sarcoidosis (PS) and other ILD of non-infectious origin. The sTREM-1 levels were assessed by ELISA in 46 patients suffering from ILD, out of them 22 with PS. The levels of BALF sTREM-1 in PS patients were higher than in control group of ILD patients of non-infectious origin, however, the difference was not statistically significant. Since all PS patients except one were non-smokers we compared non-smokers PS with non-smokers ILD patients and found four times higher levels of BALF sTREM-1 in PS patients (P = 0.001). We also recorded the effect of smoking, ILD smokers had higher sTREM-1 levels than non-smokers (P = 0.0019). Higher concentrations of sTREM-1 were detected in BALF of patients with lymphadenopathy and with elevated inflammatory markers in BALF. Our results show that BALF sTREM-1 could be a good inflammatory marker and could help in diagnosis and PS monitoring. Detection of sTREM-1 in BALF indirectly points to myeloid cells activation in the lungs and helps to complete the information about the number of myeloid cells commonly determined in BALF with additional information concerning the intensity of their activation. This is the first study that analyses BALF sTREM-1 levels in patients with PS (Tab. 8, Ref. 28). Text in PDF www.elis.sk.

  1. Nutrition Screening Tools and the Prediction of Clinical Outcomes among Chinese Hospitalized Gastrointestinal Disease Patients

    PubMed Central

    Wang, Fang; Chen, Wei; Bruening, Kay Stearns; Raj, Sudha

    2016-01-01

    Nutrition risk Screening 2002 (NRS-2002) and Subjective Global Assessment (SGA) are widely used screening tools but have not been compared in a Chinese population. We conducted secondary data analysis of a cross-sectional study which included 332 hospitalized gastrointestinal disease patients, collected by the Gastrointestinal department of Peking Union Medical College Hospital (PUMCH) in 2008. Results of NRS-2002 and SGA screening tools, complications, length of stay (LOS), cost, and death were measured. The agreement between the tools was assessed via Kappa (κ) statistics. The performance of NRS-2002 and SGA in predicting LOS and cost was assessed via linear regression. The complications and death prediction of tools was assessed using receiver operating characteristic (ROC) curves. NRS-2002 and SGA identified nutrition risk at 59.0% and 45.2% respectively. Moderate agreement (κ >0.50) between the two tools was found among all age groups except individuals aged ≤ 20, which only slight agreement was found (κ = 0.087). NRS-2002 (R square 0.130) and SGA (R square 0.140) did not perform differently in LOS prediction. The cost prediction of NRS-2002 (R square 0.198) and SGA (R square 0.190) were not significantly different. There was no difference between NRS-2002 (infectious complications: area under ROC (AUROC) = 0.615, death: AUROC = 0.810) and SGA (infectious complications: AUROC = 0.600, death: AUROC = 0.846) in predicting infectious complication and death, but NRS-2002 (0.738) seemed to perform better than SGA (0.552) in predicting non-infectious complications. The risk of malnutrition among patients was high. NRS-2002 and SGA have similar capacity to predict LOS, cost, infectious complications and death, but NRS-2002 performed better in predicting non-infectious complications. PMID:27490480

  2. Procalcitonin levels in fresh serum and fresh synovial fluid for the differential diagnosis of knee septic arthritis from rheumatoid arthritis, osteoarthritis and gouty arthritis.

    PubMed

    Wang, Chenggong; Zhong, DA; Liao, Qiande; Kong, Lingyu; Liu, Ansong; Xiao, Han

    2014-10-01

    Whether the levels of procalcitonin (PCT) in the serum and synovial fluid are effective indicators for distinguishing septic arthritis (SA) from non-infectious arthritis remains controversial. The present study aimed to evaluate whether PCT levels in fresh serum or fresh joint fluid may be used in the differential diagnosis of SA from rheumatoid arthritis (RA), osteoarthritis (OA) and gouty arthritis (GA). From January 2012 to June 2013, 23 patients with knee SA, 21 patients with RA, 40 patients with OA and 11 patients with GA were enrolled in the current study. The levels of PCT were measured within 24 h after specimen collection at room temperature. An enzyme-linked fluorescence assay (ELFA) was used to detect the levels of PCT in the serum and synovial fluid. The correlations between the levels of PCT in the serum and synovial fluid and the arthritic patient groups were determined by the Nemenyi test. Areas under the receiver operating characteristic (ROC) curve were calculated to evaluate the accuracy of the correlations. The levels of PCT in the serum and joint fluid of the patients in the SA group were higher compared with those of the other groups (P<0.01) and there were no significant differences among the RA, OA and GA groups in these levels. A PCT level of <0.5 μg/l in the serum and synovial fluid had high specificity in the differential diagnosis of SA from RA, OA and GA. Synovial fluid PCT revealed significantly greater sensitivity than serum PCT. The accuracy of the differential diagnosis of SA by the serum levels of PCT was significantly lower than that by the synovial fluid levels of PCT. The levels of PCT in the serum and synovial fluid may be used as alternative laboratory indicators to distinguish between SA and the non-infectious types of arthritis; however, the PCT levels in fresh synovial fluid are more sensitive and accurate indicators than PCT levels in fresh serum.

  3. Using Social Media for Actionable Disease Surveillance and Outbreak Management: A Systematic Literature Review

    PubMed Central

    Charles-Smith, Lauren E.; Reynolds, Tera L.; Cameron, Mark A.; Conway, Mike; Lau, Eric H. Y.; Olsen, Jennifer M.; Pavlin, Julie A.; Shigematsu, Mika; Streichert, Laura C.; Suda, Katie J.; Corley, Courtney D.

    2015-01-01

    Objective Research studies show that social media may be valuable tools in the disease surveillance toolkit used for improving public health professionals’ ability to detect disease outbreaks faster than traditional methods and to enhance outbreak response. A social media work group, consisting of surveillance practitioners, academic researchers, and other subject matter experts convened by the International Society for Disease Surveillance, conducted a systematic primary literature review using the PRISMA framework to identify research, published through February 2013, answering either of the following questions: Can social media be integrated into disease surveillance practice and outbreak management to support and improve public health? Can social media be used to effectively target populations, specifically vulnerable populations, to test an intervention and interact with a community to improve health outcomes? Examples of social media included are Facebook, MySpace, microblogs (e.g., Twitter), blogs, and discussion forums. For Question 1, 33 manuscripts were identified, starting in 2009 with topics on Influenza-like Illnesses (n = 15), Infectious Diseases (n = 6), Non-infectious Diseases (n = 4), Medication and Vaccines (n = 3), and Other (n = 5). For Question 2, 32 manuscripts were identified, the first in 2000 with topics on Health Risk Behaviors (n = 10), Infectious Diseases (n = 3), Non-infectious Diseases (n = 9), and Other (n = 10). Conclusions The literature on the use of social media to support public health practice has identified many gaps and biases in current knowledge. Despite the potential for success identified in exploratory studies, there are limited studies on interventions and little use of social media in practice. However, information gleaned from the articles demonstrates the effectiveness of social media in supporting and improving public health and in identifying target populations for intervention. A primary recommendation resulting

  4. Nutrition Screening Tools and the Prediction of Clinical Outcomes among Chinese Hospitalized Gastrointestinal Disease Patients.

    PubMed

    Wang, Fang; Chen, Wei; Bruening, Kay Stearns; Raj, Sudha; Larsen, David A

    2016-01-01

    Nutrition risk Screening 2002 (NRS-2002) and Subjective Global Assessment (SGA) are widely used screening tools but have not been compared in a Chinese population. We conducted secondary data analysis of a cross-sectional study which included 332 hospitalized gastrointestinal disease patients, collected by the Gastrointestinal department of Peking Union Medical College Hospital (PUMCH) in 2008. Results of NRS-2002 and SGA screening tools, complications, length of stay (LOS), cost, and death were measured. The agreement between the tools was assessed via Kappa (κ) statistics. The performance of NRS-2002 and SGA in predicting LOS and cost was assessed via linear regression. The complications and death prediction of tools was assessed using receiver operating characteristic (ROC) curves. NRS-2002 and SGA identified nutrition risk at 59.0% and 45.2% respectively. Moderate agreement (κ >0.50) between the two tools was found among all age groups except individuals aged ≤ 20, which only slight agreement was found (κ = 0.087). NRS-2002 (R square 0.130) and SGA (R square 0.140) did not perform differently in LOS prediction. The cost prediction of NRS-2002 (R square 0.198) and SGA (R square 0.190) were not significantly different. There was no difference between NRS-2002 (infectious complications: area under ROC (AUROC) = 0.615, death: AUROC = 0.810) and SGA (infectious complications: AUROC = 0.600, death: AUROC = 0.846) in predicting infectious complication and death, but NRS-2002 (0.738) seemed to perform better than SGA (0.552) in predicting non-infectious complications. The risk of malnutrition among patients was high. NRS-2002 and SGA have similar capacity to predict LOS, cost, infectious complications and death, but NRS-2002 performed better in predicting non-infectious complications. PMID:27490480

  5. A Review and Framework for Categorizing Current Research and Development in Health Related Geographical Information Systems (GIS) Studies

    PubMed Central

    Nøhr, C.; Sørensen, E. M.; Gudes, O.; Geraghty, E. M.; Shaw, N. T.; Bivona-Tellez, C.

    2014-01-01

    Summary Objectives The application of GIS in health science has increased over the last decade and new innovative application areas have emerged. This study reviews the literature and builds a framework to provide a conceptual overview of the domain, and to promote strategic planning for further research of GIS in health. Method The framework is based on literature from the library databases Scopus and Web of Science. The articles were identified based on keywords and initially selected for further study based on titles and abstracts. A grounded theory-inspired method was applied to categorize the selected articles in main focus areas. Subsequent frequency analysis was performed on the identified articles in areas of infectious and non-infectious diseases and continent of origin. Results A total of 865 articles were included. Four conceptual domains within GIS in health sciences comprise the framework: spatial analysis of disease, spatial analysis of health service planning, public health, health technologies and tools. Frequency analysis by disease status and location show that malaria and schistosomiasis are the most commonly analyzed infectious diseases where cancer and asthma are the most frequently analyzed non-infectious diseases. Across categories, articles from North America predominate, and in the category of spatial analysis of diseases an equal number of studies concern Asia. Conclusion Spatial analysis of diseases and health service planning are well-established research areas. The development of future technologies and new application areas for GIS and data-gathering technologies such as GPS, smartphones, remote sensing etc. will be nudging the research in GIS and health. PMID:25123730

  6. The effect of perioperative probiotics treatment for colorectal cancer: short-term outcomes of a randomized controlled trial

    PubMed Central

    Chen, Hongqi; Hong, Leiming; Feng, Junlan; Yang, Jun; Yang, Zhe; Shi, Chenzhang; Wu, Wen; Gao, Renyuan; Wei, Qing; Qin, Huanlong; Ma, Yanlei

    2016-01-01

    This study was designed to mainly evaluate the anti-infective effects of perioperative probiotic treatment in patients receiving confined colorectal cancer (CRC) respective surgery. From November 2011 to September 2012, a total of 60 patients diagnosed with CRC were randomly assigned to receive probiotic (n = 30) or placebo (n = 30) treatment. The operative and post-operative clinical results including intestinal cleanliness, days to first - flatus, defecation, fluid diet, solid diet, duration of pyrexia, average heart rate, length of intraperitoneal drainage, length of antibiotic therapy, blood index changes, rate of infectious and non-infectious complications, postoperative hospital stay, and mortality were investigated. The patient demographics were not significantly different (p > 0.05) between the probiotic treated and the placebo groups. The days to first flatus (3.63 versus 3.27, p = 0.0274) and the days to first defecation (4.53 versus 3.87, p = 0.0268) were significantly improved in the probiotic treated patients. The incidence of diarrhea was significantly lower (p = 0.0352) in probiotics group (26.67%, 8/30) compared to the placebo group (53.33%, 16/30). There were no statistical differences (p > 0.05) in other infectious and non-infectious complication rates including wound infection, pneumonia, urinary tract infection, anastomotic leakage, and abdominal distension. In conclusion, for those patients undergoing confined CRC resection, perioperative probiotic administration significantly influenced the recovery of bowel function, and such improvement may be of important clinical significance in reducing the short-term infectious complications such as bacteremia. PMID:26824990

  7. sTREM-1 in bronchoalveolar lavage fluid in patients with pulmonary sarcoidosis, effect of smoking and inflammation.

    PubMed

    Suchankova, M; Bucova, M; E, Tibenska; Demian, J; Majer, I; Novosadova, H; Tedlova, E; Durmanova, V; Paulovicova, E

    2013-01-01

    Soluble TREM-1 (sTREM-1; Triggering receptor expressed on myelocytes) is a new inflammatory marker indicating the intensity of myeloid cells activation and the presence of infection caused by extracellular bacteria and mould.The aim of our work was to detect and compare the levels of sTREM-1 in bronchoalveolar lavage fluid (BALF) in patients with pulmonary sarcoidosis (PS) and other ILD of non-infectious origin. The sTREM-1 levels were assessed by ELISA in 46 patients suffering from ILD, out of them 22 with PS. The levels of BALF sTREM-1 in PS patients were higher than in control group of ILD patients of non-infectious origin, however, the difference was not statistically significant. Since all PS patients except one were non-smokers we compared non-smokers PS with non-smokers ILD patients and found four times higher levels of BALF sTREM-1 in PS patients (P = 0.001). We also recorded the effect of smoking, ILD smokers had higher sTREM-1 levels than non-smokers (P = 0.0019). Higher concentrations of sTREM-1 were detected in BALF of patients with lymphadenopathy and with elevated inflammatory markers in BALF. Our results show that BALF sTREM-1 could be a good inflammatory marker and could help in diagnosis and PS monitoring. Detection of sTREM-1 in BALF indirectly points to myeloid cells activation in the lungs and helps to complete the information about the number of myeloid cells commonly determined in BALF with additional information concerning the intensity of their activation. This is the first study that analyses BALF sTREM-1 levels in patients with PS (Tab. 8, Ref. 28). Text in PDF www.elis.sk. PMID:24329508

  8. Survival patterns and mortality in the North American population of silvered leaf monkeys (Trachypithecus cristatus).

    PubMed

    Shelmidine, Nichole; McAloose, Denise; McCann, Colleen

    2013-03-01

    This study examines mortality in the North American (N.A.) population of silvered leaf monkeys (Trachypithecus cristatus) maintained in Association of Zoos and Aquarium's zoos. Understanding the causes of death associated with mortality rates (MR) can highlight relative susceptibility to intrinsic/extrinsic factors and differences between age and sex classes. Overall, life tables can provide insight into a species' population dynamics. We expect that the MR will fit the general mammalian and primate trends of a U-shaped curve when graphed, that males will have a higher MR and shorter life expectancy than females and that infant survival will be higher in captivity than in wild populations. Our results indicate that the N.A. captive population fits expected MR trends of a U-shaped curve. However, no differences in MR or life expectancy were found between the sexes. Infant survivorship did not differ from the wild or other leaf monkey populations (both captive and wild). The majority of infant deaths occurred on day 1 of life (52.8% of all infant deaths) and infant survivorship to 1 year was 66%. Neonates (n = 6, 31.6%) and infants (n = 4, 44.4%) died from trauma, juveniles (n = 2, 33.3%) from nutritional reasons, adults from non-infectious diseases (n = 7, 29.2%) and from post-surgical complications (n = 7, 29.2%), and older adults from idiopathic diseases (n = 4, 26.7%) and non-infectious diseases (n = 4, 26.7%). Only older adult males died from degenerative diseases (i.e., heart failure, n = 3, 42.9%). In general, this captive population demonstrated some similar trends to those observed in mammalian and Old World monkey populations.

  9. Deciphering the Contribution of Biofilm to the Pathogenesis of Peritoneal Dialysis Infections: Characterization and Microbial Behaviour on Dialysis Fluids.

    PubMed

    Sampaio, Joana; Machado, Diana; Gomes, Ana Marta; Machado, Idalina; Santos, Cledir; Lima, Nelson; Carvalho, Maria João; Cabrita, António; Rodrigues, Anabela; Martins, Margarida

    2016-01-01

    Infections are major complications in peritoneal dialysis (PD) with a multifactorial etiology that comprises patient, microbial and dialytic factors. This study aimed at investigating the contribution of microbial biofilms on PD catheters to recalcitrant infections and their interplay with PD related-factors. A prospective observational study was performed on 47 patients attending Centro Hospitalar of Porto and Vila Nova de Gaia/Espinho to whom the catheter was removed due to infectious (n = 16) and non-infectious causes (n = 31). Microbial density on the catheter was assessed by culture methods and the isolated microorganisms identified by matrix-assisted laser desorption/ionization time-of-flight intact cell mass spectrometry. The effect of conventional and three biocompatible PD solutions on 16 Coagulase Negative Staphylococci (CNS) and 10 Pseudomonas aeruginosa strains planktonic growth and biofilm formation was evaluated. Cultures were positive in 87.5% of the catheters removed due infectious and 90.3% removed due to non-infectious causes. However, microbial yields were higher on the cuffs of catheters removed due to infection vs. non-infection. Staphylococci (CNS and Staphylococcus aureus) and P. aeruginosa were the predominant species: 32% and 20% in the infection and 43.3% and 22.7% in the non-infection group, respectively. In general, PD solutions had a detrimental effect on planktonic CNS and P. aeruginosa strains growth. All strains formed biofilms in the presence of PD solutions. The solutions had a more detrimental effect on P. aeruginosa than CNS strains. No major differences were observed between conventional and biocompatible solutions, although in icodextrin solution biofilm biomass was lower than in bicarbonate/lactate solution. Overall, we show that microbial biofilm is universal in PD catheters with the subclinical menace of Staphylococci and P. aeruginosa. Cuffs colonization may significantly contribute to infection. PD solutions differentially

  10. Medical Waste Co-Firing Comes of Age

    SciTech Connect

    Smith-Berntson, K.; Stuart, J.M.

    1996-12-18

    In early 1992 DONLEE Technologies, Inc., in cooperation with the Department of Energy Fossil Energy Program, completed pilot testing of simulated non-infectious waste combustion, co-fired with coal, at its test facility in York, Pennsylvania. The goal of this testing was to demonstrate the ability of fluidized bed combustion to completely destruct medical waste with minimized dioxin emissions. The test facility is a full scale circulating fluidized bed unit with a maximum heat input capability of ten million BTU per hour. The tests showed that the circulating fluidized bed system is ideally suited to meet the medical/infectious waste destruction needs of the health care industry. The dioxin emission levels proved to be significantly lower than those from presently operating MWIS. Based on the successful test results, a cooperative agreement with the Department of Energy Fossil Energy Power Systems, DONLEE Technologies, and the Veterans Administration was reached to design, construct, and test a demonstration unit at the Veterans Administration Medical Center in Lebanon, Pennsylvania. Plant design and construction was started in 1993, with DONLEE Technologies functioning as both the technology supplier and the plant EPC contractor. After some delay the construction of the demonstration unit finally reached completion in the spring of 1996. The unit is currently undergoing initial shakedown and testing to verify the base operating parameters. The unit will first be fired with coal only, followed by the introduction of non-infectious waste and finally total waste, including the ``red bag`` material. The program calls for an extended testing period of up to one year. While the unit is being operated as part of the stream supply system at the VA Hospital, the hospital`s waste is destroyed via combustion in the Fluidized Bed Unit.

  11. Deciphering the Contribution of Biofilm to the Pathogenesis of Peritoneal Dialysis Infections: Characterization and Microbial Behaviour on Dialysis Fluids.

    PubMed

    Sampaio, Joana; Machado, Diana; Gomes, Ana Marta; Machado, Idalina; Santos, Cledir; Lima, Nelson; Carvalho, Maria João; Cabrita, António; Rodrigues, Anabela; Martins, Margarida

    2016-01-01

    Infections are major complications in peritoneal dialysis (PD) with a multifactorial etiology that comprises patient, microbial and dialytic factors. This study aimed at investigating the contribution of microbial biofilms on PD catheters to recalcitrant infections and their interplay with PD related-factors. A prospective observational study was performed on 47 patients attending Centro Hospitalar of Porto and Vila Nova de Gaia/Espinho to whom the catheter was removed due to infectious (n = 16) and non-infectious causes (n = 31). Microbial density on the catheter was assessed by culture methods and the isolated microorganisms identified by matrix-assisted laser desorption/ionization time-of-flight intact cell mass spectrometry. The effect of conventional and three biocompatible PD solutions on 16 Coagulase Negative Staphylococci (CNS) and 10 Pseudomonas aeruginosa strains planktonic growth and biofilm formation was evaluated. Cultures were positive in 87.5% of the catheters removed due infectious and 90.3% removed due to non-infectious causes. However, microbial yields were higher on the cuffs of catheters removed due to infection vs. non-infection. Staphylococci (CNS and Staphylococcus aureus) and P. aeruginosa were the predominant species: 32% and 20% in the infection and 43.3% and 22.7% in the non-infection group, respectively. In general, PD solutions had a detrimental effect on planktonic CNS and P. aeruginosa strains growth. All strains formed biofilms in the presence of PD solutions. The solutions had a more detrimental effect on P. aeruginosa than CNS strains. No major differences were observed between conventional and biocompatible solutions, although in icodextrin solution biofilm biomass was lower than in bicarbonate/lactate solution. Overall, we show that microbial biofilm is universal in PD catheters with the subclinical menace of Staphylococci and P. aeruginosa. Cuffs colonization may significantly contribute to infection. PD solutions differentially

  12. Deciphering the Contribution of Biofilm to the Pathogenesis of Peritoneal Dialysis Infections: Characterization and Microbial Behaviour on Dialysis Fluids

    PubMed Central

    Sampaio, Joana; Machado, Diana; Gomes, Ana Marta; Machado, Idalina; Santos, Cledir; Lima, Nelson; Carvalho, Maria João; Cabrita, António

    2016-01-01

    Infections are major complications in peritoneal dialysis (PD) with a multifactorial etiology that comprises patient, microbial and dialytic factors. This study aimed at investigating the contribution of microbial biofilms on PD catheters to recalcitrant infections and their interplay with PD related-factors. A prospective observational study was performed on 47 patients attending Centro Hospitalar of Porto and Vila Nova de Gaia/Espinho to whom the catheter was removed due to infectious (n = 16) and non-infectious causes (n = 31). Microbial density on the catheter was assessed by culture methods and the isolated microorganisms identified by matrix-assisted laser desorption/ionization time-of-flight intact cell mass spectrometry. The effect of conventional and three biocompatible PD solutions on 16 Coagulase Negative Staphylococci (CNS) and 10 Pseudomonas aeruginosa strains planktonic growth and biofilm formation was evaluated. Cultures were positive in 87.5% of the catheters removed due infectious and 90.3% removed due to non-infectious causes. However, microbial yields were higher on the cuffs of catheters removed due to infection vs. non-infection. Staphylococci (CNS and Staphylococcus aureus) and P. aeruginosa were the predominant species: 32% and 20% in the infection and 43.3% and 22.7% in the non-infection group, respectively. In general, PD solutions had a detrimental effect on planktonic CNS and P. aeruginosa strains growth. All strains formed biofilms in the presence of PD solutions. The solutions had a more detrimental effect on P. aeruginosa than CNS strains. No major differences were observed between conventional and biocompatible solutions, although in icodextrin solution biofilm biomass was lower than in bicarbonate/lactate solution. Overall, we show that microbial biofilm is universal in PD catheters with the subclinical menace of Staphylococci and P. aeruginosa. Cuffs colonization may significantly contribute to infection. PD solutions differentially

  13. Expression of CD11c and EMR2 on neutrophils: potential diagnostic biomarkers for sepsis and systemic inflammation.

    PubMed

    Lewis, S M; Treacher, D F; Edgeworth, J; Mahalingam, G; Brown, C S; Mare, T A; Stacey, M; Beale, R; Brown, K A

    2015-11-01

    There is a need for cellular biomarkers to differentiate patients with sepsis from those with the non-infectious systemic inflammatory response syndrome (SIRS). In this double-blind study we determined whether the expression of known (CD11a/b/c, CD62L) and putative adhesion molecules [CD64, CD97 and epidermal growth factor (EGF)-like molecule containing mucin-like hormone receptor (EMR2)] on blood neutrophils could serve as useful biomarkers of infection and of non-infectious SIRS in critically ill patients. We studied 103 patients with SIRS, 83 of whom had sepsis, and 50 healthy normal subjects, using flow cytometry to characterize neutrophils phenotypically in whole blood samples. Patients with SIRS had an increased prevalence of neutrophils expressing CD11c, CD64 and EMR2 in comparison with healthy subjects (P < 0.001), but normal expression of CD11a, CD11b, CD62L and CD97. An increase in the percentage of neutrophils bearing CD11c was associated with sepsis, EMR2 with SIRS and CD64 with sepsis and SIRS. Neutrophils expressing CD11c had the highest sensitivity (81%) and specificity (80%) for the detection of sepsis, and there was an association between the percentage of neutrophils expressing EMR2 and the extent of organ failure (P < 0.05). Contrary to other reports, we did not observe an abnormal expression of CD11b or CD62L on neutrophils from patients with SIRS, and suggest that this discrepancy is due to differences in cell processing protocols. We propose that blood neutrophils expressing CD11c and EMR2 be considered as potential biomarkers for sepsis and SIRS, respectively.

  14. Inactivated and subunit vaccines against porcine reproductive and respiratory syndrome: Current status and future direction.

    PubMed

    Renukaradhya, Gourapura J; Meng, Xiang-Jin; Calvert, Jay G; Roof, Michael; Lager, Kelly M

    2015-06-17

    Within a few years of its emergence in the late 1980s, the PRRS virus had spread globally to become the foremost infectious disease concern for the pork industry. Since 1994, modified live-attenuated vaccines against porcine reproductive and respiratory syndrome virus (PRRSV-MLV) have been widely used, but have failed to provide complete protection against emerging and heterologous field strains of the virus. Moreover, like many other MLVs, PRRSV-MLVs have safety concerns including vertical and horizontal transmission of the vaccine virus and several documented incidences of reversion to virulence. Thus, the development of efficacious inactivated vaccines is warranted for the control and eradication of PRRS. Since the early 1990s, researchers have been attempting to develop inactivated PRRSV vaccines, but most of the candidates have failed to elicit protective immunity even against homologous virus challenge. Recent research findings relating to both inactivated and subunit candidate PRRSV vaccines have shown promise, but they need to be pursued further to improve their heterologous efficacy and cost-effectiveness before considering commercialization. In this comprehensive review, we provide information on attempts to develop PRRSV inactivated and subunit vaccines. These includes various virus inactivation strategies, adjuvants, nanoparticle-based vaccine delivery systems, DNA vaccines, and recombinant subunit vaccines produced using baculovirus, plant, and replication-deficient viruses as vector vaccines. Finally, future directions for the development of innovative non-infectious PRRSV vaccines are suggested. Undoubtedly there remains a need for novel PRRSV vaccine strategies targeted to deliver cross-protective, non-infectious vaccines for the control and eradication of PRRS. PMID:25980425

  15. Management of immunization solid wastes in Kano State, Nigeria

    SciTech Connect

    Oke, I.A.

    2008-12-15

    Inadequate management of waste generated from injection activities can have a negative impact on the community and environment. In this paper, a report on immunization wastes management in Kano State (Nigeria) is presented. Eight local governments were selected randomly and surveyed by the author. Solid wastes generated during the Expanded Programme on Immunization were characterised using two different methods: one by weighing the waste and the other by estimating the volume. Empirical data was obtained on immunization waste generation, segregation, storage, collection, transportation, and disposal; and waste management practices were assessed. The study revealed that immunization offices were accommodated in either in local government buildings, primary health centres or community health care centres. All of the stations demonstrated a high priority for segregation of the infectious wastes. It can be deduced from the data obtained that infectious waste ranged from 67.6% to 76.7% with an average of 70.1% by weight, and 36.0% to 46.1% with an average of 40.1% by volume. Non-infectious waste generated ranged from 23.3% to 32.5% with an average of 29.9% by weight and 53.9% to 64.0% with an average of 59.9% by volume. Out of non-infectious waste (NIFW) and infectious waste (IFW), 66.3% and 62.4% by weight were combustible and 33.7% and 37.6% were non-combustible respectively. An assessment of the treatment revealed that open pit burning and burial and small scale incineration were the common methods of disposal for immunization waste, and some immunization centres employed the services of the state or local government owned solid waste disposal board for final collection and disposal of their immunization waste at government approved sites.

  16. Using social media for actionable disease surveillance and outbreak management. A systematic literature review

    DOE PAGES

    Charles-Smith, Lauren E.; Reynolds, Tera L.; Cameron, Mark A.; Conway, Mike; Lau, Eric H. Y.; Olsen, Jennifer M.; Pavlin, Julie A.; Shigematsu, Mika; Streichert, Laura C.; Suda, Katie J.; et al

    2015-10-05

    Here, research studies show that social media may be valuable tools in the disease surveillance toolkit used for improving public health professionals’ ability to detect disease outbreaks faster than traditional methods and to enhance outbreak response. A social media work group, consisting of surveillance practitioners, academic researchers, and other subject matter experts convened by the International Society for Disease Surveillance, conducted a systematic primary literature review using the PRISMA framework to identify research, published through February 2013, answering either of the following questions: 1) Can social media be integrated into disease surveillance practice and outbreak management to support and improvemore » public health? 2) Can social media be used to effectively target populations, specifically vulnerable populations, to test an intervention and interact with a community to improve health outcomes? Examples of social media included are Facebook, MySpace, microblogs (e.g., Twitter), blogs, and discussion forums. For Question 1, 33 manuscripts were identified, starting in 2009 with topics on Influenza-like Illnesses (n=15), Infectious Diseases (n = 6), Non-infectious Diseases (n=4), Medication and Vaccines (n=3), and Other (n=5). For Question 2, 32 manuscripts were identified, the first in 2000 with topics on Health Risk Behaviors (n=10), Infectious Diseases (n = 3), Non-infectious Diseases (n=9), and Other (n=10). The literature on the use of social media to support public health practice has identified many gaps and biases in current knowledge. Despite the potential for success identified in exploratory studies, there are limited studies on interventions and little use of social media in practice. However, information gleaned from the articles demonstrates the effectiveness of social media in supporting and improving public health and in identifying target populations for intervention. A primary recommendation resulting from the review

  17. Using social media for actionable disease surveillance and outbreak management. A systematic literature review

    SciTech Connect

    Charles-Smith, Lauren E.; Reynolds, Tera L.; Cameron, Mark A.; Conway, Mike; Lau, Eric H. Y.; Olsen, Jennifer M.; Pavlin, Julie A.; Shigematsu, Mika; Streichert, Laura C.; Suda, Katie J.; Corley, Courtney D.; Braunstein, Lidia Adriana

    2015-10-05

    Here, research studies show that social media may be valuable tools in the disease surveillance toolkit used for improving public health professionals’ ability to detect disease outbreaks faster than traditional methods and to enhance outbreak response. A social media work group, consisting of surveillance practitioners, academic researchers, and other subject matter experts convened by the International Society for Disease Surveillance, conducted a systematic primary literature review using the PRISMA framework to identify research, published through February 2013, answering either of the following questions: 1) Can social media be integrated into disease surveillance practice and outbreak management to support and improve public health? 2) Can social media be used to effectively target populations, specifically vulnerable populations, to test an intervention and interact with a community to improve health outcomes? Examples of social media included are Facebook, MySpace, microblogs (e.g., Twitter), blogs, and discussion forums. For Question 1, 33 manuscripts were identified, starting in 2009 with topics on Influenza-like Illnesses (n=15), Infectious Diseases (n = 6), Non-infectious Diseases (n=4), Medication and Vaccines (n=3), and Other (n=5). For Question 2, 32 manuscripts were identified, the first in 2000 with topics on Health Risk Behaviors (n=10), Infectious Diseases (n = 3), Non-infectious Diseases (n=9), and Other (n=10). The literature on the use of social media to support public health practice has identified many gaps and biases in current knowledge. Despite the potential for success identified in exploratory studies, there are limited studies on interventions and little use of social media in practice. However, information gleaned from the articles demonstrates the effectiveness of social media in supporting and improving public health and in identifying target populations for intervention. A primary recommendation resulting from the review is to

  18. Acupuncture and rehabilitation of the painful shoulder: study protocol of an ongoing multicentre randomised controlled clinical trial [ISRCTN28687220

    PubMed Central

    Vas, Jorge; Perea-Milla, Emilio; Mendez, Camila; Galante, Antonia Herrera; Madrazo, Fernando; Medina, Ivan; Ortega, Caridad; Olmo, Victoria; Fernandez, Francisco Perez; Hernandez, Luz; Seminario, Jose Maria; Brioso, Mauricio; Luna, Francisco; Gordo, Isabel; Godoy, Ana Maria; Jimenez, Carmen; Ruiz, Manuel Anselmo; Montes, Joaquin; Hidalgo, Alonso; Gonzalez-Quevedo, Rosa; Bosch, Pablo; Vazquez, Antonio; Lozano, Juan Vicente

    2005-01-01

    Background Although the painful shoulder is one of the most common dysfunctions of the locomotor apparatus, and is frequently treated both at primary healthcare centres and by specialists, little evidence has been reported to support or refute the effectiveness of the treatments most commonly applied. According to the bibliography reviewed, physiotherapy, which is the most common action taken to alleviate this problem, has not yet been proven to be effective, because of the small size of sample groups and the lack of methodological rigor in the papers published on the subject. No reviews have been made to assess the effectiveness of acupuncture in treating this complaint, but in recent years controlled randomised studies have been made and these demonstrate an increasing use of acupuncture to treat pathologies of the soft tissues of the shoulder. In this study, we seek to evaluate the effectiveness of physiotherapy applied jointly with acupuncture, compared with physiotherapy applied with a TENS-placebo, in the treatment of painful shoulder caused by subacromial syndrome (rotator cuff tendinitis and subacromial bursitis). Methods/design Randomised controlled multicentre study with blind evaluation by an independent observer and blind, independent analysis. A study will be made of 465 patients referred to the rehabilitation services at participating healthcare centres, belonging to the regional public health systems of Andalusia and Murcia, these patients presenting symptoms of painful shoulder and a diagnosis of subacromial syndrome (rotator cuff tendinitis and subacromial bursitis). The patients will be randomised into two groups: 1) experimental (acupuncture + physiotherapy); 2) control (TENS-placebo + physiotherapy); the administration of rescue medication will also be allowed. The treatment period will have a duration of three weeks. The main result variable will be the change produced on Constant's Shoulder Function Assessment (SFA) Scale; as secondary

  19. Intertester reliability of shoulder complaints diagnoses in primary health care

    PubMed Central

    Storheil, Benny; Klouman, Elise; Holmvik, Stian; Emaus, Nina; Fleten, Nils

    2016-01-01

    Objective Shoulder complaints are frequently encountered in general practice, but precise diagnosing is challenging. This study investigated agreement of shoulder complaints diagnoses between clinicians in a primary health care setting. Design Cross-sectional study. Setting Four primary health care clinicians used patients’ history and functional examination of the shoulder by selective tissue tension techniques (STTs), to diagnose shoulder complaints. Subjects 62 patients, aged 18–75 years. Main outcome measure Reliability of diagnoses was assessed by observed intertester agreement and Cohen’s kappa. A total of 372 diagnostic pairs were available for intertester comparisons. Results Six diagnoses were assigned by all clinicians; supraspinatus-, infraspinatus-, subscapularis-tendinopathies; chronic subacromial bursitis; glenohumeral capsulitis, and acromioclavicular joint lesion. The observed agreement on these diagnoses ranged from 0.84 for glenohumeral capsulitis to 0.97 for acromioclavicular joint lesion. Kappa scores were 0.46 (95% CI 0.33, 0.58) for chronic subacromial bursitis; 0.53 (95% CI 0.34, 0.68), 0.59 (95% CI 0.47, 0.70), and 0.68 (95% CI 0.53, 0.82) for infraspinatus -, supraspinatus -, and subscapularis-tendinopathy, respectively. For glenohumeral capsulitis and acromioclavicular lesion kappa scores were 0.66 (95% CI 0.57, 0.73) and 0.78 (95% CI 0.61, 0.90). Kappa scores were higher for individual diagnoses than for individual tests, except for limitation in passive abduction (0.70, 95% CI 0.62, 0.78) and passive lateral rotation (0.66, 95% CI 0.57, 0.73). Conclusions Although experienced clinicians showed substantial intertester agreement, precise diagnoses of shoulder complaints in primary health care remain a challenge. The present results call for further research on refined diagnoses of shoulder complaints. Key Points Based on medical history and a systematic functional examination by selective tissue tension techniques (STTs), we

  20. Does group size have an impact on welfare indicators in fattening pigs?

    PubMed

    Meyer-Hamme, S E K; Lambertz, C; Gauly, M

    2016-01-01

    Production systems for fattening pigs have been characterized over the last 2 decades by rising farm sizes coupled with increasing group sizes. These developments resulted in a serious public discussion regarding animal welfare and health in these intensive production systems. Even though large farm and group sizes came under severe criticism, it is still unknown whether these factors indeed negatively affect animal welfare. Therefore, the aim of this study was to assess the effect of group size (30 pigs/pen) on various animal-based measures of the Welfare Quality(®) protocol for growing pigs under conventional fattening conditions. A total of 60 conventional pig fattening farms with different group sizes in Germany were included. Moderate bursitis (35%) was found as the most prevalent indicator of welfare-related problems, while its prevalence increased with age during the fattening period. However, differences between group sizes were not detected (P>0.05). The prevalence of moderately soiled bodies increased from 9.7% at the start to 14.2% at the end of the fattening period, whereas large pens showed a higher prevalence (15.8%) than small pens (10.4%; P<0.05). With increasing group size, the incidence of moderate wounds with 8.5% and 11.3% in small- and medium-sized pens, respectively, was lower (P<0.05) than in large-sized ones (16.3%). Contrary to bursitis and dirtiness, its prevalence decreased during the fattening period. Moderate manure was less often found in pigs fed by a dry feeder than in those fed by a liquid feeding system (P<0.05). The human-animal relationship was improved in large in comparison to small groups. On the contrary, negative social behaviour was found more often in large groups. Exploration of enrichment material decreased with increasing live weight. Given that all animals were tail-docked, tail biting was observed at a very low rate of 1.9%. In conclusion, the results indicate that BW and feeding system are determining factors for

  1. Does group size have an impact on welfare indicators in fattening pigs?

    PubMed

    Meyer-Hamme, S E K; Lambertz, C; Gauly, M

    2016-01-01

    Production systems for fattening pigs have been characterized over the last 2 decades by rising farm sizes coupled with increasing group sizes. These developments resulted in a serious public discussion regarding animal welfare and health in these intensive production systems. Even though large farm and group sizes came under severe criticism, it is still unknown whether these factors indeed negatively affect animal welfare. Therefore, the aim of this study was to assess the effect of group size (30 pigs/pen) on various animal-based measures of the Welfare Quality(®) protocol for growing pigs under conventional fattening conditions. A total of 60 conventional pig fattening farms with different group sizes in Germany were included. Moderate bursitis (35%) was found as the most prevalent indicator of welfare-related problems, while its prevalence increased with age during the fattening period. However, differences between group sizes were not detected (P>0.05). The prevalence of moderately soiled bodies increased from 9.7% at the start to 14.2% at the end of the fattening period, whereas large pens showed a higher prevalence (15.8%) than small pens (10.4%; P<0.05). With increasing group size, the incidence of moderate wounds with 8.5% and 11.3% in small- and medium-sized pens, respectively, was lower (P<0.05) than in large-sized ones (16.3%). Contrary to bursitis and dirtiness, its prevalence decreased during the fattening period. Moderate manure was less often found in pigs fed by a dry feeder than in those fed by a liquid feeding system (P<0.05). The human-animal relationship was improved in large in comparison to small groups. On the contrary, negative social behaviour was found more often in large groups. Exploration of enrichment material decreased with increasing live weight. Given that all animals were tail-docked, tail biting was observed at a very low rate of 1.9%. In conclusion, the results indicate that BW and feeding system are determining factors for

  2. [Not Available].

    PubMed

    Dorn, U; Landauer, F; Hofstaedter, T

    2016-06-01

    Gluteal tendinopathy as well as partial and full-thickness tears of gluteal tendons (gluteus minimus and/or medius tendon) were underestimated as a cause of chronic pain in the past, and treatment was most commonly based on the diagnosis of trochanteric bursitis. Tendinous pathologies can either stay asymptomatic or cause pain and muscular dysfunction, not necessarily being associated with osteoarthritis of the hip 1. As the terminus "rotator cuff tear of the hip" was published in 1997 2, its aetiopathogenesis was reconsidered, resulting in improvements in diagnosis and treatment. Nevertheless the adoption of those findings into clinical daily routine took time 3. Ultrasound and magnetic resonance imaging (MRI) as well as histopathologic examination questioned the relevance of acute bursitis being the only cause of greater trochanteric pain 4, 5, 6, while emphasizing degenerative tendinopathy causing those symptoms 6, 7, 8. The terminus "greater trochanteric pain syndrome" (GTPS) should hereby also include further pathologies, e.g. calcific tendinitis 1, 5. GTPS affects about 10-25 % of the adult population 5. Ultrasound and MRI are reliable, non-invasive methods for detecting tendinous and bursal pathologies 7, 8, 9; in 88 % of all patients with trochanteric pain, MRI gives pathological findings 10. Nevertheless, in 50 % of suspicious pertrochanteric pathologies, patients are free of symptoms 1, 10. In patients undergoing total hip arthroplasty, the incidence of intraoperative macroscopically identified gluteal tendon tears reaches up to 22 % 2, 11, 12, 13. Tendinous tears cause pain and constrained muscular function. Sole traumatic tears are rare, most commonly they are based on pre-existing defects. Tendinosis and partial tears are primarily treated conservatively. Hereby, therapeutic options are similar to those for rotator cuff pathologies of the shoulder. Topical infiltration of corticosteroids and physical therapy offer good

  3. [Direct endoscopic approach improves prognosis of septic-synovitis in the horse].

    PubMed

    ter Braake, F

    The medical records of 71 horses with sepic arthritis, bursitis, or tenosynovitis, treated between 1996 and 2001 at Dierenkliniek Enmeloord, were reviewed. A total number of 81 joints, tendon sheaths and bursae were treated (21 tarsi, 17 digital tendon sheaths, 14 metacarpo/metatarso-phalangeal joints, 12 stifles, 6 carpi, 4 coffin joints, 2 navicular bursae, 1 elbow joint, 1 proximal-interphalangeal joint, 1 tarsal sheath, 1 bursa calcanei subtendineum). The aetiology in 42 cases was a penetrating wound (group 1), in 4 cases an intra-articular injection, and in 2 cases arthroscopic surgery (group II), and in 13 cases septic arthritis in young foals (group III); in 10 cases the aetiology was unknown (group V). A total of 93 endoscopic lavages was performed on 81 joints, tendon sheaths, and bursae (1-3 lavages, mean 1.18 lavage per synovial structure). Survival rates were 95% for group I, 100% for group II, 73% for group III and 100% for group IV. Horses were discharged after 4-73 days of hospitalization (mean 20 days). Longterm follow-up revealed a survival rate of 92% for group I, 100% for group II, 67% for group III, and 90% for group IV. Of the surviving horses, 89% were sound and 11% had some degree of residual lameness. It is concluded that instant aggressive treatment using endoscopic techniques yields the best results so far and is therefore recommended.

  4. Susceptibility of openbill storks (Anastomius oscitans) to highly pathogenic avian influenza virus subtype H5N1.

    PubMed

    Chaichoun, Kridsada; Wiriyarat, Withawat; Phonaknguen, Rassmeepen; Sariya, Ladawan; Taowan, Nam-aoy; Chakritbudsabong, Warunya; Chaisilp, Natnapat; Eiam-ampai, Krirat; Phuttavatana, Pilaipan; Ratanakorn, Parntep

    2013-09-01

    This investigation detailed the clinical disease, gross and histologic lesions in juvenile openbill storks (Anastomus oscitans) intranasally inoculated with an avian influenza virus, A/chicken/Thailand/vsmu-3 (H5N1), which is highly pathogenic for chickens. High morbidity and mortality were observed in openbill storks inoculated with HPAI H5N1 virus. Gross lesions from infected birds were congestion and brain hemorrhage (10/20), pericardial effusions, pericarditis and focal necrosis of the cardiac muscle (2/20), pulmonary edema and pulmonary necrosis, serosanguineous fluid in the bronchis (16/20), liver congestion (6/20), bursitis (5/20), subcutaneous hemorrhages (2/20) and pinpoint proventiculus hemorrhage (2/20). Real time RT-PCR demonstrated the presence of viral RNA in organs associated with the lesions: brain, trachea, lungs, liver, spleen and intestines. Similar to viral genome detection, virus was also isolated from these vital organs. Antibodies to influenza virus detected with a hemagglutination inhibition test, were found only in the openbill storks who died 8 days post-inoculation.

  5. Ultrasound assessment of the elbow.

    PubMed

    Radunovic, Goran; Vlad, Violeta; Micu, Mihaela C; Nestorova, Rodina; Petranova, Tzvetanka; Porta, Francesco; Iagnocco, Annamaria

    2012-06-01

    Ultrasonography of the elbow is a very helpful and reliable diagnostic procedure for a broad spectrum of rheumatic and orthopedic conditions, representing a possible substitute to magnetic resonance imaging for evaluation of soft tissues of the elbow. Musculoskeletal ultrasound (US) shows many advantages over other imaging modalities, probably the most important being its capability to perform a dynamic assessment of musculoskeletal elements with patient's partnership and observation during examination. In addition, ultrasonography is cost effective, easy available, and has excellent and multiplanar capability to visualize superficial soft tissue structures. Among all imaging procedures, US is highly accepted by patients. US assessment of the elbow requires good operator experience in the assessment of normal anatomy, and suitable high-quality equipment. US of the elbow provides detailed information including joint effusions, medial and lateral epicondylitis, tears of the distal biceps and triceps tendons, radial and ulnar collateral ligament tears, ulnar nerve entrapment, cubital or olecranon bursitis and intra-articular loose bodies. The aim of this paper is to review the screening technique and the basic normal and pathological findings in elbow US.

  6. Evaluation of elbow pain in adults.

    PubMed

    Kane, Shawn F; Lynch, James H; Taylor, Jonathan C

    2014-04-15

    The elbow is a complex joint designed to withstand a wide range of dynamic exertional forces. The location and quality of elbow pain can generally localize the injury to one of the four anatomic regions: anterior, medial, lateral, or posterior. The history should include questions about the onset of pain, what the patient was doing when the pain started, and the type and frequency of athletic and occupational activities. Lateral and medial epicondylitis are two of the more common diagnoses and often occur as a result of occupational activities. Patients have pain and tenderness over the affected tendinous insertion that are accentuated with specific movements. If lateral and medial epicondylitis treatments are unsuccessful, ulnar neuropathy and radial tunnel syndrome should be considered. Ulnar collateral ligament injuries occur in athletes participating in sports that involve overhead throwing. Biceps tendinopathy is a relatively common source of pain in the anterior elbow; history often includes repeated elbow flexion with forearm supination and pronation. Olecranon bursitis is a common cause of posterior elbow pain and swelling. It can be septic or aseptic, and is diagnosed based on history, physical examination, and bursal fluid analysis if necessary. Plain radiography is the initial choice for the evaluation of acute injuries and is best for showing bony injuries, soft tissue swelling, and joint effusions. Magnetic resonance imaging is the preferred imaging modality for chronic elbow pain. Musculoskeletal ultrasonography allows for an inexpensive dynamic evaluation of commonly injured structures.

  7. Assessment of injuries sustained in mixed martial arts competition.

    PubMed

    Scoggin, James F; Brusovanik, Georgiy; Pi, Michael; Izuka, Byron; Pang, Pierre; Tokumura, Seren; Scuderi, Gaetano

    2010-05-01

    Mixed martial arts (MMA) competitions have gained much popularity, and the sport is watched by many millions annually. Despite ongoing controversy, there have been no objective studies of the injuries sustained in MMA based on on-site evaluation. In the study reported in this article, we attempted to delineate injury patterns for MMA participants. We conducted an observational cohort study of MMA competitions held in Hawaii between 1999 and 2006. The study included 116 bouts, involving 232 "exposures" and 179 male participants between ages 18 and 40. All the fighters were examined by 1 of 4 physicians, both before and after each bout. Fighters were referred to an emergency department when necessary, and follow-up was recommended as needed. Among the 232 exposures were 55 injuries: 28 abrasions and lacerations (6 requiring on-site suturing or referral to an emergency department for suturing), 11 concussions (4 with retrograde amnesia), 5 facial injuries (2 nasal fractures, 1 tympanum rupture, 1 temporomandibular joint sprain, 1 Le Fort fracture), and 11 orthopedic injuries (3 metacarpal injuries, with 1 confirmed fracture; 1 acromioclavicular separation; 1 traumatic olecranon bursitis; 1 elbow subluxation; 1 midfoot sprain; 1 aggravation of elbow medial collateral ligament sprain; 1 elbow lateral collateral ligament strain; 1 trapezius strain; 1 Achilles tendon contusion). We describe the injuries sustained in MMA competition to make comparisons with other sports. We discuss distribution and mechanism of injuries as well as injury incidence based on on-site evaluation in MMA. PMID:20567743

  8. Diagnosis, Evaluation, and Endoscopic Repair of Partial Articular Gluteus Tendon Avulsion.

    PubMed

    Nho, Shane J; Grzybowski, Jeffrey S; Bogunovic, Ljiljana; Kuhns, Benjamin D; Mather, Richard C; Salata, Michael J; Bush-Joseph, Charles A

    2016-06-01

    In addition to trochanteric bursitis, gluteus medius and minimus tears (GMMTs) can be a common source of insidious lateral hip pain and dysfunction. Partial-thickness GMMTs are much more common than full-thickness GMMTs but are frequently overlooked by both radiologists and orthopaedic surgeons. GMMTs are commonly identified on magnetic resonance imaging ordered for lateral hip pain unresponsive to conservative management. Imaging can show that high-grade partial articular gluteus tendon avulsion (PAGTA) can occur as either an isolated gluteus medius tear, an isolated gluteus minimus tear, or a combined GMMT. We describe how to identify PAGTA injuries with intraoperative assessment and identification of the interval between the gluteus medius and minimus tendons to allow access to the PAGTA without violating the bursal side of the tendon. PAGTAs can be repaired arthroscopically by single- or double-row suture anchor fixation depending on the size of the tear. The purpose of this article is to guide orthopaedic surgeons in the recognition of PAGTA with magnetic resonance imaging and dynamic examination to allow for accurate repair of GMMTs. PMID:27656357

  9. Musculoskeletal interventional radiology: ultrasound and CT.

    PubMed

    Martel Villagrán, J; Bueno Horcajadas, Á; Agrela Rojas, E

    2016-05-01

    We aim to describe imaging-guided (ultrasound and CT) interventional techniques in the musculoskeletal system that can be performed by general radiologists, whether in hospitals, primary care clinics, private offices, or other settings. The first requirement for doing these procedures is adequate knowledge of the anatomy of the musculoskeletal system. The second requirement is to inform the patient thoroughly about the technique, the risks involved, and the alternatives available in order to obtain written informed consent. The third requirement is to ensure that the procedure is performed in accordance with the principles of asepsis in relation to the puncture zone and to all the material employed throughout the procedure. The main procedures that can be done under ultrasound guidance are the following: fine needle aspiration cytology (FNAC), core needle biopsy (CNB), diagnostic and/or therapeutic arthrocentesis, drainage of juxta-articular fluid collections, drainage of abscesses, drainage of hematomas, treatment of Baker's cyst, treatment of ganglia, treatment of bursitis, infiltrations and treatment of plantar fasciitis, plantar fibrosis, epicondylitis, Achilles tendinopathy, and Morton's neuroma, puncture and lavage of calcifications in calcifying tendinopathy. We also review the following CT-guided procedures: diagnosis of spondylodiscitis, FNAC of metastases, arthrography, drainages. Finally, we also mention more complex procedures that can only be done in appropriate settings: bone biopsies, treatment of facet joint pain, radiofrequency treatment. PMID:27134018

  10. Forefoot pain involving the metatarsal region: differential diagnosis with MR imaging.

    PubMed

    Ashman, C J; Klecker, R J; Yu, J S

    2001-01-01

    Many disorders produce discomfort in the metatarsal region of the forefoot. These disorders include traumatic lesions of the soft tissues and bones (eg, turf toe, plantar plate disruption, sesamoiditis, stress fracture, stress response), Freiberg infraction, infection, arthritis, tendon disorders (eg, tendinosis, tenosynovitis, tendon rupture), nonneoplastic soft-tissue masses (eg, ganglia, bursitis, granuloma, Morton neuroma), and, less frequently, soft-tissue and bone neoplasms. Prior to the advent of magnetic resonance (MR) imaging, many of these disorders were not diagnosed noninvasively, and radiologic involvement in the evaluation of affected patients was limited. However, MR imaging has proved useful in detecting the numerous soft-tissue and early bone and joint processes that occur in this portion of the foot but are not depicted or as well characterized with other imaging modalities. Frequently, MR imaging allows a specific diagnosis based on the location, signal intensity characteristics, and morphologic features of the abnormality. Consequently, MR imaging is increasingly being used to evaluate patients with forefoot complaints. Radiologists should be familiar with the differential diagnosis and MR imaging features of disorders that can produce discomfort in this region.

  11. Imaging of traumatic injury and impingement of anterior knee fat.

    PubMed

    Lapègue, F; Sans, N; Brun, C; Bakouche, S; Brucher, N; Cambon, Z; Chiavassa, H; Larbi, A; Faruch, M

    2016-01-01

    Fat is not just used by the body as bulk tissue. In addition to its role in storing energy and regulating hormone action, fat is used in some parts of the body for its mechanical properties. The anatomy of anterior knee fat is more complex than it appears at first sight and is capable of withstanding considerable compressive and shear stress. Specific lesions occur when such mechanical stress exceeds the physiological limits and are yet little known. Superficial fat can be the site of either acute injury by closed degloving called the Morel-Lavallée lesion or chronic injury, when subject to repeat excessive shear forces, due to more complex and less well-defined disruptions that result in pseudo-bursitis. There are three main anterior, intracapsular and extrasynovial fat pads in the knee joint, which are the infrapatellar fat pad (IFP) or Hoffa's fat pad, the quadriceps fat pad and the prefemoral fat pad. The IFP plays an important role as a mechanical shock absorber and guides the patella tendon and even the patella itself during flexion-extension movements. In response to repeated excessive stress, an inflammatory reaction and swelling of the IFP is first observed, followed by a fibrotic reaction with metaplastic transformation into fibrous, cartilaginous or bone tissue. More rarely, the two other deep fat pads (quadriceps and prefemoral) can, if subject to repeated stress, undergo similar restructuring inflammatory reactions with metaplasia resulting in tissue hardening, anterior pain and partial loss of function. PMID:27118690

  12. Role of FDG PET/CT in Baastrup's disease

    PubMed Central

    Subramanyam, Padma; Palaniswamy, Shanmuga Sundaram

    2016-01-01

    Baastrup's disease is a benign condition, which presents as chronic low back pain. It is also known as “kissing spine syndrome” and refers to close approximation of adjacent spinous processes producing inflammation and back pain. This condition is often misdiagnosed, resulting in incorrect treatment and persistence of symptoms. Diagnosis of Baastrup's disease is verified with clinical examination and imaging studies. Conventionally, clinicians resort to magnetic resonance imaging (MRI) of spine rather than X-ray or computed tomography (CT) in the evaluation of back pain. MRI can additionally identify flattening, sclerosis, enlargement, cystic lesions, and bone edema at the articulating surfaces of the two affected spinous processes. Studies have reported that 18Fluorine fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT) can detect a bursitis or an inflammation as a form of stress reaction despite a negative MRI and 99mTc Methylene diphosphonate (MDP) bone scan. PET/CT is usually not a recommended investigation for this condition. However, this case report highlights the benefit of FDG-PET/CT in identifying the site of inflammatory pathology. It is also known to identify the exact site of inflammation where steroid or local anesthetic injection can be administered to alleviate pain, especially in patients with multilevel vertebral involvement. PMID:27385901

  13. Assessment of injuries sustained in mixed martial arts competition.

    PubMed

    Scoggin, James F; Brusovanik, Georgiy; Pi, Michael; Izuka, Byron; Pang, Pierre; Tokumura, Seren; Scuderi, Gaetano

    2010-05-01

    Mixed martial arts (MMA) competitions have gained much popularity, and the sport is watched by many millions annually. Despite ongoing controversy, there have been no objective studies of the injuries sustained in MMA based on on-site evaluation. In the study reported in this article, we attempted to delineate injury patterns for MMA participants. We conducted an observational cohort study of MMA competitions held in Hawaii between 1999 and 2006. The study included 116 bouts, involving 232 "exposures" and 179 male participants between ages 18 and 40. All the fighters were examined by 1 of 4 physicians, both before and after each bout. Fighters were referred to an emergency department when necessary, and follow-up was recommended as needed. Among the 232 exposures were 55 injuries: 28 abrasions and lacerations (6 requiring on-site suturing or referral to an emergency department for suturing), 11 concussions (4 with retrograde amnesia), 5 facial injuries (2 nasal fractures, 1 tympanum rupture, 1 temporomandibular joint sprain, 1 Le Fort fracture), and 11 orthopedic injuries (3 metacarpal injuries, with 1 confirmed fracture; 1 acromioclavicular separation; 1 traumatic olecranon bursitis; 1 elbow subluxation; 1 midfoot sprain; 1 aggravation of elbow medial collateral ligament sprain; 1 elbow lateral collateral ligament strain; 1 trapezius strain; 1 Achilles tendon contusion). We describe the injuries sustained in MMA competition to make comparisons with other sports. We discuss distribution and mechanism of injuries as well as injury incidence based on on-site evaluation in MMA.

  14. Heel pain: A systematic review.

    PubMed

    Agyekum, Edward Kwame; Ma, Kaiyu

    2015-01-01

    Heel pain is a very common foot disease. Varieties of names such as plantar fasciitis, jogger's heel, tennis heal, policeman's heel are used to describe it. Mechanical factors are the most common etiology of heel pain. Common causes of hell pain includes: Plantar Fasciitis, Heel Spur, Sever's Disease, Heel bump, Achilles Tendinopathy, Heel neuritis, Heel bursitis. The diagnosis is mostly based on clinical examination. Normally, the location of the pain and the absence of associated symptoms indicating a systemic disease strongly suggest the diagnosis. Several therapies exist including rest, physical therapy, stretching, and change in footwear, arch supports, orthotics, night splints, anti-inflammatory agents, and surgery. Almost all patients respond to conservative nonsurgical therapy. Surgery is the last treatment option if all other treatments had failed. Rest, ice, massage, the use of correct exercise and complying with a doctor's advice all play important part in helping to recover from this hell pain condition, but getting good quality, suitable shoes with the appropriate amount of support for the whole foot is the most important. PMID:26643244

  15. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature.

    PubMed

    Kertzman, Paulo; Lenza, Mario; Pedrinelli, André; Ejnisman, Benno

    2015-01-01

    Shockwave treatment is an option within orthopedics. The exact mechanism through which shockwaves function for treating musculoskeletal diseases is unknown. The aim of this study was to make a qualitative analysis on the effectiveness of shockwave treatment among patients with musculoskeletal pathological conditions and pseudarthrosis. Searches were conducted in the Cochrane Library, Medline and Lilacs databases. Thirty-nine studies that reported using shockwave treatment for musculoskeletal diseases were found. Their results varied greatly, as did the types of protocol used. The studies that evaluated the effectiveness of shockwave treatment for lateral epicondylitis, shoulder tendinopathy, knee osteoarthrosis, femoral head osteonecrosis and trochanteric bursitis reported inconsistent results for most of their patients. Those that evaluated patients with calcifying tendinopathy, plantar fasciitis, Achilles tendinopathy, patellar tendinopathy and pseudarthrosis showed benefits. Shockwave treatment is a safe and non-invasive method for chronic cases in which conventional techniques have been unsatisfactory and should be used in association with other treatment methods for tendinopathy. Further quality studies are needed. PMID:26229889

  16. Health conditions of prisoners in the state of Rio de Janeiro, Brazil.

    PubMed

    Minayo, Maria Cecília de Souza; Ribeiro, Adalgisa Peixoto

    2016-06-01

    We present the results of a quantitative and qualitative study on the living conditions and health of prisoners in the state of Rio de Janeiro. The goal was to produce strategic information to support the action of public officials who work in prisons. The results show that prisoners are young (average age: 30 years), poor, mostly black and brown (70.5%), have little education (only 1.5% of them have a higher education), and have been in prison for less than four years. Among the problems that indirectly affect their health, we emphasize: overcrowding (1.39 prisoners per one vacancy), idleness (only 4.4% of them work), lack of perspective, violence and relationships of conflict. The most common physical health problems include: musculoskeletal problems, such as pain in the neck, back, and spine (76.7%), joint dislocation (28.2%), bursitis (22.9%), sciatica (22, 1%), arthritis (15.9%), bone fracture (15.3%), problems with bone and cartilage (12.5%), and muscle and tendon injuries (15.7%); respiratory problems, such as sinusitis (55.6%), allergic rhinitis (47%), chronic bronchitis (15.6%), tuberculosis (4.7%) and others (11.9%); and skin diseases. Despite legal requirements that include prison health care among the Universal Health System's (SUS) obligations, services are scarce and inefficient and a major cause of inmate dissatisfaction. PMID:27383337

  17. Diagnosis and Management of Extra-articular Causes of Pain After Total Knee Arthroplasty.

    PubMed

    Manning, Blaine T; Lewis, Natasha; Tzeng, Tony H; Saleh, Jamal K; Potty, Anish G R; Dennis, Douglas A; Mihalko, William M; Goodman, Stuart B; Saleh, Khaled J

    2015-01-01

    Postoperative pain, which has been attributed to poor outcomes after total knee arthroplasty (TKA), remains problematic for many patients. Although the source of TKA pain can often be delineated, establishing a precise diagnosis can be challenging. It is often classified as intra-articular or extra-articular pain, depending on etiology. After intra-articular causes, such as instability, aseptic loosening, infection, or osteolysis, have been ruled out, extra-articular sources of pain should be considered. Physical examination of the other joints may reveal sources of localized knee pain, including diseases of the spine, hip, foot, and ankle. Additional extra-articular pathologies that have potential to instigate pain after TKA include vascular pathologies, tendinitis, bursitis, and iliotibial band friction syndrome. Patients with medical comorbidities, such as metabolic bone disease and psychological illness, may also experience prolonged postoperative pain. By better understanding the diagnosis and treatment options for extra-articular causes of pain after TKA, orthopaedic surgeons may better treat patients with this potentially debilitating complication. PMID:25745922

  18. Epidemiologic study on carcinoma of the breast following irradiation for benign conditions in infancy and childhood

    SciTech Connect

    Oviedo, M.A.; Chmiel, J.S.; Curb, J.D.; Kautz, J.A.; Haenszel, W.; Scanlon, E.F.

    1983-07-01

    To investigate the relationship of irradiation during infancy and childhood to the subsequent development of carcinoma of the breast, 996 eligible patients were studied at Evanston Hospital, Evanston, Illinois, and Northwestern Memorial Hospital, Chicago. This was a case-control study, with those in the control group being selected from concurrent hospital admissions for nonmalignant surgical conditions. A second group consisting of those with benign biopsy results was also studied. The Mantel-Haenszel method of analysis, controlling for age and race, was used to estimate the approximate relative risk of carcinoma of the breast in the irradiated group compared with that for the nonirradiated group. The type of radiation history included radiotherapy for mastitis or enlarged thymus (nine patients), irradiation of the head and neck (69 patients), diagnostic fluoroscopies (ten patients) and miscellaneous irradiation (52 patients) for bursitis, eczema or keloid. Based upon the data obtained from the results of this study and its analysis, we conclude that there is little evidence of increased risk of carcinoma of the breast after irradiation about the head, neck and chest areas for benign conditions in the population being studied herein. Such a risk, if indeed it exists at all for this population, is estimated to be about 10 per cent.

  19. Phaeohyphomycosis infection in the knee☆

    PubMed Central

    Sadigursky, David; Nogueira e Ferreira, Luisa; Moreno de Oliveira Corrêa, Liz

    2016-01-01

    Phaeohyphomycosis is caused by cutaneous fungi and rarely affects large joints. This is a case report on phaeohyphomycosis in the left knee of an elderly individual without immunosuppression. It was accompanied by pain and swelling the anterior knee. The case was first suspected to be suprapatellar bursitis, and was treated with nonsteroidal anti-inflammatory drugs, without remission of symptoms. Surgical treatment was performed, with resection of the suprapatellar bursa and anterior region of the quadriceps tendon. The material was sent for anatomopathological examination and culturing. The pathological examination showed phaeohyphomycosis. The treatment instituted consisted of itraconazole, 200 mg/day for six weeks, and complete remission of symptoms was achieved. The physical examination remained normal after one year of follow-up. This is the first published case of phaeohyphomycosis infection in the suprapatellar region of the knee. Although almost all the cases reported have been associated with immunosuppressed patients, this was an exception. It is important to suspect phaeohyphomycosis in cases of knee infection, in the area of the suprapatellar bursa, when the symptoms do not resolve after clinical treatment. PMID:27069894

  20. Snapping scapular syndrome secondary to rib intramedullary fixation device

    PubMed Central

    Zaidenberg, Ezequiel E.; Rossi, Luciano A.; Bongiovanni, Santiago L.; Tanoira, Ignacio; Maignon, Gaston; Ranalletta, Maximiliano

    2015-01-01

    Background Scapulo-thoracic joint disorders, including bursitis and crepitus, are commonly misdiagnosed problems and can be a source of persistent pain and dysfunction Presentation of the case This article describes an unusual case of a snapping scapula syndrome secondary to a migration through the lateral cortex of a rib splint intramedullary fixation device into the scapulothoracic joint. Discussion Recently, the operative fixation of multiple ribs fractures with intramedullary fixation devices has become popular. Despite the good outcomes with new rib splint designs, concern remains about the potential complications related to potential loss of fracture reduction with migration of the wire resulting in pain or additional injury to the surrounding tissues. Conclusion Surgeons should pay attention to any protrusion of intramedullary rib implants, especially in the evaluation of routine X-rays following surgical treatment. We should be aware of the possibility of this rare cause of snapping scapula syndrome to avoid delayed diagnosis and consider removing the implant will resolve the pain. PMID:26629853

  1. Shoulder pain in primary care: frozen shoulder.

    PubMed

    Cadogan, Angela; Mohammed, Khalid D

    2016-03-01

    BACKGROUND AND CONTEXT Frozen shoulder is a painful condition that follows a protracted clinical course. We aim to review the management of patients with a diagnosis of frozen shoulder who are referred for specialist orthopaedic evaluation against existing guidelines in primary care. ASSESSMENT OF PROBLEM Referrals and clinical records were reviewed for all patients referred for orthopaedic specialist assessment who received a specialist diagnosis of frozen shoulder. Diagnostic, investigation and management practices from a regional primary health care setting in New Zealand were compared with guideline-recommended management. RESULTS Eighty patients with frozen shoulder were referred for orthopaedic evaluation in the 13 month study period, mostly from general practice. Fifteen patients (19%) were identified as having a frozen shoulder in their medical referral. Most (99%) had received previous imaging. Seven patients (12%) had received guideline recommended treatment. STRATEGIES FOR IMPROVEMENT Education of all clinicians involved in patient management is important to ensure an understanding of the long natural history of frozen shoulder and provide reassurance that outcomes are generally excellent. HealthPathways now include more information regarding diagnosis, imaging and evidence-based management for frozen shoulder. LESSONS Frozen shoulder may be under-diagnosed among patients referred for orthopaedic review. Ultrasound imaging is commonly used and may identify occult and unrelated pathology in this age-group. When managed according to clinical guidelines, patients report significant clinical and functional improvement with most reporting 80% function compared with normal after 1 year. KEYWORDS Adhesive capsulitis; bursitis; injections; practice guideline; primary health care; ultrasound.

  2. Detailed shoulder MRI findings in manual wheelchair users with shoulder pain.

    PubMed

    Morrow, Melissa M B; Van Straaten, Meegan G; Murthy, Naveen S; Braman, Jonathan P; Zanella, Elia; Zhao, Kristin D

    2014-01-01

    Shoulder pain and pathology are common in manual wheelchair (MWC) users with paraplegia, and the biomechanical mechanism of injury is largely unknown. Establishing patterns of MRI characteristics in MWC users would help advance understanding of the mechanical etiology of rotator cuff disease, thus improving the logic for prescribed interventions. The purpose of this study was to report detailed shoulder MRI findings in a sample of 10 MWC users with anterolateral shoulder pain. The imaging assessments were performed using our standardized MRI Assessment of the Shoulder (MAS) guide. The tendon most commonly torn was the supraspinatus at the insertion site in the anterior portion in either the intrasubstance or articular region. Additionally, widespread tendinopathy, CA ligament thickening, subacromial bursitis, labral tears, and AC joint degenerative arthrosis and edema were common. Further reporting of detailed shoulder imaging findings is needed to confirm patterns of tears in MWC users regarding probable tendon tear zone, region, and portion. This investigation was a small sample observational study and did not yield data that can define patterns of pathology. However, synthesis of detailed findings from multiple studies could define patterns of pathological MRI findings allowing for associations of imaging findings to risk factors including specific activities. PMID:25180192

  3. Emergence of Q fever arthritis in France.

    PubMed

    Angelakis, Emmanouil; Edouard, Sophie; Lafranchi, Marie-Alix; Pham, Thao; Lafforgue, Pierre; Raoult, Didier

    2014-04-01

    Osteoarticular infection is an uncommon presentation of Q fever. Positron emission tomography (PET) scanning is a valuable tool for the diagnosis of Coxiella burnetii graft prosthesis infection and endocarditis. Our objective was to test a series of culture-negative osteoarticular samples using molecular assays for Coxiella burnetii. We tested for C. burnetii by molecular assays targeting the IS1111 and the IS30A spacer regions, using culture-negative osteoarticular samples obtained in our laboratory between January 2011 and December 2012. We examine a total of 1,410 osteoarticular samples, and we observed two cases of arthritis and subacromial bursitis caused by C. burnetii. The infections were localized using PET scanning, and the diagnosis was confirmed through serology. For one, a C. burnetii strain with a multispacer sequence type 8 genotype was isolated from synovial fluid culture. Q fever articular infections could be undiagnosed because of the long evolution of articular attack, and patients with high antibody titers against C. burnetii should be tested using PET scanning to localize the site of infection.

  4. Interobserver reliability of rheumatologists performing musculoskeletal ultrasonography: results from a EULAR "Train the trainers" course

    PubMed Central

    Scheel, A; Schmidt, W; Hermann, K; Bruyn, G; D'Agostino, M; Grassi, W; Iagnocco, A; Koski, J; Machold, K; Naredo, E; Sattler, H; Swen, N; Szkudlarek, M; Wakefield, R; Ziswiler, H; Pasewaldt, D; Werner, C; Backhaus, M

    2005-01-01

    Objective: To evaluate the interobserver reliability among 14 experts in musculoskeletal ultrasonography (US) and to determine the overall agreement about the US results compared with magnetic resonance imaging (MRI), which served as the imaging "gold standard". Methods: The clinically dominant joint regions (shoulder, knee, ankle/toe, wrist/finger) of four patients with inflammatory rheumatic diseases were ultrasonographically examined by 14 experts. US results were compared with MRI. Overall agreements, sensitivities, specificities, and interobserver reliabilities were assessed. Results: Taking an agreement in US examination of 10 out of 14 experts into account, the overall κ for all examined joints was 0.76. Calculations for each joint region showed high κ values for the knee (1), moderate values for the shoulder (0.76) and hand/finger (0.59), and low agreement for ankle/toe joints (0.28). κ Values for bone lesions, bursitis, and tendon tears were high (κ = 1). Relatively good agreement for most US findings, compared with MRI, was found for the shoulder (overall agreement 81%, sensitivity 76%, specificity 89%) and knee joint (overall agreement 88%, sensitivity 91%, specificity 88%). Sensitivities were lower for wrist/finger (overall agreement 73%, sensitivity 66%, specificity 88%) and ankle/toe joints (overall agreement 82%, sensitivity 61%, specificity 92%). Conclusion: Interobserver reliabilities, sensitivities, and specificities in comparison with MRI were moderate to good. Further standardisation of US scanning techniques and definitions of different pathological US lesions are necessary to increase the interobserver agreement in musculoskeletal US. PMID:15640263

  5. Small diameter acetabulum and femoral head in total hip arthroplasty for developmental dysplasia of the hip, with no femoral osteotomy.

    PubMed

    Verettas, Dionysios-Alexandros; Chloropoulou, Pelagia; Xarchas, Konstantinos; Drosos, Georgios; Ververidis, Athanasios; Kazakos, Konstantinos

    2015-01-01

    We present the results of 66 total hip arthroplasties in 62 patients of mean age 46 years (24-74 years), with developmental dysplasia of the hip. In all cases the centre of rotation of the new hip was positioned at the site of the true acetabulum. In all patients cementless press fit acetabular components of small diameter (42-44 mm) were used, articulating exclusively with a 22.25 mm modular metal femoral head, without the use of bone grafts or shortening osteotomies of the femur. Despite the use of small diameter femoral heads the rate of dislocation was 3%. After an average follow-up period of 9 years (4-18 years), no revisions were required for infection, loosening or wear or implant migration. Osteolytic lesions were seen in the periacetabular region in 3 patients who were symptom free. A total of 2 revisions were required for instability and 2 patients had the wires of their trochanteric osteotomy removed because of bursitis. Leg length inequality was improved in 55% of the patients and one postoperative transient sciatic nerve lesion settled within 4 months. We believe that in patients with painful dysplastic hips, the use of small diameter implants with the centre of rotation at the true acetabulum, can give very satisfactory results, without any supplementary procedures. PMID:25907394

  6. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature☆

    PubMed Central

    Kertzman, Paulo; Lenza, Mario; Pedrinelli, André; Ejnisman, Benno

    2015-01-01

    Shockwave treatment is an option within orthopedics. The exact mechanism through which shockwaves function for treating musculoskeletal diseases is unknown. The aim of this study was to make a qualitative analysis on the effectiveness of shockwave treatment among patients with musculoskeletal pathological conditions and pseudarthrosis. Searches were conducted in the Cochrane Library, Medline and Lilacs databases. Thirty-nine studies that reported using shockwave treatment for musculoskeletal diseases were found. Their results varied greatly, as did the types of protocol used. The studies that evaluated the effectiveness of shockwave treatment for lateral epicondylitis, shoulder tendinopathy, knee osteoarthrosis, femoral head osteonecrosis and trochanteric bursitis reported inconsistent results for most of their patients. Those that evaluated patients with calcifying tendinopathy, plantar fasciitis, Achilles tendinopathy, patellar tendinopathy and pseudarthrosis showed benefits. Shockwave treatment is a safe and non-invasive method for chronic cases in which conventional techniques have been unsatisfactory and should be used in association with other treatment methods for tendinopathy. Further quality studies are needed. PMID:26229889

  7. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature.

    PubMed

    Kertzman, Paulo; Lenza, Mario; Pedrinelli, André; Ejnisman, Benno

    2015-01-01

    Shockwave treatment is an option within orthopedics. The exact mechanism through which shockwaves function for treating musculoskeletal diseases is unknown. The aim of this study was to make a qualitative analysis on the effectiveness of shockwave treatment among patients with musculoskeletal pathological conditions and pseudarthrosis. Searches were conducted in the Cochrane Library, Medline and Lilacs databases. Thirty-nine studies that reported using shockwave treatment for musculoskeletal diseases were found. Their results varied greatly, as did the types of protocol used. The studies that evaluated the effectiveness of shockwave treatment for lateral epicondylitis, shoulder tendinopathy, knee osteoarthrosis, femoral head osteonecrosis and trochanteric bursitis reported inconsistent results for most of their patients. Those that evaluated patients with calcifying tendinopathy, plantar fasciitis, Achilles tendinopathy, patellar tendinopathy and pseudarthrosis showed benefits. Shockwave treatment is a safe and non-invasive method for chronic cases in which conventional techniques have been unsatisfactory and should be used in association with other treatment methods for tendinopathy. Further quality studies are needed.

  8. Pain and ketoprofen: what is its role in clinical practice?

    PubMed

    Sarzi-Puttini, P; Atzeni, F; Lanata, L; Bagnasco, M; Colombo, M; Fischer, F; D'Imporzano, M

    2010-01-01

    Ketoprofen is a drug belonging to the family of non-steroidal anti-inflammatory drugs (NSAIDs). The present review examines the main available clinical evidence of ketoprofen in the treatment of acute and chronic pain, of both rheumatic and traumatic origin, as well as postoperative pain. Ketoprofen has shown to be an excellent choice of drug for the treatment of chronic pain in patients with osteoarthritis, rheumatoid arthritis or gout, demonstrating a high level of efficacy with good tolerability also in elderly patients. Even in the treatment of acute forms of pain such as bursitis, tendinitis and back pain, ketoprofen compares favourably to other NSAIDs (e.g., ibuprofen and diclofenac) in terms of efficacy. Ketoprofen has been shown to be effective also for the treatment of post-operative pain, particularly in the orthopaedic field, with an efficacy similar to opioids in some studies. In this setting, some evidence indicates that ketoprofen exhibits additional important benefits, showing to be effective in the prophylaxis of heterotopic calcification following hip or pelvic major intervention, without affecting the bone healing process. Moreover, the use of ketoprofen in elastomeric pump in combination with opioids or other NSAIDs has proven to be effective and safe. In conclusion, available data confirm that ketoprofen is effective and well tolerated, through different administration routes, for the treatment of various forms of rheumatic, traumatic and post-surgical pain, and may therefore be considered as a valid therapeutic option for these patients. PMID:21052564

  9. An intraosseous lipoma of the calcaneus: a case report.

    PubMed

    Pappas, Alexander J; Haffner, Kyle E; Mendicino, Samuel S

    2014-01-01

    Intraosseous lipomas are one of the rarest bone tumors found in the body. The incidence has been reported to be <0.1% of all primary bone tumors. The differential diagnoses of an intraosseous lipoma in the calcaneus include plantar fasciitis, retrocalcaneal bursitis, gout, stress fracture, unicameral bone cyst, aneurysmal bone cyst, osteoblastoma, enchondroma, chondromyxoid fibroma, nonossifying fibroma, giant cell tumor, chondroblastoma, fibrous dysplasia, and chondrosarcoma. It has been reported that 60% to 70% of patients with an intraosseous lipoma present with symptoms. This article describes a case of a pathologic fracture secondary to a large intraosseous lipoma, the surgical treatments, and the subsequent resolution of symptoms. The purpose of our report was 3-fold: (1) to increase awareness of intraosseous lipomas and their potential to cause pathologic fractures in the calcaneus; (2) to suggest a possible treatment protocol for intraosseous lipomas in the calcaneus; and (3) to describe a rare case of an intraosseous lipoma of the calcaneus not located exclusively in the neutral triangle. PMID:24875966

  10. Compound f: the history of hydrocortisone and hand surgery.

    PubMed

    Cooney, William P

    2013-04-01

    Hydrocortisone (cortisol) is used daily in the practice of medicine and hand surgery. It has an effective use in a number of orthopedic conditions, including tendinitis, tenovaginitis, bursitis, carpal tunnel syndrome, and joint inflammation. But are surgeons aware of how this important pharmaceutical agent was discovered and prepared for clinical trial and who was responsible for its first clinical application? How did medical doctors determine that, like penicillin, cortisone and its derivative hydrocortisone would have such a life-changing effect on certain medical conditions? The purpose of this review is to relate the story of the development of cortisone (Compound E) and hydrocortisone (Compound F) and how both influenced the practice of hand surgeons in the treatment of rheumatoid arthritis and related inflammatory conditions. This history of cortisone and hydrocortisone also relates to the importance of partnership between physician and research scientist and of the principle at Mayo Clinic that the only concern--or the first concern--is the concern for the patient. PMID:23403170

  11. Methylprednisolone versus triamcinolone in painful shoulder using ultrasound-guided injection.

    PubMed

    Chávez-López, Mario Alfredo; Navarro-Soltero, Luis Alberto; Rosas-Cabral, Alejandro; Gallaga, Adán; Huerta-Yáñez, Guillermo

    2009-01-01

    There is little evidence about the comparative efficacy of corticosteroids in the treatment of painful shoulder. The main aim was to compare the efficacy of methylprednisolone (MTP) versus triamcinolone (TMC) in the treatment of painful shoulder using an ultrasound-guided injection. Patients with painful shoulder due to subacromial bursitis and partial or full-thickness rotator cuff tears demonstrated by musculoskeletal ultrasound received a guided-injection of MTP acetate 40 mg (12 patients) or TMC acetonide 40 mg (12 patients). Range of motion and pain visual analogue scale were registered at 10 and 30 min, 1 and 2 weeks postinjection. Two weeks postinjection, both groups reported a mean improvement in range of motion (33%) and relief of pain (61%). Relief of pain of 50% or more was observed in 92% of patients in MTP group and 50% of TMC group (p = 0.02). Two months postinjection, 50% of the patients in MTP group and 25% in TMC group reported total relief of pain (p = 0.3). Patients with painful shoulder receiving an ultrasound-guided injection of MTP or TMC have a rapid and sustained overall response. Relief of pain tends to be more rapid with MTP than TMC.

  12. Small diameter acetabulum and femoral head in total hip arthroplasty for developmental dysplasia of the hip, with no femoral osteotomy.

    PubMed

    Verettas, Dionysios-Alexandros; Chloropoulou, Pelagia; Xarchas, Konstantinos; Drosos, Georgios; Ververidis, Athanasios; Kazakos, Konstantinos

    2015-01-01

    We present the results of 66 total hip arthroplasties in 62 patients of mean age 46 years (24-74 years), with developmental dysplasia of the hip. In all cases the centre of rotation of the new hip was positioned at the site of the true acetabulum. In all patients cementless press fit acetabular components of small diameter (42-44 mm) were used, articulating exclusively with a 22.25 mm modular metal femoral head, without the use of bone grafts or shortening osteotomies of the femur. Despite the use of small diameter femoral heads the rate of dislocation was 3%. After an average follow-up period of 9 years (4-18 years), no revisions were required for infection, loosening or wear or implant migration. Osteolytic lesions were seen in the periacetabular region in 3 patients who were symptom free. A total of 2 revisions were required for instability and 2 patients had the wires of their trochanteric osteotomy removed because of bursitis. Leg length inequality was improved in 55% of the patients and one postoperative transient sciatic nerve lesion settled within 4 months. We believe that in patients with painful dysplastic hips, the use of small diameter implants with the centre of rotation at the true acetabulum, can give very satisfactory results, without any supplementary procedures.

  13. Subacromial Impingement Syndrome Caused by a Voluminous Subdeltoid Lipoma

    PubMed Central

    2014-01-01

    Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right shoulder. Despite a well-followed 6-months physiotherapy program, the patient was still suffering from his right shoulder. The MRI scan revealed a well-circumscribed 6 cm × 2 cm × 5 cm homogenous lesion compatible with a subdeltoid intermuscular lipoma. The mass was excised en bloc, and subsequent histopathologic examination confirmed a benign lipoma. At 6-months follow-up, the patient was asymptomatic with a complete return to his activities. Based on this case and a review of the literature, a subacromial lipoma has to be included in the differential diagnosis of a subacromial impingement syndrome refractory to nonoperative treatment. Complementary imaging modalities are required only after a failed conservative management to assess the exact etiology and successfully direct the surgical treatment. PMID:24778890

  14. Sonography of Sports Injuries of the Hip

    PubMed Central

    Dawes, Aaron R. L.; Seidenberg, Peter H.

    2014-01-01

    Context: Sports-related injuries of the hip are a common complaint of both competitive and recreational athletes of all ages. The anatomic and biomechanical complexity of the hip region often cause diagnostic uncertainty for the clinicians evaluating these injuries. Therefore, obtaining additional diagnostic information is often crucial for providing injured athletes with a prompt and accurate diagnosis so they can return to activity as soon as possible. Musculoskeletal ultrasound is becoming increasingly important in evaluating and treating sports-related injuries of the hip. Evidence Acquisition: The PubMed database was searched in May of 2013 for English-language articles pertaining to sonography of sports injuries of the hip using the following keywords in various combinations: musculoskeletal, ultrasound, hip, hip sonography, and sports. Study Design: Clinical review. Level of Evidence: Level 4. Results: Musculoskeletal ultrasound is currently being used for both diagnosis and treatment in a wide range of acute and chronic conditions affecting the hip, including tendinosis, tendon/muscle strains, ligamentous sprains, enthesopathies, growth plate injuries, fractures, bursitis, effusions, synovitis, labral tears, and snapping hip. Therapeutically, it is used to guide injections, aspirations, and biopsies. Conclusion: Musculoskeletal ultrasound use is expanding and will likely continue to do so as more clinicians realize its capabilities. Characteristics, including accessibility, portability, noninvasiveness, dynamic examination, power Doppler examination, and low cost highlight the potential of ultrasound. PMID:25364486

  15. Different distributions of operative diagnoses for Achilles tendon overuse injuries in Italian and Finnish athletes

    PubMed Central

    Johansson, Kristian; Lempainen, Lasse; Sarimo, Janne; Laitala-Leinonen, Tiina; Orava, Sakari

    2016-01-01

    Summary Background the origin of chronic Achilles tendinopathy (AT) is currently unclear and epidemiological factors, such as ethnicity, may be associated. Methods intraoperative findings from the treatment of 865 Finnish and 156 Italian athletic patients with chronic Achilles tendon related pain were evaluated, retrospectively. The mean age was 34 years (range, 18 to 65 years) in the Finnish and 29 years (range, 17–63 years) in the Italian patients. In total, 786 patients were males and 226 females of which 84 and 87% Finnish, respectively. Data were collected, retrospectively from patient records. The differences in the frequencies of operative findings were assessed for statistical significance. Results retrocalcaneal bursitis, partial tear and chronic paratenonitis were the most prevalent findings in patients with chronic AT undergoing surgery. Tendinosis and chronic paratenonitis were significantly (p=0.011) more common in Finnish athletes. Italian patients exhibited significantly (p<0.001) more insertional calcific tendinopathy (heel spurs) and prominent posterosuperior calcaneal corners (Haglund’s heel). Conclusion ethnicity appears to be associated with specific characteristics of overuse-related Achilles tendon pathology. This is an issue that should be considered in the planning of genetic research on AT. PMID:27331038

  16. Rheumatic manifestations in inflammatory bowel disease.

    PubMed

    Atzeni, Fabiola; Defendenti, Caterina; Ditto, Maria Chiara; Batticciotto, Alberto; Ventura, Donatella; Antivalle, Marco; Ardizzone, Sandro; Sarzi-Puttini, Piercarlo

    2014-01-01

    Musculoskeletal symptoms (articular, periarticular and muscular involvement, osteoporosis and related fractures, and fibromyalgia) are the most common frequent extra-intestinal manifestations of inflammatory bowel disease (IBD) and affect 6-46% of patients. IBD-related arthropathy is one of a group of inflammatory arthritides known as seronegative spondyloarthropathies (SpA), which also includes idiopathic ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis, and undifferentiated SpA. The articular involvement in IBD significantly affects the patients' quality of the life. Although magnetic resonance imaging (MRI) is still the gold standard for assessing entheseal involvement, ultrasonography (US) is a non-invasive and easily reproducible means of detecting early pathological changes in SpA patients. It can identify characteristic features of SpA such as enthesitis, bone erosions, synovitis, bursitis, and tenosynovitis and is therefore helpful for diagnostic purposes. Anti-TNF drugs should be used to treat AS patients with axial and peripheral symptoms (arthritis and enthesitis) who have persistently high levels of disease activity despite conventional treatment, and adalimumab and infliximab can also be beneficially used in patients with IBD.

  17. Helpful tips for performing musculoskeletal injections.

    PubMed

    Metz, John P

    2010-01-01

    Injections are valuable procedures for managing musculoskeletal conditions commonly encountered by family physicians. Corticosteroid injections into articular, periarticular, or soft tissue structures relieve pain, reduce inflammation, and improve mobility. Injections can provide diagnostic information and are commonly used for postoperative pain control. Local anesthetics may be injected with corticosteroids to provide additional, rapid pain relief. Steroid injection is the preferred and definitive treatment for de Quervain tenosynovitis and trochanteric bursitis. Steroid injections can also be helpful in controlling pain during physical rehabilitation from rotator cuff syndrome and lateral epicondylitis. Intra-articular steroid injection provides pain relief in rheumatoid arthritis and osteoarthritis. There is little systematic evidence to guide medication selection for therapeutic injections. The medication used and the frequency of injection should be guided by the goal of the injection (i.e., diagnostic or therapeutic), the underlying musculoskeletal diagnosis, and clinical experience. Complications from steroid injections are rare, but physicians should understand the potential risks and counsel patients appropriately. Patients with diabetes who receive periarticular or soft tissue steroid injections should closely monitor their blood glucose for two weeks following injection. PMID:20052957

  18. Musculoskeletal injections: a review of the evidence.

    PubMed

    Stephens, Mark B; Beutler, Anthony I; O'Connor, Francis G

    2008-10-15

    Injections are valuable procedures for managing musculoskeletal conditions commonly encountered by family physicians. Corticosteroid injections into articular, periarticular, or soft tissue structures relieve pain, reduce inflammation, and improve mobility. Injections can provide diagnostic information and are commonly used for postoperative pain control. Local anesthetics may be injected with corticosteroids to provide additional, rapid pain relief. Steroid injection is the preferred and definitive treatment for de Quervain tenosynovitis and trochanteric bursitis. Steroid injections can also be helpful in controlling pain during physical rehabilitation from rotator cuff syndrome and lateral epicondylitis. Intra-articular steroid injection provides pain relief in rheumatoid arthritis and osteoarthritis. There is little systematic evidence to guide medication selection for therapeutic injections. The medication used and the frequency of injection should be guided by the goal of the injection (i.e., diagnostic or therapeutic), the underlying musculoskeletal diagnosis, and clinical experience. Complications from steroid injections are rare, but physicians should understand the potential risks and counsel patients appropriately. Patients with diabetes who receive periarticular or soft tissue steroid injections should closely monitor their blood glucose for two weeks following injection. PMID:18953975

  19. Polymyalgia Rheumatica Revealing a Lymphoma: A Two-Case Report

    PubMed Central

    Chouk, Mickaël

    2016-01-01

    Introduction. Polymyalgia rheumatica (PMR) is one of the most common inflammatory rheumatism types in elderly population. The link between cancer and PMR is a matter of debate. Methods. We report two cases of PMR leading to the diagnosis of lymphoma and the growing interest of PET-TDM in this indication. Results. A 84-year-old man known for idiopathic neutropenia presented an inflammatory arthromyalgia of the limb girdle since one month. Blood exams highlighted the presence of a monoclonal B cell clone. Bone marrow concluded to a B cell lymphoma of the marginal zone. He was successfully treated with 0.3 mg/kg/d of prednisone, and response was sustained after 6 months. A 73-year-old man known for prostatic neoplasia in remission for 5 years presented arthromyalgia of the limb girdle since one month. PET-CT revealed bursitis of the hips and the shoulders, no prostatic cancer recurrence, and a metabolically active iliac lymphadenopathy whose pathologic exam concluded to a low grade follicular lymphoma. He was successfully treated with 0.3 mg/kg/d of prednisone. Conclusion. These observations may imply that lymphoma is sometimes already present when PMR is diagnosed and PET-CT is a useful tool in the initial assessment of PMR to avoid missing neoplasia. PMID:27597921

  20. Lateral Hip Pain in an Athletic Population

    PubMed Central

    Grumet, Robert C.; Frank, Rachel M.; Slabaugh, Mark A.; Virkus, Walter W.; Bush-Joseph, Charles A.; Nho, Shane J.

    2010-01-01

    Context: Historically, the term greater trochanteric pain syndrome has been used to describe a spectrum of conditions that cause lateral-sided hip pain, including greater trochanteric bursitis, snapping iliotibial band, and/or strains or tendinopathy of the abductor mechanism. Diagnosis of these conditions may be difficult because clinical presentations are variable and sometimes inconclusive. Especially difficult is differentiating intrinsic pain from pain referred to the greater trochanteric region. The purposes of this article are to review the relevant anatomy and pathophysiology of the lateral hip. Evidence Acquisition: Data were collected through a thorough review of the literature conducted through a MEDLINE search of all relevant papers between 1980 and January 2010. Results: Recent advances in imaging and an improved understanding of pathomechanics have helped to guide the evaluation, diagnosis, and appropriate treatment for patients presenting with lateral hip pain. Conclusion: Various diagnostic tools and treatment modalities can be used to effectively manage the athletic patient presenting with lateral hip pain. PMID:23015937

  1. Phaeohyphomycosis infection in the knee.

    PubMed

    Sadigursky, David; Nogueira E Ferreira, Luisa; Moreno de Oliveira Corrêa, Liz

    2016-01-01

    Phaeohyphomycosis is caused by cutaneous fungi and rarely affects large joints. This is a case report on phaeohyphomycosis in the left knee of an elderly individual without immunosuppression. It was accompanied by pain and swelling the anterior knee. The case was first suspected to be suprapatellar bursitis, and was treated with nonsteroidal anti-inflammatory drugs, without remission of symptoms. Surgical treatment was performed, with resection of the suprapatellar bursa and anterior region of the quadriceps tendon. The material was sent for anatomopathological examination and culturing. The pathological examination showed phaeohyphomycosis. The treatment instituted consisted of itraconazole, 200 mg/day for six weeks, and complete remission of symptoms was achieved. The physical examination remained normal after one year of follow-up. This is the first published case of phaeohyphomycosis infection in the suprapatellar region of the knee. Although almost all the cases reported have been associated with immunosuppressed patients, this was an exception. It is important to suspect phaeohyphomycosis in cases of knee infection, in the area of the suprapatellar bursa, when the symptoms do not resolve after clinical treatment.

  2. Painful os Acromiale: Conservative Management in a Young Swimmer Athlete

    PubMed Central

    Frizziero, Antonio; Benedetti, Maria G.; Creta, Domenico; Moio, Antonio; Galletti, Stefano; Maffulli, Nicola

    2012-01-01

    An os acromiale (OA) arises from a fusion failure of the anterior acromial apophysis. This case report presents the successful management of a painful OA associated to rotator cuff impingement in a competitive swimmer, based on ultrasonographic diagnosis and conservative management. Rest from sport activity, oral anti-inflammatory drugs and previous attempt of treatment of shoulder pain were ineffective. After two months of conservative treatment consisting of avoidance of swimming, local anti-inflammatory, physical therapy with ice, strengthening exercises with elastic bands to strengthen the scapular stabilizing muscles, rotator cuff and lowering humeral head muscles, the patient was pain free and all specific clinical tests for impingement syndrome (Neer, Hawkins, Whipple and Yocum tests) were negative. Digital compression of the OA site was not painful, and the Jobe and Palm-up tests were negative. The athlete returned to swim continuing the rehabilitation exercises, and the successful results were maintained at one year follow up. An unstable and symptomatic OA can be easily diagnosed with ultrasound exam. Rehabilitation for rotator cuff tendinopathies or/and bursitis can be a valid alternative to surgery. Key pointsAn os acromiale (OA) arises from a fusion failure of the anterior acromial apophysis.A correct diagnosis of OA associated to rotator cuff impingement can be performed by ultrasonographic exam.A conservative management of rotator cuff impingement syndrome, associated to OA, can be planned in athletic patients as a valid alternative to surgery. PMID:24149210

  3. Experience with carprofen in extra-articular inflammatory processes.

    PubMed

    Gotter, G

    1982-01-01

    Carprofen is a new non-steroidal compound with analgesic, anti-inflammatory and anti-pyretic properties. Eighty patients with different types of extra-articular inflammatory processes such as periarthritis humero-scapularis, tendinitis, bursitis, etc., were studied by means of two double-blind protocol designs comparing carprofen 150 and 300 mg daily, either as a b.i.d. or a t.i.d. administration, for two weeks. The criteria to determine the therapeutic properties of the compound was based on the improvement of spontaneous pain, pain with movement and functional limitation. Evolution of symptoms showed that either 150 or 300 mg carprofen administered as a b.i.d. schedule, were equally effective (chi 2 test between groups was not significant). According to a t.i.d. schedule results were better with 300 mg. General tolerance was excellent and only 15% of the patients receiving 300 mg complained of side-effects, such as nausea, mild dermatitis, acidity and insomnia. In conclusion, carprofen 150 or 300 mg has a good therapeutical activity in extra-articular inflammatory processes, employing either a b.i.d. or a t.i.d. schedule. PMID:6983966

  4. Ultrasound in rheumatoid arthritis.

    PubMed

    Rizzo, Chiara; Ceccarelli, Fulvia; Gattamelata, Angelica; Vavala, Caterina; Valesini, Guido; Iagnocco, Annamaria

    2013-09-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial inflammation that can lead to structural damage of cartilage, bone and tendons. Assessing the inflammatory activity and the severity is essential in RA to help rheumatologists in adopting proper therapeutic strategies and in evaluating disease outcome and response to treatment. In the last years musculoskeletal (MS) ultrasonography (US) underwent tremendous technological development of equipment with increased sensitivity in detecting a wide set of joint and soft tissues abnormalities. In RA MSUS with the use of Doppler modalities is a useful imaging tool to depict inflammatory abnormalities (i.e. synovitis, tenosynovitis and bursitis) and structural changes (i.e. bone erosions, cartilage damage and tendon lesions). In addition, MSUS has been demonstrated to be able to monitor the response to different therapies in RA to guide local diagnostic and therapeutic procedures such as biopsy, fluid aspirations and injections. Future applications based on the development of new tools may improve the role of MSUS in RA.

  5. Polymyalgia Rheumatica Revealing a Lymphoma: A Two-Case Report.

    PubMed

    Verhoeven, Frank; Guillot, Xavier; Chouk, Mickaël; Prati, Clément; Wendling, Daniel

    2016-01-01

    Introduction. Polymyalgia rheumatica (PMR) is one of the most common inflammatory rheumatism types in elderly population. The link between cancer and PMR is a matter of debate. Methods. We report two cases of PMR leading to the diagnosis of lymphoma and the growing interest of PET-TDM in this indication. Results. A 84-year-old man known for idiopathic neutropenia presented an inflammatory arthromyalgia of the limb girdle since one month. Blood exams highlighted the presence of a monoclonal B cell clone. Bone marrow concluded to a B cell lymphoma of the marginal zone. He was successfully treated with 0.3 mg/kg/d of prednisone, and response was sustained after 6 months. A 73-year-old man known for prostatic neoplasia in remission for 5 years presented arthromyalgia of the limb girdle since one month. PET-CT revealed bursitis of the hips and the shoulders, no prostatic cancer recurrence, and a metabolically active iliac lymphadenopathy whose pathologic exam concluded to a low grade follicular lymphoma. He was successfully treated with 0.3 mg/kg/d of prednisone. Conclusion. These observations may imply that lymphoma is sometimes already present when PMR is diagnosed and PET-CT is a useful tool in the initial assessment of PMR to avoid missing neoplasia. PMID:27597921

  6. Fluocinolone acetonide ophthalmic--Bausch & Lomb: fluocinolone acetonide Envision TD implant.

    PubMed

    2005-01-01

    Bausch & Lomb and Control Delivery Systems have developed an intravitreal implant that can deliver the corticosteroid fluocinolone acetonide [fluocinolone acetonide implant, Retisert] to posterior eye tissue for up to 3 years. The implant uses Bausch & Lomb's Envision TD technology. This fluocinolone acetonide implant has been designed for the treatment of non-infectious uveitis affecting the posterior segment of the eye and other eye disorders, which benefit from local anti-inflammatory therapy. In July 2003, Bausch & Lomb assumed all responsibility for day-to-day clinical development and regulatory activities relating to fluocinolone acetonide implant development from Control Delivery Systems. In May 2002, Control Delivery systems and Bausch & Lomb formally amended their budget for their license and development agreement. Bausch & Lomb will increase its funding to support the development of agents for the treatment of diabetic macular oedema, posterior uveitis and wet age-related macular degeneration to USD $206 million through to 2008. In January 2004, Bausch & Lomb decided to focus development of the fluocinolone acetonide implant in only one indication, non-infectious uveitis affecting the posterior segment of the eye. It had been in development for other indications, including macular oedema and age-related macular degeneration. However, these will be targeted with later-generation implant technologies, different drugs, or combinations of both. The implant delivering fluocinolone acetonide 0.59 mg or 2.1mg has completed enrollment in two pivotal 3-year phase IIb/III trials in the US, Canada, Australia and Asia for the treatment of posterior uveitis. Enrollment in these multicenter randomised, double-masked studies was closed in May 2003. Bausch & Lomb was expected to file an NDA with the US FDA for the use of the agent in the treatment of uveitis in mid-2003. However, in February 2003, the company reported that, after a review of various filing strategies

  7. Can rapid integrated polymerase chain reaction-based diagnostics for gastrointestinal pathogens improve routine hospital infection control practice? A diagnostic study.

    PubMed Central

    Pankhurst, Louise; Macfarlane-Smith, Louissa; Buchanan, James; Anson, Luke; Davies, Kerrie; O'Connor, Lily; Ashwin, Helen; Pike, Graham; Dingle, Kate E; Peto, Timothy Ea; Wordsworth, Sarah; Walker, A Sarah; Wilcox, Mark H; Crook, Derrick W

    2014-01-01

    BACKGROUND Every year approximately 5000-9000 patients are admitted to a hospital with diarrhoea, which in up to 90% of cases has a non-infectious cause. As a result, single rooms are 'blocked' by patients with non-infectious diarrhoea, while patients with infectious diarrhoea are still in open bays because of a lack of free side rooms. A rapid test for differentiating infectious from non-infectious diarrhoea could be very beneficial for patients. OBJECTIVE To evaluate MassCode multiplex polymerase chain reaction (PCR) for the simultaneous diagnosis of multiple enteropathogens directly from stool, in terms of sensitivity/specificity to detect four common important enteropathogens: Clostridium difficile, Campylobacter spp., Salmonella spp. and norovirus. DESIGN A retrospective study of fixed numbers of samples positive for C. difficile (n = 200), Campylobacter spp. (n = 200), Salmonella spp. (n = 100) and norovirus (n = 200) plus samples negative for all these pathogens (n = 300). Samples were sourced from NHS microbiology laboratories in Oxford and Leeds where initial diagnostic testing was performed according to Public Health England methodology. Researchers carrying out MassCode assays were blind to this information. A questionnaire survey, examining current practice for infection control teams and microbiology laboratories managing infectious diarrhoea, was also carried out. SETTING MassCode assays were carried out at Oxford University Hospitals NHS Trust. Further multiplex assays, carried out using Luminex, were run on the same set of samples at Leeds Teaching Hospitals NHS Trust. The questionnaire was completed by various NHS trusts. MAIN OUTCOME MEASURES Sensitivity and specificity to detect C. difficile, Campylobacter spp., Salmonella spp., and norovirus. RESULTS Nucleic acids were extracted from 948 clinical samples using an optimised protocol (200 Campylobacter spp., 199 C. difficile, 60 S. enterica, 199 norovirus and 295 negative

  8. Calibration-free concentration analysis of protein biomarkers in human serum using surface plasmon resonance.

    PubMed

    Grover Shah, Veenita; Ray, Sandipan; Karlsson, Robert; Srivastava, Sanjeeva

    2015-11-01

    In complex biological samples such as serum, determination of specific and active concentration of target proteins, independent of a calibration curve, will be valuable in many applications. Calibration-free concentration analysis (CFCA) is a surface plasmon resonance (SPR)-based label-free approach, which calculates active concentration of proteins using their known diffusion coefficient and observed changes in binding rates at different flow rates under diffusion-limited conditions. Here, for the first time we demonstrate the application of CFCA for determining protein biomarker abundance, specifically serum amyloid A (SAA), directly in the serum samples of patients suffering from different infectious and non-infectious diseases. The assay involves preparation of appropriate reaction surfaces by immobilizing antibodies on CM5 chips via amine coupling followed by serum sample preparation and injection over activated and reference surfaces at flow-rates of 5 and 100 μL/min. The system was validated in healthy and diseased (infectious and non-infectious) serum samples by quantifying two different proteins: β2-microglobulin (β2M) and SAA. All concentration assays were performed for nearly 100 serum samples, which showed reliable quantification in unattended runs with high accuracy and sensitivity. The method could detect the serum β2M to as low as 13 ng/mL in 1000-fold serum dilution, indicating the possible utility of this approach to detect low abundance protein biomarkers in body fluids. Applying the CFCA approach, significant difference in serum abundance of SAA was identified in diseased subjects as compared to the healthy controls, which correlated well with our previous proteomic investigations. Estimation of SAA concentration for a subset of healthy and diseased sera was also performed using ELISA, and the trend was observed to be similar in both SPR assay and ELISA. The reproducibility of CFCA in various serum samples made the interpretation of assay

  9. An elevated IgG4 response in chronic infectious aortitis is associated with aortic atherosclerosis.

    PubMed

    Siddiquee, Zakir; Smith, R Neal; Stone, James R

    2015-11-01

    Recently, it was shown that infectious bacterial aortitis can stimulate an elevated IgG4⁺ plasma cell response in the vessel wall, which could mimic IgG4 aortitis/periaortitis. However, the factors that are associated with an elevated IgG4⁺ plasma cell response in infectious aortitis are unclear. To ascertain these factors, 17 cases of infectious aortitis and 6 cases of non-infectious severe abdominal aortic atherosclerosis were assessed for the magnitude of IgG4⁺ plasma cell response. The degree of IgG4⁺ plasma cell infiltration was determined by immunohistochemistry. Infectious cases were subcharacterized as chronic (>3 weeks duration) or acute (<3 weeks duration) based on the duration of symptoms, and as involving either the ascending aorta or the distal aorta, ie, the descending thoracic and/or abdominal aorta. There was a 5-16-fold greater degree of IgG4⁺ plasma cell infiltration in the chronic distal infectious aortitis group compared with the other three infectious aortitis groups (P ≤ 0.0007), and compared with non-infectious severe abdominal aortic atherosclerosis (P<0.0008). This resulted in a greater IgG4/IgG ratio in the chronic distal infectious aortitis group compared with the acute ascending and acute distal infectious aortitis groups (P<0.03). The degree of IgG4⁺ plasma cell infiltration in chronic distal infectious aortitis overlaps with that seen in the aortitis and periaortitis of IgG4-related disease. In the chronic infectious aortitis cases, the degree of IgG4⁺ plasma cell infiltration was more intense in patients with moderate to severe aortic atherosclerosis compared with those patients with less aortic atherosclerosis (P=0.007). These findings indicate that an elevated IgG4⁺ plasma cell response occurs in the descending thoracic and abdominal aorta in the setting of chronic bacterial infectious aortitis and pre-existing atherosclerosis. This inflammatory response to chronic infection in atherosclerosis-laden aortas may have

  10. Psychiatric comorbidities in opioid-dependent patients undergoing a replacement therapy programme in Spain: The PROTEUS study.

    PubMed

    Roncero, Carlos; Barral, Carmen; Rodríguez-Cintas, Laia; Pérez-Pazos, Jesús; Martinez-Luna, Nieves; Casas, Miguel; Torrens, Marta; Grau-López, Lara

    2016-09-30

    Opioid-dependent patients show a high rate of psychiatric comorbidities. The prevalence and characteristics of patients with dual diagnosis have not been well established in Spanish opioid agonist treatment (OAT) programmes. Thus, 621 opioid-dependent patients enrolled in OAT programmes were assessed, using the EuropASI questionnaire, for psychiatric comorbidities, which were detected in 67% of patients (anxiety 53%, mood disorders 48%, sleep disorders 41%, substance-related disorders 36%). In addition, compared with patients without a dual diagnosis, patients with dual pathology were significantly older, used benzodiazepines and cannabis in significantly greater percentages, and showed significantly more frequent infectious and non-infectious comorbidities, worse overall working status, a lower proportion of drivers and higher levels of severity regarding medical, employment, alcohol, legal, family and psychological issues. Therefore, the data showed a very high prevalence of psychiatric comorbidity in opioid-dependent patients receiving OAT in Spain and several problems frequently associated with patients with dual diagnosis. Physicians treating opioid-dependent patients should be aware of these facts to correctly identify and manage patients with a dual diagnosis. PMID:27416536

  11. Adaptation in the innate immune system and heterologous innate immunity.

    PubMed

    Martin, Stefan F

    2014-11-01

    The innate immune system recognizes deviation from homeostasis caused by infectious or non-infectious assaults. The threshold for its activation seems to be established by a calibration process that includes sensing of microbial molecular patterns from commensal bacteria and of endogenous signals. It is becoming increasingly clear that adaptive features, a hallmark of the adaptive immune system, can also be identified in the innate immune system. Such adaptations can result in the manifestation of a primed state of immune and tissue cells with a decreased activation threshold. This keeps the system poised to react quickly. Moreover, the fact that the innate immune system recognizes a wide variety of danger signals via pattern recognition receptors that often activate the same signaling pathways allows for heterologous innate immune stimulation. This implies that, for example, the innate immune response to an infection can be modified by co-infections or other innate stimuli. This "design feature" of the innate immune system has many implications for our understanding of individual susceptibility to diseases or responsiveness to therapies and vaccinations. In this article, adaptive features of the innate immune system as well as heterologous innate immunity and their implications are discussed.

  12. Evolutionary, historical and political economic perspectives on health and disease.

    PubMed

    Armelagos, George J; Brown, Peter J; Turner, Bethany

    2005-08-01

    The origin and rise of social inequalities that are a feature of the post-Neolithic society play a major role in the pattern of disease in prehistoric and contemporary populations. We use the concept of epidemiological transition to understand changing ecological relationships between humans, pathogens and other disease insults. With the Paleolithic period as a baseline, we begin with ecological and social relationships that minimized the impact of infectious disease. Paleolithic populations would have retained many of the pathogens that they shared with their primate ancestors and would have been exposed to zoonoses that they picked up as they adapted to a foraging existence. The sparse mobile populations would have precluded the existence of endemic infectious disease. About 10,000 years ago, the shift to an agricultural subsistence economy created the first epidemiological transition, marked by the emergence of infections, a pattern that has continued to the present. Beginning about a century ago, some populations have undergone a second epidemiological transition in which public health measures, improved nutrition and medicine resulted in declines in infectious disease and a rise in non-infectious, chronic and degenerative diseases. Human populations are entering the third epidemiological transition in which there is a reemergence of infectious diseases previously thought to be under control, and the emergence of novel diseases. Many of the emerging and reemerging pathogens are antibiotic resistant and some are multi-antibiotic resistant. Inequality continues to widen within and between societies, accelerating the spread of emerging and reemerging diseases.

  13. Subclinical intestinal inflammation in chronic granulomatous disease patients.

    PubMed

    Broides, Arnon; Sagi, Orli; Pinsk, Vered; Levy, Jacov; Yerushalmi, Baruch

    2016-02-01

    Chronic granulomatous disease is a primary immunodeficiency caused by impaired neutrophil production of reactive oxygen species. Non-infectious colitis is common in chronic granulomatous disease, and high levels of antimicrobial antibodies that are associated with Crohn's disease are common even without colitis. Fecal calprotectin concentration is a marker for intestinal inflammation. We sought to determine whether subclinical intestinal inflammation occurs in asymptomatic chronic granulomatous disease patients. Asymptomatic chronic granulomatous disease patients without overt gastrointestinal symptoms suggestive of colitis at the time of enrollment were studied for fecal calprotectin concentration, antibodies associated with Crohn's disease and systemic inflammatory markers. Eight patients were included, aged 54-176 months. In 7/8 (87.5 %) fecal calprotectin concentration was normal (<50) and elevated (137 mg/kg) in only one patient. This patient later developed colitis. In 7/8 (87.5 %) anti-Saccharomyces cerevisiae antibody was positive. C-reactive protein, albumin, complete blood count and p-anti-neutrophil cytoplasmic antibody were normal in all 8 patients. Subclinical colitis is not evident in most asymptomatic chronic granulomatous disease patients; however, in some patients, fecal calprotectin concentration may be elevated, possibly indicating the presence of subclinical colitis and predicting the occurrence of clinically relevant colitis. Serum anti-Saccharomyces cerevisiae antibody concentrations do not seem to correlate with fecal calprotectin concentration in asymptomatic chronic granulomatous disease patients.

  14. Evaluation of virus inactivation by formaldehyde to enhance biosafety of diagnostic electron microscopy.

    PubMed

    Möller, Lars; Schünadel, Livia; Nitsche, Andreas; Schwebke, Ingeborg; Hanisch, Manuela; Laue, Michael

    2015-02-10

    Formaldehyde (FA) fixation of infectious samples is a well-established protocol in diagnostic electron microscopy of viruses. However, published experimental data that demonstrate virus inactivation by these fixation procedures are lacking. Usually, fixation is performed immediately before the sample preparation for microscopy. The fixation procedure should transform viruses in a non-infectious but nonetheless structurally intact form in order to allow a proper diagnosis based on morphology. FA provides an essential advantage in comparison to other disinfectants, because it preserves the ultrastructure of biological material without interfering significantly with the preparation (i.e., the negative staining) and the detection of viruses. To examine the efficiency of FA inactivation, we used Vaccinia virus, Human adenovirus and Murine norovirus as models and treated them with FA under various conditions. Critical parameters for the inactivation efficiency were the temperature, the duration of the FA treatment, and the resistance of the virus in question. Our results show that FA inactivation at low temperature (4 °C) bears a high risk of incomplete inactivation. Higher temperatures (25 °C) are more efficient, although they still require rather long incubation times to fully inactivate a complex and highly robust virus like Vaccinia. A protocol, which applied 2% buffered FA for 60 min and a temperature-shift from 25 to 37 °C after 30 min was efficient for the complete inactivation of all test viruses, and therefore has the potential to improve both biosafety and speed of diagnostic electron microscopy.

  15. Novel immunogenic baculovirus expressed virus-like particles of foot-and-mouth disease (FMD) virus protect guinea pigs against challenge.

    PubMed

    Bhat, S A; Saravanan, P; Hosamani, M; Basagoudanavar, S H; Sreenivasa, B P; Tamilselvan, R P; Venkataramanan, R

    2013-12-01

    Vaccination is a well accepted strategy for control of foot-and-mouth disease (FMD) in endemic countries. Currently, chemically inactivated virus antigens are used for preparation of FMD vaccine. To develop a non-infectious and safe recombinant vaccine, we expressed structural polypeptide of FMDV (O/IND/R2/75) using baculovirus expression system. We show that inclusion of mutated viral 3C protease in frame with the polypeptide (P1-2A), enhanced the yield of structural proteins. The structural proteins retained antigenicity and assembled into empty virus-like particles (VLPs). Immunization of guinea pigs with purified fractions of the VLPs resulted in humoral and cell mediated immune response by 4 weeks. The VLPs elicited comparable humoral immune response and relatively higher cell mediated immune response, when compared to conventional vaccine in guinea pigs. Further, up to 70% of the VLP immunized guinea pigs were protected against challenge with homologous guinea pig adapted virus. Our results highlight the application of recombinant FMDV VLPs in FMD vaccination. PMID:23969204

  16. Turning off the spigot: reducing drug-resistant tuberculosis transmission in resource-limited settings

    PubMed Central

    Nardell, E.; Dharmadhikari, A.

    2013-01-01

    SUMMARY Ongoing transmission and re-infection, primarily in congregate settings, is a key factor fueling the global multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) epidemic, especially in association with the human immunodeficiency virus. Even as efforts to broadly implement conventional TB transmission control measures begin, current strategies may be incompletely effective under the overcrowded conditions extant in high-burden, resource-limited settings. Longstanding evidence suggesting that TB patients on effective therapy rapidly become non-infectious and that unsuspected, untreated TB cases account for the most transmission makes a strong case for the implementation of rapid point-of-care diagnostics coupled with fully supervised effective treatment. Among the most important decisions affecting transmission, the choice of an MDR-TB treatment model that includes community-based treatment may offer important advantages over hospital or clinic-based care, not only in cost and effectiveness, but also in transmission control. In the community, too, rapid identification of infectious cases, especially drug-resistant cases, followed by effective, fully supervised treatment, is critical to stopping transmission. Among the conventional interventions available, we present a simple triage and separation strategy, point out that separation is intimately linked to the design and engineering of clinical space and call attention to the pros and cons of natural ventilation, simple mechanical ventilation systems, germicidal ultraviolet air disinfection, fit-tested respirators on health care workers and short-term use of masks on patients before treatment is initiated. PMID:20843413

  17. Infection of the Beard area. Kerion: a review of 2 cases.

    PubMed

    Wall, D; Fraher, M; O'Connell, B; Watson, R; Timon, C; Stassen, L F A; Barnes, L

    2014-01-01

    Folliculitis barbae is a common condition of both infective and non-infectious aetiology. It most frequently presents as a superficial folliculitis, with fine pustules appearing at the opening of hair follicles in the beard area, often associated with shaving; known as Bockhart impetigo and usually due to infection caused by Staphylococcus aureus. If untreated, the infection and inflammation can progress, leading to a more deeply seated infection known as sycosis barbae. Perifollicular nodules, termed furuncles, may appear and when these are multiple and coalesce, a deep-seated, communicating, pustulating plaque called a carbuncle develops, often with associated systemic upset. Such an appearance, which can prompt incision and drainage, should not, however, be assumed to be solely due to staphylococcal infection. Particularly in the context of a history of close animal contact or a lack of response to antibiotic treatment, a diagnosis of tinea barbae should be considered and investigated. Prompt treatment with antifungal agents and often systemic steroids is required once the diagnosis is made. This will help reduce an exacerbation of the pronounced destruction that results from the immune response to the fungal infection, known as a kerion, which would be compounded by surgical intervention. In this article, we review two such cases and review the investigation and management of the disease. PMID:25226722

  18. 3D rotating wall vessel and 2D cell culture of four veterinary virus pathogens: A comparison of virus yields, portions of infectious particles and virus growth curves.

    PubMed

    Malenovská, Hana

    2016-02-01

    Only very few comparative studies have been performed that evaluate general trends of virus growth under 3D in comparison with 2D cell culture conditions. The aim of this study was to investigate differences when four animal viruses are cultured in 2D and 3D. Suid herpesvirus 1 (SuHV-1), Vesicular stomatitis virus (VSIV), Bovine adenovirus (BAdV) and Bovine parainfluenza 3 virus (BPIV-3) were cultivated in 3D rotating wall vessels (RWVs) and conventional 2D cultures. The production of virus particles, the portion of infectious particles, and the infectious growth curves were compared. For all viruses, the production of virus particles (related to cell density), including the non-infectious ones, was lower in 3D than in 2D culture. The production of only infectious particles was significantly lower in BAdV and BPIV-3 in 3D cultures in relation to cell density. The two cultivation approaches resulted in significantly different virus particle-to-TCID50 ratios in three of the four viruses: lower in SuHV-1 and BPIV-3 and higher in BAdV in 3D culture. The infectious virus growth rates were not significantly different in all viruses. Although 3D RWV culture resulted in lower production of virus particles compared to 2D systems, the portion of infectious particles was higher for some viruses.

  19. Public health problems and global warming faced by developing countries

    SciTech Connect

    Moreno, A.R.

    1996-12-31

    Climatic change potentially causes direct and indirect impacts on human health, resulting in a net increase in morbidity and associated mortality. Impacts would be greater in communities with higher exposure and with fewer technical and social resources. Age, skin pigmentation, hygiene level, socio-economic and health status, are determinants of the net effects. Climatic change will have indirect health effects by changing natural ecosystems, affecting such aspects as food production, patterns of vector-borne diseases, a number of non-infectious diseases, and unknown infections. The health effects, occurring largely as a result of increases in biologically effective UVR, are expected to consist of: increase in malignant and nonmalignant skin cancer; several eye diseases (primarily cataract); and possible alterations in the immune response. Some of the largest public health issues will be respiratory diseases brought about by increased air pollution, exacerbation of allergic disorders, and deaths and injuries from extreme weather events. Additionally, vaccination programs may be ineffective and nutritional requirements may be different in heavily sun-exposed populations.

  20. HTLV-1 viral RNA is detected rarely in plasma of HTLV-1 infected subjects.

    PubMed

    Demontis, Maria Antonietta; Sadiq, Maaz Tahir; Golz, Simon; Taylor, Graham P

    2015-12-01

    Plasma of patients infected with HTLV-1 is considered non-infectious but detection of HTLV-1 genomic RNA in plasma has been recently reported. The aim of this project was to detect and quantify HTLV-1 RNA in plasma and assess its potential value in diagnosis and prognosis. RNA from 1 ml of plasma from 65 subjects infected with HTLV-1 (27 asymptomatic carriers [AC]), 17 patients with HTLV-1-associated myelopathy (HAM/TSP), 14 with adult T-cell leukemia/lymphoma (ATLL), two co-infected with HIV, and five with other HTLV-1-associated disease, was extracted and reverse transcribed. HTLV-1 specific nested PCR was performed using primers to amplify the conserved Tax region. All samples were run in quadruplicate, nested PCR products were detected by gel electrophoresis. HTLV-1 RNA was detected in plasma from 18 (28%) patients, always at a very low copy number (3-13 copies viral cDNA per milliliter of plasma). Mean values of HTLV-1 proviral load did not differ between patients in whom HTLV-1 RNA was detected and patients in whom it was not possible to detect HTLV-1 RNA in plasma. HTLV-1 genomic RNA can be detected in the plasma of a minority of patients but not at a level or frequency to be useful clinically or diagnostically. Lack of transmission of HTLV-1 by plasma is due to the rare presence of HTLV-1 virions, regardless of any other factor.

  1. Neutrophil migration into the placenta: Good, bad or deadly?

    PubMed Central

    Giaglis, Stavros; Stoikou, Maria; Grimolizzi, Franco; Subramanian, Bibin Y.; van Breda, Shane V.; Hoesli, Irene; Lapaire, Olav; Hasler, Paul; Than, Nandor Gabor; Hahn, Sinuhe

    2016-01-01

    ABSTRACT Almost 2 decades have passed since the discovery that pregnancy is associated with a basal inflammatory state involving neutrophil activation, and that this is more overt in cases with preeclampsia, than in instances with sepsis. This pivotal observation paved the way for our report, made almost a decade ago, describing the first involvement of neutrophil extracellular traps (NETs) in a non-infectious human pathology, namely preeclampsia, where an abundance of these structures were detected directly in the placental intervillous space. Despite these remarkable findings, there remains a paucity of interest among reproductive biologists in further exploring the role or involvement of neutrophils in pregnancy and related pathologies. In this review we attempt to redress this deficit by highlighting novel recent findings including the discovery of a novel neutrophil subset in the decidua, the interaction of placental protein 13 (PP13) and neutrophils in modulating spiral artery modification, as well as the use of animal model systems to elucidate neutrophil function in implantation, gestation and parturition. These model systems have been particularly useful in identifying key components implicated in recurrent fetal loss, preeclampsia or new signaling molecules such as sphingolipids. Finally, the recent discovery that anti-phospolipid antibodies can trigger NETosis, supports our hypothesis that these structures may contribute to placental dysfunction in pertinent cases with recurrent fetal loss. PMID:26933824

  2. Pharmacologic Agents for Chronic Diarrhea.

    PubMed

    Lee, Kwang Jae

    2015-10-01

    Chronic diarrhea is usually associated with a number of non-infectious causes. When definitive treatment is unavailable, symptomatic drug therapy is indicated. Pharmacologic agents for chronic diarrhea include loperamide, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, diosmectite, cholestyramine, probiotics, antispasmodics, rifaximin, and anti-inflammatory agents. Loperamide, a synthetic opiate agonist, decreases peristaltic activity and inhibits secretion, resulting in the reduction of fluid and electrolyte loss and an increase in stool consistency. Cholestyramine is a bile acid sequestrant that is generally considered as the first-line treatment for bile acid diarrhea. 5-HT3 receptor antagonists have significant benefits in patients with irritable bowel syndrome (IBS) with diarrhea. Ramosetron improves stool consistency as well as global IBS symptoms. Probiotics may have a role in the prevention of antibiotic-associated diarrhea. However, data on the role of probiotics in the treatment of chronic diarrhea are lacking. Diosmectite, an absorbent, can be used for the treatment of chronic functional diarrhea, radiation-induced diarrhea, and chemotherapy-induced diarrhea. Antispasmodics including alverine citrate, mebeverine, otilonium bromide, and pinaverium bromide are used for relieving diarrheal symptoms and abdominal pain. Rifaximin can be effective for chronic diarrhea associated with IBS and small intestinal bacterial overgrowth. Budesonide is effective in both lymphocytic colitis and collagenous colitis. The efficacy of mesalazine in microscopic colitis is weak or remains uncertain. Considering their mechanisms of action, these agents should be prescribed properly. PMID:26576135

  3. Septic Shock in Advanced Age: Transcriptome Analysis Reveals Altered Molecular Signatures in Neutrophil Granulocytes

    PubMed Central

    Vieira da Silva Pellegrina, Diogo; Severino, Patricia; Vieira Barbeiro, Hermes; Maziero Andreghetto, Flávia; Tadeu Velasco, Irineu; Possolo de Souza, Heraldo; Machado, Marcel Cerqueira César; Reis, Eduardo Moraes; Pinheiro da Silva, Fabiano

    2015-01-01

    Sepsis is one of the highest causes of mortality in hospitalized people and a common complication in both surgical and clinical patients admitted to hospital for non-infectious reasons. Sepsis is especially common in older people and its incidence is likely to increase substantially as a population ages. Despite its increased prevalence and mortality in older people, immune responses in the elderly during septic shock appear similar to that in younger patients. The purpose of this study was to conduct a genome-wide gene expression analysis of circulating neutrophils from old and young septic patients to better understand how aged individuals respond to severe infectious insult. We detected several genes whose expression could be used to differentiate immune responses of the elderly from those of young people, including genes related to oxidative phosphorylation, mitochondrial dysfunction and TGF-β signaling, among others. Our results identify major molecular pathways that are particularly affected in the elderly during sepsis, which might have a pivotal role in worsening clinical outcomes compared with young people with sepsis. PMID:26047321

  4. Evaluation of antipyretic activity of some medicinal plants from Cholistan desert Pakistan.

    PubMed

    Alam, Muhammad Khurshid; Ahmed, Saeed; Anjum, Shazia; Akram, Muhammad; Shah, Syed Muhammad Ali; Wariss, Hafiz Muhammad; Usmanghani, Khan

    2016-03-01

    Traditional herbal healers "Hakims" use various plants of the Cholistan desert, Pakistan for treating a number of infectious and non-infectious diseases. However, there has never been a scientific validation of these plant-based therapeutics. We compared the antipyretic effect of Echinops echinatus, Alhagi maurorum, Fagonia cretica, Cymbopogon jwarancusa and Panicum turgidum in animal model. These plants were used to reduce E.coli lysate induced pyrexia in rabbits. There were five groups of rabbits having five rabbits in each group. Among these five groups, three received various doses of experimental treatment, paracetamol was given to fourth group known as positive control. The fifth group of animals served as negative control and received no treatment. Ethanol extracts of Fagonia cretica (500 mg/kg), Panicum turgidum (500 mg/kg and 750 mg/kg), Alhagi maurorum (500 and 750 mg/kg), Cymbopogon jwarancusa (250 mg/kg) and Echinops echinatus (750 mg/kg) showed significant antipyretic effects when compared with controls and experimental counterparts. These results revealed that ethanol extracts of the plants evaluated in this study have dose dependent antipyretic activity. Further detailed screening of these plant species is recommended. PMID:27087078

  5. Four-tiered {pi} interaction at the dimeric interface of HIV-1 integrase critical for DNA integration and viral infectivity

    SciTech Connect

    Al-Mawsawi, Laith Q.; Hombrouck, Anneleen; Dayam, Raveendra; Debyser, Zeger; Neamati, Nouri

    2008-08-01

    HIV-1 integrase (IN) is an essential enzyme for viral infection. Here, we report an extensive {pi} electron orbital interaction between four amino acids, W132, M178, F181 and F185, located at the dimeric interface of IN that is critical for the strand transfer activity alone. Catalysis of nine different mutant IN proteins at these positions were evaluated. Whereas the 3'-processing activity is predominantly strong, the strand transfer activity of each enzyme was completely dependent on an intact {pi} electron orbital interaction at the dimeric interface. Four representative IN mutants were constructed in the context of the infectious NL4.3 HIV-1 viral clone. Whereas viruses with an intact {pi} electron orbital interaction at the IN dimeric interface replicated comparable to wild type, viruses containing an abolished {pi} interaction were non-infectious. Q-PCR analysis of viral DNA forms during viral replication revealed pleiotropic effects of most mutations. We hypothesize that the {pi} interaction is a critical contact point for the assembly of functional IN multimeric complexes, and that IN multimerization is required for a functional pre-integration complex. The rational design of small molecule inhibitors targeting the disruption of this {pi}-{pi} interaction should lead to powerful anti-retroviral drugs.

  6. External phenome analysis enables a rational federated query strategy to detect changing rates of treatment-related complications associated with multiple myeloma.

    PubMed

    Warner, Jeremy L; Alterovitz, Gil; Bodio, Kelly; Joyce, Robin M

    2013-01-01

    Electronic health records (EHRs) are increasingly useful for health services research. For relatively uncommon conditions, such as multiple myeloma (MM) and its treatment-related complications, a combination of multiple EHR sources is essential for such research. The Shared Health Research Information Network (SHRINE) enables queries for aggregate results across participating institutions. Development of a rational search strategy in SHRINE may be augmented through analysis of pre-existing databases. We developed a SHRINE query for likely non-infectious treatment-related complications of MM, based upon an analysis of the Multiparameter Intelligent Monitoring in Intensive Care (MIMIC II) database. Using this query strategy, we found that the rate of likely treatment-related complications significantly increased from 2001 to 2007, by an average of 6% a year (p=0.01), across the participating SHRINE institutions. This finding is in keeping with increasingly aggressive strategies in the treatment of MM. This proof of concept demonstrates that a staged approach to federated queries, using external EHR data, can yield potentially clinically meaningful results.

  7. STAGGERS IN SHEEP IN PATAGONIA

    PubMed Central

    Jones, F. S.; Arnold, J. F.

    1917-01-01

    After observations and experimental work both in the field and laboratory, the following conclusions seem justified. 1. Staggers is a non-infectious disorder affecting horses, cattle, and sheep. 2. The disease is characterized by weakness, muscular twitching, irregular movements of the head, stiffness of the limbs, and transient motor paralysis, accompanied with spastic spasms on excitement. There is also a derangement of vision and conjunctivitis. 3. The postmortem lesions are not characteristic. 4. We readily produced the disease by feeding susceptible sheep on a coarse tuft grass commonly known as coiron or pampa grass (Poa argentina). 5. The time required to produce definite symptoms by feeding the grass varied. Two animals developed typical staggers after two feedings; in another instance a period of 21 days of feeding was required. The average time for the production of unmistakable symptoms in our experiments was 10 days. 6. Many sheep recover from staggers spontaneously. A complete change of diet will usually effect a cure within 2 weeks. 7. Older .animals that have pastured for long periods on lands where the grass grows become tolerant and are rarely affected with staggers. 8. The grass is toxic to sheep at all seasons of the year. We fed late winter and early spring grass and grass in flower, and produced staggers in every instance. The young green grass is as toxic as any edible portion of the plant. PMID:19868185

  8. Healthcare utilization and lost productivity due to infectious gastroenteritis, results from a national cross-sectional survey Australia 2008-2009.

    PubMed

    Chen, Y; Ford, L; Hall, G; Dobbins, T; Kirk, M

    2016-01-01

    The aim of this study was to estimate the healthcare usage and loss of productivity due to gastroenteritis in Australia using the National Gastroenteritis Survey II. In 2008-2009, 7578 participants across Australia were surveyed about infectious gastroenteritis by telephone interview. A gastroenteritis case was defined as a person experiencing ⩾ 3 loose stools and/or ⩾ 2 vomits in a 24-h period, excluding cases with a non-infectious cause for their symptoms, such as pregnancy or consumption of alcohol. Lost productivity was considered any lost time from full- or part-time paid work due to having gastroenteritis or caring for someone with the illness. Interference with other daily activities was also examined along with predictors of healthcare-seeking practices using multivariable regression. Results were weighted to obtain nationally representative estimates using Stata v. 13·1. Of the 341 cases, 52 visited a doctor due to gastroenteritis, 126 reported taking at least one medication for their symptoms and 79 cases reported missing ⩾ 1 days' paid work due to gastroenteritis. Gastroenteritis results in a total of 13·1 million (95% confidence interval 6·7-19·5) days of missed paid work each year in Australia. The indirect costs of gastroenteritis are significant, particularly from lost productivity.

  9. A novel experimental in vivo model of cerebral immunomodulation induced by inactivated Staphylococcus epidermidis.

    PubMed

    Löhr, Mario; Molcanyi, Marek; Stenzel, Werner; Seifert, Harald; Tzouras, Georgios; Röhn, Gabriele; Mohseni, Daud; Hampl, Jürgen A

    2012-01-15

    The genesis and appropriate treatment of neuroinflammation in various infectious and non-infectious disorders of the central nervous system is still a matter of debate. We introduce an alternative and simple experimental model for the investigation of the cellular inflammatory response to bacterial antigens by stereotactic intracerebral injection of heat-inactivated Staphylococcus epidermidis (HISE). HISE-injection resulted in well-circumscribed intraparenchymal deposits encompassed by an early micro- and astroglial response and a selective but sustained opening of the blood-brain barrier (BBB). After 24h, the HISE collections were densely infiltrated by granulocytes and few circumjacent macrophages that became the predominating immunocompetent cell type from day 4 on. CD8a+ lymphocytes peaked at day 4, whereas CD4+ and CD20+ lymphocytes increased gradually in number, developing a scattered infiltrate until day 17, indicating the initiation of an adaptive immune response. MHC class II presenting cells were abundantly recruited from day 1 and eventually shaped an increasingly dense accumulation within the lesion. Intracerebral HISE administration provides a controlled, highly reproducible and well defined influx of immunocompetent cells across the BBB leading to a distinct and condensed inflammatory reaction. The technique is straightforward, easily feasible and may significantly enable further investigations of the initiation, maintenance and therapeutic modulation of acute neuroinflammation.

  10. Skin lesions in returning travellers.

    PubMed

    Korzeniewski, Krzysztof; Juszczak, Dariusz; Jerzemowski, Janusz

    2015-01-01

    Skin lesions, apart from diarrhoeas, fever of unknown origin, and respiratory tract infections belong to the most frequent medical problems in travellers returned from tropical and subtropical destinations, accounting more than 10% of reported cases. Most dermatoses have their clinical onset during travel, although some of them can occur after return. Travel-related dermatological problems can have a wide spectrum of clinical picture, from macular, popular or nodular rash, linear and migratory lesions, to plaques, vesicles, bullae, erosions or ulcers. Skin conditions in returning travellers may be of infectious and non-infectious aetiologies. Infectious lesions may be originally tropical (e.g. dengue, chikungunya, schistosomiasis, leishmaniasis, myiasis, tungiasis, loiasis), although the majority are cosmopolitan (arthropod bites, sunburns, allergic rashes). The evaluation of skin lesions depends on many factors, including immune status of patients, use of medicines, exposure on health hazards (fauna, flora, risky behaviours), as well as the time, duration and location of travel. As the number of travellers to tropical and subtropical destinations has been continuously rising, the number of skin illnesses has also been increasing. This means that specialists in travel medicine need to extend their knowledge of epidemiology, clinical features and diagnosis of travel-related health problems including skin lesions in returning travellers. PMID:26394319

  11. An observational study of mortality on bison farms in Saskatchewan with special emphasis on malignant catarrhal fever.

    PubMed

    Epp, Tasha; Waldner, Cheryl; Woodbury, Murray

    2016-01-01

    In December 2011, the Malignant Catarrhal Fever (MCF) Task Force in Saskatchewan recommended that research be conducted on the relationship between the proximity of bison and sheep under typical commercial production settings and bison deaths due to MCF. The objective of this study was to evaluate all causes of death in bison herds and compare the incidence of MCF in herds at varying distances of exposure from sheep operations. Necropsies were completed on 76 of 133 bison reported to have died during the 18-month study period. A total of 7 MCF deaths was reported from 2 large herds within 1.0 km of sheep operations. Although there was a greater risk of MCF deaths in bison herds within 1.0 km of sheep operations than in herds more than 1.0 km away, the overall incidence of MCF deaths within the study period was very low. Most deaths were attributed to non-infectious causes, including copper deficiency. PMID:26740696

  12. Connecting Primary Health Care: A Comprehensive Pilot Study.

    PubMed

    Maghsoudloo, Mehran; Abolhassani, Farid; Lotfibakhshaiesh, Nasrin

    2016-07-01

    The collection of data within the primary health care facilities in Iran is essentially paper-based. It is focused on family's health, monitoring of non-infectious and infectious diseases. Clearly due to the paper-based nature of the tasks, timely decision making at most can be difficult if not impossible. As part of an on-going electronic health record implementation project at Tehran University of Medical Sciences, for the first time in the region, based on a comprehensive pilot project, four urban healthcare facilities are connected to their headquarters and beyond, covering all aspects of primary health care, for the last four years. Without delving into the technical aspects of its software engineering processes, the progress of the implementation is reported, selection of summarized data is presented, and experience gained thus far are discussed. Four years passed and if time is any important reason to go by, then it is safe to accept that the software architecture and electronic health record structural model implemented are robust and yet extensible. Aims and duration of a pilot study should be clearly defined prior to start and managed till its completion. Resistance to change and particularly to information technology, apart from its technical aspects, is also based on human factors. PMID:27424015

  13. Personalized medicine: theranostics (therapeutics diagnostics) essential for rational use of tumor necrosis factor-alpha antagonists.

    PubMed

    Bendtzen, Klaus

    2013-04-01

    With the discovery of the central pathogenic role of tumor necrosis factor (TNF)-alpha in many immunoinflammatory diseases, specific inhibition of this pleiotropic cytokine has revolutionized the treatment of patients with several non-infectious inflammatory disorders. As a result, genetically engineered anti-TNF-alpha antibody constructs now constitute one of the heaviest medicinal expenditures in many countries. All currently used TNF antagonists may dramatically lower disease activity and, in some patients, induce remission. Unfortunately, however, not all patients respond favorably, and safety can be severely impaired by immunogenicity, i.e., the ability of a drug to induce anti-drug antibodies (ADA). Assessment of ADA is therefore an important component of the evaluation of drug safety in both pre-clinical and clinical studies and in the process of developing less immunogenic and safer biopharmaceuticals. Therapeutics diagnostics, also called theranostics, i.e., monitoring functional drug levels and neutralizing ADA in the circulation, is central to more effective use of biopharmaceuticals. Hence, testing-based strategies rather than empirical dose-escalation may provide more cost-effective use of TNF antagonists as this allows therapies tailored according to individual requirements rather than the current universal approach to diagnosis. The objective of the present review is to discuss the reasons for recommending theranostics to implement an individualized use of TNF antagonists and to highlight some of the methodological obstacles that have obscured cost-effective ways of using these therapies.

  14. Planning and implementing a hospital recycling program at Naval Hospital, Camp Pendleton, California. Final report

    SciTech Connect

    Frost, J.A.

    1992-08-01

    The purpose of this project was to develop a comprehensive plan and begin the implementation of a recycling program at Naval Hospital Camp Pendleton. Many cities, counties, and states have source reduction and recycling goals for their areas. The President has mandated that the Department of Defense and other Federal agencies promote cost-effective waste reduction and recycling of reusable materials. The Commandant of the Marine Corps has set a goal of a 50% reduction by weight in the amount of solid waste disposed of over the FY90 to FY95 period. The policy of Marine Corps Base Camp Pendleton is that all tenant organizations actively engage in materials recycling. Naval Hospital Camp Pendleton generates a huge amount of waste but has no active program to recycle non-infectious reusable material. As a result the hospital is not in compliance with current Navy, Marine Corps, and DoD directives; is spending too much on trash disposal; is contributing to the depletion of the base landfill; and is not taking advantage of the additional MWR funds that could be made available through the sale of recycable material. The methods and procedures used in developing the recycling program followed the techniques of team management and strategic planning in a five step process. Hospital recycling.

  15. Organ distribution of histones after intravenous infusion of FITC histones or after sepsis.

    PubMed

    Fattahi, Fatemeh; Grailer, Jamison J; Jajou, Lawrence; Zetoune, Firas S; Andjelkovic, Anuska V; Ward, Peter A

    2015-03-01

    Histones appear in plasma during infectious or non-infectious sepsis and are associated with multiorgan injury. In the current studies, intravenous infusion of histones resulted in their localization in major organs. In vitro exposure of mouse macrophages to histones caused a buildup of histones on cell membranes followed by localization into cytosol and into the nucleus. After polymicrobial sepsis (cecal ligation and puncture), histones appeared in plasma as well as in a multiorgan pattern, peaking at 8 h followed by decline. In lungs, histones and neutrophils appeared together, with evidence for formation of neutrophil extracellular traps (NETs), which represent an innate immune response to trap and kill bacteria and other infectious agents. In liver, there was intense NET formation, featuring linear patterns containing histones and strands of DNA. When neutrophils were activated in vitro with C5a or phorbol myristate acetate, NET formation ensued. While formation of NETs represents entrapment and killing of infectious agents, the simultaneous release from neutrophils of histones often results in tissue/organ damage.

  16. Gene-based vaccines and immunotherapeutic strategies against neurodegenerative diseases: Potential utility and limitations.

    PubMed

    Kudrna, Jeremy J; Ugen, Kenneth E

    2015-01-01

    There has been a recent expansion of vaccination and immunotherapeutic strategies from controlling infectious diseases to the targeting of non-infectious conditions including neurodegenerative disorders. In addition to conventional vaccine and immunotherapeutic modalities, gene-based methods that express antigens for presentation to the immune system by either live viral vectors or non-viral naked DNA plasmids have been developed and evaluated. This mini-review/commentary summarizes the advantages and disadvantages, as well as the research findings to date, of both of these gene-based vaccination approaches in terms of how they can be targeted against appropriate antigens within the Alzheimer and Parkinson disease pathogenesis processes as well as potentially against targets in other neurodegenerative diseases. Most recently, the novel utilization of these viral vector and naked DNA gene-based technologies includes the delivery of immunoglobulin genes from established biologically active monoclonal antibodies. This modified passive immunotherapeutic strategy has recently been applied to deliver passive antibody immunotherapy against the pathologically relevant amyloid β protein in Alzheimer disease. The advantages and disadvantages of this technological application of gene-based immune interventions, as well as research findings to date are also summarized. In sum, it is suggested that further evaluation of gene based vaccines and immunotherapies against neurodegenerative diseases are warranted to determine their potential clinical utility.

  17. Expression and Purification of Virus-like Particles for Vaccination.

    PubMed

    Arevalo, Maria T; Wong, Terianne M; Ross, Ted M

    2016-01-01

    Virus-like particles (VLPs) and subviral particles (SVPs) are an alternative approach to viral vaccine design that offers the advantages of increased biosafety and stability over use of live pathogens. Non-infectious and self-assembling, VLPs are used to present structural proteins as immunogens, bypassing the need for live pathogens or recombinant viral vectors for antigen delivery. In this article, we demonstrate the different stages of VLP design and development for future applications in preclinical animal testing. The procedure includes the following stages: selection of antigen, expression of antigen in cell line of choice, purification of VLPs/SVPs, and quantification for antigen dosing. We demonstrate use of both mammalian and insect cell lines for expression of our antigens and demonstrate how methodologies differ in yield. The methodology presented may apply to a variety of pathogens and can be achieved by substituting the antigens with immunogenic structural proteins of the user's microorganism of interest. VLPs and SVPs assist with antigen characterization and selection of the best vaccine candidates. PMID:27286040

  18. Using Qualitative Methods to Explore Lay Explanatory Models, Health-Seeking Behaviours and Self-Care Practices of Podoconiosis Patients in North-West Ethiopia

    PubMed Central

    Banks, Harrison S.; Tsegay, Girmay; Wubie, Moges; Tamiru, Abreham; Davey, Gail; Cooper, Max

    2016-01-01

    Background Podoconiosis (endemic non-filarial elephantiasis) is a chronic, non-infectious disease resulting from exposure of bare feet to red-clay soil in tropical highlands. This study examined lay beliefs about three under-researched aspects of podoconiosis patients’ care: explanatory models, health-seeking behaviours and self-care. Methods In-depth interviews and focus group discussions were undertaken with 34 participants (19 male, 15 female) between April-May 2015 at podoconiosis treatment centres across East and West Gojjam regions in north-west Ethiopia. Results Explanatory models for podoconiosis included contamination from blood, magic, soil or affected individuals. Belief in heredity or divine punishment often delayed clinic attendance. All participants had tried holy water treatment and some, holy soil. Herbal treatments were considered ineffectual, costly and appeared to promote fluid escape. Motivators for clinic attendance were failure of traditional treatments and severe or disabling symptoms. Patients did not report self-treatment with antibiotics. Self-care was hindered by water being unavailable or expensive and patient fatigue. Conclusion A pluralistic approach to podoconiosis self-treatment was discovered. Holy water is widely valued, though some patients prefer holy soil. Priests and traditional healers could help promote self-care and “signpost” patients to clinics. Change in behaviour and improving water access is key to self-care. PMID:27536772

  19. Interferon (IFN) and Cellular Immune Response Evoked in RNA-Pattern Sensing During Infection with Hepatitis C Virus (HCV).

    PubMed

    Nakai, Masato; Oshiumi, Hiroyuki; Funami, Kenji; Okamoto, Masaaki; Matsumoto, Misako; Seya, Tsukasa; Sakamoto, Naoya

    2015-01-01

    Hepatitis C virus (HCV) infects hepatocytes but not dendritic cells (DCs), but DCs effectively mature in response to HCV-infected hepatocytes. Using gene-disrupted mice and hydrodynamic injection strategy, we found the MAVS pathway to be crucial for induction of type III interferons (IFNs) in response to HCV in mouse. Human hepatocytes barely express TLR3 under non-infectious states, but frequently express it in HCV infection. Type I and III IFNs are induced upon stimulation with polyI:C, an analog of double-stranded (ds)RNA. Activation of TLR3 and the TICAM-1 pathway, followed by DC-mediated activation of cellular immunity, is augmented during exposure to viral RNA. Although type III IFNs are released from replication-competent human hepatocytes, DC-mediated CTL proliferation and NK cell activation hardly occur in response to the released type III IFNs. Yet, type I IFNs and HCV-infected hepatocytes can induce maturation of DCs in either human or mouse origin. In addition, mouse CD8+ DCs mature in response to HCV-infected hepatocytes unless the TLR3/TICAM-1 pathway is blocked. We found the exosomes containing HCV RNA in the supernatant of the HCV-infected hepatocytes act as a source of TLR3-mediated DC maturation. Here we summarize our view on the mechanism by which DCs mature to induce NK and CTL in a status of HCV infection.

  20. Development of a versatile and stable internal control system for RT-qPCR assays.

    PubMed

    Felder, Eva; Wölfel, Roman

    2014-11-01

    RT-qPCR, an established method for the detection of RNA viruses, requires internal RNA controls for the correct interpretation of PCR results. Robust and versatile RT-PCR controls can be achieved for example by packaging RNA into a virus-derived protein shell. In this study a MS2-based internal control system was developed, that allows stable and universal packing of different RNAs into non-infectious, non-lytic MS2-based viral like particles (VLPs). Two competitive internal controls for a hantavirus assay and a Crimean-Congo Hemorrhagic Fever Virus (CCHFV) assay were cloned for the expression of VLPs. The expression of VLPs containing the RNA of interest could be induced with arabinose in Escherichia coli. The VLPs proved to be temperature resistant and could be frozen and thawed several times without degradation. Distinction of IC RNA from the target RNA was facilitated by a clear shift in the melting temperature or by specific hybridization signals. Furthermore, target and IC PCR amplification could be easily distinguished by their size in gel-electrophoretic analyses. Limits of detection were determined, demonstrating that the application of the IC did not reduce the sensitivity of the target RT-qPCR reactions. The system can be adapted to nearly any required sequence, resulting in a highly flexible method with broad range applications.

  1. Incidence and risk factors of chylous ascites after pancreatic resection

    PubMed Central

    Pan, Wu; Yang, Chen; Cai, Shen-Yang; Chen, Zhi-Meng; Cheng, Nan-Sheng; Li, Fu-Yu; Xiong, Xian-Ze

    2015-01-01

    Chylous ascites (CA) is a rare postoperative complication. It also occurs in pancreatic surgery and can influence the patient’s prognosis after pancreatic resection. There are few studies focusing on CA following pancreatic resection. We aimed to evaluate the incidence and risk factors of CA following pancreatic resection. Patients who underwent pancreatic resection from the year 2007 to 2013 were retrospectively reviewed. The diagnosis of CA was based on the presence of a non-infectious milky or creamy peritoneal fluid greater than 100 ml/day with a triglyceride concentration ≥110 mg/dl. The incidence and possible risk factors following pancreatic resection were evaluated. In this study, 1921 patients who underwent pancreatic resection were included. 49 patients developed CA. The overall incidence was 2.6 percent (49 out of 1921). The incidence following pancreaticoduodenectomy and distal pancreatectomy was much higher (35 out of 1241, 12 out of 332, respectively). A multivariable analysis demonstrated that manipulating para-aortic area and superior mesenteric artery root area; retroperitoneal invasion; focal chronic pancreatitis and early enteral feeding were the independent risk factors for CA after pancreatic surgery. In conclusion, CA is a rare complication after pancreatic resection. Some clinicopathological factors were associated with the development of CA following pancreatic resection. PMID:26064374

  2. Gut microbe-derived extracellular vesicles induce insulin resistance, thereby impairing glucose metabolism in skeletal muscle.

    PubMed

    Choi, Youngwoo; Kwon, Yonghoon; Kim, Dae-Kyum; Jeon, Jinseong; Jang, Su Chul; Wang, Taejun; Ban, Minjee; Kim, Min-Hye; Jeon, Seong Gyu; Kim, Min-Sun; Choi, Cheol Soo; Jee, Young-Koo; Gho, Yong Song; Ryu, Sung Ho; Kim, Yoon-Keun

    2015-01-01

    Gut microbes might influence host metabolic homeostasis and contribute to the pathogenesis of type 2 diabetes (T2D), which is characterized by insulin resistance. Bacteria-derived extracellular vesicles (EVs) have been suggested to be important in the pathogenesis of diseases once believed to be non-infectious. Here, we hypothesize that gut microbe-derived EVs are important in the pathogenesis of T2D. In vivo administration of stool EVs from high fat diet (HFD)-fed mice induced insulin resistance and glucose intolerance compared to regular diet (RD)-fed mice. Metagenomic profiling of stool EVs by 16S ribosomal DNA sequencing revealed an increased amount of EVs derived from Pseudomonas panacis (phylum Proteobacteria) in HFD mice compared to RD mice. Interestingly, P. panacis EVs blocked the insulin signaling pathway in both skeletal muscle and adipose tissue. Moreover, isolated P. panacis EVs induced typical diabetic phenotypes, such as glucose intolerance after glucose administration or systemic insulin injection. Thus, gut microbe-derived EVs might be key players in the development of insulin resistance and impairment of glucose metabolism promoted by HFD.

  3. HIV and COPD: a conspiracy of risk factors.

    PubMed

    Lalloo, Umesh G; Pillay, Sandy; Mngqibisa, Rosie; Abdool-Gaffar, Sabeer; Ambaram, Anish

    2016-10-01

    Chronic obstructive pulmonary disease (COPD) is an under recognized complication of HIV infection. It is estimated that up to 25% of HIV infected people may have COPD. HIV is associated with COPD as a result of a complex interplay of multiple factors such as pulmonary inflammation, recurrent pulmonary infections especially tuberculosis (TB), increased cigarette smoking, socio-economic status, childhood respiratory illnesses and industrial and environmental exposures; each of which are risk factors for COPD in their own right. COPD presents at an earlier age in people with HIV infection. There are over 35 million people living with HIV, and most people infected with HIV live in developing regions of the world where they are faced with multiple risk factors for COPD and suboptimal access to health care. TB is the commonest infectious complication of HIV, and HIV infected persons often experience multiple episodes of TB. Cigarette smoking is increasing in developing countries where the greatest burden of TB and HIV is experienced. Cigarette smoking is associated with increased risk of TB and may be associated with acquisition of HIV infection and progression. It is not clear whether non-infectious pulmonary inflammation persists in the lung when immune reconstitution occurs. Prevention and control of HIV infection must be part of the multiple interventions to reduce the global burden of COPD. A multidisciplinary approach, including behavioural science is required to address this challenge. It presents research opportunities that should be driven by the pulmonology community. PMID:27237114

  4. Evolutionary biology and anthropology suggest biome reconstitution as a necessary approach toward dealing with immune disorders

    PubMed Central

    Parker, William; Ollerton, Jeff

    2013-01-01

    Industrialized society currently faces a wide range of non-infectious, immune-related pandemics. These pandemics include a variety of autoimmune, inflammatory and allergic diseases that are often associated with common environmental triggers and with genetic predisposition, but that do not occur in developing societies. In this review, we briefly present the idea that these pandemics are due to a limited number of evolutionary mismatches, the most damaging being ‘biome depletion’. This particular mismatch involves the loss of species from the ecosystem of the human body, the human biome, many of which have traditionally been classified as parasites, although some may actually be commensal or even mutualistic. This view, evolved from the ‘hygiene hypothesis’, encompasses a broad ecological and evolutionary perspective that considers host-symbiont relations as plastic, changing through ecological space and evolutionary time. Fortunately, this perspective provides a blueprint, termed ‘biome reconstitution’, for disease treatment and especially for disease prevention. Biome reconstitution includes the controlled and population-wide reintroduction (i.e. domestication) of selected species that have been all but eradicated from the human biome in industrialized society and holds great promise for the elimination of pandemics of allergic, inflammatory and autoimmune diseases. PMID:24481190

  5. Disposable swim diaper retention of Cryptosporidium-sized particles on human subjects in a recreational water setting.

    PubMed

    Amburgey, James E; Anderson, J Brian

    2011-12-01

    Cryptosporidium is a chlorine-resistant protozoan parasite responsible for the majority of waterborne disease outbreaks in recreational water venues in the USA. Swim diapers are commonly used by diaper-aged children participating in aquatic activities. This research was intended to evaluate disposable swim diapers for retaining 5-μm diameter polystyrene microspheres, which were used as non-infectious surrogates for Cryptosporidium oocysts. A hot tub recirculating water without a filter was used for this research. The microsphere concentration in the water was monitored at regular intervals following introduction of microspheres inside of a swim diaper while a human subject undertook normal swim/play activities. Microsphere concentrations in the bulk water showed that the majority (50-97%) of Cryptosporidium-sized particles were released from the swim diaper within 1 to 5 min regardless of the swim diaper type or configuration. After only 10 min of play, 77-100% of the microspheres had been released from all swim diapers tested. This research suggests that the swim diapers commonly used by diaper-aged children in swimming pools and other aquatic activities are of limited value in retaining Cryptosporidium-sized particles. Improved swim diaper solutions are necessary to efficiently retain pathogens and effectively safeguard public health in recreational water venues.

  6. Adaptive management of Sudden Oak Death in California woodlands

    NASA Astrophysics Data System (ADS)

    Garbelotto, M.

    2009-04-01

    Sudden Oak Death is an emergent disease caused by the exotic pathogen Phytophthora ramorum. This newly described Phytophthora is also responsible for a disease of ornamental plants, and multiple lines of evidence indicate its introduction in North America is linked to the trade of infected ornamental plants. P. ramorum is predominantly aerially transmitted, but a soil and water phases, not unlike other forest Phytophthoras are also present. One striking feature of the epidemiology of the disease is that the largest amounts of infectious aerial sporangia are produced on bay laurel leaves, while oaks appear to be non-infectious. Our strategy to deal with the disease has been multiple and involves the following aspects: 1)- Understand the mode of introduction of the pathogen, and monitor potential new escapes in the wild; 2)- Understand factors linked to the reproductive and spread potential, e.g. seasonalpatterns in the life cycle of the pathogen and distance of spread; 3)- Define the relationship between ecological stand characteristics and severity of the disease, inclusive of predictive modeling; 4)- Qualify precise pathways for infection; 5)- Reduce infection rates by modifying known infection pathways; 6)- Change stands characteristics to make them less favorable to the spread of the disease, e.g. by selective thinnings; 7)- Protect individual trees and some populations of the highly susceptible tanoak using phosphonate chemical treatments. Because our knowledge of the epidemiology and biology of the disease is still rather limited, recommendations are expected to change in time, as our understanding of the disease improves.

  7. Regulation of the Host Antiviral State by Intercellular Communications

    PubMed Central

    Assil, Sonia; Webster, Brian; Dreux, Marlène

    2015-01-01

    Viruses usually induce a profound remodeling of host cells, including the usurpation of host machinery to support their replication and production of virions to invade new cells. Nonetheless, recognition of viruses by the host often triggers innate immune signaling, preventing viral spread and modulating the function of immune cells. It conventionally occurs through production of antiviral factors and cytokines by infected cells. Virtually all viruses have evolved mechanisms to blunt such responses. Importantly, it is becoming increasingly recognized that infected cells also transmit signals to regulate innate immunity in uninfected neighboring cells. These alternative pathways are notably mediated by vesicular secretion of various virus- and host-derived products (miRNAs, RNAs, and proteins) and non-infectious viral particles. In this review, we focus on these newly-described modes of cell-to-cell communications and their impact on neighboring cell functions. The reception of these signals can have anti- and pro-viral impacts, as well as more complex effects in the host such as oncogenesis and inflammation. Therefore, these “broadcasting” functions, which might be tuned by an arms race involving selective evolution driven by either the host or the virus, constitute novel and original regulations of viral infection, either highly localized or systemic. PMID:26295405

  8. Protection against Rift Valley fever virus infection in mice upon administration of interferon-inducing RNA transcripts from the FMDV genome.

    PubMed

    Lorenzo, Gema; Rodríguez-Pulido, Miguel; López-Gil, Elena; Sobrino, Francisco; Borrego, Belén; Sáiz, Margarita; Brun, Alejandro

    2014-09-01

    In this work we have addressed the effect of synthetic, non-infectious, RNA transcripts, mimicking structural domains of the non-coding regions (NCRs) of the foot-and-mouth disease virus (FMDV) genome on the infection of mice with Rift Valley fever virus (RVFV). Groups of 5 mice were inoculated intraperitoneally (i.p.) with 200 μg of synthetic RNA resembling the 5'-terminal S region, the internal ribosome entry site (IRES) or the 3'-NCR of the FMDV genome. RNA inoculation was performed 24h before (-24 h), 24 h after (+24 h) or simultaneously to the challenge with a lethal dose of RVFV. Administration of the IRES RNA afforded higher survival rates than administration of S or 3'NCR transcripts either at -24h or +24h after challenge. In contrast, when RNA inoculation and viral challenge were performed simultaneously, all mice survived in both IRES- and 3'NCR-inoculated groups, with an 80% survival in mice receiving the S RNA. Among survivors, a complete correlation between significant anti-RVFV circulating antibody titers and resistance to a second lethal challenge with the virus was observed, supporting a limited viral replication in the RNA-inoculated animals upon the first challenge. All three RNA transcripts were able to induce the production of systemic antiviral and pro-inflammatory cytokines. These data show that triggering of intracellular pathogen sensing pathways constitutes a promising approach towards development of novel RVF preventive or therapeutic strategies. PMID:24973761

  9. Adenoviral protein VII packages intracellular viral DNA throughout the early phase of infection.

    PubMed Central

    Chatterjee, P K; Vayda, M E; Flint, S J

    1986-01-01

    The proteins associated with parental, adenoviral DNA in productively-infected HeLa cells have been examined both directly and indirectly. HeLa cells infected with 32P-labelled Ad2 were irradiated with u.v. light at various points in the infectious cycle. Following degradation of the DNA, nuclear proteins carrying cross-linked nucleotides, or oligonucleotides, were distinguished from virion phosphoproteins by the resistance of their 32P radioactivity to 1 M NaOH. The major core protein of the virion, protein VII, was found to be associated with viral DNA throughout infection, even when cells were infected at a multiplicity of 0.14. Micrococcal nuclease digestion of intranuclear viral DNA 4 h after infection liberated two nucleoprotein particles containing viral DNA, neither of which co-migrated with HeLa cell mononucleosomes. These results indicate that core protein VII remains associated with parental adenoviral DNA during productive infections. The observation that protein VII can be cross-linked to DNA in cells infected at very low multiplicity, together with the results of a comparison of proteins cross-linkable to viral DNA in cells infected by wild-type virus and a non-infectious mutant containing the precursor to protein VII, suggest that nucleoproteins comprising viral DNA and protein VII must be the templates for expression of pre-early and early viral genes. Images Fig. 1. Fig. 3. Fig. 3. Fig. 4. Fig. 5. Fig. 6. Fig. 7. Fig. 8. PMID:3743550

  10. A prospective observational study of vulvovagintis in pregnant women in Argentina, with special reference to candidiasis.

    PubMed

    Mucci, María J; Cuestas, María L; Cervetto, María M; Landaburu, María F; Mujica, María T

    2016-07-01

    To evaluate the frequency of yeast, bacteria or protozoa in pregnant women and to correlate the possible associations of these microorganisms and their relationships with vulvovaginitis (VV) and cervicitis. Vaginal specimens were collected and prepared for smears in microscope slides for the evaluation of yeast, Trichomonas vaginalis and bacteria. Samples were cultured in specific culture medium. Cervical specimens were used to investigate the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis. We enrolled 210 pregnant women, aged 10-42 years old. Of them, 38.1% were symptomatic. Symptoms were most prevalent in the second and third trimesters of pregnancy coincident with a major prevalence of microorganisms. In this study, 39.5% of pregnant women had normal microbial biota and symptoms of VV due to non-infectious causes were observed (6.2%). The occurrence of vulvovaginal candidiasis was 25% and Candida albicans with a prevalence of 80.7% was the dominant species (P = 0.005) while non-albicans Candida species and other yeast were more common in asymptomatic ones (P = 0.0038). The frequency of bacterial vaginosis, T. vaginalis, C. trachomatis and N. gonorrhoeae were 18.1%, 1.4, 1.4% and 0.5% respectively.

  11. Impact of port of entry referrals on initiation of follow-up evaluations for immigrants with suspected tuberculosis: Illinois.

    PubMed

    Bell, Teal R; Molinari, NoelleAngelique M; Blumensaadt, Sena; Selent, Monica U; Arbisi, Michael; Shah, Neha; Christiansen, Demian; Philen, Rossanne; Puesta, Benjamin; Jones, Joshua; Lee, Deborah; Vang, Arnold; Cohen, Nicole J

    2013-08-01

    US-bound immigrants with suspected non-infectious TB are encouraged to be medically re-evaluated after arrival in the United States. We evaluated the Centers for Disease Control and Prevention's immigrant referral process, designed to facilitate timely post-arrival evaluations. Over 1,200 immigrants with suspected TB arriving during October 1, 2008-September 30, 2010 were identified. In 2011, differences in days to evaluation initiation were assessed by referral type using survival analysis and Cox proportional hazard models. Among those receiving any referral, median time to post-arrival evaluation was significantly lower compared with immigrants receiving no referral (16 vs. 69 days, respectively; p < 0.0001). After adjusting for the covariates, immigrants receiving any referral initiated follow-up at 4 times the rate (adjusted hazard ratio = 4.0; p < 0.0001) of those receiving no referral. Implementing a referral system at US ports of entry will improve timeliness and increase the proportion of immigrants initiating domestic evaluation.

  12. Co-expression of HIV-1 virus-like particles and granulocyte-macrophage colony stimulating factor by GEO-D03 DNA vaccine.

    PubMed

    Hellerstein, Michael; Xu, Yongxian; Marino, Tracie; Lu, Shan; Yi, Hong; Wright, Elizabeth R; Robinson, Harriet L

    2012-11-01

    Here, we report on GEO-D03, a DNA vaccine that co-expresses non-infectious HIV-1 virus-like particles (VLPs) and the human cytokine, granulocyte-macrophage colony-stimulating factor (GM-CSF). The virus-like particles display the native gp160 form of the HIV-1 Envelope glycoprotein (Env) and are designed to elicit antibody against the natural form of Env on virus and virus-infected cells. The DNA-expressed HIV Gag, Pol and Env proteins also have the potential to elicit virus-specific CD4 and CD8 T cells. The purpose of the co-expressed GM-CSF is to target a cytokine that recruits, expands and differentiates macrophages and dendritic cells to the site of VLP expression. The GEO-D03 DNA vaccine is currently entered into human trials as a prime for a recombinant modified vaccinia Ankara (MVA) boost. In preclinical studies in macaques using an SIV prototype vaccine, this vaccination regimen elicited both anti-viral T cells and antibody, and provided 70% protection against acquisition during 12 weekly rectal exposures with a heterologous SIV. Higher avidity of the Env-specific Ab for the native form of the Env in the challenge virus correlated with lower likelihood of SIV infection.

  13. Pediatric IBS: an overview on pathophysiology, diagnosis and treatment.

    PubMed

    Chogle, Ashish; Mintjens, Stijn; Saps, Miguel

    2014-04-01

    Irritable bowel syndrome (IBS) is a common disorder in children and adults. The pathogenesis and pathophysiology of IBS remains incompletely understood. The biopsychosocial model, which conceptualizes chronic pain as a dysregulation of the gut-brain-homeostasis with peripheral and central factors mutually influencing each other, is the most accepted framework to explain IBS. Twin and family aggregation studies suggest a genetic component that does not exclusively explain the higher prevalence of IBS in certain families. Social learning (environmental factors) and maladaptive coping predispose children to develop IBS with greater disability and more frequent medical consultations. Early-life events constitute an additional risk factor for the development of IBS and other functional gastrointestinal disorders (FGIDs). Children with a history of cow's milk protein hypersensitivity or abdominal surgeries have a higher prevalence of IBS and other FGIDs years later. IBS frequently follows an episode of acute gastrointestinal inflammation (infectious or non-infectious). This article discusses the importance, known pathophysiological mechanisms, clinical approach, and evidence-based therapeutic options for the management of IBS in children and adolescents. PMID:24716562

  14. Assessment of airborne microorganisms by real-time PCR: optimistic findings and research challenges.

    PubMed

    Oppliger, Anne; Masclaux, Frederic G; Niculita-Hirzel, Helene

    2011-01-01

    Most airborne microorganisms are natural components of our ecosystem. Soil, vegetation and animals, including humans, are sources for aerial release of these living or dead cells. In the past, assessment of airborne microorganisms was mainly restricted to occupational health concerns. Indeed, in several occupations, exposure to very high concentrations of non-infectious airborne bacteria and fungi, result in allergenic, toxic or irritant reactions. Recently, the threat of bioterrorism and pandemics have highlighted the urgent need to increase knowledge of bioaerosol ecology. More fundamentally, airborne bacterial and fungal communities begin to draw much more consideration from environmental microbiologists, who have neglected this area for a long time. This increased interest of scientists is to a great part due to the development and use of real-time PCR techniques to identify and quantify airborne microorganisms. Even if the advantages of the PCR technology are obvious, researchers are confronted with new problems. This review describes the methodological state of the art in bioaerosols field and emphasizes the future challenges and perspectives of the real-time PCR-based methods for airborne microorganism studies. PMID:21196388

  15. Photoimmunological properties of borage in bovine neutrophil in vitro model.

    PubMed

    Asadollahi, Firouzeh; Mehrzad, Jalil; Chaichi, Mohammad Javad; Taghavi Razavizadeh, Alireza

    2015-10-01

    Borage (Echium amoenum fisch) is one of the most commonly used medicinal plants, and has long been used as a traditional herbal medicine for many (non)infectious diseases in Iran. Study on photoredox and photoimmunology of borage is little. Natural immunomodulatory plants with minimal adverse/toxic effects could help boost animal health and, ultimately, public health. To determine the effect of borage on the functions of key circulating innate immune cells, effects of borage extract (BE) on bovine neutrophils (PMN) photoredox and phagocytosis events were evaluated using an in vitro model system. Blood PMN isolated from healthy high yielding dairy cows (n = 8/treatment) were pre-incubated with BE and the impact on phagocytosis-dependent-and-independent cellular chemiluminescence (CL), phagocytosis, killing of Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli), fluorescence-based PMN H2O2 production and necrosis were assessed. Relative to control (no BE) PMN, treatment with BE significantly increased phagocytosis-dependent-and-independent PMN CL (>10-15% increase). While BE also led to increased PMN H2O2 production, necrosis was also surprisingly higher in these cells. Phagocytosis and killing of both E. coli and S. aureus by PMN treated with BE was substantially higher than that by control PMN. The increased photoimmunobiological events especially intracellular CL, intracellular H2O2 formation, and phagocytic capacity of BE-treated PMN support the potential immunotherapeutic implications of borage and its components for particularly immunocompromised animals and humans. PMID:26334939

  16. Th17 Cell Pathway in Human Immunity: Lessons from Genetics and Therapeutic Interventions.

    PubMed

    Patel, Dhavalkumar D; Kuchroo, Vijay K

    2015-12-15

    The T helper 17 (Th17) cell pathway has been linked by genome-wide association studies to multiple autoimmune diseases. Identification of the genetic causes of primary immunodeficiency diseases revealed that Th17 cells are also critical in host immunity to mucocutaneous candida infections and Staphylococcus aureus. Therapeutic interventions with inhibitors of the different components of the pathway such as interleukin-12 (IL-12), IL-23, IL-17A, and IL-17RA have variably beneficial effects in psoriasis, Crohn's disease, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, non-infectious uveitis, and multiple sclerosis. Thus, whereas Th17 cells are protective against Candida albicans and to a lesser degree Staphylococcus aureus, they are pathogenic in many autoimmune diseases. Here, we compare and contrast the effects of human genetic mutations of and therapeutic interventions targeted at Th17 cell molecules. We discuss that although there are similarities when Th17 cell pathway molecules are modulated, each molecule has unique non-Th17 cell features that lead to different functional outcomes.

  17. Chimeric virus-like particles for the delivery of an inserted conserved influenza A-specific CTL epitope.

    PubMed

    Cheong, Wan-Shoo; Reiseger, Jessica; Turner, Stephen John; Boyd, Richard; Netter, Hans-Jürgen

    2009-02-01

    The small hepatitis B virus surface antigens (HBsAg-S) have the ability to self-assemble with host-derived lipids into empty non-infectious virus-like particles (VLPs). HBsAg-S VLPs are the sole component of the licensed hepatitis B vaccine, and they are a useful delivery platform for foreign epitopes. To develop VLPs capable of transporting foreign cytotoxic T lymphocyte (CTL) epitopes, HBsAg-S specific CTL epitopes at various sites were substituted with a conserved CTL epitope derived from the influenza matrix protein. Depending on the insertion site, the introduction of the MHC class I A2.1-restricted influenza epitope was compatible with the secretion competence of HBsAg-S indicating that chimeric VLPs were assembled. Immunizations of transgenic HHDII mice with chimeric VLPs induced anti-influenza CTL responses proving that the inserted foreign epitope can be correctly processed and cross-presented. Chimeric VLPs in the absence of adjuvant were able to induce memory T cell responses, which could be recalled by influenza virus infections in the mouse model system. The ability of chimeric HBsAg-S VLPs to induce anti-foreign CTL responses and also with the proven ability to induce humoral immune responses constitute a highly versatile platform for the delivery of selected multiple epitopes to target disease associated infectious agents.

  18. Hydrogel iontophoresis for gentamicin administration to the rabbit eye

    NASA Astrophysics Data System (ADS)

    Eljarrat-Binstock, Esther; Raiskup, Frederik; Frucht-Pery, Joseph; Domb, Abraham J.

    2005-04-01

    Iontophoresis (IONT) is a non-invasive technique in which a low electric current is used to enhance the penetration of charged molecules into tissue. This technique has been used in various fields of medicine, mostly in transdermal drug delivery. This study was aimed to evaluate the efficacy and the distribution profile of gentamicin using corneal IONT on infected and healthy rabbit eyes. Corneal iontophoresis of gentamicin sulfate was studied using drug-loaded disposable hydrogel probes mounted on a portable iontophoretic device, applying a low current for 60 seconds. This study confirmed that a triple iontophoretic treatment of gentamicin for only 60 seconds (0.5mA) significantly reduces the count of pseudomonas in the infected cornea to a non-infectious level. Peak gentamicin concentrations at the healthy corneas (363.1 +/- 127.3 μg/g) and at the aqueous humor (29.4 +/- 17.4 μg/ml) were reached immediately and two hours after a single iontophoretic treatment, respectively. The concentration versus time profile of gentamicin following iontophoresis revealed a gentamicin half life of 2.07 h in the anterior chamber, and a clearance of 1.73 μl/min from the anterior chamber to the posterior segments of the eye. This study indicates that a short iontophoretic treatment using gentamicin-loaded hydrogels has a potential clinical value in treating corneal infections, by increasing drug penetration to the eye and maintaining therapeutic levels for more than eight hours.

  19. The Structural Architecture of an Infectious Mammalian Prion Using Electron Cryomicroscopy.

    PubMed

    Vázquez-Fernández, Ester; Vos, Matthijn R; Afanasyev, Pavel; Cebey, Lino; Sevillano, Alejandro M; Vidal, Enric; Rosa, Isaac; Renault, Ludovic; Ramos, Adriana; Peters, Peter J; Fernández, José Jesús; van Heel, Marin; Young, Howard S; Requena, Jesús R; Wille, Holger

    2016-09-01

    The structure of the infectious prion protein (PrPSc), which is responsible for Creutzfeldt-Jakob disease in humans and bovine spongiform encephalopathy, has escaped all attempts at elucidation due to its insolubility and propensity to aggregate. PrPSc replicates by converting the non-infectious, cellular prion protein (PrPC) into the misfolded, infectious conformer through an unknown mechanism. PrPSc and its N-terminally truncated variant, PrP 27-30, aggregate into amorphous aggregates, 2D crystals, and amyloid fibrils. The structure of these infectious conformers is essential to understanding prion replication and the development of structure-based therapeutic interventions. Here we used the repetitive organization inherent to GPI-anchorless PrP 27-30 amyloid fibrils to analyze their structure via electron cryomicroscopy. Fourier-transform analyses of averaged fibril segments indicate a repeating unit of 19.1 Å. 3D reconstructions of these fibrils revealed two distinct protofilaments, and, together with a molecular volume of 18,990 Å3, predicted the height of each PrP 27-30 molecule as ~17.7 Å. Together, the data indicate a four-rung β-solenoid structure as a key feature for the architecture of infectious mammalian prions. Furthermore, they allow to formulate a molecular mechanism for the replication of prions. Knowledge of the prion structure will provide important insights into the self-propagation mechanisms of protein misfolding. PMID:27606840

  20. Identification of amino acid residues of the coat protein of Sri Lankan cassava mosaic virus affecting symptom production and viral titer in Nicotiana benthamiana.

    PubMed

    Kelkar, Vaishali; Kushawaha, Akhilesh Kumar; Dasgupta, Indranil

    2016-06-01

    Sri Lankan cassava mosaic virus (SLCMV) is bipartite begomovirus infecting cassava in India and Sri Lanka. Interestingly, the DNA-A component of the SLCMV alone is able to infect Nicotiana benthamiana causing symptoms of upward leaf rolling and stunting. One of the differences between monopartite and bipartite begomoviruses is the requirement of Coat Protein (CP) for infectivity; CP being essential for the former, but dispensable in the latter. This investigation was aimed to determine the importance of CP in the infectivity of the bipartite SLCMV, behaving as a monopartite virus in N. benthamiana. We tested CP-null mutants, single amino acid replacement mutants and double, triple and quadruple combinations of the above in SLCMV DNA-A, for infectivity, symptom development and viral DNA accumulation in N. benthamiana. While CP-null mutants were non-infectious, a majority of the single amino acid replacement mutants and their combinations retained infectivity, some with attenuated symptoms and reduced viral titers. Some of the combined mutations restored the attenuated symptoms to wild type levels. Some of the mutations were predicted to cause changes in the secondary structure of the CP, which roughly correlated with the attenuation of symptoms and the reduction in viral titers. PMID:26948262

  1. Clinical Applications of Dexamethasone for Aged Eyes.

    PubMed

    Abadia, Beatriz; Calvo, Pilar; Ferreras, Antonio; Bartol, Fran; Verdes, Guayente; Pablo, Luis

    2016-09-01

    The risk of severe eye problems has been found to increase significantly with age, particularly between the fifth and sixth decades of life. Cataracts, dry eye, neovascular age-related macular degeneration, diabetic retinopathy and retinal vein occlusion (RVO) are very common and very different age-related ocular diseases that reduce the patient's quality of life. The rationale for using corticosteroids to treat anterior and posterior ocular segment diseases is driven by inflammation. Dexamethasone, one of the most powerful corticosteroids available, is widely used for topical or intravitreal administration. Topical dexamethasone has proven efficacy for the management of postoperative inflammation in the anterior segment after cataract surgery and symptom relief in dry-eye disease. A new sustained-release 700 µg dexamethasone intravitreal implant (DEX) was recently approved for the treatment of macular edema following RVO, diabetic macular edema, or non-infectious uveitis, and its use is increasing, especially when other therapeutic agents have failed. The most common side effects are increased intraocular pressure and cataract formation. The potency of DEX, alone or in combination with other agents, makes DEX a promising option for treating several retinal diseases. PMID:27566619

  2. "Neuropeptides in the brain defense against distant organ damage".

    PubMed

    Hamasaki, Mike Yoshio; Barbeiro, Hermes Vieira; Barbeiro, Denise Frediani; Cunha, Débora Maria Gomes; Koike, Marcia Kiyomi; Machado, Marcel Cerqueira César; Pinheiro da Silva, Fabiano

    2016-01-15

    Delirium, or acute confusional state, is a common manifestation in diseases that originate outside the central nervous system, affecting 30-40% of elderly hospitalized patients and up to 80% of the critically ill, even though it remains unclear if severe systemic inflammation is able or not to induce cellular disturbances and immune activation in the brain. Neuropeptides are pleotropic molecules heterogeneously distributed throughout the brain and possess a wide spectrum of functions, including regulation of the inflammatory response, so we hypothesized that they would be the major alarm system in the brain before overt microglia activation. In order to investigate this hypothesis, we induced acute pancreatitis in 8-10week old rats and collected brain tissue, 12 and 24h following pancreatic injury, to measure neuropeptide and cytokine tissue levels. We found significantly higher levels of β-endorphin, orexin and oxytocin in the brain of rats submitted to pancreatic injury, when compared to healthy controls. Interestingly, these differences were not associated with increased local cytokine levels, putting in evidence that neuropeptide release occurred independently of microglia activation and may be a pivotal alarm system to initiate neurologic reactions to distant inflammatory non-infectious aggression.

  3. Caffeine affects the biological responses of human hematopoietic cells of myeloid lineage via downregulation of the mTOR pathway and xanthine oxidase activity.

    PubMed

    Gibbs, Bernhard F; Gonçalves Silva, Isabel; Prokhorov, Alexandr; Abooali, Maryam; Yasinska, Inna M; Casely-Hayford, Maxwell A; Berger, Steffen M; Fasler-Kan, Elizaveta; Sumbayev, Vadim V

    2015-10-01

    Correction of human myeloid cell function is crucial for the prevention of inflammatory and allergic reactions as well as leukaemia progression. Caffeine, a naturally occurring food component, is known to display anti-inflammatory effects which have previously been ascribed largely to its inhibitory actions on phosphodiesterase. However, more recent studies suggest an additional role in affecting the activity of the mammalian target of rapamycin (mTOR), a master regulator of myeloid cell translational pathways, although detailed molecular events underlying its mode of action have not been elucidated. Here, we report the cellular uptake of caffeine, without metabolisation, by healthy and malignant hematopoietic myeloid cells including monocytes, basophils and primary acute myeloid leukaemia mononuclear blasts. Unmodified caffeine downregulated mTOR signalling, which affected glycolysis and the release of pro-inflammatory/pro-angiogenic cytokines as well as other inflammatory mediators. In monocytes, the effects of caffeine were potentiated by its ability to inhibit xanthine oxidase, an enzyme which plays a central role in human purine catabolism by generating uric acid. In basophils, caffeine also increased intracellular cyclic adenosine monophosphate (cAMP) levels which further enhanced its inhibitory action on mTOR. These results demonstrate an important mode of pharmacological action of caffeine with potentially wide-ranging therapeutic impact for treating non-infectious disorders of the human immune system, where it could be applied directly to inflammatory cells.

  4. Reducing uncertainty in within-host parameter estimates of influenza infection by measuring both infectious and total viral load.

    PubMed

    Petrie, Stephen M; Guarnaccia, Teagan; Laurie, Karen L; Hurt, Aeron C; McVernon, Jodie; McCaw, James M

    2013-01-01

    For in vivo studies of influenza dynamics where within-host measurements are fit with a mathematical model, infectivity assays (e.g. 50% tissue culture infectious dose; TCID50) are often used to estimate the infectious virion concentration over time. Less frequently, measurements of the total (infectious and non-infectious) viral particle concentration (obtained using real-time reverse transcription-polymerase chain reaction; rRT-PCR) have been used as an alternative to infectivity assays. We investigated the degree to which measuring both infectious (via TCID50) and total (via rRT-PCR) viral load allows within-host model parameters to be estimated with greater consistency and reduced uncertainty, compared with fitting to TCID50 data alone. We applied our models to viral load data from an experimental ferret infection study. Best-fit parameter estimates for the "dual-measurement" model are similar to those from the TCID50-only model, with greater consistency in best-fit estimates across different experiments, as well as reduced uncertainty in some parameter estimates. Our results also highlight how variation in TCID50 assay sensitivity and calibration may hinder model interpretation, as some parameter estimates systematically vary with known uncontrolled variations in the assay. Our techniques may aid in drawing stronger quantitative inferences from in vivo studies of influenza virus dynamics.

  5. Preparation of an attenuated dengue 4 (341750 Carib) virus vaccine. I. Pre-clinical studies.

    PubMed

    Marchette, N J; Dubois, D R; Larsen, L K; Summers, P L; Kraiselburd, E G; Gubler, D J; Eckels, K H

    1990-08-01

    Dengue 4 (DEN-4) virus strain 341750 Carib was modified by serial passage in primary canine kidney (PCK) cell cultures. By the 15th PCK passage, this virus was less infectious for monkeys and resulted in a significantly reduced viremia as compared to the parent DEN-4 virus. The 30th PCK passage of DEN-4 341750 Carib was non-infectious for monkeys. A vaccine prepared at the 20th PCK passage in DBS-FRhL-2 cells stimulated the production of both neutralizing and hemagglutination inhibition antibodies in monkeys; these animals were also protected against challenge with the homologous strain as well as a heterologous strain of DEN-4. An ID50 titration in monkeys resulted in a titer of greater than 10(4) plaque-forming units (PFU) for the vaccine virus and 0.5 PFU for the parent virus. Reduced monkey infectivity of this magnitude has been correlated with human attenuation in previous dengue vaccine candidates. The DEN-4 strain 341750 Carib PCK-20/FRhL-4 vaccine has been characterized and sufficiently tested to be considered for safety and immunogenicity trials in humans.

  6. Ideology and disease identity: the politics of rickets, 1929-1982.

    PubMed

    Bivins, Roberta

    2014-06-01

    How can we assess the reciprocal impacts of politics and medicine in the contemporary period? Using the example of rickets in twentieth century Britain, I will explore the ways in which a preventable, curable non-infectious disease came to have enormous political significance, first as a symbol of socioeconomic inequality, then as evidence of racial and ethnic health disparities. Between the 1920s and 1980s, clinicians, researchers, health workers, members of Parliament and later Britain's growing South Asian ethnic communities repeatedly confronted the British state with evidence of persistent nutritional deficiency among the British poor and British Asians. Drawing on bitter memories of the 'Hungry Thirties', postwar rickets-so often described as a 'Victorian' disease-became a high-profile sign of what was variously constructed as a failure of the Welfare State; or of the political parties charged with its protection; or of ethnically Asian migrants and their descendants to adapt to British life and norms. Here I will argue that rickets prompted such consternation not because of its severity, the cost of its treatment, or even its prevalence; but because of the ease with which it was politicised. I will explore the ways in which this condition was envisioned, defined and addressed as Britain moved from the postwar consensus to Thatcherism, and as Britain's diverse South Asian communities developed from migrant enclaves to settled multigenerational ethnic communities.

  7. Procalcitonin in bacterial infections--hype, hope, more or less?

    PubMed

    Christ-Crain, Mirjam; Müller, Beat

    2005-08-01

    An ideal marker for bacterial infections should allow an early diagnosis, inform about the course and prognosis of the disease and facilitate therapeutic decisions. Procalcitonin (ProCT) covers these features better as compared to other, more commonly used biomarkers, and thus, the current hype on ProCT has a solid scientific basis. A superior diagnostic accuracy of ProCT has been shown for a variety of infections, eg respiratory tract infections, meningitis, acute infectious endocarditis and pancreatitis. Importantly, a ProCT-based therapeutic strategy can safely and markedly reduce antibiotic usage in lower respiratory tract infections, the major cause of sepsis. Being a hormokine mediator, immunoneutralisation of ProCT might offer new hope for more effective treatment options in sepsis. It is now evidence-based that ProCT provides more information and, thereby, questions the currently used "gold standards" for the diagnosis of clinically relevant bacterial infections. Yet, ProCT is less than a perfect marker. ProCT can be increased in non-infectious conditions, and may remain low in infections. The diagnosis of bacterial infections will continue to require a critical clinical awareness, careful patient history, dedicated physical examination, and appropriate cultures. This review aims to help the clinician to understand the physiopathological basis, to appreciate strengths and weaknesses of this biomarker, and thereby to promote a rational implementation of ProCT in a routine setting.

  8. Reduction and degradation of amyloid aggregates by a pulsed radio-frequency cold atmospheric plasma jet

    NASA Astrophysics Data System (ADS)

    Bayliss, D. L.; Walsh, J. L.; Shama, G.; Iza, F.; Kong, M. G.

    2009-11-01

    Surface-borne amyloid aggregates with mature fibrils are used as a non-infectious prion model to evaluate cold atmospheric plasmas (CAPs) as a prion inactivation strategy. Using a helium-oxygen CAP jet with pulsed radio-frequency (RF) excitation, amyloid aggregates deposited on freshly cleaved mica discs are reduced substantially leaving only a few spherical fragments of sub-micrometer sizes in areas directly treated by the CAP jet. Outside the light-emitting part of the CAP jet, plasma treatment results in a 'skeleton' of much reduced amyloid stacks with clear evidence of fibril fragmentation. Analysis of possible plasma species and the physical configuration of the jet-sample interaction suggests that the skeleton structures observed are unlikely to have arisen as a result of physical forces of detachment, but instead by progressive diffusion of oxidizing plasma species into porous amyloid aggregates. Composition of chemical bonds of this reduced amyloid sample is very different from that of intact amyloid aggregates. These suggest the possibility of on-site degradation by CAP treatment with little possibility of spreading contamination elsewhere , thus offering a new reaction chemistry route to protein infectivity control with desirable implications for the practical implementation of CAP-based sterilization systems.

  9. Structural and energetic basis of infection by the filamentous bacteriophage IKe.

    PubMed

    Jakob, Roman P; Geitner, Anne-Juliane; Weininger, Ulrich; Balbach, Jochen; Dobbek, Holger; Schmid, Franz X

    2012-06-01

    Filamentous phage use the two N-terminal domains of their gene-3-proteins to initiate infection of Escherichia coli. One domain interacts with a pilus, and then the other domain binds to TolA at the cell surface. In phage fd, these two domains are tightly associated with each other, which renders the phage robust but non-infectious, because the TolA binding site is inaccessible. Activation for infection requires partial unfolding, domain disassembly and prolyl isomerization. Phage IKe infects E. coli less efficiently than phage fd. Unlike in phage fd, the pilus- and TolA-binding domains of phage IKe are independent of each other in stability and folding. The site for TolA binding is thus always accessible, but the affinity is very low. The structures of the two domains, analysed by X-ray crystallography and by NMR spectroscopy, revealed a unique fold for the N-pilus-binding domain and a conserved fold for the TolA-binding domain. The absence of an activation mechanism as in phage fd and the low affinity for TolA probably explain the low infectivity of phage IKe. They also explain why, in a previous co-evolution experiment with a mixture of phage fd and phage IKe, all hybrid phage adopted the superior infection mechanism of phage fd.

  10. The impact of a 24-h ultra-marathon on salivary antimicrobial protein responses.

    PubMed

    Gill, S K; Teixeira, A M; Rosado, F; Hankey, J; Wright, A; Marczak, S; Murray, A; Costa, R J S

    2014-10-01

    Depressed oral respiratory mucosal immunity and increased incidence of upper respiratory symptoms are commonly reported after bouts of prolonged exercise. The current study observed the impact of a 24-h continuous overnight ultra-marathon competition (distance range: 122-208 km; ambient temperature range: 0-20 °C) on salivary antimicrobial protein responses and incidence of upper respiratory symptoms. Body mass, unstimulated saliva and venous blood samples were taken from ultra-endurance runners (n=25) and controls (n=17), before and immediately after competition. Upper respiratory symptoms were assessed during and until 4-weeks after event completion. Samples were analyzed for salivary IgA, lysozyme, α-amylase and cortisol in addition to plasma osmolality. Decreased saliva flow rate (p<0.001), salivary IgA (p<0.001) and lysozyme (p=0.015) secretion rates, and increased salivary α-amylase secretion rate (p<0.001) and cortisol responses (p<0.001) were observed post-competition in runners, with no changes being observed in controls. No incidences of upper respiratory symptoms were reported by participants. A 24-h continuous overnight ultra-marathon resulted in the depression of some salivary antimicrobial protein responses, but no incidences of upper respiratory symptoms were evident during or following competition. Salivary antimicrobial protein synergism, effective management of non-infectious episodes, maintaining euhydration, and (or) favourable environmental influences could have accounted for the low prevalence of upper respiratory symptoms. PMID:24886918

  11. A small heat shock protein is essential for thermotolerance and intracellular survival of Leishmania donovani

    PubMed Central

    Hombach, Antje; Ommen, Gabi; MacDonald, Andrea; Clos, Joachim

    2014-01-01

    ABSTRACT Leishmania parasites must survive and proliferate in two vastly different environments – the guts of poikilothermic sandflies and the antigen-presenting cells of homeothermic mammals. The change of temperature during the transmission from sandflies to mammals is both a key trigger for the progression of their life cycle and for elevated synthesis of heat shock proteins, which have been implicated in their survival at higher temperatures. Although the functions of the main heat shock protein families in the Leishmania life cycle have been studied, nothing is known about the roles played by small heat shock proteins. Here, we present the first evidence for the pivotal role played by the Leishmania donovani 23-kDa heat shock protein (which we called HSP23), which is expressed preferentially during the mammalian stage where it assumes a perinuclear localisation. Loss of HSP23 causes increased sensitivity to chemical stressors and renders L. donovani non-viable at 37°C. Consequently, HSP23-null mutants are non-infectious to primary macrophages in vitro. All phenotypic effects could be abrogated by the introduction of a functional HSP23 transgene into the null mutant, confirming the specificity of the mutant phenotype. Thus, HSP23 expression is a prerequisite for L. donovani survival at mammalian host temperatures and a crucial virulence factor. PMID:25179594

  12. Sociality and health: impacts of sociality on disease susceptibility and transmission in animal and human societies

    PubMed Central

    Kappeler, Peter M.; Cremer, Sylvia; Nunn, Charles L.

    2015-01-01

    This paper introduces a theme issue presenting the latest developments in research on the impacts of sociality on health and fitness. The articles that follow cover research on societies ranging from insects to humans. Variation in measures of fitness (i.e. survival and reproduction) has been linked to various aspects of sociality in humans and animals alike, and variability in individual health and condition has been recognized as a key mediator of these relationships. Viewed from a broad evolutionary perspective, the evolutionary transitions from a solitary lifestyle to group living have resulted in several new health-related costs and benefits of sociality. Social transmission of parasites within groups represents a major cost of group living, but some behavioural mechanisms, such as grooming, have evolved repeatedly to reduce this cost. Group living also has created novel costs in terms of altered susceptibility to infectious and non-infectious disease as a result of the unavoidable physiological consequences of social competition and integration, which are partly alleviated by social buffering in some vertebrates. Here, we define the relevant aspects of sociality, summarize their health-related costs and benefits, and discuss possible fitness measures in different study systems. Given the pervasive effects of social factors on health and fitness, we propose a synthesis of existing conceptual approaches in disease ecology, ecological immunology and behavioural neurosciences by adding sociality as a key factor, with the goal to generate a broader framework for organismal integration of health-related research. PMID:25870402

  13. Canadian Public Health Laboratory Network laboratory guidelines for the diagnosis of neurosyphilis in Canada.

    PubMed

    Wong, Tom; Fonseca, Kevin; Chernesky, Max A; Garceau, Richard; Levett, Paul N; Serhir, Bouchra

    2015-01-01

    Neurosyphilis refers to infection of the central nervous system by Treponema pallidum, which may occur at any stage. Neurosyphilis has been categorized in many ways including early and late, asymptomatic versus symptomatic and infectious versus non-infectious. Late neurosyphilis primarily affects the central nervous system parenchyma, and occurs beyond early latent syphilis, years to decades after the initial infection. Associated clinical syndromes include general paresis, tabes dorsalis, vision loss, hearing loss and psychiatric manifestations. Unique algorithms are recommended for HIV-infected and HIV-uninfected patients, as immunocompromised patients may present with serologic and cerebrospinal fluid findings that are different from immunocompetent hosts. Antibody assays include a VDRL assay and the FTA-Abs, while polymerase chain reaction for T. pallidum can be used as direct detection assays for some specimens. This chapter reviews guidelines for specimen types and sample collection, and identifies two possible algorithms for use with immunocompromised and immunocompetent hosts using currently available tests in Canada, along with a review of treatment response and laboratory testing follow-up.

  14. The Theoretical Construction of a Classification of Clinical Somatic Symptoms in Psychosomatic Medicine Theory

    PubMed Central

    Zeng, Fanmin; Sun, Xueli; Yang, Bangxiang; Shen, Hong; Liu, Ling

    2016-01-01

    Objective This article adopts the perspective of psychosomatic medicine to present and test a theoretical model of the classification of clinical somatic symptoms. The theoretical model consists of four dimensions: emotional somatic symptoms, biological somatic symptoms, imaginative somatic symptoms, and cognitive somatic symptoms. Method A clinical somatic symptom classification scale was developed according to the theoretical model. A total of 542 participants completed the clinical somatic symptoms classification scale. The data were analyzed using exploratory and confirmatory factor analyses. Results The results confirmed the theoretical model. The analyses found that the proposed theoretical structure of the scale was good, as indicated by factor loadings and fit indices, and that the scale had good reliability and construct validity. Conclusions Based on the interpretation of the clinical symptoms of psychosomatic medicine, the treatment of chronic non-infectious diseases includes at least three dimensions: the first is the etiological treatment, the second is the pathophysiological and pathopsychological dimension, and the third is symptomatic treatment. The unified psychosomatic point of view and diverse clinical thinking modes are aimed at identifying different classes of somatic symptoms and important prerequisites for the treatment of these symptoms. We registered the study with the Chinese Clinical Trial Registry and it was approved by the West China Hospital, Sichuan University ethics committee. Trial registration: The registration number is ChiCTR-OCS-14004632 (time: 2014-05-12). PMID:27525701

  15. Long amplicon (LA)-qPCR for the discrimination of infectious and noninfectious phix174 bacteriophages after UV inactivation.

    PubMed

    Ho, Johannes; Seidel, Michael; Niessner, Reinhard; Eggers, Jutta; Tiehm, Andreas

    2016-10-15

    Waterborne viruses are increasingly being considered in risk assessment schemes. In general, virus detection by culture methods is time consuming. In contrast, detection by quantitative polymerase chain reaction (qPCR) is more rapid and therefore, more suitable for monitoring. At present, qPCR lacks the essential ability for discriminating between infectious and non-infectious viruses, thus limiting its applicability for monitoring disinfection processes. In this study, a method was developed to quantify UV inactivation by long amplicon (LA)-qPCR. Bacteriophage phiX174 was used as a surrogate for human pathogenic viruses. A qPCR protocol was developed with new sets of primers, resulting in amplicon lengths of 108, 250, 456, 568, 955, 1063, 1544, and 1764 nucleotides. The log reduction of gene copies increased with increasing amplicon length. Additional treatment with the intercalating dye, PMA, had no effect, indicating that the bacteriophage capsids were not damaged by low pressure UV irradiation. A qPCR of nearly the complete genome (approx. 5000 nucleotides) showed similar results to the plaque assay. The log reduction in qPCR correlates with [specific amplicon length x UV dose]. The normalized DNA effect constant can be applied to calculate phiX174 inactivation based on qPCR detection. PMID:27450352

  16. Targeted supplementation design for improved production and quality of enveloped viral particles in insect cell-baculovirus expression system.

    PubMed

    Monteiro, Francisca; Bernal, Vicente; Chaillet, Maxime; Berger, Imre; Alves, Paula M

    2016-09-10

    The recent approval of vaccines and gene therapy products for human use produced in the Insect Cell-Baculovirus Expression Vector System (IC-BEVS) underlines the high potential and versatility of this platform. The interest in developing robust production processes emerges to cope with manufacturing pressure, as well as stringent product quality guidelines. Previously, we addressed the impact of the baculovirus infection on the physiology of insect host cell lines, identifying key cellular pathways enrolled in heterologous gene/protein expression. In the present work, this knowledge was applied to design tailored media supplementation schemes to boost IC-BEVS production yields and quality of enveloped viral particles: influenza VLPs (Inf-VLP) and baculovirus vectors (BV). The addition of reduced glutathione, antioxidants and polyamines increased the cell specific yields of baculovirus particles up to 3 fold. Cholesterol was identified as the most critical system booster, capable of improving 2.5 and 6-fold cell specific yields of BV and Inf-VLPs, respectively. Surprisingly, the combination of polyamines and cholesterol supplementation improved baculovirus stock quality, by preventing the accumulation of non-infectious particles during viral replication while selectively increasing infectious particles production. In addition, the specific yields of both enveloped viral particles, BVs and Inf-VLPs, were also increased. The correlation between supplement addition and systems productivity was extensively analyzed, providing a critical assessment on final product quantity and quality as drivers of bioprocess optimization efforts.

  17. Simulations of Oligomeric Intermediates in Prion Diseases

    NASA Astrophysics Data System (ADS)

    Mobley, D.

    2003-10-01

    We extend our previous stochastic cellular automata based model for areal aggregation of prion proteins on neuronal surfaces. The new anisotropic model allow us to simulate both strong beta-sheet and weaker attachment bonds between proteins. Constraining binding directions allows us to generate aggregate structures with the hexagonal lattice symmetry found in recently observed in vitro experiments. We argue that these constraints on rules may correspond to underlying steric constraints on the aggregation process. We find that monomer dominated growth of the areal aggregate is too slow to account for some observed doubling time-to-incubation time ratios inferred from data, and so consider aggregation dominated by relatively stable but non-infectious oligomeric intermediates. We compare a kinetic theory analysis of oligomeric aggregation to spatially explicit simulations of the process. We find that with suitable rules for misfolding of oligomers, possibly due to water exclusion by the surrounding aggregate, the resulting oligomeric aggregation model maps onto our previous monomer aggregation model. Therefore it can produce some of the same attractive features for the description of prion incubation time data. We propose experiments to test the oligomeric aggregation model.

  18. DenHunt - A Comprehensive Database of the Intricate Network of Dengue-Human Interactions

    PubMed Central

    Arjunan, Selvam; Sastri, Narayan P.; Chandra, Nagasuma

    2016-01-01

    Dengue virus (DENV) is a human pathogen and its etiology has been widely established. There are many interactions between DENV and human proteins that have been reported in literature. However, no publicly accessible resource for efficiently retrieving the information is yet available. In this study, we mined all publicly available dengue–human interactions that have been reported in the literature into a database called DenHunt. We retrieved 682 direct interactions of human proteins with dengue viral components, 382 indirect interactions and 4120 differentially expressed human genes in dengue infected cell lines and patients. We have illustrated the importance of DenHunt by mapping the dengue–human interactions on to the host interactome and observed that the virus targets multiple host functional complexes of important cellular processes such as metabolism, immune system and signaling pathways suggesting a potential role of these interactions in viral pathogenesis. We also observed that 7 percent of the dengue virus interacting human proteins are also associated with other infectious and non-infectious diseases. Finally, the understanding that comes from such analyses could be used to design better strategies to counteract the diseases caused by dengue virus. The whole dataset has been catalogued in a searchable database, called DenHunt (http://proline.biochem.iisc.ernet.in/DenHunt/). PMID:27618709

  19. Interleukin-17 in systemic lupus erythematosus: A comprehensive review.

    PubMed

    Li, Duo; Guo, Bin; Wu, Haijing; Tan, Lina; Chang, Christopher; Lu, Qianjin

    2015-01-01

    Systemic lupus erythematosus (SLE) is a complicated autoimmune disease of multifactorial pathoaetiology. One of the most serious manifestations is lupus nephritis. The pathogenesis of SLE has not been well elucidated, but it has been reported that interleukin-17 (IL-17) and Th17 cells play important roles in the pathogenesis of SLE. IL-17A, a member of IL-17 family, amplifies the immune response by inducing the local production of chemokines and cytokines, recruiting neutrophils and monocytes, augmenting the production of autoantibodies, and aggravating the inflammation and damage of target organs such as the kidney in SLE. In recent years, several IL-17A pathway inhibitors have advanced into clinical trials, including the anti-IL-17A monoclonal antibody and the anti-17RA monoclonal antibody. Several agents have shown great success in Phase II trials in multiple autoimmune diseases such as psoriasis, rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis, and non-infectious uveitis, which has sparked the urgent need of anti-IL-17A as innovative therapeutic option in controlling disease activity of moderate-to-severe SLE. Here, we review and summarize current progress in IL-17A and SLE from in vitro studies, human expression studies, and animal models, providing novel insight into its therapeutic potential.

  20. Pharmacologic Agents for Chronic Diarrhea

    PubMed Central

    2015-01-01

    Chronic diarrhea is usually associated with a number of non-infectious causes. When definitive treatment is unavailable, symptomatic drug therapy is indicated. Pharmacologic agents for chronic diarrhea include loperamide, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, diosmectite, cholestyramine, probiotics, antispasmodics, rifaximin, and anti-inflammatory agents. Loperamide, a synthetic opiate agonist, decreases peristaltic activity and inhibits secretion, resulting in the reduction of fluid and electrolyte loss and an increase in stool consistency. Cholestyramine is a bile acid sequestrant that is generally considered as the first-line treatment for bile acid diarrhea. 5-HT3 receptor antagonists have significant benefits in patients with irritable bowel syndrome (IBS) with diarrhea. Ramosetron improves stool consistency as well as global IBS symptoms. Probiotics may have a role in the prevention of antibiotic-associated diarrhea. However, data on the role of probiotics in the treatment of chronic diarrhea are lacking. Diosmectite, an absorbent, can be used for the treatment of chronic functional diarrhea, radiation-induced diarrhea, and chemotherapy-induced diarrhea. Antispasmodics including alverine citrate, mebeverine, otilonium bromide, and pinaverium bromide are used for relieving diarrheal symptoms and abdominal pain. Rifaximin can be effective for chronic diarrhea associated with IBS and small intestinal bacterial overgrowth. Budesonide is effective in both lymphocytic colitis and collagenous colitis. The efficacy of mesalazine in microscopic colitis is weak or remains uncertain. Considering their mechanisms of action, these agents should be prescribed properly. PMID:26576135

  1. Pharmacologic Agents for Chronic Diarrhea.

    PubMed

    Lee, Kwang Jae

    2015-10-01

    Chronic diarrhea is usually associated with a number of non-infectious causes. When definitive treatment is unavailable, symptomatic drug therapy is indicated. Pharmacologic agents for chronic diarrhea include loperamide, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, diosmectite, cholestyramine, probiotics, antispasmodics, rifaximin, and anti-inflammatory agents. Loperamide, a synthetic opiate agonist, decreases peristaltic activity and inhibits secretion, resulting in the reduction of fluid and electrolyte loss and an increase in stool consistency. Cholestyramine is a bile acid sequestrant that is generally considered as the first-line treatment for bile acid diarrhea. 5-HT3 receptor antagonists have significant benefits in patients with irritable bowel syndrome (IBS) with diarrhea. Ramosetron improves stool consistency as well as global IBS symptoms. Probiotics may have a role in the prevention of antibiotic-associated diarrhea. However, data on the role of probiotics in the treatment of chronic diarrhea are lacking. Diosmectite, an absorbent, can be used for the treatment of chronic functional diarrhea, radiation-induced diarrhea, and chemotherapy-induced diarrhea. Antispasmodics including alverine citrate, mebeverine, otilonium bromide, and pinaverium bromide are used for relieving diarrheal symptoms and abdominal pain. Rifaximin can be effective for chronic diarrhea associated with IBS and small intestinal bacterial overgrowth. Budesonide is effective in both lymphocytic colitis and collagenous colitis. The efficacy of mesalazine in microscopic colitis is weak or remains uncertain. Considering their mechanisms of action, these agents should be prescribed properly.

  2. Early feeding and early life housing conditions influence the response towards a noninfectious lung challenge in broilers.

    PubMed

    Simon, K; de Vries Reilingh, G; Bolhuis, J E; Kemp, B; Lammers, A

    2015-09-01

    Early life conditions such as feed and water availability immediately post hatch (PH) and housing conditions may influence immune development and therefore immune reactivity later in life. The current study addressed the consequences of a combination of these 2 early life conditions for immune reactivity, i.e., the specific antibody response towards a non-infectious lung challenge. Broiler chicks received feed and water either immediately p.h. or with a 72 h delay and were either reared in a floor or a cage system. At 4 weeks of age, chicks received either an intra-tracheally administered Escherichia coli lipopolysaccharide (LPS)/Human Serum Albumin (HUSA) challenge or a placebo, and antibody titers were measured up to day 14 after administration of the challenge. Chicks housed on the floor and which had a delayed access to feed p.h. showed the highest antibody titers against HuSA. These chicks also showed the strongest sickness response and poorest performance in response to the challenge, indicating that chicks with delayed access to feed might be more sensitive to an environment with higher antigenic pressure. In conclusion, results from the present study show that early life feeding strategy and housing conditions influence a chick's response to an immune challenge later in life. These 2 early life factors should therefore be taken into account when striving for a balance between disease resistance and performance in poultry.

  3. Bioactive lipid mediators in skin inflammation and immunity.

    PubMed

    Kendall, Alexandra C; Nicolaou, Anna

    2013-01-01

    The skin is the primary barrier from the outside environment, protecting the host from injury, infectious pathogens, water loss and solar ultraviolet radiation. In this role, it is supported by a highly organized system comprising elements of innate and adaptive immunity, responsive to inflammatory stimuli. The cutaneous immune system is regulated by mediators such as cytokines and bioactive lipids that can initiate rapid immune responses with controlled inflammation, followed by efficient resolution. However, when immune responses are inadequate or mounted against non-infectious agents, these mediators contribute to skin pathologies involving unresolved or chronic inflammation. Skin is characterized by active lipid metabolism and fatty acids play crucial roles both in terms of structural integrity and functionality, in particular when transformed to bioactive mediators. Eicosanoids, endocannabinoids and sphingolipids are such key bioactive lipids, intimately involved in skin biology, inflammation and immunity. We discuss their origins, role and influence over various cells of the epidermis, dermis and cutaneous immune system and examine their function in examples of inflammatory skin conditions. We focus on psoriasis, atopic and contact dermatitis, acne vulgaris, wound healing and photodermatology that demonstrate dysregulation of bioactive lipid metabolism and examine ways of using this insight to inform novel therapeutics.

  4. Absence of E protein arrests transmissible gastroenteritis coronavirus maturation in the secretory pathway

    SciTech Connect

    Ortego, Javier; Ceriani, Juan E.; Patino, Cristina; Plana, Juan; Enjuanes, Luis

    2007-11-25

    A recombinant transmissible gastroenteritis coronavirus (rTGEV) in which E gene was deleted (rTGEV-{delta}E) has been engineered. This deletion mutant only grows in cells expressing E protein (E{sup +} cells) indicating that E was an essential gene for TGEV replication. Electron microscopy studies of rTGEV-{delta}E infected BHK-pAPN-E{sup -} cells showed that only immature intracellular virions were assembled. These virions were non-infectious and not secreted to the extracellular medium in BHK-pAPN-E{sup -} cells. RNA and protein composition analysis by RNase-gold and immunoelectron microscopy showed that rTGEV-{delta}E virions contained RNA and also all the structural TGEV proteins, except the deleted E protein. Nevertheless, full virion maturation was blocked. Studies of the rTGEV-{delta}E subcellular localization by confocal and immunoelectron microscopy in infected E{sup -} cells showed that in the absence of E protein virus trafficking was arrested in the intermediate compartment. Therefore, the absence of E protein in TGEV resulted in two actions, a blockade of virus trafficking in the membranes of the secretory pathway, and prevention of full virus maturation.

  5. The Race against Protease Activation Defines the Role of ESCRTs in HIV Budding

    PubMed Central

    Bendjennat, Mourad; Saffarian, Saveez

    2016-01-01

    HIV virions assemble on the plasma membrane and bud out of infected cells using interactions with endosomal sorting complexes required for transport (ESCRTs). HIV protease activation is essential for maturation and infectivity of progeny virions, however, the precise timing of protease activation and its relationship to budding has not been well defined. We show that compromised interactions with ESCRTs result in delayed budding of virions from host cells. Specifically, we show that Gag mutants with compromised interactions with ALIX and Tsg101, two early ESCRT factors, have an average budding delay of ~75 minutes and ~10 hours, respectively. Virions with inactive proteases incorporated the full Gag-Pol and had ~60 minutes delay in budding. We demonstrate that during budding delay, activated proteases release critical HIV enzymes back to host cytosol leading to production of non-infectious progeny virions. To explain the molecular mechanism of the observed budding delay, we modulated the Pol size artificially and show that virion release delays are size-dependent and also show size-dependency in requirements for Tsg101 and ALIX. We highlight the sensitivity of HIV to budding “on-time” and suggest that budding delay is a potent mechanism for inhibition of infectious retroviral release. PMID:27280284

  6. The Structural Architecture of an Infectious Mammalian Prion Using Electron Cryomicroscopy

    PubMed Central

    Vázquez-Fernández, Ester; Vos, Matthijn R.; Afanasyev, Pavel; Cebey, Lino; Sevillano, Alejandro M.; Vidal, Enric; Rosa, Isaac; Renault, Ludovic; Ramos, Adriana; Peters, Peter J.; Fernández, José Jesús; van Heel, Marin; Young, Howard S.; Requena, Jesús R.

    2016-01-01

    The structure of the infectious prion protein (PrPSc), which is responsible for Creutzfeldt-Jakob disease in humans and bovine spongiform encephalopathy, has escaped all attempts at elucidation due to its insolubility and propensity to aggregate. PrPSc replicates by converting the non-infectious, cellular prion protein (PrPC) into the misfolded, infectious conformer through an unknown mechanism. PrPSc and its N-terminally truncated variant, PrP 27–30, aggregate into amorphous aggregates, 2D crystals, and amyloid fibrils. The structure of these infectious conformers is essential to understanding prion replication and the development of structure-based therapeutic interventions. Here we used the repetitive organization inherent to GPI-anchorless PrP 27–30 amyloid fibrils to analyze their structure via electron cryomicroscopy. Fourier-transform analyses of averaged fibril segments indicate a repeating unit of 19.1 Å. 3D reconstructions of these fibrils revealed two distinct protofilaments, and, together with a molecular volume of 18,990 Å3, predicted the height of each PrP 27–30 molecule as ~17.7 Å. Together, the data indicate a four-rung β-solenoid structure as a key feature for the architecture of infectious mammalian prions. Furthermore, they allow to formulate a molecular mechanism for the replication of prions. Knowledge of the prion structure will provide important insights into the self-propagation mechanisms of protein misfolding. PMID:27606840

  7. Should we treat fever in critically ill patients? A summary of the current evidence from three randomized controlled trials

    PubMed Central

    Serpa, Ary; Pereira, Victor Galvão Moura; Colombo, Giancarlo; Scarin, Farah Christina de la Cruz; Pessoa, Camila Menezes Souza; Rocha, Leonardo Lima

    2014-01-01

    Fever is a nonspecific response to various types of infectious or non-infectious insult and its significance in disease remains an enigma. Our aim was to summarize the current evidence for the use of antipyretic therapy in critically ill patients. We performed systematic review and meta-analysis of publications from 1966 to 2013. The MEDLINE and CENTRAL databases were searched for studies on antipyresis in critically ill patients. The meta-analysis was limited to: randomized controlled trials; adult human critically ill patients; treatment with antipyretics in one arm versus placebo or non-treatment in another arm; and report of mortality data. The outcomes assessed were overall intensive care unit mortality, changes in temperature, intensive care unit length of stay, and hospital length of stay. Three randomized controlled trials, covering 320 participants, were included. Patients treated with antipyretic agents showed similar intensive care unit mortality (risk ratio 0.91, with 95% confidence interval 0.65-1.28) when compared with controls. The only difference observed was a greater decrease in temperature after 24 hours in patients treated with antipyretics (-1.70±0.40 versus - 0.56±0.25ºC; p=0.014). There is no difference in treating or not the fever in critically ill patients. PMID:25628209

  8. Use of procalcitonin for the detection of sepsis in the critically ill burn patient: a systematic review of the literature.

    PubMed

    Mann, Elizabeth A; Wood, Geri L; Wade, Charles E

    2011-06-01

    The purpose of this systematic review was to assess the evidence for use of routine procalcitonin testing to diagnose the presence of sepsis in the burn patient. The electronic databases MEDLINE, Cochrane, CINAHL, ProQuest, and SCOPUS were searched for relevant studies using the MeSH terms burn, infection, procalcitonin, and meta-analysis. The focus of the review was the adult burn population, but other relevant studies of critically ill patients were included as data specific to the patient with burns are limited. Studies were compiled in tabular form and critically appraised for quality and level of evidence. Four meta-analyses, one review of the literature, one randomized controlled trial, nine prospective observational, and three retrospective studies were retrieved. Six of these studies were specific to the burn population, with one specific to burned children. Only one meta-analysis, one adult burn and one pediatric burn study reported no benefit of procalcitonin testing to improve diagnosis of sepsis or differentiate sepsis from non-infectious systemic inflammatory response. The collective findings of the included studies demonstrated benefit of incorporating procalcitonin assay into clinical sepsis determination. Evaluation of the burn specific studies is limited by the use of guidelines to define sepsis and inconsistent results from the burn studies. Utility of the procalcitonin assay is limited due to the lack of availability of rapid, inexpensive tests. However, it appears procalcitonin assay is a safe and beneficial addition to the clinical diagnosis of sepsis in the burn intensive care unit.

  9. Virus Assembly and Maturation: Auto-regulation Through Allosteric Molecular Switches

    PubMed Central

    Domitrovic, Tatiana; Movahed, Navid; Brian, Bothner; Matsui, Tsutomu; Wang, Qiu; Doerschuk, Peter; Johnson, John E.

    2013-01-01

    We generalize the concept of allostery from the traditional non active-site control of enzymes to virus maturation. Virtually all animal viruses transition from a procapsid, non infectious state, to a mature infectious state. The procapsid contains an encoded chemical program that is executed following an environmental cue. We developed an exceptionally accessible virus system for the study of the activators of maturation and the down stream consequences that result in particle stability and infectivity. Nudaurelia Capensis Omegavirus (NωV) is a T=4 icosahedral virus that undergoes a dramatic maturation in which the 490Å spherical procapsid condenses to a 400Å icosahedral shaped capsid with associated specific auto-proteolysis and stabilization. Employing X-ray crystallography, time resolved electron cryo-microscopy and hydrogen/deuterium exchange as well as biochemistry it was possible to define the mechanisms of allosteric communication among the 4 quasi-equivalent subunits in the icosahedral asymmetric unit. These gene products undergo proteolysis at different rates, dependent on quaternary structure environment, while particle stability is conferred globally following only a few local subunit transitions. We show that there is a close similarity between the concepts of tensegrity, associated with geodesic domes and mechanical engineering, and allostery, associated with biochemical control mechanisms. PMID:23485419

  10. A prospective observational study of vulvovagintis in pregnant women in Argentina, with special reference to candidiasis.

    PubMed

    Mucci, María J; Cuestas, María L; Cervetto, María M; Landaburu, María F; Mujica, María T

    2016-07-01

    To evaluate the frequency of yeast, bacteria or protozoa in pregnant women and to correlate the possible associations of these microorganisms and their relationships with vulvovaginitis (VV) and cervicitis. Vaginal specimens were collected and prepared for smears in microscope slides for the evaluation of yeast, Trichomonas vaginalis and bacteria. Samples were cultured in specific culture medium. Cervical specimens were used to investigate the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis. We enrolled 210 pregnant women, aged 10-42 years old. Of them, 38.1% were symptomatic. Symptoms were most prevalent in the second and third trimesters of pregnancy coincident with a major prevalence of microorganisms. In this study, 39.5% of pregnant women had normal microbial biota and symptoms of VV due to non-infectious causes were observed (6.2%). The occurrence of vulvovaginal candidiasis was 25% and Candida albicans with a prevalence of 80.7% was the dominant species (P = 0.005) while non-albicans Candida species and other yeast were more common in asymptomatic ones (P = 0.0038). The frequency of bacterial vaginosis, T. vaginalis, C. trachomatis and N. gonorrhoeae were 18.1%, 1.4, 1.4% and 0.5% respectively. PMID:26931504

  11. DNA Immunization as an Efficient Strategy for Vaccination

    PubMed Central

    Bolhassani, Azam; Yazdi, Sima Rafati

    2009-01-01

    The field of vaccinology provides excellent promises to control different infectious and non-infectious diseases. Genetic immunization as a new tool in this area by using naked DNA has been shown to induce humoral as well as cellular immune responses with high efficiency. This demonstrates the enormous potential of this strategy for vaccination purposes. DNA vaccines have been widely used to develop vaccines against various pathogens as well as cancer, autoimmune diseases and allergy. However, despite their successful application in many pre-clinical disease models, their potency in human clinical trials has been insufficient to provide protective immunity. Several strategies have been applied to increase the potency of DNA vaccine. Among these strategies, the linkage of antigens to Heat Shock Proteins (HSPs) and the utilization of different delivery systems have been demonstrated as efficient approaches for increasing the potency of DNA vaccines. The uptake of DNA plasmids by cells upon injection is inefficient. Two basic delivery approaches including physical delivery to achieve higher levels of antigen production and formulation with microparticles to target Antigen-Presenting Cells (APCs) are effective in animal models. Alternatively, different regimens called prime-boost vaccination are also effective. In this regimen, naked DNA is utilized to prime the immune system and either recombinant viral vector or purified recombinant protein with proper adjuvant is used for boosting. In this review, we discuss recent advances in upgrading the efficiency of DNA vaccination in animal models. PMID:23407787

  12. A novel endogenous betaretrovirus group characterized from polar bears (Ursus maritimus) and giant pandas (Ailuropoda melanoleuca).

    PubMed

    Mayer, Jens; Tsangaras, Kyriakos; Heeger, Felix; Avila-Arcos, María; Stenglein, Mark D; Chen, Wei; Sun, Wei; Mazzoni, Camila J; Osterrieder, Nikolaus; Greenwood, Alex D

    2013-08-15

    Transcriptome analysis of polar bears (Ursus maritimus) yielded sequences with highest similarity to the human endogenous retrovirus group HERV-K(HML-2). Further analysis of the polar bear draft genome identified an endogenous betaretrovirus group comprising 26 proviral copies and 231 solo LTRs. Molecular dating indicates the group originated before the divergence of bears from a common ancestor but is not present in all carnivores. Closely related sequences were identified in the giant panda (Ailuropoda melanoleuca) and characterized from its genome. We have designated the polar bear and giant panda sequences U. maritimus endogenous retrovirus (UmaERV) and A. melanoleuca endogenous retrovirus (AmeERV), respectively. Phylogenetic analysis demonstrated that the bear virus group is nested within the HERV-K supergroup among bovine and bat endogenous retroviruses suggesting a complex evolutionary history within the HERV-K group. All individual remnants of proviral sequences contain numerous frameshifts and stop codons and thus, the virus is likely non-infectious. PMID:23725819

  13. Immunological Priming Requires Tregs and Interleukin-10-Producing Macrophages to Accelerate Resolution from Severe Lung Inflammation

    PubMed Central

    Eto, Yoshiki; Tripathi, Ashutosh; Mandke, Pooja; Mock, Jason R.; Garibaldi, Brian T.; Singer, Benjamin D.; Sidhaye, Venkataramana K.; Horton, Maureen R.; King, Landon S.; D'Alessio, Franco R.

    2014-01-01

    Overwhelming lung inflammation frequently occurs following exposure to both direct infectious and non-infectious agents, and is a leading cause of mortality world-wide. In that context, immunomodulatory strategies may be utilized to limit severity of impending organ damage. We sought to determine whether priming the lung by activating the immune system, or immunological priming, could accelerate resolution of severe lung inflammation. We assessed the importance of alveolar macrophages, regulatory T cells, and their potential interaction during immunological priming. We demonstrate that oropharyngeal delivery of low-dose lipopolysaccharide can immunologically prime the lung to augment alveolar macrophage production of interleukin-10 and enhance resolution of lung inflammation induced by a lethal dose of lipopolysaccharide or by pseudomonas bacterial pneumonia. Interleukin-10 deficient mice did not achieve priming and were unable to accelerate lung injury resolution. Depletion of lung macrophages or regulatory T cells during the priming response completely abrogated the positive effect of immunological priming on resolution of lung inflammation and significantly reduced alveolar macrophage interleukin-10 production. Finally, we demonstrated that oropharyngeal delivery of synthetic CpG-oligonucleotides elicited minimal lung inflammation compared to low-dose lipopolysaccharide, but nonetheless primed the lung to accelerate resolution of lung injury following subsequent lethal lipopolysaccharide exposure. Immunological priming is a viable immunomodulatory strategy used to enhance resolution in an experimental acute lung injury model with the potential for therapeutic benefit against a wide array of injurious exposures. PMID:24688024

  14. Heme on innate immunity and inflammation

    PubMed Central

    Dutra, Fabianno F.; Bozza, Marcelo T.

    2014-01-01

    Heme is an essential molecule expressed ubiquitously all through our tissues. Heme plays major functions in cellular physiology and metabolism as the prosthetic group of diverse proteins. Once released from cells and from hemeproteins free heme causes oxidative damage and inflammation, thus acting as a prototypic damage-associated molecular pattern. In this context, free heme is a critical component of the pathological process of sterile and infectious hemolytic conditions including malaria, hemolytic anemias, ischemia-reperfusion, and hemorrhage. The plasma scavenger proteins hemopexin and albumin reduce heme toxicity and are responsible for transporting free heme to intracellular compartments where it is catabolized by heme-oxygenase enzymes. Upon hemolysis or severe cellular damage the serum capacity to scavenge heme may saturate and increase free heme to sufficient amounts to cause tissue damage in various organs. The mechanism by which heme causes reactive oxygen generation, activation of cells of the innate immune system and cell death are not fully understood. Although heme can directly promote lipid peroxidation by its iron atom, heme can also induce reactive oxygen species generation and production of inflammatory mediators through the activation of selective signaling pathways. Heme activates innate immune cells such as macrophages and neutrophils through activation of innate immune receptors. The importance of these events has been demonstrated in infectious and non-infectious diseases models. In this review, we will discuss the mechanisms behind heme-induced cytotoxicity and inflammation and the consequences of these events on different tissues and diseases. PMID:24904418

  15. Destructive spondyloarthropathy in a haemodialysis patient with HIV infection: case report and literature review.

    PubMed

    Agarwal, V; Gandhi, V

    2013-01-01

    This case describes the presentation, diagnosis and treatment of a 59-year-old man with medical history of HIV/AIDS and hepatitis C on haemodialysis for end stage renal disease who presented with debilitating neck pain radiating down to the left arm with associated weakness of left upper and lower extremities. He had received a prolonged course of intravenous antibiotics for similar complaints. His initial presentation, coupled with the history of recent antibiotics, triggered a non-infectious work-up and the patient was diagnosed with destructive spondyloarthropathy, a rare but under-diagnosed complication of patients on long-term haemodialysis. This was confirmed on imaging studies. The patient refused surgical intervention, and was treated conservatively. With improved survival of patients with HIV infection, other significant co-morbidities like end stage renal disease and their potential complications in these patients have become an increasing focus of attention. Destructive spondyloarthropathy is a severely debilitating condition and can be potentially fatal. The aetiopathogenesis, management and ethical and legal implications of HIV patients with destructive spondyloarthropathy secondary to long-term haemodialysis are discussed.

  16. Field trial for reducing porcine Taenia solium cysticercosis in Mexico by systematic vaccination of pigs.

    PubMed

    Molinari, J L; Rodríguez, D; Tato, P; Soto, R; Arechavaleta, F; Solano, S

    1997-04-01

    It has previously been demonstrated that immunization of pigs with a crude extract of Taenia solium metacestodes can confer a high level of protection against an egg challenge. Furthermore, vaccination of infected animals also induces an immune response against the larvae, which are either destroyed or rendered non-infectious. To assess the efficacy of immunization as a strategy for reducing the prevalence of porcine cysticercosis, a field trial of this vaccine was performed in an endemic area in the northern region of the Guerrero State, Mexico, Random samples of pigs belonging to 17 villages were examined for metacestodes by inspection of their tongues. Each animal was immunized with a dose of 150 micrograms of protein (antigenic extract from Taenia solium metacestodes) by the intramuscular route. A prevalence of 2.4% of porcine cysticercosis on average was found in these villages at the beginning of the trial (62 cysticercotic pigs out of 2650 inspected). Six of these villages were selected for the periodic vaccination of new random samples of pigs. A statistically significant decline in the prevalence of porcine cysticercosis was observed at the end of the trial, decreasing from 2.4% at the beginning of vaccination to 0.45% at the end of the trial. A reduction of 82% was observed in spite of the poor living conditions in these villages. These results are consistent with previous data and suggest that it may be possible to turn a susceptible pig population into a protected one by systematic vaccination.

  17. Recurring waterbird mortalities and unusual etiologies

    USGS Publications Warehouse

    Cole, R.A.; Franson, J.C.; Boere, G.C.; Galbraith, C.A.; Stroud, David A.

    2006-01-01

    Over the last decade, the National Wildlife Health Center of the United States Geological Survey has documented various largescale mortalities of birds caused by infectious and non-infectious disease agents. Some of these mortality events have unusual or unidentified etiologies and have been recurring. While some of the causes of mortalities have been elucidated, others remain in various stages of investigation and identification. Two examples are discussed: 1) Leyogonimus polyoon (Class: Trematoda), not found in the New World until 1999, causes severe enteritis and has killed over 15 000 American Coot Fulica americana in the upper mid-western United States. The geographic range of this parasite within North America is predicted to be limited to the Great Lakes Basin. 2) In the early 1990s, estimates of up to 6% of the North American population of the Eared Grebe Podiceps nigricollis died at Salton Sea, California, with smaller mortalities occurring throughout the 1990s. Birds were observed to have unusual preening behaviour, and to congregate at freshwater drains and move onto land. Suggested etiologies included interactions of contaminants, immuno-suppression, an unusual form of a bacterial disease, and an unknown biotoxin. During studies carried out from 2000 to 2003, Eared Grebe mortality did not approach the level seen in the early 1990s and, although bacteria were identified as minor factors, the principal cause of mortality remains undetermined. The potential population impact of these emerging and novel disease agents is currently unknown.

  18. Corneal collagen cross-linking: A review

    PubMed Central

    O’Brart, David P.S.

    2014-01-01

    The aim was to review the published literature on corneal collagen cross-linking. The emphasis was on the seminal publications, systemic reviews, meta-analyses and randomized controlled trials. Where such an evidence did not exist, selective large series cohort studies, case controlled studies and case series with follow-up preferably greater than 12 months were included. Riboflavin/Ultraviolet A (UVA) corneal collagen cross-linking appears to be the first treatment modality to halt the progression of keratoconus and other corneal ectatic disorders with improvement in visual, keratometric and topographic parameters documented by most investigators. Its precise mechanism of action at a molecular level is as yet not fully determined. Follow-up is limited to 4–6 years at present but suggests continued stability and improvement in corneal shape with time. Most published data are with epithelium-off techniques. Epithelium-on studies suggest some efficacy but less than with the epithelium-off procedures and long-term data are not currently available. The use of Riboflavin/UVA CXL for the management of infectious and non-infectious keratitis appears very promising. Its use in the management of bullous keratopathy is equivocal. Investigation of other methodologies for CXL are under investigation. PMID:25000866

  19. A review of factors that impact on the capacity of beef cattle females to conceive, maintain a pregnancy and wean a calf-Implications for reproductive efficiency in northern Australia.

    PubMed

    Burns, B M; Fordyce, G; Holroyd, R G

    2010-10-01

    A review of factors that may impact on the capacity of beef cattle females, grazing semi-extensive to extensive pastures in northern Australia, to conceive, maintain a pregnancy and wean a calf was conducted. Pregnancy and weaning rates have generally been used to measure the reproductive performance of herds. However, this review recognises that reproductive efficiency and the general measures associated with it more effectively describe the economic performance of beef cattle enterprises. More specifically, reproductive efficiency is influenced by (1) pregnancy rate which is influenced by (i) age at puberty; (ii) duration of post-partum anoestrus; (iii) fertilisation failure and (iv) embryo survival; while (2) weight by number of calves per breeding female retained for mating is influenced by (i) cow survival; (ii) foetal survival; and (iii) calf survival; and (3) overall lifetime calf weight weaned per mating. These measures of reproductive efficiency are discussed in depth. Further, a range of infectious and non-infectious factors, namely, environmental, physiological, breed and genetic factors and their impact on these stages of the reproductive cycle are investigated and implications for the northern Australian beef industry are discussed. Finally, conclusions and recommendations to minimise reproductive inefficiencies based on current knowledge are presented.

  20. Multiple invasions of an infectious retrovirus in cat genomes.

    PubMed

    Shimode, Sayumi; Nakagawa, So; Miyazawa, Takayuki

    2015-01-01

    Endogenous retroviruses (ERVs) are remnants of ancient retroviral infections of host germ-line cells. While most ERVs are defective, some are active and express viral proteins. The RD-114 virus is a replication-competent feline ERV, and several feline cell lines produce infectious RD-114 viral particles. All domestic cats are considered to have an ERV locus encoding a replication-competent RD-114 virus in their genomes; however, the locus has not been identified. In this study, we investigated RD-114 virus-related proviral loci in genomes of domestic cats, and found that none were capable of producing infectious viruses. We also found that all domestic cats have an RD-114 virus-related sequence on chromosome C2, termed RDRS C2a, but populations of the other RDRSs are different depending on the regions where cats live or breed. Our results indicate that RDRS C2a, the oldest RD-114-related provirus, entered the host genome before an ancestor of domestic cats started diverging and the other new RDRSs might have integrated into migrating cats in Europe. We also show that infectious RD-114 virus can be resurrected by the recombination between two non-infectious RDRSs. From these data, we conclude that cats do not harbor infectious RD-114 viral loci in their genomes and RD-114-related viruses invaded cat genomes multiple times. PMID:25641657