Evaluation of two commercial tests for human immunodeficiency virus antigens in culture supernatant fluid

Two commercial enzyme-linked immunosorbent assays (EIAs) for human immunodeficiency virus (HIV) antigens were evaluated for sensitivity and reproducibility by use of supernatant fluid from cell cultures of peripheral mononuclear cells of 18 patients with acquired immunodeficiency syndrome (AIDS) and 12 asymptomatic HIV antibody-positive patients. Both commercial assays detected HIV antigen in all cultures by day 21; however, the Abbott HIV antigen EIA (Abbott Laboratories, North Chicago, IL) detected HIV antigen three to seven days earlier in 15 of 48 cultures (31%), on the same day in 32 cultures (67%), and three days later in 1 culture (2%) when compared with the DuPont HIV antigen EIA (DuPont Laboratories, Wilmington, DE). In serial twofold dilution experiments, the Abbott HIV Ag EIA was found to have at least a twofold to eightfold increased sensitivity over the DuPont assay. Repeat testing of 15 initially positive supernatant fluids by both assays revealed that 13 of 15 and 12 of 15 were consistently positive by the Abbott and DuPont assays, respectively. The authors conclude that the Abbott EIA demonstrated better performance in this study than the DuPont EIA for detection of HIV in cell culture because of its shorter time-to-positivity and greater sensitivity.     

Dietary factors in oral leukoplakia and submucous fibrosis in a population-based case control study in Gujarat, India

OBJECTIVES: To investigate the relationship of specific nutrients and food items with oral precancerous lesions among tobacco users.
DESIGN: A population-based case-control study. SETTING: Villages in Palitana taluk of Bhavnagar district, Gujarat, India.
SUBJECTS AND METHODS: An interviewer-administered food frequency questionnaire, developed and validated for this population, was used to estimate nutrient intake in blinded, house-to-house interviews. Among 5018 male tobacco users, 318 were diagnosed as cases. An equal number of controls matched on age (±5 years), sex, village, and use of tobacco were selected.
MAIN OUTCOME MEASURES: Odds ratios (OR) from multiple logistic regression analysis controlling for relevant variables (type of tobacco use and economic status).
RESULTS: A protective effect of fibre was observed for both oral submucous fibrosis (OSF) and leukoplakia, with 10% reduction in risk per g day^-1 ( P < 0.05). Ascorbic acid appeared to be protective against leukoplakia with the halving of risk in the two highest quartiles of intake (versus the lowest quartile: OR = 0.46 and 0.44, respectively; P < 0.10). A protective effect of tomato consumption was observed in leukoplakia and a suggestion of a protective effect of wheat in OSF.
CONCLUSION: In addition to tobacco use, intake of specific nutrients may have a role in the development of oral precancerous lesions.     

树突状细胞与肝脏疾病

免疫反应的产生首先是由抗原提呈细胞(antigenpresenting cells,APC)捕获抗原,经其加工处理后将抗原信息传递给T,B淋巴细胞,从而引发一系列的特异性免疫应答.APC包括树突状细胞(dendritic cells,DC)、巨噬细胞(MΦ)、B细胞等,其中DC是人体内最具潜能的抗原提呈细胞(APC),能在体内外直接激活纯真(naive)T细胞,提呈抗原给MHC-Ⅰ类限制性CD8+和MHC-Ⅱ类限制性CD4+T淋巴细胞,诱导特异性免疫应答[1-6].     

Endovascular treatment of a Superior Mesenteric Artery Syndrome variant secondary to traumatic pseudoaneurysm

Pseudoaneurysms related to the superior mesenteric artery (SMA) are a recognised complication of trauma to the vessel, and successful treatment with stenting has been previously described. We report the case of a patient who presented with obstruction of the fourth part of the duodenum secondary to a traumatic pseudoaneurysm, a hitherto unreported variant of superior mesenteric artery syndrome. Exclusion of the pseudoaneurysm and relief of the duodenal obstruction were simultaneously achieved by placement of a covered stent.     

Vacuum-assisted closure as a surgical assistant in life-threatening necrotizing fasciitis in children

Necrotizing fasciitis is a severe soft tissue infection that can involve skin, subcutaneous fat, fascia and muscle. It can result in devastating sequelae including tissue necrosis, sepsis, toxic shock syndrome, cardiopulmonary collapse and death. To control rapidly spreading necrosis, early diagnosis and aggressive surgical treatment with extensive radical debridement of the affected areas is necessary, as well as systemic administration of broad-spectrum antimicrobials and, very often, intensive care support.The subatmospheric negative pressure dressing has been previously used in acute and complex wounds management. The concept of using vacuum-assisted closure dressing as another management component is presented in the current article.     

Morbidity associated with heroin overdose presentations to an emergency department: A 10‐year record linkage study

Introduction: To examine hospitalizations in a cohort of 224 patients who presented with non‐fatal heroin overdose to an ED. Methods: A record linkage study, using the morbidity, mental health and mortality databases in the Data Linkage Unit of the Department of Health, Western Australia. The main outcome measures were hospital separations 5 years before and after entry into the cohort. Results: Before entry into the cohort, 199 (89%) patients had an admission to mental health services. These 199 had a combined total of 1367 separations, most commonly for a mental health condition, injury or poisoning. Women had more than twice the relative risk (RR) of men for all separations (RR 2.35, 95% confidence interval [CI] 1.96–2.82, P < 0.001) and for injury and poisoning separations (RR 2.04, 95% CI 1.56–2.66, P < 0.001). The highest concentrations of separations occurred within 1 year before and 1 year after entry into the cohort. There were 12 (5.4%, 95% CI 2.9–9.4%) deaths, most commonly from overdose. Conclusion: Non‐fatal heroin overdose ED presentations are associated with a cluster of hospitalizations around that episode, likely to be related to heroin availability. Presentation to hospital by heroin users represents an opportunity to counsel less risky behaviour.     

Inhibitory activity of xanthine oxidase by fractions Crateva adansonii

ObjectiveTo study the inhibitory effect of various extracts from Crateva adansonii (C. adansonii) used traditionally against several inflammatory diseases such as rheumatism, arthritis, and gout, was investigated on purified bovine milk xanthine oxidase (XO) activity.MethodsXanthine oxidase inhibitory activity was assayed spectrophotometrically and the degree of enzyme inhibition was determined by measuring the increase in absorbance at 295 nm associated with uric acid formation. Enzyme kinetics was carried out using Lineweaver-Burk plots using xanthine as the substrate.ResultsAmong the fractions tested, the chloroform fraction exhibited highest potency (IC₅₀ 20.2±1.6 μg/mL) followed by the petroleum ether (IC₅₀ 30.1±2.2 μg/mL), ethyl acetate (IC₅₀ 43.9±1.4 μg/mL) and residual (IC₅₀ 98.0±3.3 μg/mL) fractions. The IC₅₀ value of allopurinol used, as the standard was 5.7±0.3 μg/mL.ConclusionsEnzyme inhibition mechanism indicated that the mode of inhibition was of a mixed type. Our findings suggest that the therapeutic use of these plants may be due to the observed Xanthine oxidase inhibition, thereby supporting their use in traditional folk medicine against inflammatory-related diseases, in particular, gout.     

Electrical Performance and Automatic Capture Characteristics of a 3.5-mm2 Passive Fixation Lead during 1-Year Follow-Up

Background: Bipolar low polarization electrodes are recommended for a regular AutoCapture™ (St. Jude Medical, Inc., Sylmar, CA, USA) function in order to effectively detect the evoked response (ER) signal. The objective of this national multicenter registry was to evaluate the electrical performance and the AutoCapture™ characteristics of the bipolar ventricular pacing lead IsoFlex S, model 1636T or 1646T (St. Jude Medical), in combination with single- and dual-chamber pacemakers.
Methods: Ventricular pacing and sensing thresholds, lead impedance, ER amplitude, and polarization signals were measured at discharge and routine follow-up visits after 1, 3, 6, 9, and 12 months. AutoCapture™ activation was recommended based on the results of the ER sensitivity test.
Results: Of the 252 patients initially included, 109 (43%) have completed the follow-up. The mean ventricular pacing threshold was 0.43 ± 0.19 V at discharge and 0.68 ± 0.32 V at 12 months postimplant. The values for the ventricular sensing threshold were between 9.51 ± 4.12 and 9.99 ± 4.09 mV at discharge and at the 12-month follow-up. The unipolar lead impedance decreased from 533 ± 94 to 476 ± 73 ohms during the follow-up. The mean ER amplitude was 16.47 ± 6.70 mV at discharge and 17.42 ± 7.43 mV after 12 months, and the corresponding mean polarization signals were 0.59 ± 1.00 and 0.74 ± 1.24 mV, respectively. AutoCapture™ activation was recommended in at least 95% of the patients investigated over the 12-month follow-up.
Conclusion: The bipolar ventricular pacing lead IsoFlex S 1636/1646T shows a good electrical performance and is mostly compatible with the AutoCapture™ algorithm.