[Detection of Legionella pneumophila by nested PCR-RFLP and ELISA on urine specimens of pregnant women with respiratory infections]

Pneumonia during pregnancy can induce serious consequences to the mother and the fetus, therefore its diagnosis and therapy is very important. There are few published articles on Legionella infection prevalence during pregnancy. In patients with Legionellosis, bacterial LPS and DNA are excreted into urine for extended periods, so combination of PCR and ELISA methods would be a good diagnostic tool. This research was done to determine the prevalence of L. pneumophila in pregnant women with respiratory infections. This is a cross-sectional study on 95 pregnant women with respiratory infection carried out during winter to summer 2006. Presence of Legionella infection was con-firmed by nested PCR-RFLP and antigen detection in urine specimens by ELISA method. The data were analyzed by SPSS, version 13, by using independent t tests, Fisher's exact test, ?2, a logistic model and McNemar's test, while considering p<0.05 as significant. The prevalence of infection using PCR was 22.1% [CI=14.1%-30.1%] and by ELISA it was 4.2% [CI=2%-8.2%]; this difference was statistically significant [p<0.005]. The most pre-valent clinical features were Cough [56.8%], headache [54.7%], abdominal pain [38.9%], chills [35.8%], fever [22.1%] and diarrhea [8.4%]. There were significant statistical relationships bet-ween cases with a positive CRP and fever, chills and abdominal pain and previous liver or renal problems [p<0.05, p<0.001]. There were significant relationships between fever and chills with ELISA results [p<0.05] but no relationships with other variables. There was a considerable prevalence of this infection in the studied population [22.1%]. It seems that performing PCR and ELISA tests on urine sample is suitable in detecting Legionella species and it can provide results in a less than a day_ a great help in the diagnosis and treatment of pneumonia especially during pregnancy

Therapeutic evaluation of intralesional injection of bleomycin sulfate in the treatment of resistant warts

From June 1992 to March 1993, a group of patients suffering from different types of warts were treated with intralesional injections of bleomycin sulfate. This study reviews the literature concerning this modality of treatment and the pathophysiology and immunohistopathology of warts and options for treatment. In this prospective study, a combination of a Img/mL solution of bleomycin in distilled water and lidocaine 2% [in equal portions] was injected in 22 patients. No patient received more than 2mL of the solution. Eighty-four of 95 warts [88.4%] showed complete resolution after 1-3 bleomycin injections, while 10 warts [10.5%] showed incomplete resolution. In only one plantar wart did bleomycin fail to elicit any therapeutic response [1.1%].The cure rate was 96.3% for periungual warts, 84.6% for palmoplantar warts, and 75% for warts located on the extremities. The responsive warts developed a hemorrhagic eschar that healed without scarring. No systemic side-effects were observed but a mild transient pigmentary change was seen at the injection site of one palmar wart. It is concluded that this form of treatment for resistant warts is safe, reliable and well accepted by the patients if used in the dose mentioned