Epiregulin (EREG) and human V-ATPase (TCIRG1): genetic variation, ethnicity and pulmonary tuberculosis susceptibility in Guinea-Bissau and The Gambia.

We analyzed two West African samples (Guinea-Bissau: n=289 cases and 322 controls; The Gambia: n=240 cases and 248 controls) to evaluate single-nucleotide polymorphisms (SNPs) in Epiregulin (EREG) and V-ATPase (T-cell immune regulator 1 (TCIRG1)) using single and multilocus analyses to determine whether previously described associations with pulmonary tuberculosis (PTB) in Vietnamese and Italians would replicate in African populations. We did not detect any significant single locus or haplotype associations in either sample. We also performed exploratory pairwise interaction analyses using Visualization of Statistical Epistasis Networks (ViSEN), a novel method to detect only interactions among multiple variables, to elucidate possible interaction effects between SNPs and demographic factors. Although we found no strong evidence of marginal effects, there were several significant pairwise interactions that were identified in either the Guinea-Bissau or the Gambian samples, two of which replicated across populations. Our results indicate that the effects of EREG and TCIRG1 variants on PTB susceptibility, to the extent that they exist, are dependent on gene-gene interactions in West African populations as detected with ViSEN. In addition, epistatic effects are likely to be influenced by inter- and intra-population differences in genetic or environmental context and/or the mycobacterial lineages causing disease.

Endothelial dysfunction, increased inflammation, and activated coagulation in HIV-infected patients improve after initiation of highly active antiretroviral therapy.

OBJECTIVES: Endothelial dysfunction and inflammation have been demonstrated to be markers of cardiovascular risk. We investigated the effects of HIV infection per se and the antiretroviral treatment prescribed on the levels of risk factors of cardiovascular disease. METHODS: This was a prospective study of 20 treatment-naïve, nonsmoking, HIV-positive patients examined before and after 3 months of treatment with a protease inhibitor (PI)-containing regimen followed by 3 months of treatment with nonnucleoside reverse transcriptase inhibitor (NNRTI)-containing therapy. Parameters of inflammation, endothelial function and coagulation were examined. The results were compared with those for an age- and gender-matched, nonsmoking, healthy control group. RESULTS: Compared with controls, treatment-naïve HIV-infected patients exhibited endothelial dysfunction [flow-mediated dilation (FMD) 108 vs. 111% for HIV-infected vs. control groups, respectively; P < 0.05] and activation [von Willebrand factor 2.0 vs. 0.9 U/l; soluble intercellular adhesion molecule (sICAM) 313 vs. 211 ng/L, respectively; P < 0.01]. Inflammation [C-reactive protein (CRP) 24 vs. 8.6 nmol/L; fibrinogen 9.4 vs. 8.6 µmol/L, respectively; P < 0.05] and coagulation/fibrinolysis (D-dimers 0.55 vs. 0.23 µg/mL, respectively; P < 0.01) were increased. Initiating therapy resulted in normalization of FMD and a significant decrease in endothelial activation and CRP. CONCLUSION: Endothelial dysfunction together with increased inflammation and coagulation were more prevalent in untreated HIV-infected patients compared with controls. These cardiovascular risk factors improved with treatment, although not all parameters normalized after 6 months.

[Detection of Chlamydia trachomatis infection among young people. The effect of home-sampling and mailing the samples]. / Påvisning af Chlamydia trachomatis-infektion blandt unge. Effekten af hjemmetagne og postfremsendte prøver.

Genital Chlamydia trachomatis infection is common and treatable, but often asymptomatic. New diagnostic strategies targeting healthy individuals are therefore needed. The 17 high schools in Aarhus County, Denmark, comprising 8909 students, were cluster-randomized into an intervention group which was offered examination by mailing a urine sample (males and females) and a vaginal flush sample (females) directly to the laboratory, and a control group who were offered examination by a physician. Ninety-three percent (867/928) of the sexually experienced female responders underwent examination in the intervention group, compared with 8% (63/833) in the control group (p < 0.001). The corresponding figures for males were 97%, (430/442) and 2% (4/246), respectively (p < 0.001). Also statistically significantly more infected females and males were found in the intervention group (43 females and 11 males in the intervention group vs. five females and one male in the control group). Home sampling improves the diagnosis of C trachomatis infection among apparently healthy young individuals.

[Self-collected and mailed samples for diagnosis of urogenital Chlamydia trachomatis infection in women]. / Selvtagne og postfremsendte prøver til diagnostik af urogenital Chlamydia trachomatis-infektion hos kvinder.

The study compared urine and vaginal flush samples, collected by women at home by endocervical and urine swabs obtained from their general practitioners, for their efficacy in the diagnosis of Chlamydia trachomatis infection. The study was a multipractice study in 33 general practices. A total of 222 women aged 18-25 years, who attended the general practitioner for a gynaecological examination, were included. Diagnostic tests-eight per woman-were performed by the polymerase chain reaction and the ligase chain reaction. A test was considered true positive if two tests or more were positive The prevalence of infection was 11.2% (23/205). Test sensitivity in samples obtained by general practitioners, samples obtained at home subjected to polymerase chain reaction, and samples obtained at home subjected to ligase chain reaction were 91%, 96%, and 100% respectively. The corresponding specificities were 100%, 92.9% and 99.5%. It is concluded that the diagnostic efficacy of samples obtained at home is as good as tests obtained by the general practitioner.

[Digital strangulation--released by the use of a dentist's drill]. / Strangulatio digiti--afhjulpet af tandloegens diamantbor.

A six year-old girl got her third right finger stuck into a padlock-fitting made of hardened steel. It was impossible to loosen the finger using the conventional methods of oil, soap, cooling, compression or wind-unwind technique. The fitting was split using a dentist's high speed drill and then easily removed leaving the finger uninjured.

[Chlamydia pneumoniae]. / Chlamydia pneumoniae.

Chlamydia are obligate intracellular bacteria with a biphasic life cycle. In 1986 a new species of Chlamydiae, Chlamydia psittaci TWAR was discovered, later named Chlamydia pneumoniae. C. pneumoniae is probably an important pathogen causing respiratory tract infections in man, ranging from subclinical infection to life threatening pneumonia. Infections can occur in epidemics. Furthermore, associations between C. pneumoniae infection and coronary artery disease, lethal myocarditis and sarcoidosis have been suggested. The current diagnostic method is based on detection of specific antibodies against C. pneumoniae in blood. Macrolides or tetracyclines are the drugs of choice for treatment of C. pneumoniae infection.

[The polymerase chain reaction used in microbiologic diagnosis]. / Polymerasekaedereaktionen, anvendt i mikrobiologisk diagnostik.

Among the new DNA technological methods for microbiological diagnosis, the most promising seems to be the polymerase chain reaction (PCR). The sensitivity of the method is approximately 100% and the specificity is between 90% and 100%, depending on the availability of an already existing test sufficient for comparison. The PCR is able to detect only one microorganism in clinical samples. Because of this high sensitivity, contamination of samples is one of the major problems. After certain preparation procedures, the method can be used on different kinds of human sample material. The PCR could be used for detection of a microorganism, for detection of a single gene (toxin gene) or for typing of microorganisms. It is expected that, in the immediate future PCR will be a prominent part of the methods used in microbiological diagnosis.