Meningococcal pericarditis caused by the MenW:cc11 strain in an older adult.

INTRODUCTION: Invasive meningococcal disease (IMD) caused by Neisseria meningitidis is a disease with a high mortality and morbidity rate. Serogroup W meningococci (MenW) used to be associated with sporadic disease worldwide. In recent years, a surge in MenW incidence is being observed. REPORT: An older adult presenting with acute onset shortness of breath, chest pain and fever, was diagnosed with pericarditis with meningococcemia due to MenW:ST11 strain. MenW infections are reported to have a higher case fatality rate and atypical clinical presentations: MenW has been identified in patients presenting with pneumonia, gastro-intestinal symptoms, arthritis, and pericarditis. DISCUSSION: In Belgium, the National Reference Laboratory is also noticing an increase in serogroup Wmeningococcal disease. Recent epidemiological data for Belgium is reported in the article. MenW infections are reported to have a higher case fatality rate and atypical clinical presentations: MenW has been identified in patients presenting with pneumonia, gastro-intestinal symptoms, arthritis, and pericarditis. CONCLUSION: When factors for poor prognosis are present in patients with pericarditi clinicians should be vigilant and search for the underlying aetiology .

Improving the detection limit of conformational analysis by utilizing a dual polarization Vernier cascade.

The dual polarization microring technique enables the simultaneous and accurate detection of thickness and refractive index of a bound molecular layer. By using three microring resonators in a double Vernier cascade configuration, the dual polarization technique is improved on three distinct levels: an increase of the sensitivity, a suppression of common noise due to self-referencing and the ability to migrate from a standard tunable laser to a cheap broadband LED and an on-chip arrayed waveguide grating as read-out system, allowing for a system which is orders of magnitude faster and cheaper. A dual polarization Vernier cascade proof-of-concept is fabricated and characterized, a read-out computational framework is constructed and it is shown on a theoretical basis that the limit of detection is improved.

Effectiveness and tolerability of second-line therapy with vildagliptin versus other oral agents in type 2 diabetes (EDGE): post-hoc subanalysis of the Belgian data.

AIM: To assess the efficacy and safety of vildagliptin versus other oral glucose-lowering drugs added to antidiabetic monotherapy in Belgian patients with type 2 diabetes mellitus, in comparison to the global EDGE study results. METHODS: This is a pre-specified post-hoc subanalysis of the Belgian patient cohort from a worldwide 1-year observational study that compared the effectiveness and tolerability of vildagliptin to other oral antidiabetic agents in type 2 diabetes patients failing monotherapy with oral glucose-lowering agents (EDGE). A total of 1793 Belgian patients were enrolled. Physicians could add any oral antidiabetic drug and patients entered either into the vildagliptin or the comparator cohort. The primary effectiveness and tolerability endpoint was defined as the proportion of patients having a treatment response (HbA1c reduction from baseline to month 12 endpoint >0·3%) without hypoglycemia, weight gain, peripheral oedema, or gastrointestinal side-effects. RESULTS: In the Belgian population, 37·8% of patients in the vildagliptin group and 32·8% in the comparator group had a decrease in HbA1c of >0·3% without the predefined tolerability issues of hypoglycemia, weight gain, oedema or, gastrointestinal complaints (primary endpoint), resulting in an unadjusted odds ratio of 1·24 (95% CI: 0·96-1·61). Mean HbA1c change from baseline was -0·81% in the vildagliptin cohort and -0·75% in the comparator cohort. Overall, vildagliptin was well tolerated with similarly low incidences of total adverse events (14·9% versus 14·5% in the compactor group) and serious adverse events (2·7% versus 2·5% in the comparator group). CONCLUSION: In this EDGE subgroup of Belgian patients with type 2 diabetes who do not achieve the glycemic targets with monotherapy, a similar trend as in the global EDGE study was observed. Adding vildagliptin as a second oral glucose-lowering agent resulted in lowering HbA1c to <7% without weight gain, hypoglycemia or peripheral oedema in a higher proportion of patients than comparator oral antidiabetic drugs, with no differences in the reported number of adverse events.

Conformational analysis of proteins with a dual polarisation silicon microring.

Optical microresonator biosensors have proven to be a valid tool to perform affinity analysis of a biological binding event. However, when these microresonators are excited with a single optical mode they can not distinguish between a thin dense layer of biomolecules or a thick sparse layer. This means the sensor is "blind" to changes in shape of bound biomolecules. We succeeded in exciting a Silicon-on-Insulator (SOI) microring with TE and TM polarisations simultaneously by using an asymmetrical directional coupler and as such were able to separately determine the thickness and the density (or refractive index) of a bound biolayer. A proof-of-concept is given by determining both parameters of deposited dielectric layers and by analysing the conformational changes of Bovine Serum Albumin (BSA) proteins due to a change in pH of the buffer.

Residual effect of zolpidem 10 mg and zopiclone 7.5 mg versus flunitrazepam 1 mg and placebo on driving performance and ocular saccades.

RATIONALE: Studies report contradictory results concerning the residual effects of zolpidem and zopiclone. Moreover, residual effects of these compounds on healthy subjects have not yet been simultaneously assessed. OBJECTIVE: The present study with healthy subjects investigated the residual effects of zolpidem 10 mg and zopiclone 7.5 mg on driving performance and on ocular saccade and compared them to those under flunitrazepam 1 mg and placebo. METHODS: The study involved 16 subjects divided into two groups, a 9:00 a.m. group and a 11:00 a.m. group, in a balanced, double-blind, cross-over design. RESULTS: In the 9:00 a.m. group, zolpidem had no residual effects while zopiclone and flunitrazepam both impaired driving performance (P < 0.001 for both) and increased saccadic latency (P < 0.005; P = 0.052, respectively). Zopiclone impaired driving performance 5 times less than did flunitrazepam. In the 11:00 a.m. group, zolpidem and zopiclone had no residual effects, while flunitrazepam increased saccadic latency (P = 0.065) but did not impair driving performance. CONCLUSIONS: Zopiclone and flunitrazepam had residual effects in the first part of the morning, whereas zolpidem had no residual effects. The hierarchical character of the effects of the molecules differed according to the test administered. This is probably linked more to drug-induced specific alterations than to different sensitivities of the tests.

Charged-particle activation analysis of biological material.

Charged-particle activation analysis offers a number of interesting possibilities for the determination of trace elements in biological material. It allows the determination of those elements that are difficult or impossible to determine by neutron activation, such as Li, B, Al, Si, V, Cr, Ni, Cd, Sn, Tl, and Pb. Up to now, protons have been successfully applied to samples of both vegetal and human origin. A number of difficulties have to be overcome, one of which is excessive heating of the samples owing to the limited range of the charged particles, thus giving rise to a high energy deposition in a small volume. Moreover, the sample composition has to be known to allow the calculation of the range of the particles. An interesting alternative has been proposed using an internal standard together with a standard additions procedure. Proton activation analysis was tested on a wide variety of reference materials, giving evidence that accurate results can be obtained for many trace elements, even when applying a purely instrumental method. Thus, the method can also be applied in the certification of reference materials, since nuclear methods are independent of chemical properties of the sample.

Biological markers of alcohol intake among 4796 subjects injured in accidents.

An epidemiological survey was carried out in France in 1982-3 to study the proportions of occasional and chronic drinkers among people injured in accidents of all kinds. The characteristics of 4796 victims recruited in the emergency units of 21 hospitals were recorded. Systematic blood sampling was performed to determine the blood alcohol concentration and two markers of chronic alcohol consumption--gamma-glutamyltransferase activity and mean corpuscular volume. Alcohol was present in the blood of 35% of the injured people, with concentrations exceeding 17.4 mmol/l (0.8 g/l) in one man out of four and in one woman out of 10. gamma-Glutamyltransferase values and mean corpuscular volume were also much higher than in a reference population of healthy subjects, indicating that most of the intoxicated subjects were probably chronic drinkers. This was confirmed by a discriminant analysis which showed an overall proportion of 30% of chronic drinkers among casualties. In France, therefore, the policy for preventing accidents should focus on chronic as much as on occasional drinking.

Sample contamination as a source of error in trace-element analysis of biological samples.

Trace-element levels estimated by different investigators are often disparate. It is becoming increasingly evident that sample contamination may explain some of the discrepancies. A method has been developed for the direct estimation of potential errors. This shows that extraneous additions occurring during sample collection and preparation may give rise to grossly misleading results on subsequent analysis.

Potential interferences inherent in neutron-activation analysis of trace elements in biological materials.

A comprehensive review is given of how neutron-activation analysis for trace elements in biological matrices can be jeopardized by radiation damage, by the impurities present in the packing material or by nuclear interferences of major elements. Systematic errors during the counting process and the quantitative interpretation of the gamma-ray spectra should not be disregarded.

Serum molybdenum in diseases of the liver and biliary system.

We determined the serum molybdenum concentration by neutron activation analysis in apparently healthy subjects and in patients with diseases of the liver and biliary system. The level was found to be markedly elevated in the initial phase of acute viral hepatitis (mean +/- S.D. 3.10 +/- 1.46 ng/ml vs. 0.55 +/- 0.21 in controls) and to return to normal during convalescence, in parallel with the liver function tests. The most significant correlations were found between the serum molybdenum concentration and the serum levels of GOT ( r = 0.710, p less than 0.001) and GPT (r = 0.683, p less than 0.001). Besides, the serum molybdenum level (mean +/- S.D.) was observed to be definitely increased in patients with HBsAg-positive chronic active hepatitis (0.97 +/- 0.49 ng/ml), HBsAg-positive liver cirrhosis (1.01 +/- 0.50), alcoholic liver disease (1.32 +/- 0.56), liver metastases (1.40 +/-0.39), gallstones (1.28 +/- 0.38), tumors of the gallbladder or extrahepatic bile ducts (1.64 +/- 0.44), and carcinoma of the head of the pancreas (1.61 +/- 0.91). Finally, the serum molybdenum level was found to be raised in two patients with primary biliary cirrhosis and in two out of four patients with drug-induced liver injury. The etiologic mechanism and the clinical importance of the observed abnormality remain to be established. Our study enlarges the existing information concerning the disorders of trace element metabolism in liver diseases.

Determination of molybdenum in human serum by neutron activation analysis.

Several investigators have reported serum molybdenum determinations in healthy humans. However, their results diverge quite widely. We determined the element by neutron activation analysis in 30 individuals. We found a mean value of 0.58 ng/ml, a standard deviation of 0.21 ng/ml and a range of 0.28--1.17 ng/ml.

Determination of chromium and cobalt in human serum by neutron activation analysis.

Confusion exists about the chromium and cobalt concentrations in the serum of healthy individuals. We determined these elements by neutron activation analysis. The samples were irradiated during 12 days at a flux of approximately 10(14) neutrons.cm-2.s-1. Chromium was selectively separated by distillation after the irradiation. We obtained the following values (mean +/- standard deviation): 0.160 +/- 0.083 mug/liter for chromium, and 0.108 +/- 0.060 mug/liter for cobalt.

Simultaneous determination of iron, zinc, selenium, rubidium, and cesium in serum and packed blood cells by neutron activation analysis.

We determined the iron, zinc, selenium, rubidium, and cesium concentrations in serum and packed blood cells by instrumental neutron activation analysis without chemical separations. Lyophilized samples were irradiated for 12 days at a flux of 10(13) neutrons-cm-2-s-1, mineralized by wet digestion, and measured two times with a high-resolution Ge(Li) detector--for 6 h about a month after the irradiation and for 15 h two or three months after the irradiation, The following values were obtained: 163 +/- 0.43 mg/liter (serum iron), 1025 +/- 136 mg/kg wet wt (packed cells iron), 1¿ +/- 0.20 mg/liter (serum zinc), 11.15 +/- 1.83 mg/kg wet wt (packed cells zinc), 0.13 +/- 0.02 mg/liter (serum selenium), 0.16 +/- 0.03 mg/kg wet wt (packed cells selenium), 0.17 +/- 0.04 mg/liter (serum rubidium), 4.28 +/- 0.98 mg/kg wet wt (packed cells rubidium), 0.74 +/- 0.20 microgram/liter (serum cesium), and 4.82 +/- 2.10 microgram/kg wet wt (packed cells cesium).