Isolation, identification and associated risk factors of non-tuberculous mycobacteria infection in humans and dromedary camels in Samburu County, Kenya.

Non-tuberculous mycobacteria are of public health significance, and zoonotic infection is attributed to the sociocultural practice of consumption of raw milk and the close human-livestock contact in pastoral communities. This study aimed at isolation, identification of mycobacteria from human sputum and camel milk and risk factors assessment in Samburu East, Kenya. Six hundred and twelve camels and 48 people presumed to have tuberculosis (TB) from 86 households in Wamba and Waso regions were screened. Camels were categorized into Somali, Turkana and Rendile breeds. Single intradermal comparative tuberculin test (SICTT) was used as a herd-screening test on lactating camels and a milk sample collected from reactive camels. Sputum samples were collected from eligible members of participating households. A standard questionnaire on possible risk factors for both humans and camels was administered to respective household heads or their representatives. Total camel skin test reactors were 238/612 (38.9%). Milk and sputum samples were analysed at KEMRI/TB research laboratory for microscopy, GeneXpert® , culture and identification. Isolates were identified using 16S rRNA gene sequencing at Inqaba biotec in South Africa. Sixty-four isolates were acid-fast bacilli (AFB) positive of which M. fortuitum (3), M. szulgai (20), M. monacense (5), M. lehmanni (4), M. litorale (4), M. elephantis (3), M. duvalii (3), M. brasiliensis (1), M. arcueilense (1) and M. lentiflavum (1) were from milk; M. fortuitum (1), M. szulgai (2) and M. litorale (1) were from humans. Risk factors included the following: Turkana breed (OR = 3.4; 95% CI: 1.2-9.3), replacements from outside the County (OR = 2.1; 95% CI: 0.3-12.3), presence of other domestic species (small stock; OR = 4.6) and replacement from within the herd (OR = 3.2; 95% CI: 0.7-14.7). Zoonotic risk practices included raw milk consumption, shared housing and handling camels. Monitoring of zoonotic NTM through surveillance and notification systems is required.

Limited benefits of the direct anterior approach in primary hip arthroplasty: A prospective single centre cohort study.

BACKGROUND: Since years a discussion is held on the best approach to perform total hip replacement (THR). Risk of dislocation, abductor weakness and a possible difference in rehabilitation are mentioned. We performed this study to objectify that the use of the direct anterior approach (DAA) results in a faster rehabilitation after THR compared to the non-DAA (posterolateral and anterolateral) approach. METHODS: A single centre prospective cohort study was conducted. Pre- and 16-weeks postoperative completed PROMs like the VAS, PSC, GPE and HOOS were analyzed. A leg press and power test were performed. Functional capacity was determined by the TUG and the 6MWT. RESULTS: A total of 119 patients were included for analysis: 87 in the DAA group, 32 in the non-DAA group. There were no differences in general baseline characteristics. The length of stay was significant (p = .000) shorter in the DAA group. At 16 weeks, the DAA group showed a significant greater improvement with respect to the VAS and HOOS. Also significant differences for all strength, power and functional capacity parameters between the pre- and postoperative measurements were found. A subgroup analysis at 6-weeks postoperative showed significant improvements in the TUG (p = .009) and 6MWT (p = .009) in the DAA group, but not in the non-DAA group. CONCLUSION: PROMs, strength, power and functional capacity tests show significant improvement in all approaches after THR. There seems to be a small advantage in favour of the DAA, in particular directly postoperative and the first postoperative weeks.

Oral health of patients under short hospitalization period: observational study.

OBJECTIVE: To assess the impact of hospitalization on the oral health status of individuals hospitalized for a short period of time. MATERIAL AND METHODS: This was an observational study of hospitalized patients. The plaque index (PI), gingival index (GI) was measured at baseline (T0 - first 24 h of hospital admission), and at 3 (T1), 7 (T2), 14 (T3) days. RESULTS: One hundred and sixty-two patients were examined at baseline (T0), 35 examined at 3 days (T1), 23 at 7 days (T2) and 16 at 14 days (T3). The main reason for loss of patients was hospital discharge. The mean PI increased at T1 (0.97-1.21; p < 0.001), at T2 (1.06-1.30; p < 0.007) and at T3 (1.19-1.44; p < 0.03). Gingival index (GI) increased at T2 (0.74-0.96; p < 0.04) and at T3 (0.74-0.96; p < 0.02). CONCLUSION: Oral health, assessed through PI and GI, deteriorates after a short period of hospitalization.

Functional improvement after unicompartmental knee replacement: a follow-up study with a performance based knee test.

In literature no reports appear on functional recovery of unicompartmental knee replacement using both subjective and objective methods. Functional aspects are especially of importance, since prosthetic replacement is considered more often in younger patients, who require an optimal knee function for activities such as sports. In a prospective study on 38 patients with a mean age of 62.2 years functional improvement was measured. Using Knee Society Score (KSS) as a clinician based score and the Dynaport Knee Test as a functional test measurements were performed at preoperative, 3 and 6 months, 1 and 2 years, after surgery. The Dynaport Knee Test is an accelerometer-based system that objectively measures functional aspects of gait during various tasks of daily life. It consists of four sub scores. The KSS assesses pain and function. Both scores range from 0 to 100. The mean KSS preoperative was 44.0 and improved significantly to 81.7 at 3 months (P<0.001) and to 87.4 (P=0.025) at 6 months. No significant differences were noted after 6 months. The mean preoperative Dynaport Knee Test score was 35.8 and at 3 months 43.6 (P<0.001), 48.6 at 6 months (P<0.001). No significant differences were noted after 6 months follow-up. Of the Dynaport sub scores, the low demanding tasks Lift and Move and Locomotion, cease to improve beyond 6 months. The high demanding task Transfers only improved up to 3 months. However, the other high demanding tasks Rise and Descend showed improvement beyond 1 year after surgery, since the improvement from 6 months to 2 years was significant (P=0.023). This study has found that functional recovery continues beyond 6 months and even up to 2 years. It seems only more challenging tests can discriminate on improvement beyond a point where questionnaires cease to improve. The use of objective measurement methods is advocated next to the clinician based scores and self reported questionnaires.

Effect of neuropeptide Y microinjected into the hypothalamus on ethanol consumption.

Guide cannula were implanted in rats aimed at the paraventricular nucleus (PVN) of the hypothalamus for microinjection of neuropeptide Y (NPY), D-NPY27-36, or vehicle. In the Wistar rat, there was no significant effect on the consumption of ethanol. In Myers' high ethanol preferring (mHEP) rats, D-NPY27-36 caused a significant 54% decrease in ethanol consumption from baseline, but the response was not different from vehicle. NPY-induced feeding in satiated Wistar rats, was blocked by a Y1 receptor antagonist, D-NPY27-3). D-NPY27-36 decreased 78% feeding in food-deprived rats. Thus, neither the Wistar nor the mHEP rat perceives ethanol as a source of calories comparable to food.

Differences in brain area concentrations of dopamine and serotonin in Myers' High Ethanol Preferring (mHEP) and outbred rats.

Both male and female mHEP rats consume excessive amounts of ethanol and thus offer a rational model for examining biochemical and behavioral differences with non-drinking rat lines. Differences in basal concentrations of 5-hydroxytryptamine (5-HT) and dopamine (DA) correlate with the consumption of ethanol in some ethanol-preferring rat lines. The concentrations of 5-HT and DA were examined by HPLC in five brain areas (prefrontal cortex, hippocampus, nucleus accumbens, striatum and hypothalamus) of ethanol-näive rats and after the oral administration of 0.25 or 1.0 g ethanol/kg in the male and female mHEP rat, the male Wistar rat, and the female Sprague-Dawley rat. The mHEP and control rats that received ethanol were screened for drinking in a 10-day "step-up" 3% to 30% ethanol solutions beginning at postnatal days 40 and 80, and then tested at 150 days of age. The levels of DOPAC in females were lower in the hippocampus of both naïve mHEP and ethanol-treated Sprague-Dawley rats. In striatum, the concentrations of 5-HT and DA were elevated in both mHEP and ethanol-treated Sprague-Dawley female rats. The concentrations of 5-HT and its metabolite, 5-HIAA, were lower in the nucleus accumbens of the ethanol-näive female mHEP rat relative to the female outbred control. In the male rats, the levels of DA, HVA and DOPAC, as well as 5-HT and 5-HIAA were reduced in the hypothalamus of both ethanol-näive mHEP rats and Wistar rats receiving ethanol by gavage. These data demonstrate differences in neurotransmitter activity between the selectively bred mHEP rat and the outbred rat strains. There are few common features found in both the male and the female mHEP rat when compared to their respective controls. Differences in neurotransmitter function in these brain areas may account for some of the behavioral differences previously demonstrated between the two sexes of the mHEP rat.

Circadian variation in concentrations of testosterone in the plasma of male mice: a difference between BALB/cBy and C57BL/6By inbred strains.

Diurnal variations in testosterone in plasma were studied in two inbred strains of mice, BALB/cBy and C57BL/6By. Blood was taken every 4 h over 24 h from male mice at 70 days of age using a lighting regimen of 12 h light t 12 h darkness (lights on 07.00-19.00 h). Values of testosterone in plasma were transformed to log(testosterone in ng/ml) to reduce inequality of variance between groups. In both strains, the distribution of pooled values over all times of day was bimodal, and bimodality was present at most times of day. Circadian variation was evaluated by dividing the transformed values into high and low modes at each time of day and testing for significant variation in the number of animals in each mode over time using the chi-squared test. Significant circadian variation was found in the BALB/cBy strain of mice but not in the C57BL/6By strain. The highest number of high mode cases for BALB/cBy mice was at 22.00 h and the lowest number of high mode cases was at 10.00 h. The log transformation and bimodality of these values are presented as biological expressions of blood levels of testosterone and of tissue responses to these levels in the male mouse. The strain difference in circadian variation may be related to reported circadian changes in behaviour and to possible genetic effects on sensitivity to environmental change or capacity to express circadian rhythms.