Detection of Airborne Sporangia of Pseudoperonospora cubensis and P. humuli in Michigan Using Burkard Spore Traps Coupled to Quantitative PCR.

Cucurbit downy mildew (CDM), caused by the oomycete pathogen Pseudoperonospora cubensis, is a devastating foliar disease on cucumber resulting in reduced yields. In 2004, the pathogen re-emerged in the United States, infecting historically resistant cucumber cultivars and requiring the adoption of an intensive fungicide program. The pathogen cannot overwinter in Michigan fields but because of an influx of airborne sporangia CDM occurs annually. In Michigan, spore traps are used to monitor the presence of airborne P. cubensis sporangia in cucumber growing regions to guide the initiation of a fungicide program. However, Pseudoperonospora humuli sporangia, the causal agent of downy mildew on hop, are morphologically indistinguishable from P. cubensis sporangia. This morphological similarity reduces the ability to accurately detect P. cubensis from spore trap samples when examined with the aid of light microscopy. To improve P. cubensis detection, we adapted a qPCR-based assay to allow the differentiation between P. cubensis and P. humuli on Burkard spore trap samples collected in the field. Specifically, we evaluated the specificity and sensitivity of P. cubensis detection on Burkard spore trap tapes using a morphological-based and quantitative-PCR (qPCR)-based identification assay and determined whether sporangia of P. cubensis and P. humuli on Burkard samples could be distinguished using qPCR. We found that the qPCR assay was able to detect a single sporangium of each species on spore trap samples collected in the field with Cq values <35.5. The qPCR assay also allowed the detection of P. cubensis and P. humuli in samples containing sporangia from both species. However, the number of sporangia quantified using light microscopy explained only 54 and 10% of the variation in the Cq values of P. cubensis and P. humuli, respectively, suggesting a limited capacity of the qPCR assay for the absolute quantification of sporangia in field samples. After 2 years of monitoring using Burkard spore traps coupled with the qPCR in cucumber fields, P. humuli sporangia were detected more frequently than P. cubensis early in the growing season (May and June). P. cubensis sporangia were detected ∼5 to 10 days before CDM symptoms were first observed in cucumber fields during both years. This research describes an improved sporangial detection system that is key for the monitoring and management of P. cubensis in Michigan.

[TRADITIONAL CHINESE MEDICINE IN TREATMENT OF ATOPIC DERMATITIS].

BACKGROUND: Atopic dermatitis is a common chronic inflammatory skin disease, affecting up to 15-30% of children in industrialized countries. As there is no definitive cure for atopic dermatitis, patients often seek other complementary therapeutic options, such as traditional Chinese medicine (TCM). TCM comprises numerous treatment modalities for the management of atopic dermatitis including acupuncture and herbal medicine. We report a case of a two and a half year old child with atopic dermatitis exacerbation treated successfully with TCM. During the treatment, we observed gradual decreases in symptoms with complete disappearance of dermatological complaints following 4 months of treatment. CONCLUSIONS: There is considerable evidence suggesting a benefit in the use of TCM for the treatment of atopic dermatitis. As the current state of evidence of TCM treatment for atopic dermatitis remains unknown, further studies should be conducted before definite guidelines can be published. DISCUSSION: The use of TCM has become increasingly popular among children with atopic dermatitis, as clinical evidence report efficacy in improving quality of life and symptoms severity, along with reduction of topical corticosteroid use. Yet, this data is inconclusive, as studies are not randomized double blind controlled.

The effectiveness of combined Chinese herbal medicine and acupuncture in the treatment of atopic dermatitis.

BACKGROUND: Patients with atopic dermatitis increasingly use complementary medicine. OBJECTIVE: The objective of this study was to assess the effectiveness of the combination of Chinese herbal medicine and acupuncture for the treatment of atopic dermatitis. METHODS: Twenty (20) patients between the ages of 13 and 48 who had mild-to-severe atopic dermatitis were given a combined treatment of acupuncture and Chinese herbal medicine and were followed prospectively. The patients received acupuncture treatment twice a week and the Chinese herbal formula 3 times daily for a total of 12 weeks. Assessments were performed before treatment, and at weeks 3, 6, 9, and 12 of treatment. The primary outcomes were defined as the changes in the Eczema Area and Severity Index (EASI), Dermatology Life Quality Index (DLQI), and patient assessment of itch measured on a visual analogue scale (VAS). RESULTS: After 12 weeks of treatment, an improvement in EASI was noted in 100% of patients, when compared with the baseline. The mean EASI fell from 4.99 to 1.81; the median percentage of decrease was 63.5%. Moreover, 78.8% of patients experienced a reduction in DLQI and VAS, as compared with the baseline. The mean DLQI decreased from 12.5 to 7.6 at the end of treatment, with 39.1% improvement. Mean VAS decreased from 6.8 to 3.7, with 44.7% improvement. No adverse effects were observed. CONCLUSIONS: The results of this study suggest that the combination of acupuncture and Chinese herbal medicine have a beneficial effect on patients with atopic dermatitis and may offer better results than Chinese herbal medicine alone.

Traumatismos encefalocraneano infantil y sus características clínicas / Child encephalocranial injuries and its clinical characteristics

Una revisión muy acusiosa acerca del traumatismo encefalocraneano infantil TEC, desde el punto de vista del neurólogo infantil, que además se desempeña en un servicio de urgencia pediátrico