TB treatment using family members, treatment supporters and self-administered therapies in rural Papua New Guinea.

SETTING: Papua New Guinea (PNG) has one of the world's highest TB incidence rates. It is difficult for patients to access TB care in remote provinces due to insufficient infrastructure and challenging terrain, making varied, targeted delivery models for treating TB necessary. OBJECTIVE: To assess treatment outcomes using self-administered treatment (SAT), family-supported treatment and community-based directly observed therapy (DOT) via treatment supporter (TS) in the PNG context. DESIGN: A retrospective, descriptive analysis of routinely collected data from 360 patients at two sites in 2019-2020. All patients were assigned a treatment model based on risk factors (adherence or default) and offered patient education and counselling (PEC), family counselling and transportation fees. End-of-treatment outcomes were assessed for each model. RESULTS: Treatment success rates among drug-susceptible TB (DS-TB) were good overall: 91.1% for SAT, 81.4% for family-supported treatment and 77% for DOT patients. SAT was strongly associated with favourable outcomes (OR 5.7, 95% CI 1.7-19.3), as were PEC sessions (OR 4.3, 95% CI 2.5-7.2). CONCLUSION: By considering risk factors when determining their treatment delivery model, strong outcomes were seen in all three groups. Multiple modes of treatment administration, tailored to individuals' needs and risk factors, is a feasible, effective, patient-centred care model for hard-to-reach, resource-limited settings.

LIEU: La Papouasie-Nouvelle-Guinée (PNG) présente l'un des taux d'incidence de TB les plus élevés au monde. Il est difficile pour les patients d'accéder aux soins contre la TB dans les provinces éloignées en raison d'une infrastructure insuffisante et d'un terrain difficile, rendant nécessaire l'utilisation de modèles de prestation variés et ciblés pour le traitement de la tuberculose. OBJECTIF: Évaluer les résultats du traitement en utilisant l'autotraitement, le traitement soutenu par la famille et la thérapie directement observée (DOT) basée sur la communauté avec un accompagnateur de traitement, dans le contexte de la PNG. MÉTHODES: Une analyse rétrospective et descriptive des données collectées de manière routinière auprès de 360 patients dans deux sites entre 2019 et 2020. Tous les patients ont été assignés à un modèle de traitement en fonction des facteurs de risque (adhésion ou abandon) et ont bénéficié d'une éducation et d'un accompagnement des patients, de conseils aux familles et de frais de transport. Les résultats en fin de traitement ont été évalués pour chaque modèle. RÉSULTATS: Les taux de réussite du traitement de la TB sensible aux médicaments (DS-TB) étaient globalement bons: 91,1% pour l'autotraitement, 81,4% pour le traitement soutenu par la famille et 77% pour les patients en DOT. L'autotraitement était fortement associé à des résultats favorables (OR 5,7; IC 95% 1,7­19,3), tout comme les séances d'éducation et d'accompagnement des patients (OR 4,3; IC 95% 2,5­7,2). CONCLUSION: En tenant compte des facteurs de risque lors de la détermination du modèle de prestation de traitement, de bons résultats ont été observés dans les trois groupes. Plusieurs modes d'administration du traitement, adaptés aux besoins et aux facteurs de risque individuels, constituent un modèle de soins réalisable, efficace et centré sur le patient pour les contextes difficiles d'accès et aux ressources limitées.

Adverse events using shorter MDR-TB regimens: outcomes from Port Moresby, Papua New Guinea.

Evidence increasingly indicates that standardised, shorter regimens (SR) for multidrug-resistant TB (MDR-TB) is effective in treating this global disease, but there is little published data on associated adverse events. We report outcomes from a cohort treated with the SR in Port Moresby, Papua New Guinea (PNG). Among 26 patients treated with a TB SR from September 2017 to September 2018, 10 (39%) were successful treatments, 12 (46%) were failures, 2 died, and 2 were lost to follow-up. Of those whose treatment failed, most (n = 10) changed their regimen due to adverse events, including seven from ototoxicity, suggesting this SR may not be suited to all patients in PNG and similar settings.

Les preuves disponibles montrent de plus en plus que des protocoles standardisés, plus courts (SR) de la TB multirésistante (MDR-TB) traitent efficacement cette maladie mondiale, mais il y a peu de données publiées sur les effets secondaires. Nous rapportons les résultats d'une cohorte traitée par SR à Port Moresby, Papouasie Nouvelle-Guinée (PNG). Parmi 26 patients traités par SR de TB de septembre 2017 à septembre 2018 : 10 (39%) ont été traités avec succès, 12 (46%) ont échoué, 2 sont décédés et 2 ont été perdus de vue. Parmi les échecs, la majorité (n = 10) a changé de protocole en raison d'effets secondaires, notamment sept patients pour ototoxicité, suggérant que ce protocole standardisé n'était pas forcément adapté à tous les patients en PNG et dans des contextes similaires.

The HIV-1 Pr55 gag polyprotein binds to plastidial membranes and leads to severe impairment of chloroplast biogenesis and seedling lethality in transplastomic tobacco plants.

Chloroplast genetic engineering has long been recognised as a powerful technology to produce recombinant proteins. To date, however, little attention has been given to the causes of pleiotropic effects reported, in some cases, as consequence of the expression of foreign proteins in transgenic plastids. In this study, we investigated the phenotypic alterations observed in transplastomic tobacco plants accumulating the Pr55(gag) polyprotein of human immunodeficiency virus (HIV-1). The expression of Pr55(gag) at high levels in the tobacco plastome leads to a lethal phenotype of seedlings grown in soil, severe impairment of plastid development and photosynthetic activity, with chloroplasts largely resembling undeveloped proplastids. These alterations are associated to the binding of Pr55(gag) to thylakoids. During particle assembly in HIV-1 infected human cells, the binding of Pr55(gag) to a specific lipid [phosphatidylinositol-(4-5) bisphosphate] in the plasma membrane is mediated by myristoylation at the amino-terminus and the so-called highly basic region (HBR). Surprisingly, the non-myristoylated Pr55(gag) expressed in tobacco plastids was likely able, through the HBR motif, to bind to nonphosphorous glycerogalactolipids or other classes of lipids present in plastidial membranes. Although secondary consequences of disturbed chloroplast biogenesis on expression of nuclear-encoded plastid proteins cannot be ruled out, results of proteomic analyses suggest that their altered accumulation could be due to retrograde control in which chloroplasts relay their status to the nucleus for fine-tuning of gene expression.

Heterotrophic microorganisms in deteriorated medieval wall paintings in southern Italian churches.

The Campania region in southern Italy is noted for its large number of churches that harbour invaluable frescoes, dated from the beginnings of the 4th up to the 13th century. The wall paintings represent an integral part of the monuments, and their deterioration constitutes a potentially significant loss for the world's cultural heritage. Heterotrophic microorganisms such as bacteria and mould can grow on the surface of paintings that contain a wide range of organic and inorganic constituents, and provide different ecological niches that are exploited by a large variety of microbial species. We isolated and identified the heterotrophic microorganisms found in the biodegraded medieval wall paintings of seven historical churches in Campania. The paintings showed different levels of microbial contamination. Microbiological analysis of different paintings gave an overview of the different heterotrophic microorganisms. Bacteria and moulds were isolated from 77% of the sampling points analysed, in which the most common type of alteration was discolouration often associated with detachment of the paint layer. Bacterial strains were identified by 16S rRNA partial sequence analysis. The Bacillus genus was isolated in all churches, even though the type of species was variable, whereas all actinomycetes strains, isolated in five of the seven churches analysed, could be referred to the Streptomyces genus. The similarity of the sequences analysed of the 42 Bacillus spp., 2 Paenibacillus spp. and reference strains of different species showed that these bacteria differentiated in 14 groups. The most frequently occurring taxa were most closely related to Bacillus cereus/thurigiensis/anthracis and Bacillus pumilus groups. Thirteen Streptomyces spp. were differentiated in seven groups on the basis of neighbor-joining analysis of 16S rRNA. Fungi belonging to the genera Penicillium, Aspergillus, Fusarium and Alternaria were also isolated from deteriorated wall paintings.

Co-existence of different host-adapted forms of the Myzus persicae group (Hemiptera: Aphididae) in southern Italy.

Multivariate morphometric analysis (method of canonical variates) was used to compare 38 parthenogenetic lineages and three field collections of aphids of the Myzus persicae (Sulzer) group sampled on peach and tobacco in the Caserta region of southern Italy. Comparisons were also made with the morphology of lineages collected on peach in Lehonia, in central eastern Greece away from tobacco-growing regions, and on tobacco in Naphplion, in southern Greece. The lineages were measured after parthenogenetic rearing for one to three generations on the same host (potato) under constant conditions. As in previous work, the multivariate morphometric approach separated the aphids from peach from those feeding on tobacco. The life cycle category of the lineages was also examined. Almost all the lineages from peach in Caserta were holocyclic, yet the lineages from tobacco in the same region were unable to produce sexual morphs. The results suggest that tobacco-adapted and non-tobacco-adapted forms co-exist in the same region in southern Italy, not only because they colonize different host plants, but also because they have different life cycles. This is in complete contrast to the situation in peach-growing areas of northern Greece, and shows that the ecology and population structure of M. persicae is different in neighbouring counties of the Mediterranean area, even where climatic conditions and cultivated crops are similar.

Behaviour of Listeria monocytogenes during the traditional manufacture of water-buffalo Mozzarella cheese.

The behaviour of a four-strains mixture of Listeria monocytogenes (strains Scott A, V7, OH and Cal) during the traditional manufacture of water-buffalo Mozzarella cheese was investigated at two levels of inoculation: ca 10(5) and 10(3) cfu ml-1 of vat milk. No significant change in Listeria counts was observed during the curd ripening (4.0-4.5 h), at the end of which the pH ranged between 4.83 and 4.91. A decrease of about 2 log was observed after stretching of the curd in hot water (95 degrees C), followed by complete elimination of Listeria after 48 and 24 h of storage of the final cheese in the conditioning liquid (skim water resulting from the stretching, pH ca 4.0) with initial high and low contamination of the cheese milk respectively. Results also indicated that a 1.7 log reduction of L. monocytogenes could be achieved during the preparation of the natural whey culture utilized as starter in cheesemaking.

[Action of emetine hydrochloride in some experimental viral infections]. / Azione del cloridrato di emetina in alcune infezioni sperimentali da virus

The Authors tested the virulicidal effect of emetine hydrochloride (EH) observed by Fusillo in clinical practice. By adding EH to HE p-2 cellular system, in a concentration such as to cause some inhibition of cellular growth, there is no meaningfull virostatic or virulicidal action against poliovirus, Mahoney's strain. EH, in the same proportion as that employed by Fusillo in human therapy, damages in the albino mouse liver. By halving the concentration of EH such a damage is not evident but no beneficial effect on the pattern of the subacute hepatitis, caused by 5 LD50 of MHV3 ensues.