The associations of quality of life and general functioning with trauma, borderline intellectual functioning and mild intellectual disability in outpatients with serious mental illness.

BACKGROUND: Trauma and intellectual disability are highly prevalent in the serious mental ill (SMI). Little is known of their impact on general functioning and quality of life. AIM: This study investigated the association of trauma and intellectual disability (ID) with general functioning and quality of life in SMI. METHODS: Patient characteristics and diagnoses were extracted from electronic patient records. We used the Trauma Screening Questionnaire (TSQ), the Screener for Intelligence and Learning Disabilities (SCIL), the Health of the Nation Outcome Scale (HoNOS) and the Manchester Short Assessment of Quality of Life (MANSA) to asses trauma, intellectual impairment, general functioning and quality of life. Proportions on cut-off scores were analysed with cross-tabulations, questionnaire scores with t-tests. Multivariable associations were determined by logistic regression analysis. RESULTS: 611 patients from an outpatient service were assessed. Trauma and ID were associated with each other (r = -0.207). Trauma was associated with worse general functioning and a lower quality of life. Mild intellectual disability (MID) or borderline intellectual functioning (BIF) were associated with worse general functioning. CONCLUSIONS: For patients with SMI, trauma and ID should be identified early in care to treat the lower general functioning and quality of life it caused.

[The predictive value of mild intellectual disability/ borderline intellectual functioning and ptsd for treatment results in severely mentally Ill patients]. / Voorspellende waarde van lichte verstandelijke beperking en PTSS voor behandelresultaten van patiënten met ernstige psychiatrische aandoeningen.

BACKGROUND: Little is known about the influence of mild intellectual disability/borderline intellectual functioning (mid/biF) or posttraumatic stress disorder (ptsd) on treatment results in severely mentally ill (smi).
AIM: To investigate whether screeners determining mid/biF or ptsd are associated with less favorable treatment outcome in smi.
METHOD: The screener for intelligence and learning disabilities (scil) was used to screen for mid/biF. The trauma screening questionnaire (tsq) was used to detect ptsd. Outcomes of these screeners were associated with repeated measures on the health of the nation outcome scales (HoNOS) in 628 smi at the Mental Care Centre of Oost Brabant.
RESULTS: In 628 patients one or more HoNOS was acquired. In 352 (56%) patients a scil was acquired, in 334 (53%) patients a tsq. The largest improvement was observed in patients not meeting the criteria for mid/biF and/or ptsd. Less improvement was observed in patients with ptsd and a suspected iq between 70-85, estimated with the scil. No significant change on the HoNOS was observed in patients with an estimated iq below 70.
CONCLUSION: Routine screening for mid/biF and ptsd symptoms is important for early recognition of the disorder, resulting in providing better treatment interventions for patients with mid/biF and ptsd.

Schistosome-induced pulmonary B cells inhibit allergic airway inflammation and display a reduced Th2-driving function.

Chronic schistosome infections protect against allergic airway inflammation (AAI) via the induction of IL-10-producing splenic regulatory B (Breg) cells. Previous experiments have demonstrated that schistosome-induced pulmonary B cells can also reduce AAI, but act independently of IL-10. We have now further characterized the phenotype and inhibitory activity of these protective pulmonary B cells. We excluded a role for regulatory T (Treg) cell induction as putative AAI-protective mechanisms. Schistosome-induced B cells showed increased CD86 expression and reduced cytokine expression in response to Toll-like receptor (TLR) ligands compared with control B cells. To investigate the consequences for T cell activation we cultured ovalbumin (OVA)-pulsed, schistosome-induced B cells with OVA-specific transgenic T cells and observed less Th2 cytokine expression and T cell proliferation compared with control conditions. This suppressive effect was preserved even under optimal T cell stimulation by anti-CD3/28. Blocking of the inhibitory cytokines IL-10 or TGF-ß only marginally restored Th2 cytokine induction. These data suggest that schistosome-induced pulmonary B cells are impaired in their capacity to produce cytokines to TLR ligands and to induce Th2 cytokine responses independent of their antigen-presenting function. These findings underline the presence of distinct B cell subsets with different stimulatory or inhibitory properties even if induced by the same type of helminth.

Hip muscle strength is decreased in middle-aged recreational male athletes with midportion Achilles tendinopathy: A cross-sectional study.

OBJECTIVE: Investigating differences in hip muscle strength between athletes with Achilles tendinopathy (AT) and asymptomatic controls. DESIGN: Cross-sectional case-control study. SETTING: Sports medical center. PARTICIPANTS: Twelve recreational male athletes with mid-portion AT and twelve matched asymptomatic controls. OUTCOME MEASURES: Isometric strength of the hip abductors, external rotators, and extensors was measured using a handheld dynamometer. Functional hip muscle performance was evaluated with the single-leg squat. The Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire was completed to determine clinical severity of symptoms. RESULTS: Compared to controls, participants with AT demonstrated 28.9% less isometric hip abduction strength (p = 0.012), 34.2% less hip external rotation strength (p = 0.010), and 28.3% less hip extension strength (p = 0.034) in the injured limb. Similar differences were found for the non-injured limb (26.7-41.8%; p < 0.03). No significant differences were found in functional hip muscle performance between the injured and non-injured limb or between the groups, and no significant correlation was found between hip muscle strength and VISA-A scores. CONCLUSION: Recreational male athletes with chronic mid-portion AT demonstrated bilateral weakness of hip abductors, external rotators, and extensors compared to their asymptomatic counterparts. These findings suggest that hip muscle strength may be important in the assessment and rehabilitation of those with AT.

CD24(hi)CD27(+) B cells from patients with allergic asthma have impaired regulatory activity in response to lipopolysaccharide.

BACKGROUND: Regulatory B cells have been identified that strongly reduce allergic and auto-immune inflammation in experimental models by producing IL-10. Recently, several human regulatory B-cell subsets with an impaired function in auto-immunity have been described, but there is no information on regulatory B cells in allergic asthma. OBJECTIVE: In this study, the frequency and function of IL-10 producing B-cell subsets in allergic asthma were investigated. METHODS: Isolated peripheral blood B cells from 13 patients with allergic asthma and matched healthy controls were analyzed for the expression of different regulatory B-cell markers. Next, the B cells were activated by lipopolysaccharide (LPS), CpG or through the B-cell receptor, followed by co-culture with endogenous memory CD4(+) T cells and house dust mite allergen DerP1. RESULTS: Lower number of IL-10 producing B cells were found in patients in response to LPS, however, this was not the case when B cells were activated through the B-cell receptor or by CpG. Further dissection showed that only the CD24(hi)CD27(+) B-cell subset was reduced in number and IL-10 production to LPS. In response to DerP1, CD4(+) T cells from patients co-cultured with LPS-primed total B cells produced less IL-10 compared to similar cultures from controls. These results are in line with the finding that sorted CD24(hi)CD27(+) B cells are responsible for the induction of IL-10(+) CD4(+) T cells. CONCLUSIONS: Taken together, these data indicate that CD24(hi)CD27(+) B cells from allergic asthma patients produce less IL-10 in response to LPS leading to a weaker IL-10 induction in T cells in response to DerP1, which may play a role in allergic asthma.

Brucellosis in pastoral and confined livestock: prevention and vaccination.

The traditional lifestyle and beliefs of pastoralists and small-scale farmers with confined livestock, together with certain farming environments, create favourable conditions for the spread and transmission of brucellosis. The risks associated with these practices are difficult to control because of a lack of alternatives and simple and/or affordable solutions. Brucellosis affects the health and productivity of livestock as well as that of their owners and caretakers and can have a deep economic impact. The control of brucellosis is likely to be cost effective. Good quantitative information on brucellosis in livestock and the human population is essential for demonstrating the benefits of intervention. Effective vaccines for the control of brucellosis in cattle and small ruminants are available and cheap, and in high-risk areas there is an urgent need to start large-scale vaccination programmes. Risks for the spread and transmission of brucellosis, such as the migration of herds with frequent contacts with other herds at common feeding grounds and near water sources, are inherent in the way of life of pastoralists. Such risks may need to be accepted when developing a control programme. Thus, the control of brucellosis by vaccination is expected to be more effective for confined livestock. Essential to the success of mass vaccination in controlling brucellosis is achieving a high degree of protection of adult livestock in a very short period and vaccinating young stock before natural infection can occur. To reduce the risk of transmission of infection from neighbouring areas where animals are not vaccinated, a region-wide approach is important. Because shepherds and farmers may have very little knowledge of infectious diseases and the consequences of infection, providing disease information and education is important to help them understand the need for control measures. Public health services can also assist in encouraging acceptance of control programmes in livestock by creating awareness of brucellosis as a human disease. To reduce costs, brucellosis control programmes can be combined with other veterinary or public health activities or interventions. An up-to-date livestock census and an effective surveillance system are crucial for the control of brucellosis, as the disease may quickly re-emerge from remaining foci of infection. Although test and slaughter may be an option for the management of remaining or re-emerging foci of infection, such a strategy is frequently not an option because of the cost.

A limited role for regulatory T cells in post-ischemic neovascularization.

Recently, it was demonstrated that arteriogenesis is enhanced in mice deficient in regulatory T cells (CD4(+) CD25(+) FoxP3(+) T cell), which can suppress effector T cell responses. The present study investigates the effects of these regulatory T cells on arteriogenesis in more detail by either specific expanding or depleting regulatory T cells. Hind limb ischemia was induced by electro-coagulation of the femoral artery in mice. Regulatory T cells were either expanded by injecting mice with a complex of interleukin (IL)-2 with the IL-2 monoclonal antibody JES6-1, or depleted by anti-CD25 antibody or diphtheria toxin injections in DEREG mice (depletion of regulatory T cells). Blood flow restoration was monitored using laser Doppler perfusion imaging. Collateral arteries were visualized by immunohistochemistry. Regulatory T cell expansion led to a moderate though significant suppression of blood flow restoration after ischemia induction. Surprisingly, depletion of regulatory T cells resulted in minor increase on blood flow recovery. However, collateral and capillary densities in the post-ischemic skeletal muscle were significantly increased in DEREG mice depleted for regulatory T cells. The presence of regulatory T cells after ischemia induction when analysed in non-depleted DEREG mice could be demonstrated by green fluorescent protein staining only in lymph nodes in the ischemic area, and not in the ischemic muscle tissue. The current study demonstrates that, even under conditions of major changes in regulatory T cell content, the contribution of regulatory T cells to the regulation of the arteriogenic response is only moderate.

Spinal cord stimulation of dorsal columns in a rat model of neuropathic pain: evidence for a segmental spinal mechanism of pain relief.

Although spinal cord stimulation (SCS) of the dorsal columns is an established method for treating chronic neuropathic pain, patients still suffer from a substantial level of pain. From a clinical perspective it is known that the location of the SCS is of pivotal importance, thereby suggesting a segmental spinal mode of action. However, experimental studies suggest that SCS acts also through the modulation of supraspinal mechanisms, which might suggest that the location is unimportant. Here we investigated the effect of the rostrocaudal location of SCS stimulation and the effectiveness of pain relief in a rat model of chronic neuropathic pain. Adult male rats (n=45) were submitted to a partial ligation of the sciatic nerve. The majority of animals developed tactile hypersensitivity in the nerve lesioned paw. All allodynic rats were submitted to SCS (n=33) for 30 minutes (f=50 Hz; pulse width 0.2 ms). In one group (n=16) the electrodes were located at the level where the injured sciatic nerve afferents enter the spinal cord (T13), and in a second group (n=17) the electrodes were positioned at more rostral levels (T11) as verified by X-ray. A repositioning experiment of electrodes from T12 to T13 was performed in 2 animals. Our data demonstrate that SCS of the dorsal columns at the level where the injured fibers enter the spinal cord dorsal horn result in a much better pain-relieving effect than SCS at more rostral levels. From this we conclude that SCS in treatment of neuropathic pain acts through a segmental spinal site of action.

Microbiological quality and antibiotic residues in informally marketed raw cow milk within the coastal savannah zone of Ghana.

OBJECTIVES: To investigate the microbiological quality and the presence of antibiotic residues in raw cow milk and in some indigenous milk products produced and marketed by the informal sector in the coastal savannah zone of Ghana. METHODS: Milk samples were aseptically collected from 224 kraals and samples of 26 indigenous milk products were purchased from processors and retailers. Total plate counts, total coliform counts and the presence of Escherichia coli and E. coli O157:H7 were determined in all 250 samples. Milk samples were also tested for antibiotic residues. RESULTS: Total plate counts exceeded 105 CFU/ml in 45.2% of the samples while coliforms exceeded 10³ CFU/ml in 66.0% and E. coli was detected in 11.2%. E. coli was present in raw cow milk but not in the indigenous products and all E. coli isolates were negative for E. coli O157:H7. Antibiotic residues were detected in 3.1% of the raw cow milk samples. CONCLUSION: Bulk milk contains unacceptable levels of hygiene indicators and antibiotic residues and is a potential source of milk-borne infections. The detection of E. coli and antibiotic residues raises public health concerns about the safety of fresh unpasteurized cow milk in the coastal savannah zone of Ghana and calls for improved farm hygiene, the need for milk pasteurization and the sensible use of antibiotics in the milk industry.

Cholera toxin B suppresses allergic inflammation through induction of secretory IgA.

In healthy individuals, humoral immune responses to allergens consist of serum IgA and IgG4, whereas cellular immune responses are controlled by regulatory T (Treg) cells. In search of new compounds that might prevent the onset of allergies by stimulating this type of immune response, we have focused on the mucosal adjuvant, cholera toxin B (CTB), as it induces the formation of Treg cells and production of IgA. Here, we have found that CTB suppresses the potential of dendritic cells to prime for Th2 responses to inhaled allergen. When we administered CTB to the airways of naïve and allergic mice, it strongly suppressed the salient features of asthma, such as airway eosinophilia, Th2 cytokine synthesis, and bronchial hyperreactivity. This beneficial effect was only transferable to other mice by transfer of B but not of T lymphocytes. CTB caused a transforming growth factor-beta-dependent rise in antigen-specific IgA in the airway luminal secretions, which was necessary for its preventive and curative effect, as all effects of CTB were abrogated in mice lacking the luminal IgA transporting polymeric Ig receptor. Not only do these findings show a novel therapeutic avenue for allergy, they also help to explain the complex relationship between IgA levels and risk of developing allergy in humans.

Spinal anesthesia for a parturient with the triad of Currarino.

The triad of Currarino, also known as Currarino syndrome or complex, is a rare hereditary syndrome involving a bony sacral defect, an anorectal malformation and a presacral mass. Thus far, only 250 cases have been reported, but milder cases may not be recognized, and many cases may not be published. In addition to disorders of the gastrointestinal and urogenital tracts, sensory and motor deficits may be present. Currently, there are no reports of women with the triad of Currarino undergoing cesarean delivery with the use of neuraxial anesthesia. Neuraxial anesthesia in patients with congenital malformations of the spine may be complicated or contraindicated, depending on the level and severity of the anatomic abnormality. We present the case of a pregnant woman at 36 weeks of gestation who underwent uncomplicated neuraxial anesthesia for cesarean delivery. When neuraxial anesthesia is contemplated in such patients, they should first receive careful neurologic and radiologic evaluation.

Selection of probiotic bacteria for prevention of allergic diseases: immunomodulation of neonatal dendritic cells.

Modification of intestinal microbiota early in life by administration of probiotic bacteria may be a potential approach to prevent allergic disease. To select probiotic bacteria for in vivo purposes, we investigated the capacity of probiotic bacteria to interact with neonatal dendritic cells (DC) and studied the ensuing T cell polarizing effect. Immature DC were generated from cord blood-derived monocytes and maturation was induced by maturation factors (MF), lipopolysaccharide (LPS) plus MF and Bifidobacterium bifidum, B. infantis, Lactobacillus salivarius, Lactococcus lactis alone or combined with MF. After 12 days of co-culture with DC and Staphylococcus aureus enterotoxin B (SEB) as antigenic stimulus, cytokine production by autologous T cells was determined by intracellular cytokine staining. Additionally, cells were stimulated with CD3 and CD28 monoclonal antibodies and cytokines were measured in supernatants by multiplex assay. The probiotic strains induced partial maturation of DC. Full maturation of DC was induced for all strains tested when MF was added. The percentage of interleukin (IL)-4 producing T cells was lower in T cell cultures stimulated with B. bifidum matured DC compared to MF and LPS matured DC, which coincided with a higher percentage of interferon (IFN)-gamma-producing T cells. Furthermore, T cells stimulated by B. bifidum matured DC produced significantly more IL-10 compared to MF matured DC. Selected species of the Bifidobacterium genus prime in vitro cultured neonatal DC to polarize T cell responses and may therefore be candidates to use in primary prevention of allergic diseases.

Safety and immunogenicity of subcutaneous or intramuscular administration of a monovalent inactivated vaccine against Leptospira interrogans serogroup Icterohaemorrhagiae in healthy volunteers.

The safety and immunogenicity of a monovalent inactivated vaccine against Leptospira interrogans serogroup Icterohaemorrhagiae was evaluated in 84 volunteers according to the route of administration, i.e., subcutaneous (SC) or intramuscular (IM), in a double-blind randomised trial. The volunteers were randomised into four groups: SC vaccine; IM vaccine; SC placebo; and IM placebo. Primary vaccination comprised two injections on day 0 and day 14, with a booster after 6 months. A second booster was given 30 months after primary vaccination. Local reactions within 1 h of injections were rare, with no difference between vaccine groups. Local reactions within 3 h were more frequent after the second, third and fourth SC injections than after IM injections. Systemic reactions never occurred within 1 h of vaccination and were rare within 3 days; the rates were comparable for the different vaccine groups. Evolution of the antibody responses, as assessed by microscopic agglutination tests and specific IgG and IgM ELISAs, were similar for both injection routes. IgG seroconversion rates after the first booster were 97% (95% CI 80-100%) for the SC vaccine group, and 96% (95% CI 80-100%) for the IM vaccine group, and both reached 100% for IgG after the second booster. The safety and immunogenicity of the anti-leptospiral vaccine were both good. Monitoring of antibody levels established that a booster dose triggered a strong antibody response in fully vaccinated subjects at 30 months after primary vaccination.

Effect of spinal cord stimulation in an animal model of neuropathic pain relates to degree of tactile "allodynia".

Spinal cord stimulation (SCS) is an established treatment for chronic neuropathic pain. However, in recent studies conflicting results regarding the effect of SCS were noted in a selected group of patients suffering from complex regional pain syndrome and mechanical allodynia. In the present study we investigated the pain relieving effect of SCS in a rat experimental model of neuropathic pain as related to the severity of mechanical allodynia. Adult male rats (n=45) were submitted to a unilateral sciatic nerve ligation. The level of allodynia was tested using the withdrawal response to tactile stimuli with the von Frey test. A portion of these rats developed marked tactile hypersensitivity in the nerve-lesioned paw (von Frey test), similar to "tactile allodynia" observed after nerve injury in humans. Prior to SCS treatment the rats were subdivided into three groups based on the level of allodynia: mild, moderate and severe. All allodynic rats were treated with SCS (n=27) for 30 min (f=50 Hz; pulse width 0.2 ms and stimulation at 2/3 of motor threshold) at 16 days post-injury. Our data demonstrate a differential effect of SCS related to the severity of the mechanical allodynia. SCS leads to a faster and better pain relief in mildly allodynic rats as compared with the more severely allodynic rats. Thus, we suggest that the selection and subdivision of patient groups similar to those defined in our experimental setting (mild, moderate and severe allodynic) may provide better pre-treatment prediction of possible therapeutic benefits of SCS.

Leptospirosis: an emerging health problem in Thailand.

Leptospirosis is an emerging health problem in Thailand, with dramatic increases in reported incidence since 1996. The annual number of reported leptospirosis cases increased from 398 cases in 1996 to 14,285 cases in 2000. In 2001, 2002, and 2003, the number of reported cases decreased, but still remained high at 10,217, 6,864, and 4,958 cases, respectively. The epidemiological characteristics of leptospirosis in Thailand include a peak incidence in September and October in association with the rainy season. A vast majority of the cases (90%) were reported in the Northeast region. The case fatality rate was as high as 4.4%, having a predominant association with male farmers aged 15 to 45 years. Outpatient cases were approximately 9 times more common than admitted cases, with an apparent recent shift in the pattern of infecting serovars among reservoir animals and humans.

Rapid serological assays for leptospirosis are of limited value in southern Vietnam.

Leptospirosis, although ubiquitous and potentially lethal, is often not diagnosed. The seroprevalence of anti-Leptospira antibodies and the utility of two rapid tests for the serodiagnosis of the disease were studied in Binh Thuan, an area in southern Vietnam with favourable conditions for Leptospira. In an initial survey, blood samples from 44 patients with undifferentiated fever and 83 healthy subjects were each examined for anti- Leptospira antibodies using three tests: an ELISA; a latex card-agglutination test (Dri Dot); and a lateral-flow assay (LeptoTek Lateral Flow). In the ELISA, samples from 35% of the healthy subjects and 40% of the febrile patients were found to have titres of anti- Leptospira IgM of at least 1:80. Only one of the 13 patients checked again, in ELISA, 3 weeks later, showed the marked increase in IgM titre that is indicative of acute leptospirosis. In the initial survey, although the positive results of the lateral-flow assay, applied to whole blood and serum, showed a good agreement with those of the ELISA (kappa = 0.743), the results of the lateral-flow assay were often indeterminate. The card-agglutination test was more specific. The overall agreement between the results of the rapid tests and those of the ELISA was generally poor. When the samples classified as 'indeterminate' in the lateral-flow assay were considered positive, the maximum kappa-value for this assay applied to whole blood was only 0.512. In conclusion, it appears that high seroprevalences of anti- Leptospira IgM and low incidences of acute leptospirosis limit the diagnostic value of the rapid tests that were investigated. The lateral-flow assay is not specific enough. The card-agglutination test is possibly better but, because of the low incidence, its sensitivity could not be evaluated adequately in the present study.

Simple and fast lateral flow test for classification of leprosy patients and identification of contacts with high risk of developing leprosy.

The interruption of leprosy transmission is one of the main challenges for leprosy control programs since no consistent evidence exists that transmission has been reduced after the introduction of multidrug therapy. Sources of infection are primarily people with high loads of bacteria with or without clinical signs of leprosy. The availability of a simple test system for the detection of antibodies to phenolic glycolipid-I (PGL-I) of Mycobacterium leprae to identify these individuals may be important in the prevention of transmission. We have developed a lateral flow assay, the ML Flow test, for the detection of antibodies to PGL-I which takes only 10 min to perform. An agreement of 91% was observed between enzyme-linked immunosorbent assay and our test; the agreement beyond chance (kappa value) was 0.77. We evaluated the use of whole blood by comparing 539 blood and serum samples from an area of high endemicity. The observed agreement was 85.9% (kappa = 0.70). Storage of the lateral flow test and the running buffer at 28 degrees C for up to 1 year did not influence the results of the assay. The sensitivity of the ML Flow test in correctly classifying MB patients was 97.4%. The specificity of the ML Flow test, based on the results of the control group, was 90.2%. The ML Flow test is a fast and easy-to-perform method for the detection of immunoglobulin M antibodies to PGL-I of M. leprae. It does not require any special equipment, and the highly stable reagents make the test robust and suitable for use in tropical countries.

Clinical utility of a dipstick assay in patients with brucellosis: correlation with the period of evolution of the disease.

To examine the clinical utility of a dipstick assay for the detection of Brucella-specific IgM antibodies, and the correlation with the evolution of the disease. Twenty-six patients who were admitted to the General Hospital of Albacete (Spain) over a 2-year period and diagnosed with brucellosis were included in the study. One hundred and twenty-five serum samples collected at the time of diagnosis and at intervals during and after treatment were tested by the Coombs test, the standard seroagglutination test (SAT), the SAT in the presence of dithiothreitol (DTT-SAT), and a dipstick assay for the detection of Brucella-specific immunoglobulin M (IgM) antibodies. The sensitivity of the dipstick assay at the moment of the diagnosis was similar to that of the SAT (62% and 73%, respectively), somewhat higher than that of the DTT-SAT (50%), and lower than that of the Coombs test (100%). Patients with a negative dipstick test at the moment of diagnosis displayed a period of evolution of the disease longer than that of the dipstick-positive patients. After the beginning of therapy, the detection rate of the dipstick assay decreased faster than those of the SAT, the DTT-SAT, and the Coombs test. Thirty days after the start of therapy, the detection rate of the dipstick assay had decreased to 7%, whereas that of the SAT and DTT-SAT was 46%, and that of the Coombs test was still 92%. The dipstick assay could be used as a rapid diagnostic test for patients in the early stages of illness. Patients with a long period of illness will probably have a negative dipstick test, and could be diagnosed with the aid of the Coombs test and classical clinical findings.

Simple and fast lateral flow test for classification of leprosy patients and identification of contacts with high risk of developing leprosy

The interruption of leprosy transmission is one of the main challenges for leprosy control programs since no consistent evidence exists that transmission has been reduced after the introduction of multidrug therapy. Sources of infection are primarily people with high loads of bacteria with or without clinical signs of leprosy. The availability of a simple test system for the detection of antibodies to phenolic glycolipid-I (PGL-I) of Mycobacterium leprae to identify these individuals may be important in the prevention of transmission. We have developed a lateral flow assay, the ML Flow test, for the detection of antibodies to PGL-I which takes only 10 min to perform. An agreement of 91% was observed between enzyme-linked immunosorbent assay and our test; the agreement beyond chance (kappa value) was 0.77. We evaluated the use of whole blood by comparing 539 blood and serum samples from an area of high endemicity. The observed agreement was 85.9% (kappa = 0.70). Storage of the lateral flow test and the running buffer at 28 degrees C for up to 1 year did not influence the results of the assay. The sensitivity of the ML Flow test in correctly classifying MB patients was 97.4%. The specificity of the ML Flow test, based on the results of the control group, was 90.2%. The ML Flow test is a fast and easy-to-perform method for the detection of immunoglobulin M antibodies to PGL-I of M. leprae. It does not require any special equipment, and the highly stable reagents make the test robust and suitable for use in tropical countries.

Fermentation performance and intracellular metabolite patterns in laboratory and industrial xylose-fermenting Saccharomyces cerevisiae.

Heterologous genes for xylose utilization were introduced into an industrial Saccharomyces cerevisiae, strain A, with the aim of producing fuel ethanol from lignocellulosic feedstocks. Two transformants, A4 and A6, were evaluated by comparing the performance in 4-l anaerobic batch cultivations to both the parent strain and a laboratory xylose-utilizing strain: S. cerevisiae TMB 3001. During growth in a minimal medium containing a mixture of glucose and xylose (50 g/l each), glucose was preferentially consumed. During the first growth phase on glucose, the specific growth rates were 0.26, 0.32, 0.27 and 0.30 h(-1) for strains TMB 3001, A (parental strain), A4, and A6, respectively. The specific ethanol productivities were 0.04, 0.13, 0.04 and 0.03 g/g.per hour, for TMB 3001, A, A4 and A6, respectively. The specific xylose consumption rates were 0.06, 0.21 and 0.14 g/g.per hour, respectively for strains TMB 3001, A4 and A6. Xylose consumption resulted mainly in the formation of xylitol, with biomass and ethanol being minor products. The metabolite profile of intermediates in the pentose phosphate pathway and key glycolytic intermediates were determined during growth on glucose and xylose, respectively. The metabolite pattern differed depending on whether glucose or xylose was utilized. The levels of intracellular metabolites were higher in the industrial strains than in the laboratory strain during growth on xylose.