Assessment of Mycoplasma hyopneumoniae-induced Pneumonia using Different Lung Lesion Scoring Systems: a Comparative Review.

Mycoplasma hyopneumoniae is the primary aetiological agent of swine enzootic pneumonia (EP) and one of the major contributors to the porcine respiratory disease complex (PRDC). Gross lung lesions in pigs affected by EP consist of cranioventral pulmonary consolidation (CVPC), usually distributed bilaterally in the apical, intermediate, accessory and cranial parts of the diaphragmatic lobes. Several lung scoring methods are currently in place for the evaluation of CVPC. The aims of this study were (1) to review the lung lesion scoring systems used to assess pneumonia associated with M. hyopneumoniae infection, and (2) to evaluate eight of these scoring systems by applying them to the lungs of 76 pigs with experimentally-induced M. hyopneumoniae pneumonia. A significant correlation between all lung lesion scoring systems was observed and the coefficients of determination in a regression analysis were very high between each pair-wise comparison, except for a unique scoring system based on image analysis. A formula of equivalence between lung scoring methods was developed in order to compare the results obtained with these methods. The present review provides a basis for comparison (even retrospectively) of lesions evaluated using different lung scoring systems.

Evolutionary relationships, species delimitation and biogeography of Eastern Afromontane horned chameleons (Chamaeleonidae: Trioceros).

The Eastern Afromontane Region (EAR) contains numerous endemic species, yet its reptile diversity remains relatively poorly understood. We used molecular data to examine species diversity of the Sub-Saharan chameleon genus Trioceros. In particular, we focus on establishing species boundaries for taxa with disjunct distributions across the fragmented mountains of the EAR, including T. affinis, T. balebicornutus, T. deremensis, T. harennae, T. tempeli and T. werneri. We applied three species-delimiting approaches, General Mixed Yule-Coalescent (GMYC), a Bayesian implementation of the GMYC, and Bayes Factor Delimitation to estimate species diversity. Using a dated phylogeny, we also examined spatial and temporal diversification patterns in Trioceros. We found strong congruence between different species delimitation approaches, with all methods suggesting that species diversity is currently underestimated. In particular, T. werneri consists of at least four candidate species (i.e. species awaiting description) with some mountain ranges (Uluguru and Udzungwa) having potentially more than one species. Most interspecific divergences between extant Trioceros lineages are estimated to be >5Mya, consistent with a Pliocene origin of the endemic montane fauna, as exhibited in other taxonomic groups. Multiple, overlapping geographic events (climate and/or geomorphological changes) might account for speciation patterns in Trioceros given the dating results.

Vanadium doped tin dioxide as a novel sulfur dioxide sensor.

Considering the short-term exposure limit of SO2 to be 5 ppm, we first time report that semiconductor sensors based on vanadium doped SnO2 can be used for SO2 leak detection because of their good sensitivity towards SO2 at concentrations down to 5 ppm. Such sensors are quite selective in presence of other gases like carbon monoxide, methane and butane. The high sensitivity of vanadium doped tin dioxide towards SO2 may be understood by considering the oxidation of sulfur dioxide to sulfur trioxide on SnO2 surface through redox cycles of vanadium-sulfur-oxygen adsorbed species.

A shrinking service: can it mislead people into thinking there is less disease?

This study looks at the impact of reduced clinical services on infection rates in a small suburban genitourinary medicine clinic, and compares the rates with the national trends. Data were gathered from the KC60 reports and compared with national data on the Health Protection Association Website. Between 1996 and 2001, waiting time for appointments increased along with the number of patients not attending appointments. There was an apparent drop in the number of cases of chlamydial infection in contrast to a national increase; however, when the figures were adjusted for the fall in clinic size, a small rise was seen. The incidence of gonorrhoea, in contrast, rose in excess of national trends, and new HIV/AIDS diagnoses tripled. A disproportionate number of wart virus infections were seen. It seems that long waits for appointments and high DNA rates are skewing diagnosis rates for the clinic, and the shrinking service appears not to be meeting the community's needs.

Is it evidence-based practice? Prophylactic antibiotics for termination of pregnancy to minimize post-abortion pelvic infection?

Sexually transmitted infections (STIs) causing upper genital tract problems after termination of pregnancy (TOP) is well recognized. We undertook this study to assess the local prevalence of Chlamydia trachomatis infection and to estimate the potential benefits of introducing screening. The prevalence rate of C. trachomatis was 6%. Nine sexual contacts of the index cases were identified. They were symptom free, but all had non-specific urethritis (NSU). Four of them were positive for C. trachomatis. We conclude that screening for chlamydial infection is essential and routine prophylactic antibiotic cover may not be beneficial.

Cryotherapy gas--to use nitrous oxide or carbon dioxide?

Cryotherapy is regularly used in our clinic for treating genital warts. Nitrous oxide was used as the cryogenic gas. Following a health and safety review it was decided to monitor the nitrous oxide levels in the treatment room under different conditions. The Occupational Exposure Standard for nitrous oxide is 100 parts per million (PPM) (8-h time weighted average) and an indicative short-term exposure limit of 300 PPM (15-min reference period). High levels of gas were detected, especially when the exhaust was not vented to the outside. Venting of the gas to the outside could also present a hazard to adjacent areas. The situation was considered to be unacceptable and carbon dioxide was proposed as an alternative. The Occupational Exposure Standard for carbon dioxide is 5000 PPM (8-h time weighted average) and a short-term limit of 15,000 PPM (15-min reference period). Carbon dioxide levels were found to be within the Occupational Exposure Standard. There is no noticeable difference in the cryogenic efficacy of the 2 gases. Carbon dioxide is, therefore, a safer alternative. It also offers significant savings when compared with nitrous oxide.

Ofloxacin in the treatment of uncomplicated gonorrhea and chlamydial genital infection.

The subjects were 149 patients (96 men, 53 women) with gonorrhea only (n = 66), chlamydial infection only (n = 48), or both gonorrhea and chlamydial infection (n = 35). All patients with gonorrhea were culture positive; all isolates cultured before treatment were sensitive to ofloxacin. Chlamydial infection was diagnosed by culture, inclusions being identified by indirect immunofluorescence. The patients with gonorrhea received a single dose of 400 mg of ofloxacin. Clinical and microbiologic cure was evident in 86 of 88 patients evaluated at seven days after treatment and in 71 of 72 patients at 14 days. Three patients developed postgonococcal urethritis; the cause was chlamydial in two. The patients with chlamydial infection received 200 mg of ofloxacin twice daily for seven days. Clinical and microbiologic cure was evident in all 78 patients evaluated one day after treatment and in 73 of 74 patients at 14 days. Side effects were reported by 11 patients. It is concluded that ofloxacin is a safe and effective treatment for uncomplicated gonorrhea in patients with and without concurrent chlamydial infections.

Cytological screening to detect subclinical anal human papillomavirus (HPV) infection in homosexual men attending genitourinary medicine clinic.

Unselected homosexual men attending a department of genitourinary medicine were screened for human papilloma virus (HPV) infection using anal cytology. Satisfactory smears were obtained from 221 patients, and 73 showed cytological abnormality with warty atypia. Abnormal cytology was detected in 55 (31%) of 178 patients in whom there was no macroscopic evidence of anal or perianal warts, and anal cytology may therefore be valuable to detect patients with subclinical condylomatous lesions and may also serve to identify those who possibly have intraepithelial neoplasia.

The efficacy of ofloxacin against infection caused by Neisseria gonorrhoeae and Chlamydia trachomatis.

Ofloxacin was used to treat patients with gonorrhoea and/or Chlamydia trachomatis infection. Gonorrhoea was treated with a single 400 mg dose and chlamydial infection with a seven day course (200 mg bd). Fifty of 84 patients with gonorrhoea (60 men and 24 women) returned for two follow-up examinations 7 and 14 days after treatment, 17 patients returned for only one follow-up examination and 17 defaulted. Neisseria gonorrhoeae was re-isolated from three patients who had probably become re-infected. Treatment was successful in 64 patients, 58 of whom were assessed after a single 400 mg dose of ofloxacin. Chlamydial infection was identified in 30 patients with gonorrhoea (13 men and 17 women) and in 35 other patients (17 men and 18 women). C. trachomatis was not recovered from any of the 49 patients who returned for two follow-up examinations, or from the ten patients who attended for one follow-up visit only. Sixteen patients did not return for follow-up examination. Our results suggest a seven day course of ofloxacin would eradicate N. gonorrhoeae and C. trachomatis in patients infected with both organisms. Such treatment may be advisable in patients with gonorrhoea if microbiological tests for C. trachomatis are not available.

Does detection of chlamydial antibodies by microimmunofluorescence help in managing chlamydial lower genital tract infection in women?

A total of 113 women thought to have chlamydial infection of the lower genital tract were studied prospectively to evaluate the effect of antibiotic treatment on antibodies to chlamydiae detected by microimmunofluorescence. Of them, 81 were randomly selected for treatment with a two week course of either triple tetracycline or erythromycin stearate, and 32 who had microimmunofluorescent antibodies to, but did not yield cultures for, chlamydiae were used as controls and left untreated. Results for the treated patients showed that 22 (27%) had at least a fourfold fall in the microimmunofluorescent titre, but there was a similar rise in titre in 14 (17%), and the titre remained unaltered in 45 (56%) patients. In the control group 10 (31%) patients had at least a fourfold fall in titre, but there was a similar rise in titre in seven (22%), and it remained unaltered in 15 (47%) patients. The differences between these percentages in treated and untreated patients were not significant.