Persistent chronic respiratory symptoms despite TB cure is poorly correlated with lung function.

BACKGROUND: Persistent respiratory symptoms and lung function deficits are common after patients with TB. We aimed to define the burden of post-TB lung disease (PTLD) and assess associations between symptoms and impairment in two high TB incidence communities.METHODS: This was a cross-sectional survey of adults in Cape Town, South Africa who completed TB treatment 1-5 years previously. Questionnaires, spirometry and 6-minute walking distance (6MWD) were used to assess relationships between outcome measures and associated factors.RESULTS: Of the 145 participants recruited (mean age: 42 years, range: 18-75; 55 [38%] women), 55 (38%) had airflow obstruction and 84 (58%) had low forced vital capacity (FVC); the mean 6MWD was 463 m (range: 240-723). Respiratory symptoms were common: chronic cough (n = 27, 19%), wheeze (n = 61, 42%) and dyspnoea (modified MRC dyspnoea score 3 or 4: n = 36, 25%). There was poor correlation between FVC or obstruction and 6MWD. Only low body mass index showed consistent association with outcomes on multivariable analyses. Only 19 (13%) participants had a diagnosis of respiratory disease, and 16 (11%) currently received inhalers.CONCLUSION: There was substantial burden of symptoms and physiological impairment in this "cured" population, but poor correlation between objective outcome measures, highlighting deficits in our understanding of PTLD.

Differentiation between Bacillus amyloliquefaciens and Bacillus subtilis isolated from a South African sugarcane processing factory using ARDRA and rpoB gene sequencing.

A total of 104 exopolysaccharide (gum)-producing bacteria were isolated from the juice screen and juice tank in a sugarcane processing factory at times of low- and high dextran concentrations in the produced sugar. Dextran is an indicator of cane deterioration and sucrose loss after harvesting of the cane. The isolates were identified as Bacillus amyloliquefaciens (96 isolates) and Bacillus subtilis (eight isolates) based on restriction enzyme banding patterns of amplified 16S rRNA genes and rpoB gene sequence analysis. Exopolysaccharide production in sugarcane is normally associated with dextran produced by Leuconostoc mesenteroides. B. amyloliquefaciens, and to a lesser extent B. subtilis, could, however, also be responsible for exopolysaccharide (slime or gum) production in cane processing factories.

A histomorphometric study on the effects of antiretroviral therapy (ART) combined with a high-calorie diet (HCD) on aortic perivascular adipose tissue (PVAT).

Perivascular adipose tissue (PVAT), surrounding arteries is metabolically active. Obesity and antiretroviral therapy (ART) may cause pathophysiological conditions in the aortic wall and surrounding PVAT. The aim of the study was to determine the histological effects on the aortic wall, aortic PVAT adipocyte morphology and leptin staining intensity in obese rats treated with ART. Wistar rats (N=36) were divided into four groups; a lean control (C/ART-), ART control (C/ART+), high-calorie diet (HCD) untreated (HCD/ART-) and HCD and ART experimental (HCD/ART+). The aorta and surrounding PVAT were stained with haematoxylin and eosin (H&E) and anti-leptin antibodies for immunohistochemistry (IHC). The C/ART+ group had a thinner tunica media compared to the HCD/ART- group. The tunica adventitia was thicker in the ART groups (C/ART+ and HCD/ART+) compared to the lean control group. White adipocytes in the HCD/ART- group was larger in size compared to the other three groups. The high-calorie diet groups (HCD/ART- and HCD/ART+) had increased adipocyte sizes, for both brown and differentiating adipocytes, compared to the control groups (C/ART- and C/ART+). The unilocular and differentiating adipocytes in the C/ART+ group showed intense leptin staining. Unilocular and differentiating adipocytes in the HCD/ART- and HCD/ART+ groups showed weak to no leptin staining intensity. The present study indicated that ART and a HCD, separately and combined, altered both the tunica media and adventitia of the aortic wall, whereas the HCD alone caused adipocytes to increase in size. The leptin staining intensity suggested that ART alone may lead to increased leptin expression, whereas ART combined with a HCD may cause leptin deficiency. Changes seen with ART in a rat model suggest that aortic wall thickness and PVAT adipocyte morphology alterations should be considered by clinicians in obese individuals receiving ART.

Nanoprobes for Multimodal Visualization of Bone Mineral Phase in Magnetic Resonance and Near-Infrared Optical Imaging.

Imaging agents with affinity for bone can enable early detection of changes to bone mineral density, which is a hallmark of many bone-associated pathologies such as Paget's disease and osteoporosis. Here, we report the development of a polymer nanoparticle (NP)-based multimodal imaging probe that enables visualization of bone mineral phase in near-infrared (NIR) optical tomography and detection in T2-weighted magnetic resonance imaging (MRI). Ultrasmall superparamagnetic iron oxide was first encapsulated in NPs derived by blending poly(dl-lactic-co-glycolic acid)-poly(ethylene glycol) (PLGA-PEG) with N-hydroxysuccinimide functionalized-PLGA (NHS-PLGA). Postmodification of NHS surface functionality on the NPs with alendronic acid (Aln), a bone-targeting ligand, yielded stable ultrasmall superparamagnetic iron oxide nanoparticles (USPIONs) containing NPs that exhibit good serum stability and favorable cytocompatibility. These post-Aln-modified NPs exhibit 8- to 10-fold higher affinity for synthetic and biogenic hydroxyapatite in comparison to NPs where Aln was introduced before NP formation and shorten the T2 relaxation times in both agarose phantoms and fresh spongy bone, thus enabling the interrogation of bone mineral phase in T2-MRI. Finally, by introducing an NIR-dye-modified PLGA during the NP formation step, NP probes that enable the visualization of bone mineral phase in both NIR optical tomography and MRI have been realized. The system presented herein meets many of the criteria for clinical translation and therefore opens new opportunities for bone imaging and targeted therapeutics.

An echocardiographic study of infective endocarditis, with special reference to patients with HIV.

OBJECTIVE: The aim was to describe the echocardiographic features of patients with infective endocarditis (IE), and to compare the manifestations of IE in HIV-positive versus HIV-negative patients. METHODS: The study was prospective in nature and screened patients referred to Inkosi Albert Luthuli Hospital (IALCH) with suspected IE between 2004 and 2007. Only patients with a definite diagnosis of IE according to the modified Duke criteria were enrolled for the purpose of the study. Inkosi Albert Luthuli hospital is an 842-bed tertiary referral centre, serving a KwaZulu-Natal population of 10 million people, who are of various races. RESULTS: During this period, 91 patients were screened for IE. Seventy-seven (HIV infected, n = 17) satisfied the criteria for a definite diagnosis of IE. Blood cultures were positive in 46% of cases. The commonest organism was S aureus. Most patients had advanced valve disruption with heart failure and high peri-operative mortality. The clinical profile in the HIV-infected patients was similar to the that of the non-infected patients. The prevalence of echocardiographic complications (abscesses, aneurysms, perforations, fistulae and chordal ruptures) was 50.6% in the whole group. Except for the presence of leaflet aneurysms and root abscesses in four advanced (CD4 counts > 250 /mm(3)) HIV-infected cases, complications were not more frequent in the HIV-infected group. CONCLUSION: There was a high rate of culture-negative cases in this study, probably related to prior antibiotic usage; in this setting the modified Duke criteria have diagnostic limitations. No significant differences in the clinical presentation of infective endocarditis were noted between HIV-infected and HIV-negative patients.

Responsible use of cone beam computed tomography: minimising medico-legal risks.

This communication highlights some of the ethical and possible legal responsibilities which pertain to the taking, reading, reporting, and communication of findings from cone-beam computed tomography (CBCT) scans. The importance of knowledge of head and neck anatomy and pathology to reduce the likelihood of incorrect interpretation is emphasised. Failure to detect critical findings in any diagnostic image can potentially result in medico-legal consequences. CBCT is no exception to this rule. Dental schools are advised to include CBCT imaging as a diagnostic tool in their under- and postgraduate curricula thereby equipping graduates to use 3D imaging in general and CBCT in particular. Existing dental practitioners are advised to seek continuing education on 3D imaging as part of their required lifelong learning.

Immunohistochemical and biochemical evidence of ameloblastic origin of amyloid-producing odontogenic tumors in cats.

Amyloid-producing odontogenic tumors (APOT) are rare, and in cats, the histogenesis of the amyloid remains undetermined. In the present study, APOTs in 3 cats were characterized by immunohistochemistry, and the amyloid components analyzed using tandem mass spectrometry. Antiameloblastin antibodies labeled both neoplastic epithelial cells and amyloid in all cases. Neoplastic epithelial cells had strong, diffuse immunoreactivity to antibodies against cytokeratin AE1/AE3, cytokeratin 14, and cytokeratin 19 in all cases and focal immunoreactivity to nerve growth factor receptor antibodies in 2 of 3 cases. Amyloid and some tumor stromal cells were weakly positive for laminin. Calretinin, amelogenin, S100, and glial fibrillary acidic protein antibodies did not label neoplastic epithelial cells or amyloid. Extracted amyloid peptide sequences were compared to the porcine database because the cat genome is not yet complete. Based on this comparison, 1 identical ameloblastin peptide was detected in each tumor. These results suggest that feline APOTs and the amyloid they produce are of ameloblastic lineage.

Guidelines for the safe use of dental and maxillofacial CBCT: a review with recommendations for South Africa.

The aim of this manuscript is to provide the South African dental profession with guidelines and recommendations on the safe and responsible clinical use of cone beam computed tomography (CBCT) equipment. Dental practitioners who prescribe and refer patients for CBCT examinations as well as those who operate CBCT systems and interpret the images, share responsibility for the use of CBCT systems. Applicable information pertaining to the current status of the use of CBCT was reviewed, and the Directorate of Radiation Control of the Department of Health, South Africa, was invited to participate in the development of evidence-based guidelines on the safe use of cone beam computed tomography in dentistry. These guidelines establish a basis for discussions that are likely to lead to legislation.

Immunohistochemical profile of odontogenic epithelium in developing dog teeth (Canis familiaris).

Tumors of the jaw bones and oral soft tissue are relatively common lesions in dogs. The aim of this study was to find cell markers to differentiate odontogenic epithelium from nonodontogenic epithelium for future research on the pathogenesis and pathology of odontogenic neoplasms in dogs. Keratin 14 and 19 staining was observed in odontogenic and nonodontogenic epithelium, whereas amelogenin and p75 neurotrophin receptor immunoreactivity was observed in certain odontogenic epithelial cells at various stages of development but not in other epithelial cells. Calretinin staining was observed in the alveolar epithelial cells directly overlying the developing tooth germ in 28 of 39 sections (71.8%), as well as the dental laminae in 30 of 35 sections (85.7%) and Serres rests in 24 of 28 sections (85.7%). Focal positivity was detected in the respiratory mucosa, some hair follicles, and fusion epithelium of the palate, but no calretinin staining was observed in other oral epithelial cells; therefore, calretinin has potential to be utilized as a marker to differentiate odontogenic form nonodontogenic epithelium.

Bacterial populations associated with meat from the deboning room of a high throughput red meat abattoir.

Developing countries are faced with high incidences of food poisoning outbreaks, with obvious economic consequences. In highly perishable foodstuffs such as fresh red meat the threat of food poisoning is particularly intense. In this study, red meat samples were collected from a deboning room of a high throughput abattoir. The samples were analysed for the presence of Bacillus cereus., Staphylococcus aureus., Pseudomonas spp., Listeria monocytogenes., Escherichia coli and Salmonella spp. The aerobic plate counts as well as Enterobacteriaceae were also enumerated. Almost without exception the counts exceeded the microbiological guidelines for raw meat as proposed by the South African Department of Health. The average B. cereus count over the sampling period was 8.32 × 10(3) cfu, g (-1), for S. aureus and Pseudomonas spp. 1.72 × 10(5) and 1.7 × 10(5) cfu g(-1) respectively and for E. coli 3.4 × 10(5) cfu g(-1). Sixty percent of the samples were positive for presumptive Salmonella spp. while 52% of the samples tested positive for the presence of L. monocytogenes. The aerobic plate and Enterobacteriaceae counts were 1.7 × 10(7) and 4.6 × 10(6) cfu g(-1), respectively. The data highlighted the need for a more systematic approach to ensuring safe food through implementing quality control methods to prevent the entry and proliferation of pathogens in meat and meat products, especially during processes with a high degree of handling, such as deboning.