Loop-mediated isothermal amplification (LAMP) for the identification of invasive Aedes mosquito species.

Invasive Aedes mosquito species (Diptera: Culicidae) are of public health concern in Europe because they are either recognized or potential vectors of pathogens. Loop-mediated isothermal amplification (LAMP) is a rapid and simple method for amplifying DNA with high specificity and efficiency, with the technique having potential for application in the field, including in high-throughput format. Specific LAMP assays based on rDNA internal transcribed spacers 1 or 2 sequences, considering intraspecies variability at these loci, were developed for Aedes aegypti, Aedes albopictus, Aedes japonicus, Aedes koreicus and the indigenous Aedes geniculatus. No such assays could be developed for Aedes atropalpus and Aedes triseriatus because both loci were too short to serve as target. The assays rely on the clearly visible colour change from violet to sky blue after successful amplification. Sensitivity of egg detection was confirmed with ratios of up to one mosquito egg in 99 other eggs. Simple sample preparation of adults or eggs by mechanical homogenization in water required an additional heat treatment or centrifugation step to avoid non-specific colour changes. Thus, further technical improvements are needed to render these assays truly field-applicable, which would greatly facilitate surveillance of these invasive mosquito species and allow for prompt implementation of control measures.

[Vitreoretinal operations with local anesthesia]. / Vitreoretinale Operationen in Lokalanästhesie.

The objective of this prospective study was to evaluate the intra- and postoperative pain in vitreoretinal surgery under retrobulbar anesthesia (RBA) in 53 patients, considering objective stress parameters such as blood pressure, heart rate and plasma concentration of cortisol (PCC). The level of pain was graded on a standard 4-point nominal scale. Mean pain score after RBA was 1.04, decreased perioperative to 0.77, and increased again with a maximum at 8 h postoperative to 1.15. The quality of RBA significantly correlated with the patient's pain during and at the end of surgery (P < 0.001). At the end of surgery (P < 0.001). At the end of surgery pain also correlated with the duration of surgery (P < 0.01). In 14 patients PCC was measured preoperatively. PCC decreased significantly after oral premedication with Lorazepam (18.4 to 12.6 micrograms/dl, P < 0.001). In the further course of surgery no significant differences in PCC could be detected in 26 patients. Pain during the operation correlated significantly with intraoperative (P = 0.01) and postoperative (P = 0.03) PCC. The objective stress parameters blood pressure and heart rate did not differ significantly during surgery. Of our patients, 77.4% decided that they would choose RBA again in case of ocular surgery.

[Comparison of ergometer and dipyridamole echocardiography in patients with suspected coronary heart disease]. / Vergleich von Ergometer- und Dipyridamol-Echokardiographie bei Patienten mit vermuteter koronarer Herzkrankheit.

To compare exercise echocardiography (EE) and dipyridamole echocardiography (DE), echocardiographically assessable wall motion abnormalities were examined in 80 patients with suspected coronary artery disease. Issues of the study were the evaluation of feasibility, sensitivity, specificity, and the necessity of recordings under dynamic maximal stress (peak exercise) on a bicycle. DE had a better feasibility than EE (95% vs. 84%, p < 0.05). Eleven percent of patients had no interpretable echocardiograms during peak exercise. However, after peak exercise all patients had adequate images. In order to calculate sensitivity of the methods, coronary stenoses of at least 70% on coronary angiograms were considered. Sensitivity of DE (73%) was similar to that of EE (75%). In patients with single-vessel disease both methods were less sensitive (63% and 67%) than in patients with multi-vessel disease (86% each). However, compared with stress ECG both methods proved to be superior (p < 0.05). In 31% of patients with coronary artery disease only recordings during peak exercise led to pathological findings. By not applying the EE during peak exercise the results of these patients would have been falsely negative i.e. regarded as normal. The specificity of DE (87%) was similar to that of EE (80%). In conclusion, there are no significant differences between DE and EE except feasibility and side-effects. Both methods are superior to stress ECG in terms of sensitivity regarding detection of ischemic myocardium. However, their precision needs to be evaluated differentially: Sensitivity was higher among patients with multi-vessel disease compared with those with single-vessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)