Molecular detection and prevalence of human-pathologic Enterocytozoon bieneusi among pet birds in Mosul, Iraq.

Enterocytozoon bieneusi has been classified as an emerging infectious organism (microsporidium) due to the global increase in the number of cases infecting both humans and animals. The goal of this study was to use the polymerase chain reaction method to determine the prevalence and risk factors associated with E. bieneusi infection among pet birds in Mosul, Iraq. Faecal samples from a total of six hundred and twenty-eight pet birds belonging to fifteen (15) different species were analyzed by targeting the internal transcribed spacer (ITS) of the rRNA gene. Of the total number of pet birds sampled, 203 tested positive for the parasite, representing 32.32% (95% CI = 28.75-36.06) of the sampled population. There was a significant difference (p < 0.01) in the prevalence of E. bieneusi infection among the different species of pet birds, with the highest prevalence recorded among Eurasian bullfinches (Pyrrhula pyrrhula) (64.06%; 95% CI = 55.48-72.02), budgerigars (Melopsittacus undulatus) (48.72%; 95% CI = 40.93-56.55), Fischer's lovebirds (Agapornis fischeri) (25.00%; 95% CI = 13.45-40.05), and macaws parrots (Ara ararauna) (25.00%; 95% CI = 1.25-75.77). The order, source, and health status of pet birds were significantly (p < 0.05) associated with the prevalence of E. bieneusi infection among pet birds in Mosul, Iraq. In conclusion, the level of prevalence of E. bieneusi among pet birds may increase the risk of infection for owners of pet birds in Iraq.

A novel therapeutic approach for reducing postoperative inflammatory complications after impacted mandibular third molar removal.

BACKGROUND: This study was designed to compare effect of combined use of dexamethasone and honey versus each agent alone in controlling complications associated with removal of impacted mandibular third molar. METHODS: This randomized clinical study included patients suffering from impacted mandibular wisdom teeth. Patients were divided randomly into 4 groups. Group I, control, group II, received dexamethasone injection preoperatively, group III, received honey locally in the wound after extraction, and group IV, received dexamethasone injection preoperatively and topical honey application. All patients were evaluated preoperatively and postoperatively to assess facial edema, interincisal distance, pain, and total analgesic dose used. RESULTS: Significant edema developed in group I than other groups and improved significantly in group II and III on seventh postoperative day, and tenth postoperative day in group I. Insignificant edema developed in group IV. Significant decrease in interincisal distance occurred in all groups on third postoperative day that improved significantly on seventh postoperative days in all groups except group I, it improved on tenth postoperative day. Pain was significantly minimum in group IV than other groups and its maximum degree was in group I. CONCLUSION: Both dexamethasone and honey are an effective way of minimizing swelling, pain, and trismus after removal of impacted lower third molars. Both agents either alone or in combination provide simple, safe, painless, and cost-effective method to eliminate postoperative discomfort. However, dexamethasone or honey can decrease complications related to surgical extraction of mandibular third molar, the simultaneous application of both agents is more effective method in this regard.

Decontamination of actual radioactive wastewater containing 137Cs using bentonite as a natural adsorbent: equilibrium, kinetics, and thermodynamic studies.

Batch adsorption treatment using Iraqi bentonite as a natural adsorbent was adopted in this study to decontaminate actual 137Cs radioactive wastewater from the Al-Tuwaitha Nuclear Research Center, located south of Baghdad. The bentonite characterization was applied before and after treatment, using chemical compositions analyses, X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), Brunauer-Emmett-Teller (BET) surface area analysis and Fourier-transform infrared spectroscopy (FT-IR). The batch adsorption mode was applied with the initial radioactivity concentration (1440.5 Bq/L), solid/liquid ratio (1 g/L), pH (6-8), contact time (1.5 h), and temperature (298°K). The adsorption experiments showed a decontamination removal efficiency of about 95.66% of 137Cs. A Freundlich adsorption isotherm model was approved for the adsorption of 137Cs, with a coefficient of determination R2 = 0.998. A pseudo-second-order model fitted well with the adsorption of 137Cs, with R2 = 0.983. The positive value of ΔH° in the thermodynamic results indicated that the adsorption process was endothermic physisorption (ΔH° = 15.01 kJ mol-1), spontaneous and favorable (ΔG° = -7.66 kJ mol-1 K-1), with a very low degree of disorder (ΔS° = 0.076 kJ mol-1 K-1).

Sheep and goat milk in Jordan is a reservoir of multidrug resistant extended spectrum and AmpC beta-lactamases Escherichia coli.

Limited data is available on the prevalence and antimicrobial resistance of extended spectrum (ESBL) and AmpC ß-lactamases Escherichia coli in sheep and goats in Jordan. This study determined the molecular prevalence and antimicrobial-resistance of ESBL and AmpC ß-lactamases E. coli in 155 sheep and goat flocks across Jordan by testing 948 milk samples. The samples were enriched in MacConkey broth, and then plated on MacConkey agar with cefotaxime. The presence of ESBL and AmpC genes in the E. coli isolates was determined by PCR and the resistance toward critically important antimicrobials was tested by disc diffusion. In total, 1016 E. coli isolates were isolated from the cefotaxime supplemented MacConkey, 382 isolates harbored ESBL genes and 54 harbored blaCMY. The prevalence of blaCTX-M, blaTEM, blaCMY and blaSHVE. coli in the milk samples were 33.5 %, 31.7 %, 5.7 %. and 1.1 %, respectively. At the flock level, 30.3 % flocks had ß-lactamase E. coli, specifically 25.2 %, 20.7 %, 5.2 % and 2.6 % had blaCTX-M, blaTEM, blaCMY and blaSHV E. coli, respectively. About 52.2 % of the isolates harbored both blaCTX-M and blaTEM. A high percentage (>59 %) of ESBL and AmpC ß-lactamases E. coli resisted sulfamethoxazole/trimethoprim, tetracycline and nalidixic acid. Overall, 93.5 % and 96.3 % of ESBL and AmpC E. coli were resistant to ≥1 another antimicrobial class and 44.5 % and 44.4 % were resistant to ≥3 another antimicrobial class, respectively. This study shows that sheep and goat milk is a reservoir of multidrug resistant ESBL and AmpC ß-lactamases E. coli, thus good hygienic practices and judicious antimicrobials use are important in small ruminants' farming.

The neuroinflammatory component of negative affect in patients with chronic pain.

Negative affect (NA) is a significant cause of disability for chronic pain patients. While little is known about the mechanism underlying pain-comorbid NA, previous studies have implicated neuroinflammation in the pathophysiology of both depression and chronic pain. Here, we tested the hypothesis that NA in pain patients is linked to elevations in the brain levels of the glial marker 18 kDa translocator protein (TSPO), and changes in functional connectivity. 25 cLBP patients (42.4 ± 13 years old; 13F, 12M) with chronic low back pain (cLBP) and 27 healthy control subjects (48.9 ± 13 years old; 14F, 13M) received an integrated (i.e., simultaneous) positron emission tomography (PET)/magnetic resonance imaging (MRI) brain scan with the second-generation TSPO ligand [11C]PBR28. The relationship between [11C]PBR28 signal and NA was assessed first with regression analyses against Beck Depression Inventory (BDI) scores in patients, and then by comparing cLBP patients with little-to-no, or mild-to-moderate depression against healthy controls. Further, the relationship between PET signal, BDI and frontolimbic functional connectivity was evaluated in patients with mediation models. PET signal was positively associated with BDI scores in patients, and significantly elevated in patients with mild-to-moderate (but not low) depression compared with controls, in anterior middle and pregenual anterior cingulate cortices (aMCC, pgACC). In the pgACC, PET signal was also associated with this region's functional connectivity to the dorsolateral PFC (pgACC-dlPFC), and mediated of the association between pgACC-dlPFC connectivity and BDI. These observations support a role for glial activation in pain-comorbid NA, identifying in neuroinflammation a potential therapeutic target for this condition.

Changes in Pain Sensitivity and Pain Modulation During Oral Opioid Treatment: The Impact of Negative Affect.

OBJECTIVE: Opioids are frequently prescribed for chronic low back pain (CLBP), but there are broad individual differences in the benefits and risks of opioid therapy, including the development opioid-induced hyperalgesia. This study examined quantitative sensory testing (QST) data among a group of CLBP patients undergoing sustained oral opioid treatment. We investigated whether individual differences in psychological characteristics were related to opioid-induced changes in pain perception and pain modulation. DESIGN: The six-month, open-label trial evaluated patients with low to high levels of negative affect (e.g., symptoms of distress, depression and anxiety); participants underwent QST at baseline (prior to initiating treatment) and during oral opioid treatment. SETTING: A chronic pain management center. PATIENTS: The 31 study participants had chronic discogenic back pain, with a pain intensity rating >3/10. Participants were divided into groups with high vs. low levels of Negative Affect (NA). RESULTS: In the previously-published manuscript describing the clinical outcomes of the trial, high NA patients achieved only about half of the analgesic effect observed in the low NA group (Wasan AD, Michna E, Edwards RR, et al. Psychiatric comorbidity is associated prospectively with diminished opioid analgesia and increased opioid misuse in patients with chronic low back pain. Anesthesiology 2015;123:861-72). The QST findings reported here suggested that tolerance to experimental (cold pressor) pain and conditioned pain modulation tended to decrease in the high NA group over the course of opioid treatment, while temporal summation of mechanical pain declined in the low NA group. CONCLUSIONS: These results reveal that while the low NA group seemed to exhibit a generally adaptive, analgesic pattern of changes during opioid management, the high NA group showed a pattern more consistent with opioid-induced hyperalgesic processes. A greater susceptibility to hyperalgesia-promoting changes in pain modulation among patients with high levels of distress may contribute to a lower degree of benefit from opioid treatment in high NA patients.

Catastrophic thinking and increased risk for prescription opioid misuse in patients with chronic pain.

BACKGROUND: As a consequence of the substantial rise in the prescription of opioids for the treatment of chronic noncancer pain, greater attention has been paid to the factors that may be associated with an increased risk for prescription opioid misuse. Recently, a growing number of studies have shown that patients with high levels of catastrophizing are at increased risk for prescription opioid misuse. OBJECTIVE: The primary objective of this study was to examine the variables that might underlie the association between catastrophizing and risk for prescription opioid misuse in patients with chronic pain. METHODS: Patients with chronic musculoskeletal pain (n=115) were asked to complete the SOAPP-R, a validated self-report questionnaire designed to identify patients at risk for prescription opioid misuse. Patients were also asked to complete self-report measures of pain intensity, catastrophizing, anxiety, and depression. RESULTS: Consistent with previous research, we found that catastrophizing was associated with an increased risk for prescription opioid misuse. Results also revealed that the association between catastrophizing and risk for opioid misuse was partially mediated by patients' levels of anxiety. Follow-up analyses, however, indicated that catastrophizing remained a significant 'unique' predictor of risk for opioid misuse even when controlling for patients' levels of pain severity, anxiety and depressive symptoms. DISCUSSION: Discussion addresses the factors that might place patients with high levels of catastrophizing at increased risk for prescription opioid misuse. The implications of our findings for the management of patients considered for opioid therapy are also discussed.

New manifestation of atomic parity violation in cesium: a chiral optical gain induced by linearly polarized 6S-7S excitation.

We have detected, by using stimulated emission, an atomic parity violation (APV) in the form of a chiral optical gain of a cesium vapor on the 7S-6P(3/2) transition, consecutive to linearly polarized 6S-7S excitation. We demonstrate the validity of this detection method of APV, by presenting a 9% accurate measurement of expected sign and magnitude. We stress several advantages of this new approach which fully exploits the cylindrical symmetry of the setup. Future measurements at the percent level will provide an important cross-check of an existing more precise result obtained by a different method.

Femoral nailing with transverse locking screws through the femoral neck.

We treated 55 patients with subtrochanteric or comminuted femoral fractures with a transverse locking femoral nail (Alta, Howmedica). This nail was positioned more cephalad than usual so that at least one fixation screw was located in the femoral neck or head. Forty-seven fractures (20 subtrochanteric and 27 diaphyseal) were available for follow-up averaging 12 months (3-35). The time to radiographic healing averaged 7 months (3-21). There was one delayed union, one non-union, two superficial infections, one broken proximal screw, one compartment syndrome of the thigh, and one peroneal nerve palsy. There were no femoral neck fractures, avascular changes of the femoral head, or gluteal irritation at the most recent follow up. The described technique appears safe and effective, is technically easy, and avoids intra-articular screws.

Acute complications in the operative treatment of isolated ankle fractures in patients with diabetes mellitus.

Using a computer database, we conducted a retrospective review of all ankle fractures treated at our institution from March 1985 to October 1996. Twenty-one patients with diabetes mellitus and isolated ankle fractures that were treated operatively met all inclusion criteria. Seven had insulin-dependent diabetes, and 14 had non-insulin-dependent diabetes. A randomly selected control group of 46 patients without diabetes who also underwent operative treatment of ankle fractures during this same time period were matched for age, sex, and fracture severity. The complication rate was 43% with 13 complications in nine patients with diabetes. There were seven (15.5%) complications in the control group. Complications in the diabetic group included seven infections (five deep, two superficial) and three losses of fixation. The complications were more severe in our diabetic population, requiring seven additional procedures including two below-knee amputations; a third patient refused an amputation. No additional procedures were required in our control group. All complications in our control group resolved with treatment. The relative risk for postoperative complications in patients with diabetes who sustained ankle fractures that were treated operatively was 2.76 times greater than the control group's (95% confidence interval, 1.57-3.97).