Sub-maximal and maximal Yo-Yo intermittent endurance test level 2: heart rate response, reproducibility and application to elite soccer

The aims of this study were to (1) determine the reproducibility of sub-maximal and maximal versions of the Yo-Yo intermittent endurance test level 2 (Yo-Yo IE2 test), (2) assess the relationship between the Yo-Yo IE2 test and match performance and (3) quantify the sensitivity of the Yo-Yo IE2 test to detect test-retest changes and discriminate between performance for different playing standards and positions in elite soccer. Elite (n = 148) and sub-elite male (n = 14) soccer players carried out the Yo-Yo IE2 test on several occasions over consecutive seasons. Test-retest coefficient of variation (CV) in Yo-Yo IE2 test performance and heart rate after 6 min were 3.9% (n = 37) and 1.4% (n = 32), respectively. Elite male senior and youth U19 players Yo-Yo IE2 performances were better (P < 0.01) than elite youth U16s and sub-elite players (2,603 ± 451 and 2,534 ± 549 vs. 1,855 ± 535 vs. 1,749 ± 382 m). The intra- and inter-season CV for Yo-Yo IE2 test performance were 4.2 and 5.6%, respectively. A correlation was observed (P < 0.05) between Yo-Yo IE2 test performance and the total (r = 0.74) and high-intensity (r = 0.58) running distance covered in a match. A correlation was also evident (P < 0.01) between Yo-Yo IE2 test heart rate after 6 min expressed in percentage of maximal heart rate and the peak values for high-intensity running performed by midfielders in 5-min (r = -0.71), 15-min (r = -0.75) and 45-min periods (r = -0.77). The present data demonstrate that the Yo-Yo IE2 test is reproducible and can be used to determine the capacity of elite soccer players to perform intense intermittent exercise. Furthermore, the Yo-Yo IE2 test was shown to be a sensitive tool that not only relates to match performance but can also differentiate between intermittent exercise performance of players in various standards, stages of the season and playing positions.

Determinants of sexual abstinence and condom use among Central American adolescents

Engaging in sexual intercourse early in life and without protection often leads to unplanned pregnancy and sexually transmitted diseases in teens.

METHODS

A binary logistical regression analysis was used to identify the risk and protective factors associated with two preventive health behaviors: sexual abstinence and consistent condom use among 6,902 Central American teens receiving web-based adolescent health promotion education from 2004 to 2008.

RESULTS

The average age was 15 years, with ages ranging between 10 and 20 years. Of these, 52% were girls and 48% boys. Personal competencies, social peer influences, and family factors were found to influence their sexual behavior patterns and were generally consistent with other studies worldwide.

CONCLUSION

Information technology provides new avenues to assess individual health and provide individualized data collection in a confidential, sensitive, accessible, and engaging manner. Health promotion interventions must continue to address the development of personal knowledge, skills, and motivations to prevent and or reduce sexual risk-taking behaviors.

HIV/AIDS: perceptions of the Grenadian faith-based community

OBJECTIVE

This exploratory study conducted in 2008 aimed at gathering the views and opinions of leaders of the faith-based community (FBC) in Grenada about the increased incidence of HIV/AIDS in the Caribbean region including their beliefs and attitudes towards persons living with HIV/AIDS (PLHIV/AIDS).

DESIGN AND METHODS

The study followed a cross-sectional design and used a qualitative approach. Telephone surveys were conducted with all faith-based organizations and semi-structured interviews done with key leaders representing the faith-based community in Grenada.

RESULTS

Findings showed that perceptions of HIV/AIDS are embedded in a socio-political-cultural context where many risk behaviours and factors intertwine in complex ways. Religious beliefs are based on love, compassion and acceptance. The most prominent risk behaviours associated with the spread of HIV/AIDS identified by leaders are homosexuality, prostitution, promiscuity and substance abuse which are in direct contradiction to their beliefs and teachings. Leaders felt that these risk behaviours were exacerbated by changes in family structure and the absence of a common moral discourse shared by all sectors of society.

CONCLUSION

The faith-based community has a significant presence across Grenada and it can be an effective partner in helping communities understand and prevent HIV/AIDS and overcome the stigma and discrimination associated with this disease. Training and effective strategies are needed to engage them in the national response to HIV/AIDS without threatening their ideologies and practices.

Production of biomass and beta-D-galactosidase by Candida pseudotropicalis grown in continuous culture on whey

The production of biomass and beta-D-galactosidase by the lactose-utilizing yeast Candida pseudotropicalis NCYC 744 in whey medium was studied. Apparent optimization of growth conditions and medium was done in continuous culture. Optimal pH and temperature were 2.6 and 36-38 degrees C, respectively, Limitations in Cu, Zn, and possibly Mn were detected in deproteinized whey medium. Additions of tryptophan stimulated growth of the yeast. Under optimal conditions in medium supplemented with excess tryptophan, Cu, Zn, and Mn the maximum values obtained: yeast concentration, 4.6 g/L; yeast productivity, 1.4 g/L h (at D = 0.35 h(-1)); enzyme volumetric productivity, 2100 U/L h (at D = 0.25 h(-1)); maintenance coefficient, 5-10 mg lactose/g cell h; saturation constant (K(s)) for lactose, 4.76mM; maximum specific growth rate, (mu(max)), 0.47 h(-1). No significant increase in specific enzyme activity (U/mg cell) was observed after medium optimization evidencing the importance of regulatory controls in enzyme synthesis.

The centrality of community dynamics in the socio-economic recovery of devastated communities

OBJECTIVE

To assess and explore the health and socio-economic outcomes of Jubilee, a community on the Caribbean island of Grenada hit by Hurricane Ivan in 2004 and to identify remaining barriers to recovery.

METHODS

The assessment consisted of a mixed methods approach employing observations, household surveys, in-depth interviews and focus groups.

RESULTS

Eighty-five per cent of the residents live in a single-family home type dwelling which is occupied by multiple families. Twenty-seven per cent of the respondents depended on a river or stream for water and 83% utilized an outdoor pit latrine. Construction accounted for 28% of the employment while 16% reported having no occupation. Public and private transportation was limited and 48% of the residents lived on less than one United States of America (US) dollar per day. Access to healthcare was reported by 89% and the prevalence of diabetes and hypertension was identified by 13% and 30% of the residents respectively. Social fragmentation within the community represents a barrier that keeps the community from developing common goals leading to full economic recovery.

CONCLUSION

Jubilee has not fully recovered from the effects of Hurricane Ivan, but progress has been made in the reconstruction effort. These efforts have addressed the most immediate and basic needs of the community, mainly utility service infrastructure and home repairs. However issues related to the community's economic recovery are still unresolved.

MPTP administration increases plasma levels of acute phase proteins in non-human primates (Macaca fascicularis)

Parkinson's disease (PD) is characterized by the loss of dopaminergic neurons in the Substantia Nigra pars compacta (SNpc). Parkinsonian patients and animal models of PD show inflammatory phenomena such as microglial activation and cytokine production that could modulate the progression of the disease, since they play a crucial role in the degenerative process. Since acute phase proteins (APPs) are involved in a number of homeostatic alterations and inflammatory processes, we analyzed the levels of APPs in primates before and after treatment with MPTP. A significant increase in C-reactive protein (CRP), serum amyloid A (SAA) and haptoglobin (HP) levels after MPTP treatment. These results demonstrate that MPTP induces a systemic generalized inflammatory reaction after specific dopaminergic neurotoxicity insult, suggesting that the inflammatory process in Parkinsonism may affect other immune-inflammatory responses outside the brain.

Randomised controlled trial in non-invasive ventilation: what trial?

Amyotrophic lateral sclerosis (ALS) is caused by mutations in the gene for Cu/Zn superoxide dismutase (SOD1) in 10% of familial and sporadic cases. During the SOD1 analysis of 9 FALS and 121 SALS, in only one sporadic case we found the exonic mutation N19S; in 15 SALS patients we found a 319t>a variation in IVS1 sequence, at 108 bp upstream from exon 2. This variation has an unusually high frequency of 11% and is always in linkage disequilibrium with a described polymorphism in IVS3, +34a>c. The 319t>a variation is classified in two different public databases, HGMD and The ALS Online Database, as a splicing mutation and not as a polymorphism. The unusually high frequency of this mutation in our patients prompted us to determinate its frequency in 130 age- and gender- matched healthy controls and in 54 patients with Alzheimer's disease. We found again linkage disequilibrium with the polymorphism in intron 3, and the frequency of 11% and 7.8%, respectively. These results strongly support the idea that the IVS1 +319 t>a alone is not an ALS causing mutation, and that special care must be taken in the interpretation of data from mutations databases for correct genetic counselling.

Analysis of pharmacogenetic biomarkers in rectal patients trated with chemoradiotherapy

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Background: 5FU-based chemoradiotherapy before total mesorectal excision (TME) is currently the gold standard treatment for stage II and III rectal cancer patients. Pathological complete response (pCR) is related with a longer survival. We have used known predictive pharmacogenetics biomarkers to identify in our series responders and non responders to preoperative RQ. Methods: 77 stage II/III rectal patients were genotyped using direct sequencing (TS VNTR) and SNAPshot (DPYD, EGFR) techniques. DNA was obtained from peripheral blood samples. We have studied Thymidylate synthetase (TS VNTR; high expression haplotypes: TSER 2R/3R, 3C/3G, 3G/3G and low expression: TSER 2R/2R, 2R/3C, 3C/3C; TS 1494del6: associated to a better efficay of 5Fu), dihydropyrimidine dehydrogenase (DPYD; DPYD*2 associated to worse toxicity), EGFR (CA repeats in intron 1: 16/16 associated to worse efficacy) polymorphisms. Median age of our study cohort was 65 years old (37–85). There were 24 female and 53 male patients. All of them were Caucasian. 21 patients (27.3%) had stage II and 56 (72.7%) stage III. They were staged by TC, colonoscopy and endorectal ultrasonography. The patients received 5fu 325 mg/m2/day continuous infusion along the hyperfractionated accelerated radiotherapy schedule (50,4 Gy). All were submitted to TME. Outcomes after surgery are measured by tumour regression grade (from TRG1= complete pathological response, to TRG5=no regression). Data were studied by univariate and multivariate analysis. Results: The sample was in Hardy-Weinberg equilibrium for all polymorphisms, irrespectively of the response status. 50 patients (64.9%) and 27 (35.1%) had low and high expression genotype for TS respectively. pCR (TRG1) was obtained in 24 patients (31,6%) and microscopic foci (TRG2) in 14 (18,2%), TRG 3–4 in 38 (49,3%), and 1 patient had no response (TRG5). We haven’t found a statistically significant relationship between TRG1 and TS status, or any other biomarker studied. There's no relationship also with initial clinical stage. Conclusions: Biomarkers EGFR (intron 1 CA repeats), TS (TS 1494del6, TS VNTR) and DPYD in blood samples, are not good enough to predict response to RQ in rectal cancer.

No significant financial relationships to disclose.

Samara size versus dispersal and seedling establishment in Ailanthus altissima (Miller) Swingle

We have specifically carried out a greenhouse experiment to assess relationship between samara weight and seed success. Relationship assessed as dispersal potential, germination level, germination rate and early seedling mass for the invasive species Ailanthus altissima. For this purpose, we considered two close stands as seeds source. We found no correlation between samara size and neither germination level, germination rate, nor seedling mass, but a positive correlation with samara projected area. These results suggest that samara weight is not directly related to germination, dispersal and invasion potential neither. Nevertheless, stands differed in the invasion potential of their samaras; one stand presented samaras with higher projected area per weight unit whereas the other one presented samaras that produced heavier seedlings. Whatever the origin, (genetic or environmental) of this differences it should be advantageous for a colonizing invader species such as A. altissima since it could imply a wider range of habitats susceptible to invasion.

Beliefs and practices to prevent drowning among Vietnamese-American adolescents and parents

OBJECTIVE

To determine the beliefs, attitudes and practices regarding water safety among Vietnamese-Americans through focus group interviews.

PARTICIPANTS

15 teenagers (aged 15-19 years) and 20 parents participated, and reported similar attitudes, beliefs and practices regarding water activities. Participants identified a lack of familiarity with water activities and few swimming skills, noting that these activities are not perceived as recreational sports among the Vietnamese. They reported recreating at open water sites because they are free and available, and attributed drowning to fate. Vietnamese youth swim unsupervised, responding to peer pressure despite lack of skills. Participants had negative attitudes toward life jackets using, swimming pools and lessons, because of the costs, but would attend lessons in Vietnamese. They identified schools and Vietnamese media as means of delivering injury-prevention messages.

CONCLUSIONS

Decreasing drowning among Vietnamese-Americans requires changing the knowledge, attitudes and safety practices with programs and messages in Vietnamese, as well as targeting the dominant culture.

Subependymoma of the cerebellopontine angle and prepontine cistern in a 15-year-old adolescent boy

SUMMARY

A case of cerebellopontine angle and prepontine cistern subependymoma in a 15-year-old adolescent boy is presented with a review of the literature. Apparent diffusion coefficient values for subependymoma are reported. Differential considerations for the unusual location of this rare tumor are discussed.

Age-related differences in the local cellular and molecular responses to injury in developing spinal cord of the opossum, Monodelphis domestica

Immature spinal cord, unlike adult, has an ability to repair itself following injury. Evidence for regeneration, structural repair and development of substantially normal locomotor behaviour comes from studies of marsupials due to their immaturity at birth. We have compared morphological, cellular and molecular changes in spinal cords transected at postnatal day (P)7 or P14, from 3 h to 2 weeks post-injury, in South American opossums (Monodelphis domestica). A bridge between severed ends of cords was apparent 5 days post-injury in P7 cords, compared to 2 weeks in P14. The volume of neurofilament (axonal) material in the bridge 2 weeks after injury was 30% of control in P7- but < 10% in P14-injured cords. Granulocytes accumulated at the site of injury earlier (3 h) in P7 than in P14 (24 h)-injured animals. Monocytes accumulated 24 h post-injury and accumulation was greater in P14 cords. Accumulation of GFAP-positive astrocytes at the lesion occurred earlier in P14-injured cords. Neurites and growth cones were identified ultrastructurally in contact with astrocytes forming the bridge. Results using mouse inflammatory gene arrays showed differences in levels of expression of many TGF, TNF, cytokine, chemokine and interleukin gene families. Most of the genes identified were up-regulated to a greater extent following injury at P7. Some changes were validated and quantified by RT-PCR. Overall, the results suggest that at least some of the greater ability to recover from spinal cord transection at P7 compared to P14 in opossums is due to differences in inflammatory cellular and molecular responses.

Treatment of Bolivian Mucosal Leishmaniasis with Miltefosine

BACKGROUND

Although mucosal leishmaniasis is a prominent disease, it has been studied only to a limited extent. It is classically treated with parenteral antimony or, as a last resort, amphotericin B.

METHODS

We treated Bolivian mucosal leishmaniasis due to Leishmania braziliensis with the oral agent miltefosine, 2.5 mg/kg/day for 28 days, and followed-up for 12 months.

RESULTS

Seventy-two patients were evaluable. The cure rate for the 36 patients who had "mild" disease (i.e., affecting nasal skin and nasal mucosa) was 83%. The cure rate for the 36 patients who had more extensive disease (involving the palate, pharynx, and larynx) was 58%. Patients refused to be randomized to parenteral agents, but the cure rate for an almost contemporary group who was receiving amphotericin B (45 mg/kg over 90 days) was 7 (50%) of 14.

CONCLUSIONS

In this unrandomized trial, oral miltefosine was at least as effective as heroic doses of parenteral amphotericin B. The cure rate for miltefosine was approximately equivalent to historical cure rates using parenteral pentavalent antimony for mild and extensive disease in neighboring Peru. Although gastrointestinal side reactions do occur with miltefosine, its toxicity profile is superior to that of antimony and far superior to that of amphotericin B--in part because of the inherent attractiveness of oral versus parenteral agents. Our results suggest that miltefosine should be the treatment of choice for mucosal disease in North and South America.

Specific heat of the dilute Ising magnet LiHoxY1-xF4

We present specific heat data on three samples of the dilute Ising magnet LiHoxY1-xF4 with x=0.018, 0.045, and 0.080. Previous measurements of the ac susceptibility of an x=0.045 sample showed the Ho3+ moments to remain dynamic down to very low temperatures, and the specific heat was found to have unusually sharp features. In contrast, our measurements do not exhibit these sharp features in the specific heat and instead show a broad feature, for all three samples studied, which is qualitatively consistent with a spin glass state. Integrating C/T, however, reveals an increase in residual entropy with lower Ho concentration, consistent with recent Monte Carlo simulations showing a lack of spin glass transition for low x.

High polymorphism in Plasmodium vivax merozoite surface protein-5 (MSP5)

A key issue relating to developing multi-component anti-malarial vaccines, lies in studying Plasmodium vivax surface proteins' genetic variation. The present work was aimed at amplifying, cloning and sequencing the gene encoding P. vivax merozoite surface protein 5 (PvMSP5) in samples obtained from infected patients from Colombian areas having varying malaria transmission rates. Nucleotide sequence data reported in this paper are available in the GenBank, EMBL and DDBJ databases under Accessions numbers DQ341586 to DQ341601. Our results have revealed that PvMSP5 is one of the P. vivax surface proteins having greater polymorphism, this being restricted to specific protein regions. The intron and exon II (which includes the GPI anchor and EGF-like domain) were both highly conserved when compared to exon I; exon I displayed the greatest variation and most of the recombination events occurred within it. No geographical grouping was observed. The Nei-Gojobori test revealed significant positive selection in the samples analysed here, whereas Tajima and Fu and Li tests presented a neutral selection pattern. The results reflected a localized variation pattern, recombination between PvMSP5 alleles and also functional and immune pressures, where stronger selective forces might be acting on exon I than on exon II, suggesting that the latter could be an important region to be included in an anti-malarial vaccine.

Suppression of ocular neovascularization with siRNA targeting VEGF receptor 1

In this study, we used small interfering RNA (siRNA) directed against vascular endothelial growth factor receptor 1 (vegfr1) mRNA to investigate the role of VEGFR1 in ocular neovascularization (NV). After evaluating many siRNAs, Sirna-027 was identified; it cleaved vegfr1 mRNA at the predicted site and reduced its levels in cultured endothelial cells and in mouse models of retinal and choroidal neovascularization (CNV). Compared to injection of an inverted control sequence, quantitative reverse transcriptase-PCR demonstrated statistically significant reductions of 57 and 40% in vegfr1 mRNA after intravitreous or periocular injection of Sirna-027, respectively. Staining showed uptake of 5-bromodeoxyuridine-labeled Sirna-027 in retinal cells that lasted between 3 and 5 days after intravitreous injection and was still present 5 days after periocular injection. In a CNV model, intravitreous or periocular injections of Sirna-027 resulted in significant reductions in the area of NV ranging from 45 to 66%. In mice with ischemic retinopathy, intravitreous injection of 1.0 mug of Sirna-027 reduced retinal NV by 32% compared to fellow eyes treated with 1.0 mug of inverted control siRNA. These data suggest that VEGFR1 plays an important role in the development of retinal and CNV and that targeting vegfr1 mRNA with siRNA has therapeutic potential.

The RIM101 pathway contributes to yeast cell wall assembly and its function becomes essential in the absence of mitogen-activated protein kinase Slt2p

The Saccharomyces cerevisiae ynl294cDelta (rim21Delta) mutant was identified in our lab owing to its moderate resistance to calcofluor, although it also displayed all of the phenotypic traits associated with its function as the putative sensor (Rim21p) of the RIM101 pathway. rim21Delta also showed moderate hypersensitivity to sodium dodecyl sulfate, caffeine, and zymolyase, and the cell wall compensatory response in this mutant was very poor, as indicated by the almost complete absence of Slt2 phosphorylation and the modest increase in chitin synthesis after calcofluor treatment. However, the cell integrity pathway appeared functional after caffeine treatment or thermal stress. rim21Delta and rim101Delta mutant strains shared all of the cell-wall-associated phenotypes, which were reverted by the expression of Rim101-531p, the constitutively active form of this transcription factor. Therefore, the absence of a functional RIM101 pathway leads to cell wall defects. rim21Delta, as well as rim101Delta, was synthetic lethal with slt2Delta, a synthetic defect alleviated by osmotic stabilization of the media. The double mutants grown in osmotically stabilized media were extremely hypersensitive to zymolyase and showed thicker cell walls, with poorly defined mannoprotein layers. In contrast, rim21Delta rlm1Delta and rim101Delta rlm1Delta double mutants were fully viable. Taken together, these results show that the RIM101 pathway participates directly in cell wall assembly and that it acts in parallel with the protein kinase C pathway (PKC) in this process independently of the transcriptional effect of the compensatory response mediated by this route. In addition, these results provide new experimental evidence of the direct involvement of the PKC signal transduction pathway through the Sltp2 kinase in the construction of yeast cell walls.

Ferromagnetic 0-pi junctions as classical spins

The ground state of highly damped PdNi based 0-pi ferromagnetic Josephson junctions shows a spontaneous half quantum vortex, sustained by a supercurrent of undetermined sign. This supercurrent flows in the electrode of a Josephson junction used as a detector and produces a phi(0)/4 shift in its magnetic diffraction pattern. We have measured the statistics of the positive or the negative sign shift occurring at the superconducting transition of such a junction. The randomness of the shift sign, the reproducibility of its magnitude, and the possibility of achieving exact flux compensation upon field cooling are the features which show that 0-pi junctions behave as classical spins, just as magnetic nanoparticles with uniaxial anisotropy.

Diagnosis of orthopedic infection in clinical practice using Tc-99m sulesomab (antigranulocyte monoclonal antibody fragment Fab'2)

OBJECTIVE

The aim of the study was to analyze the use of Tc-99m-labeled antigranulocyte monoclonal antibody fragment Fab'2 (SMab, Leukoscan) in the diagnosis of acute osteomyelitis and articular prosthesis infection. One hundred seventeen patients (118 studies) have been included, 92 women and 25 men. Thirty-seven had a suspicion of osteomyelitis and 81 with suspicion of infection of a hip (35 patients) or a knee (45 patients) prosthesis. The mean age was 64 years. A 3-phase bone scan and a SMab scan were obtained in all patients. Antigranulocyte scans were obtained within 3 and 8 hours postinjection of 20 mCi (740 MBq) of Tc-99m-labeled antibody. Diagnosis of infection was based on bone biopsy in 8 cases and on at least 2 positive cultures in the remaining cases. Infection was ruled out with negative cultures or 1-year patient follow up with negative C-reactive protein and normal erythrocyte sedimentation rate.

RESULTS

Sensitivity, specificity, accuracy, and negative predictive value of Tc 99m-SMab scintigraphy were: 75%, 95%, 87%, and 92% for long bone osteomyelitis and 80%, 89%, 87%, and 91% for articular prosthesis infection, respectively. Positive predictive values were 83% and 63%, respectively.

CONCLUSION

Tc-99m-antigranulocyte monoclonal antibody fragment Fab'2 scintigraphy seems to be a useful method in the diagnosis of osteoarticular infection.

Radiological progression in early rheumatoid arthritis after DMARDS: a one-year follow-up study in a clinical setting

OBJECTIVE

To analyse the frequency and prognostic factors of radiographic progression in a series of Spanish patients with early rheumatoid arthritis (RA) after 1 yr of treatment with disease-modifying anti-rheumatic drugs (DMARDs).

METHODS

Sixty patients (47 females, 13 males) with RA with a disease duration shorter than 2 yr [mean (s.d.) duration 9.5+/-6.6 months] were treated with the same therapeutic protocol using gold salts as the first DMARD and methotrexate as a second option, and were followed up for 1 yr. Radiographic progression in the hands and feet (total radiographic Larsen score and the erosion joint count) was used as the outcome variable. Clinical, laboratory, immunogenetic and radiographic data were obtained at study entry. Disease activity and response to therapy were measured at 6 and 12 months.

RESULTS

Erosive disease was found in 21.7% of patients at baseline and in 38.3% after 1 yr. Although a substantial reduction in disease activity was observed during the 1 yr follow-up [disease activity score (DAS28) 5.8+/-0.8 at entry and 3.9+/-1.3 at 12 months, P < 0.001], the Larsen score rose from 1.9+/-3.3 to 5.6+/-9.8 after 1 yr. In 26.6% of patients, a raised erosion joint count was observed after 1 yr. Radiographic progression in the total joint radiographic damage (increase in Larsen score of >or=2) was observed in 36.6%. In the multivariate analysis, baseline pain [visual analogue scale (VAS)] and the presence of two copies of the shared epitope were associated with radiographic progression in the erosion joint count. Disease duration before study entry, VAS pain and Larsen score at baseline were significant predictors of radiographic progression in total damage (Larsen score). Baseline radiographic damage had the highest positive predictive value for progression.

CONCLUSIONS

Radiographic progression was observed in up to 36.6% of patients with early RA after 1 yr of DMARD therapy in spite of a significant reduction in disease activity. Baseline factors, such as VAS pain, disease duration until DMARD therapy, damage score at baseline and the presence of two copies of the shared epitope, were associated with radiographic progression.

Prevalence and clinical significance of anti-cyclic citrullinated peptide and antikeratin antibodies in palindromic rheumatism. An abortive form of rheumatoid arthritis?

OBJECTIVE

To analyse the prevalence and clinical significance of anti-cyclic citrullinated peptide antibodies (anti-CCP) and antikeratin antibodies (AKA) in patients with palindromic rheumatism (PR).

METHOD

Sixty-three patients with PR were included: 33 were defined as pure or persistent PR at the time of serum test measurement, and 30 as associated PR, defined as patients with past history of PR who had developed persistent arthritis at the time of serum test: [21 with rheumatoid arthritis (RA)]. Sixty patients with early RA, and 80 with seronegative spondyloarthropathy were included as control groups. Anti-CCP were determined by a standardized ELISA test and AKA by indirect immunofluorescence in rat oesophagus. Clinical characteristics of these pure PR patients were compared according to the presence or absence of anti-CCP antibodies. A follow-up study was also performed.

RESULTS

Anti-CCP were detected in 18 out of 32 (56.3%) patients with pure PR and 10 out of 30 (33.3%) with associated PR (38.1% in RA-associated PR patients). AKA were detected in 12 patients out of 33, with pure PR (36.4%), and in 9 out of 30 with associated PR (30%) (33.3% in RA-associated PR patients). The prevalence of anti-CCP and AKA in the RA control group was 55% (not significantly different from the pure PR group) and 61.7% (with respect to pure PR patients, P=0.02), respectively. In the spondyloarthropathy group, the prevalence of anti-CCP and AKA was 2.5 and 3.8%, respectively (P<0.001 compared with pure PR patients). No significant clinical differences were observed between pure PR patients with and without CCP antibodies.

CONCLUSIONS

Anti-CCP and, to a lesser extent, AKA, were found in a high proportion of patients with PR, suggesting that this syndrome is an abortive form of RA. The predictive value of these antibodies in PR, as markers of progression to an established RA, remains uncertain.

Effectiveness of low-dose intramuscular anti-VHB immune globulin in the prophylaxis of viral B hepatitis reinfection after liver transplantation: preliminary report

INTRODUCTION

Prophylaxis using high-dose intravenous anti-HBV immune globulin (HBIG) is effective to prevent reinfection due to hepatitis B virus (HBV) after orthotopic liver transplantation (OLT). However, this treatment is expensive and intravenous administration is difficult during outpatient care. Our aim was to assess the effectiveness of low-dose intramuscular HBIG to prevent HBV reinfection after OLT.

PATIENTS

Six patients (all men, mean age 41 years, negative HBV DNA without hepatotropic virus coinfection) were transplanted in our institution due to HBV cirrhosis and included in a prospective noncomparative study. Intramuscular HBIG (2000 IU) was administered during the anhepatic phase of OLT, followed by daily 2000 IU doses for 7 days and then monthly. HBV antibody titers were measured every month. Reinfection was defined as the recurrence of surface HBV antigen in serum after transplantation.

RESULTS

After 1 year follow-up, none of the six patients had detectable HBV surface antigen and the liver biopsies were normal in all cases. Using 2000 IU, anti-HBs levels were: 880+/-356 IU/L at 1 month, 191+/-123 at 6 months, and 225+/-49 after 1 year. In all cases anti-HBs titers were above 100 IU/L during the follow-up.

CONCLUSIONS

Monthly administration of low-dose (2000 IU) intramuscular HBIG effectively prevents recurrence of HBV infection as well as attains a protective level of anti-HBs antibodies (over 100 IU/L) for at least the first year after transplantation.

The association of intestinal parasitosis and H. pylori infection in children and adults from a Mexican community with high prevalence of parasitosis

BACKGROUND

Experimental evidences have suggested that a Th1 response is unable to eliminate H. pylori colonization; whereas a Th2 response, like the one induced by vaccination, reduces H. pylori infection in animal models. Some parasitic infections induce a polarized Th2 response, which theoretically would favor a reduced H. pylori prevalence. The aim of this work was to study the possible association between parasitic infections and H. pylori prevalence.

MATERIALS AND METHODS

The study population included 120 children and 188 adults from a low socioeconomic level village. H. pylori prevalence was determined in serum by ELISA; parasitic infections were identified in feces by microscopic examination; and total serum IgE levels, as an indirect indicator of some parasitic infections, were determined by ELISA.

RESULTS

In children, H. pylori prevalence was no different between those with and without intestinal parasitic infection. By contrast, adults with intestinal parasitic infection had a significantly lower H. pylori prevalence than adults without parasites (62.6% compared with 80.4%; p = 0.006, OR 2.45). Also in adults, but not in children, total IgE levels were significantly higher in those without H. pylori infection than in those with H. pylori infection (p < 0.001).

CONCLUSIONS

Intestinal parasitic infections and serum IgE levels showed an age-dependent association with H. pylori prevalence. In adults, but not in children, intestinal parasitic infections and increased IgE levels where associated with a reduced H. pylori prevalence.

Distribution of genes encoding the trypsin-dependent lantibiotic ruminococcin A among bacteria isolated from human fecal microbiota

Fourteen bacterial strains capable of producing a trypsin-dependent antimicrobial substance active against Clostridium perfringens were isolated from human fecal samples of various origins (from healthy adults and children, as well as from adults with chronic pouchitis). Identification of these strains showed that they belonged to Ruminococcus gnavus, Clostridium nexile, and Ruminococcus hansenii species or to new operational taxonomic units, all from the Clostridium coccoides phylogenetic group. In hybridization experiments with a probe specific for the structural gene encoding the trypsin-dependent lantibiotic ruminococcin A (RumA) produced by R. gnavus, seven strains gave a positive response. All of them harbored three highly conserved copies of rumA-like genes. The deduced peptide sequence was identical to or showed one amino acid difference from the hypothetical precursor of RumA. Our results indicate that the rumA-like genes have been disseminated among R. gnavus and phylogenetically related strains that can make up a significant part of the human fecal microbiota.