Investigating the Occurrence of Soil-Transmitted Parasites Contaminating Soil, Vegetables, and Green Fodder in the East of Nile Delta, Egypt

Background

Food-borne parasites are major sources of human and animal illness, posing severe health risks in places with contaminated soil, poor water quality, cleanliness, and poor sanitation. The usage of untreated organic fertilizers arising from the excreta of the parasites' definitive hosts either man or animal pollutes the agricultural soil and is reflected in its products of vegetables and green fodders causing serious health problems. Therefore, to the best of our knowledge, this will be the first study that investigated the combination of parasitic contamination of the agricultural soil and its products of raw eaten vegetables and green fodder in East Nile Delta, Egypt.

Aim

The purpose of this study was to investigate the type and degree of contamination caused by parasites in regularly used raw vegetables, green fodder, and soil samples collected from open fields in Egypt's East Nile Delta. Study Procedures. A cross-sectional study comprised a simple random collection of 400 soil samples, 180 green fodder samples, and as well as 400 vegetable samples, including lettuce, radish, coriander, parsley, dill, watercress, tomatoes, green pepper, cucumber, and carrot, that were gathered throughout one year period from January to December 2021 to represent all seasons (winter, spring, summer, and autumn). The research locations were chosen from various open green fields and farming regions in Egypt's East Nile Delta producing ready-to-eat vegetables for human consumptions and planting green fodder for animal feeding. Concentrations, including sedimentation, and flotation, and staining techniques were used to recover the greatest number of parasitic life forms. The parasitic structures discovered were identified using biometric and imaging data and compared with known parasite morphology. Statistical analysis was performed with the SPSS software version 22 (IBM, Chicago, IL, USA). Data were presented in numbers and percentages. P-values equal to or less than 0.05 were considered to be statistically significant. The difference in parasitic contamination among the different categories was compared using the chi-square test.

Results

In this investigation, 243 out of 400 soil samples (60.7%) confirmed positive for parasitic contamination (P < 0.05). Various parasitic life forms were significantly found in 249 out of 400 (62.25%) of the vegetable samples, with (65.1%) of them harboring one parasite species, whereas 9.2% significantly contained up to three parasites. Ascaris eggs, Trichuris eggs, and Giardia cysts were the most prevalent parasites, which were predominantly isolated from vegetables with uneven surfaces. 109 of 180 (60.0%) green fodder samples confirmed insignificantly positive for parasitic pollution. The proportion of parasite contamination in vegetable samples was insignificant although the highest was in spring (29.3%), followed by summer (27.7%), whereas it is significant in autumn (24.5%). The prevalence rate was the lowest in winter (20.1%). Conclusion and Recommendations. Our findings demonstrated a significant load of parasites notably the soil-transmitted parasitic infection in raw vegetables and green fodder cultivated in open fields as well as in their mother soil in the east of the Nile Delta, Egypt. These results confirm the urgent need to deploy strict control measures to the soil, especially during the pre-harvest period of raw eaten vegetables and green fodder, a critical step in reducing food-borne transmission of soil-transmitted parasites to man and animals.

Therapeutic Potency of Ginger, Garlic, and Pomegranate Extracts Against Cryptosporidium parvum-Mediated Gastro-Splenic Damage in Mice

PURPOSE

Cryptosporidium parvum is a protozoan parasite infecting most mammalian hosts and causing major health issues. The present study investigated the efficacy of ginger (Zingiber officinale), garlic (Allium sativum), and pomegranate (Punica granatum) peel extracts on the development and progression of experimental cryptosporidiosis in mice.

METHODS

Eighty-two mice were assigned to 6 groups: control, infected non-treated, metronidazole (MTZ), ginger, garlic, and pomegranate. The control group topically received no treatments. The infected non-treated group was experimentally infected by 104 C. parvum oocysts per mouse using a stomach tube. The MTZ group was infected with C. parvum oocysts combined with MTZ (50 mg/kg b.w./day). The ginger, garlic, and pomegranate groups daily received different plant extracts at doses of 100 mg/kg BW, 50 mg/kg BW, and 3 gm/kg BW, respectively, followed by infection with C. parvum oocysts. All treatments were applied orally one day after the infection for continuous 30 days.

RESULTS

Histopathological and immunohistochemical examinations for P53 and caspase-3 expressions in stomach and spleen tissues showed that MTZ and garlic-treated mice had a more significant effect on infected mice.

CONCLUSION

The garlic extract was found to exert a more pronounced effect on infected mice compared with the other treatments as well as to improve health. Garlic extracts, therefore, represent an effective and natural therapeutic alternative for the treatment of cryptosporidiosis with low side effects and without drug resistance.

Ganoderma lucidum extract inhibits Schistosoma mansoni survival in silico and in vitro study

Schistosomosis is a worldwide tropical disease primarily caused by Schistosoma mansoni. Praziquantel is the only available drug for controlling schistosomosis, with many challenges. This study aims to evaluate the in vitro anti-Schistosoma effect of Ganoderma lucidum (G. lucidum) against adult and larval stages of Schistosoma based on the prediction of the binding activity of G. lucidum protein with proteins of various stages of S. mansoni by molecular docking to confirm its inhibitory potential through an insilico study. Results showed that Leu143, Ser165, Met214, and Asn213 were the primary crucial amino acids involved in the binding, with a promising large area of interactions between the two studied proteins. The in vitro study evaluated the motility and survival of adult and larval stages, compared to praziquantel and niclosamide, respectively. There was a significant reduction in the motility of adults after the two-hour incubation, with all concentrations and 100% death of all parasites with the minimal concentration (10 μg/ml) within 4 and 6 h of incubation (P<0.01). Regarding the cercariae, at a concentration of 10 μg/ml, all the cercariae (100%) died (P<0.01) after 15 min, and the miracidial complete mortality rate (100%) (P<0.01) occurred at a concentration of 10 μg/ml after 8 min. This study first predicted the binding activity of G. lucidum protein with proteins of S. mansoni at various stages and proved the anti-Schistosoma effect of G. lucidum in vitro, considered a promising treatment for schistosomosis.

SARS-CoV-2 infections amongst personnel providing home care services for older persons in Stockholm, Sweden

BACKGROUND

In Sweden, home care services is a major external contact for older persons.

METHODS

Five home care service companies in Stockholm, Sweden, enrolled 405 employees to a study including serum IgG to SARS-CoV-2 and SARS-CoV-2 virus in throat swabs.

RESULTS

20.1% (81/403) of employees were seropositive, about twice as many as in a simultaneously enrolled reference population (healthcare workers entirely without patient contact, n = 3671; 9.7% seropositivity). 13/379 employees (3.4%) had a current infection (PCR positivity). Amongst these, 5 were also seropositive and 3 were positive with low amounts of virus. High amounts of virus and no antibodies (a characteristic for presymptomatic COVID-19) were present in 5 employees (1.3%).

CONCLUSIONS

Personnel providing home services for older persons appear to be a risk group for SARS-CoV-2. Likely presymptomatic employees can be readily identified by screening. Increased protection of employees and of the older persons they serve is warranted.

The effects of advanced maternal age on T-cell subsets at the maternal-fetal interface prior to term labor and in the offspring: a mouse study

Women who conceive at 35 years of age or older, commonly known as advanced maternal age, have a higher risk of facing parturition complications and their children have an increased risk of developing diseases later in life. However, the immunological mechanisms underlying these pathological processes have yet to be established. To fill this gap in knowledge, using a murine model and immunophenotyping, we determined the effect of advanced maternal age on the main cellular branch of adaptive immunity, T cells, at the maternal-fetal interface and in the offspring. We report that advanced maternal age impaired the process of labor at term, inducing dystocia and delaying the timing of delivery. Advanced maternal age diminished the number of specific proinflammatory T-cell subsets [T helper type 1 (Th1): CD4⁺ IFN-γ⁺ , CD8⁺ IFN-γ⁺ and Th9: CD4⁺ IL-9⁺ ], as well as CD4⁺ regulatory T cells (CD4⁺ CD25⁺ FoxP3⁺ T cells), at the maternal-fetal interface prior to term labor. Advanced maternal age also altered fetal growth and survival of the offspring in early life. In addition, infants born to advanced-age mothers had alterations in the T-cell repertoire but not in CD71⁺ erythroid cells (CD3^- CD71⁺ TER119⁺ cells). This study provides insight into the immune alterations observed at the maternal-fetal interface of advanced-age mothers and their offspring.

Occurrence and molecular identification of Anisakis larval type 1 (Nematoda: Anisakidae) in marketed fish in Egypt

Anisakidosis is a zoonotic infection caused by members of the family Anisakidae. The presence of anisakid larvae in fish poses risk for humans and dissuade consumers from purchasing infected products. Although fish constitute important component of Egyptian diet, the prevalence of anisakid larvae in marketed fish in Egypt is not well described. Furthermore, the species of anisakid larvae is not defined in most of the available studies due to the over reliance on morphological analyses. The aim of the current work was to assess the prevalence and intensity of anisakid larvae in three common marketed fish in Egypt (Atlantic herring, Mediterranean horse mackerel and Atlantic mackerel) and to determine the species of the isolated larvae using morphological and molecular methods. Light and scanning electron microscope (SEM) analyses revealed the details of the isolated larvae. However, partial sequencing of cytochrome oxidase subunite-1 (mt cox1) gene revealed that all larvae isolated from Atlantic herring and Mediterranean horse mackerel belonged to Anisakis simplex sensu stricto with prevalence of 87.1% and 83.3%, respectively, whereas Atlantic mackerel harbored Anisakis typica with a prevalence of 42.8%. The Mediterranean horse mackerel demonstrated the highest larval mean intensity (n = 20 larvae/infected fish). This study highlights the importance of these fish as potential reservoirs for human anisakiasis in Egypt and possibly in other coastal countries.

Sex differences in functional connectivity during fetal brain development

Sex-related differences in brain and behavior are apparent across the life course, but the exact set of processes that guide their emergence in utero remains a topic of vigorous scientific inquiry. Here, we evaluate sex and gestational age (GA)-related change in functional connectivity (FC) within and between brain wide networks. Using resting-state functional magnetic resonance imaging we examined FC in 118 human fetuses between 25.9 and 39.6 weeks GA (70 male; 48 female). Infomap was applied to the functional connectome to identify discrete prenatal brain networks in utero. A consensus procedure produced an optimal model comprised of 16 distinct fetal neural networks distributed throughout the cortex and subcortical regions. We used enrichment analysis to assess network-level clustering of strong FC-GA correlations separately in each sex group, and to identify network pairs exhibiting distinct patterns of GA-related change in FC between males and females. We discovered both within and between network FC-GA associations that varied with sex. Specifically, associations between GA and posterior cingulate-temporal pole and fronto-cerebellar FC were observed in females only, whereas the association between GA and increased intracerebellar FC was stronger in males. These observations confirm that sexual dimorphism in functional brain systems emerges during human gestation.

The sphenopalatine foramen in man: anatomical, radiological and endoscopic study

BACKGROUND

Epistaxis is a frequent problem otorhinolaryngologists faces of in their practice. The variations of the sphenopalatine foramen (SPF) and consequ-ently the artery may be one of the major sources of such bleeding. The present work aimed to localise the site of SPF and also to illustrate its different shapes, number and any other variation.

MATERIALS AND METHODS

In the current study, 20 adult skulls of both sexes with total 40 half skulls were used in addition to 20 heads of adult living subjects of both sexes aged between 30 and 60 years examined with multislice helical com-puted tomography with 3-dimensional reconstruction of SPF. Then, examination of another ten dried skulls with endoscope was performed.

RESULTS

The number of the SPF is varied being single in nearly 80% and multiple in 20% of examined cases. The shape of the foramen also is varied; regular in 67.5% and irregular in 32.5% of all cases. The site of the foramen on the lateral nasal wall is placed in the superior meatus in most of examined skulls (62.5%) while in the rest (37.5%) they are found in the superior meatus and extending to the middle one.

CONCLUSIONS

There are variation of the number, shape and site of the SPF, and consequently of the branches of the sphenopalatine artery, and this may explain the surgical failure in management of severe epistaxis. The data obtained from the current work support the predication of more than one sphenopalatine ar-teries and gives ample knowledge on the endoscopic study of the lateral nasal wall and consequently the surgical treatment of severe epistaxis. (Folia Morphol 2018; 77, 2: 345-355).

In vivo activation of invariant natural killer T cells induces systemic and local alterations in T-cell subsets prior to preterm birth

Preterm birth, the leading cause of neonatal morbidity and mortality worldwide, is frequently preceded by spontaneous preterm labour, a syndrome of multiple aetiologies. Pathological inflammation is causally linked to spontaneous preterm labour. Indeed, direct activation of invariant natural killer T (iNKT) cells via α-galactosylceramide induces preterm labour/birth largely by initiating systemic and local (i.e. decidua and myometrium) innate immune responses. Herein, we investigated whether iNKT-cell activation altered local and systemic T-cell subsets. Administration of α-galactosylceramide induced an expansion of activated CD1d-restricted iNKT cells in the decidua and a reduction in the number of: (1) total T cells (conventional CD4⁺ and CD8⁺ T cells) through the down-regulation of the CD3ɛ molecule in the peripheral circulation, spleen, uterine-draining lymph nodes (ULNs), decidua and/or myometrium; (2) CD4⁺ regulatory T cells in the spleen, ULNs and decidua; (3) T helper type 17 (Th17) cells in the ULNs but an increase in the number of decidual Th17 cells; (4) CD8⁺ regulatory T cells in the spleen and ULNs; and (5) CD4⁺ and CD8⁺ forkhead box protein 3 negative (Foxp3^- ) responder T cells in the spleen and ULNs. As treatment with rosiglitazone prevents iNKT-cell activation-induced preterm labour/birth, we also explored whether the administration of this peroxisome proliferator-activated receptor gamma (PPARγ) agonist would restore the number of T cells. Treating α-galactosylceramide-injected mice with rosiglitazone partially restored the number of T cells in the spleen but not in the decidua. In summary, iNKT-cell activation altered the systemic and local T-cell subsets prior to preterm labour/birth; however, treatment with rosiglitazone partially reversed such effects.

Vaginal progesterone decreases preterm birth ≤ 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study

OBJECTIVE

To evaluate the efficacy of vaginal progesterone administration for preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton gestation and a mid-trimester sonographic cervical length (CL) ≤ 25 mm.

METHODS

This was an updated systematic review and meta-analysis of randomized controlled trials comparing the use of vaginal progesterone to placebo/no treatment in women with a singleton gestation and a mid-trimester sonographic CL ≤ 25 mm. Electronic databases, from their inception to May 2016, bibliographies and conference proceedings were searched. The primary outcome measure was preterm birth ≤ 34 weeks of gestation or fetal death. Two reviewers independently selected studies, assessed the risk of bias and extracted the data. Pooled relative risks (RRs) with 95% confidence intervals (CI) were calculated.

RESULTS

Five trials involving 974 women were included. A meta-analysis, including data from the OPPTIMUM study, showed that vaginal progesterone significantly decreased the risk of preterm birth ≤ 34 weeks of gestation or fetal death compared to placebo (18.1% vs 27.5%; RR, 0.66 (95% CI, 0.52-0.83); P = 0.0005; five studies; 974 women). Meta-analyses of data from four trials (723 women) showed that vaginal progesterone administration was associated with a statistically significant reduction in the risk of preterm birth occurring at < 28 to < 36 gestational weeks (RRs from 0.51 to 0.79), respiratory distress syndrome (RR, 0.47 (95% CI, 0.27-0.81)), composite neonatal morbidity and mortality (RR, 0.59 (95% CI, 0.38-0.91)), birth weight < 1500 g (RR, 0.52 (95% CI, 0.34-0.81)) and admission to the neonatal intensive care unit (RR, 0.67 (95% CI, 0.50-0.91)). There were no significant differences in neurodevelopmental outcomes at 2 years of age between the vaginal progesterone and placebo groups.

CONCLUSION

This updated systematic review and meta-analysis reaffirms that vaginal progesterone reduces the risk of preterm birth and neonatal morbidity and mortality in women with a singleton gestation and a mid-trimester CL ≤ 25 mm, without any deleterious effects on neurodevelopmental outcome. Clinicians should continue to perform universal transvaginal CL screening at 18-24 weeks of gestation in women with a singleton gestation and to offer vaginal progesterone to those with a CL ≤ 25 mm. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Evolutionary origins of the placental expression of chromosome 19 cluster galectins and their complex dysregulation in preeclampsia

INTRODUCTION

The dysregulation of maternal-fetal immune tolerance is one of the proposed mechanisms leading to preeclampsia. Galectins are key regulator proteins of the immune response in vertebrates and maternal-fetal immune tolerance in eutherian mammals. Previously we found that three genes in a Chr19 cluster encoding for human placental galectin-13 (PP13), galectin-14 and galectin-16 emerged during primate evolution and may confer immune tolerance to the semi-allogeneic fetus.

MATERIALS AND METHODS

This study involved various methodologies for gene and protein expression profiling, genomic DNA methylation analyses, functional assays on differentiating trophoblasts including gene silencing, luciferase reporter and methylation assays. These methods were applied on placental specimens, umbilical cord blood cells, primary trophoblasts and BeWo cells. Genomic DNA sequences were analyzed for transposable elements, transcription factor binding sites and evolutionary conservation.

RESULTS AND DISCUSSION

The villous trophoblastic expression of Chr19 cluster galectin genes is developmentally regulated by DNA methylation and induced by key transcription factors of villous placental development during trophoblast fusion and differentiation. This latter mechanism arose via the co-option of binding sites for these transcription factors through promoter evolution and the insertion of an anthropoid-specific L1PREC2 transposable element into the 5' untranslated region of an ancestral gene followed by gene duplication events. Among placental Chr19 cluster galectin genes, the expression of LGALS13 and LGALS14 is down-regulated in preterm severe preeclampsia associated with SGA. We reveal that this phenomenon is partly originated from the dysregulated expression of key transcription factors controlling trophoblastic functions and galectin gene expression. In addition, the differential DNA methylation of these genes was also observed in preterm preeclampsia irrespective of SGA.

CONCLUSIONS

These findings reveal the evolutionary origins of the placental expression of Chr19 cluster galectins. The complex dysregulation of these genes in preeclampsia may alter immune tolerance mechanisms at the maternal-fetal interface.

In silico prediction of conserved vaccine targets in Streptococcus agalactiae strains isolated from fish, cattle, and human samples

Streptococcus agalactiae (Lancefield group B; group B streptococci) is a major pathogen that causes meningoencephalitis in fish, mastitis in cows, and neonatal sepsis and meningitis in humans. The available prophylactic measures for conserving human and animal health are not totally effective and have limitations. Effective vaccines against the different serotypes or genotypes of pathogenic strains from the various hosts would be useful. We used an in silico strategy to identify conserved vaccine candidates in 15 genomes of group B streptococci strains isolated from human, bovine, and fish samples. The degree of conservation, subcellular localization, and immunogenic potential of S. agalactiae proteins were investigated. We identified 36 antigenic proteins that were conserved in all 15 genomes. Among these proteins, 5 and 23 were shared only by human or fish strains, respectively. These potential vaccine targets may help develop effective vaccines that will help prevent S. agalactiae infection.

Spectrophotometric determination of aliphatic primary and secondary amines by reaction with p-benzoquinone

A simple, sensitive and selective spectrophotometric method has been developed for determination of aliphatic primary and secondary amines. It is based on a reaction with excess of p-benzoquinone in ethanol whereby 1:1 (amine:quinone) coloured products are obtained, which have maximum absorption at 510 nm and E(1cm)(1%) in the range 400-650. The effect of solvent, temperature, concentration of quinone and the presence of water have been kinetically investigated by the initial rate method. The conditions for monitoring amine concentrations as low as 0.1 microg/ml are optimized in the light of the kinetic data. Results with an average recovery of 98.5% and mean standard deviation of 1.9% are obtained with 9 different amines without interference from tertiary amines, ammonia, amides, imides, anilides, hydrazines and alpha-amino-acids.

"Trophoblast islands of the chorionic connective tissue" (TICCT): a novel placental histologic feature

INTRODUCTION

We found isolated or clustered trophoblasts in the chorionic connective tissue of the extraplacental membranes, and defined this novel histologic feature as the "trophoblast islands of the chorionic connective tissue" (TICCT). This study was conducted to determine the clinical significance of TICCT.

METHODS

Immunohistochemistry for cytokeratin-7 was performed on the chorioamniotic membranes (N = 2155) obtained from singleton pregnancies of 1199 uncomplicated term and 956 preterm deliveries. The study groups comprised 1236 African-American and 919 Hispanic women. Gestational age ranged from 24(+0) weeks to 41(+6) weeks. Multiple logistic regression analysis was performed to investigate the magnitude of association between patient characteristics and the presence of TICCT.

RESULTS

The likelihood of TICCT was significantly associated with advancing gestational age both in term (OR: 1.29, 95% CI: 1.16-1.45, p < 0.001) and preterm deliveries (OR: 1.19, 95% CI: 1.07-1.32, p = 0.001) . Hispanic women were less likely than African-American women to have TICCT across gestation in term (OR: 0.23, 95% CI: 0.18-0.31, p < 0.001) and preterm pregnancies (OR: 0.41, 95% CI: 0.29-0.58, p < 0.001). Women with a female fetus were significantly more likely to have TICCT than women with a male fetus, in both term (OR: 1.64, 95% CI: 1.28-2.11, p < 0.001) and preterm gestations (OR: 2.04, 95% CI: 1.46-2.85, p < 0.001). TICCT was 40% less frequent in the presence of chronic placental inflammation [term (OR: 0.60, 95% CI: 0.45-0.81, p = 0.001) and preterm gestations (OR: 0.58, 95% CI: 0.40-0.84, p = 0.003)] and in parous women at term (OR: 0.60, 95% CI: 0.44-0.81, p = 0.001).

CONCLUSIONS

Our findings suggest that the duration of pregnancy, fetal sex, and parity may influence the behavior of extravillous trophoblast and placental mesenchymal cells.

Cross-hemispheric functional connectivity in the human fetal brain

Compelling evidence indicates that psychiatric and developmental disorders are generally caused by disruptions in the functional connectivity (FC) of brain networks. Events occurring during development, and in particular during fetal life, have been implicated in the genesis of such disorders. However, the developmental timetable for the emergence of neural FC during human fetal life is unknown. We present the results of resting-state functional magnetic resonance imaging performed in 25 healthy human fetuses in the second and third trimesters of pregnancy (24 to 38 weeks of gestation). We report the presence of bilateral fetal brain FC and regional and age-related variation in FC. Significant bilateral connectivity was evident in half of the 42 areas tested, and the strength of FC between homologous cortical brain regions increased with advancing gestational age. We also observed medial to lateral gradients in fetal functional brain connectivity. These findings improve understanding of human fetal central nervous system development and provide a basis for examining the role of insults during fetal life in the subsequent development of disorders in neural FC.

Circulating cell-free fetal DNA for the detection of RHD status and sex using reflex fetal identifiers

OBJECTIVE

To determine the sensitivity and specificity of circulating cell-free fetal DNA in determining the fetal RHD status and fetal sex.

METHODS

Maternal blood was collected in each trimester of pregnancy from RhD negative nonalloimmunized women. Whole blood was centrifuged, separated into plasma and buffy coat, and frozen at -80°C. DNA analysis was conducted via allele-specific primer extensions for exons 4, 5, and 7 of the RHD gene and for a 37-base pair insertion in exon 4 (RHD pseudogene; psi) three Y-chromosome sequences (SRY, DBY, and TTY2), and an extraction control (TGIFL-like X/Y). RhD serotyping on cord blood and gender assessment of the newborns were entered into a Web-based database.

RESULTS

One hundred twenty women were enrolled. The median gestational age at the first venipuncture was 12.4 (range: 10.6-13.9) weeks with 120 samples drawn; 118 samples were drawn at 17.6 (16-20.9) weeks; and 113 samples at 28.7 (27.9-33.9) weeks. Overall accuracy for RHD was 99.1%, 99.1%, and 98.1% for each trimester and was 99.1%, 99.1%, and 100% for fetal sex determination.

CONCLUSIONS

Fetal RHD genotyping and sex can be very accurately determined in all three trimesters using circulating cell-free fetal DNA in the maternal circulation.

Determination of chloramphenicol in pharmaceutical preparations by the cadmium ion-selective electrode, spectrophotometry and atomic-absorption spectrometry

New simple methods are described for the determination of chloramphenicol and its esters in pure powders, suppositories, injections, eye-drops, capsules and oral suspensions. These are based on reduction with cadmium metal whereby 6 equivalents of cadmium ions per mole and the corresponding amino-derivative are released. Four portions of the reduction products are used for (i) measurement of the cadmium ions by atomic-absorption spectrometry at 228.8 nm; (ii) potentiometric titration with EDTA, with use of the cadmium ion-selective electrode; (iii) visual titration with EDTA, with Eriochrome Black T as indicator, (iv) diazotization and coupling with N-(1-naphthyl)ethylenediamine and measuring the resultant colour at 550 nm. The results obtained by these procedures are in good agreement, and compare favourably with those of the official methods.

Selective measurement of chromium(VI) by fluorescence quenching of ruthenium

A flow injection method is described for the selective measurement of chromium(VI) in aqueous solutions. This method is based on the dynamic quenching of ruthenium(II) fluorescence. The detection limit is 0.43 ppm and 40 samples can be analyzed per hour. Selectivity is demonstrated over ferrous, nickel, cupric and zinc cations and no effect is observed from sulfate, chloride, borate and phosphate. Some interference quenching was measured for cyanide and nitrate, but the method is more responsive to chromium(VI) by factors of 10.2 and 82, respectively. The effects of solution pH, carrier stream flow rate and ruthenium concentration are demonstrated. Results indicate the method is suitable for measuring chromium(VI) in effluents from electroplating baths.

New spectrophotometric method for the determination of phenolic hormones

A new simple, selective and accurate spectrophotometric method is described for the determination of mono- and dihydric phenolic hormones (oestrogens and catecholamines) by nitration at 50 degrees and 100 degrees , respectively, for 10 min, followed by treatment with alkali. Coloured products with absorption maxima at 430, 385, 430, 380 and 380 nm, linearly proportional to the concentration of oestrone, oestradiol, ethinyloestradiol, adrenaline and noradrenaline, respectively, are obtained. Information is presented on the effect of nitration time, temperature, solvents, and alkali concentration. The method is satisfactorily applied to the determination of these hormones in the range 10-50mug ml in the final solution, of volume 10ml. The relative standard deviation is +/- 0.5% and no interferences are caused by non-phenolic hormones.

Microdetermination of nitrates and nitrites-III Gasometric and gravimetric methods based on reduction with formic acid

Simple microgasometric and gravimetric methods for the determination of the nitrate and nitrite groups are described. These are based on reduction with formic acid whereby one mole of nitrous oxide and four moles of carbon dioxide are simultaneously liberated per two moles of nitrate; two moles of nitrous oxide and six moles of carbon dioxide are liberated per seven moles of nitrite. Nitrous oxide is measured gasometrically and carbon dioxide gravimetrically. Results accurate to +/- 0.2% absolute are obtained for both nitrate and nitrite.

New atomic-absorption spectrometric, potentiometric and polarographic methods for the determination of nitrates

New simple, rapid and accurate methods for the determination of organic and inorganic nitrates in the presence of various other ions have been develope.

Novel mercury (II) ion-selective polymeric membrane sensor based on ethyl-2-benzoyl-2-phenylcarbamoyl acetate

Mercury (II) ion-selective PVC membrane sensor based on ethyl-2-benzoyl-2-phenylcarbamoyl acetate (EBPCA) as a novel nitrogen containing sensing material is successfully developed. The sensor exhibits good linear response of 30 mV per decade within the concentration range 10(-6)-10(-3) mol l(-1) Hg(II). The sensor shows good selectivity for mercury (II) ion in comparison with alkali, alkaline earth, transition and heavy metal ions. The EBPCA-based sensor is suitable for use with aqueous solutions of pH 2.0-4.5 and exhibits minimal interference by Ag(I) and Fe(III), which are known to interfere with other previously suggested sensors. The nature and composition of the sensing material and its mercury complex are examined using Fourier-transform infrared analysis, elemental analysis and X-ray fluorescence techniques. The proposed sensor is applied as a sensor for the determination of Hg(II) content in some amalgam alloys. The results show good correlation with data obtained by atomic absorption spectrometric method.

Microdetermination of phenols, carboxylic acids and phenolic acids by potentiometric and visual titrations in dimethylformamide

Potentiometric titration of phenols with sodium methoxide in dimethylformamide, with a glass-calomel electrode system, is limited to monohydric phenols substituted with electron-attracting groups and dihydric phenols in which the two -OH groups are substituted in isolated benzene rings. Brilliant Orange has proved to be a suitable indicator in the titration of all types of mono- and dihydric phenols. Titan Yellow is recommended as indicator for the titration of carboxylic acids. Simultaneous visual titration of -OH and -COOH groups is also described. A detailed study with 62 structurally different compounds covering the various groups is reported, and a suitable procedure for the microdetermination of each class of these compounds with an error of +/- 0.2% absolute or less is presented.

Determination of penicillins by desulphurization with lead and edta titration

A new, simple, accurate and rapid method is described for the determination of total penicillins in pharmaceutical preparations. The method is based on desulphurization with potassium plumbite whereby one mole of lead sulphide is formed per mole of penicillin. The excess of lead ions is titrated with EDTA at pH 4.5, with use of the lead ion-selective electrode. Results are reproducible within +/- 0.5% and compare favourably with those obtained by the procedures of the United States and British Pharmacopoeias.

Microdetermination of nitrates and nitramines-I Titrimetric methods based on the reduction with iron(II), titanium(III), and a mixture of both

Organic and inorganic nitrates are satisfactorily determined on the microscale by reduction with Fe(II). Titanium(III) reduces the nitrates in strongly acidic, citrate-buffered, and acetate-buffered media with the comsumption of 3, 6 and 8 equivalents respectively of Ti(III) per nitrate group. Nitramines are determined by reduction with a mixture of Ti(III) and Fe(II). Determination of nitrates and nitramines by trans-nitration with salicylic acid is suitable on the microscale. A new electrolytic reduction automatic microburette was devised for the reduction, storage and use of the titanium(III) solution.

Flow injection analysis of sulfite ion with a potentiometric titanium phosphate-epoxy based membrane sensor

A potentiometric sensor based on the use of titanium phosphate (TP) in epoxy matrix membrane is prepared and characterized. The sensor exhibits near-Nernstian response for many anionic species over the concentration range 10(-1)-10(-5) mol l(-1). The origin of response is explained on the basis of the conversion of titanium phosphate cation exchanger into hydrated titanium oxide anion exchanger by the effect of the high pH of the epoxy matrix. The sensitivity and selectivity of the sensor for sulfite ions are optimized by conversion of sulfite into gaseous SO(x) by acidification, and diffusion of the gas through a membrane-based gas dialyzer followed by potentiometric detection of sulfite ions formed within a flowing recipient stream. No interferences are caused by many common anions and acidic gas releasing species except sulfide and nitrite ions. Determination of sulfite ion at levels as low as 10(-4) mol l(-1) or less in the presence of nitrite and sulfide ions is performed by using a modified carrier buffer stream (10(-2) mol l(-1) MES, pH 5.0 containing sulfamic acid) and pretreatment with Pb(2+). Advantages offered by the proposed gas dialyzer/flow injection system with TP-epoxy membrane based sensor over traditional ion exchange based sensors includes long life time (>8 months), excellent stability and reproducibility ( approximately 1 mV), fast response time (<30 s), wide pH working range (pH 5-9), high sample throughput ( approximately 60 samples h(-1)), low detection limit (8x10(-6) mol l(-1)) and high thermal stability (up to 80 degrees C).

Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial

OBJECTIVES

Women with a sonographic short cervix in the mid-trimester are at increased risk for preterm delivery. This study was undertaken to determine the efficacy and safety of using micronized vaginal progesterone gel to reduce the risk of preterm birth and associated neonatal complications in women with a sonographic short cervix.

METHODS

This was a multicenter, randomized, double-blind, placebo-controlled trial that enrolled asymptomatic women with a singleton pregnancy and a sonographic short cervix (10-20 mm) at 19 + 0 to 23 + 6 weeks of gestation. Women were allocated randomly to receive vaginal progesterone gel or placebo daily starting from 20 to 23 + 6 weeks until 36 + 6 weeks, rupture of membranes or delivery, whichever occurred first. Randomization sequence was stratified by center and history of a previous preterm birth. The primary endpoint was preterm birth before 33 weeks of gestation. Analysis was by intention to treat.

RESULTS

Of 465 women randomized, seven were lost to follow-up and 458 (vaginal progesterone gel, n=235; placebo, n=223) were included in the analysis. Women allocated to receive vaginal progesterone had a lower rate of preterm birth before 33 weeks than did those allocated to placebo (8.9% (n=21) vs 16.1% (n=36); relative risk (RR), 0.55; 95% CI, 0.33-0.92; P=0.02). The effect remained significant after adjustment for covariables (adjusted RR, 0.52; 95% CI, 0.31-0.91; P=0.02). Vaginal progesterone was also associated with a significant reduction in the rate of preterm birth before 28 weeks (5.1% vs 10.3%; RR, 0.50; 95% CI, 0.25-0.97; P=0.04) and 35 weeks (14.5% vs 23.3%; RR, 0.62; 95% CI, 0.42-0.92; P=0.02), respiratory distress syndrome (3.0% vs 7.6%; RR, 0.39; 95% CI, 0.17-0.92; P=0.03), any neonatal morbidity or mortality event (7.7% vs 13.5%; RR, 0.57; 95% CI, 0.33-0.99; P=0.04) and birth weight < 1500 g (6.4% (15/234) vs 13.6% (30/220); RR, 0.47; 95% CI, 0.26-0.85; P=0.01). There were no differences in the incidence of treatment-related adverse events between the groups.

CONCLUSIONS

The administration of vaginal progesterone gel to women with a sonographic short cervix in the mid-trimester is associated with a 45% reduction in the rate of preterm birth before 33 weeks of gestation and with improved neonatal outcome.

The vaginal microbiome: new information about genital tract flora using molecular based techniques

Vaginal microbiome studies provide information that may change the way we define vaginal flora. Normal flora appears dominated by one or two species of Lactobacillus. Significant numbers of healthy women lack appreciable numbers of vaginal lactobacilli. Bacterial vaginosis (BV) is not a single entity, but instead consists of different bacterial communities or profiles of greater microbial diversity than is evident from cultivation-dependent studies. BV should be considered a syndrome of variable composition that results in different symptoms, phenotypical outcomes, and responses to different antibiotic regimens. This information may help to elucidate the link between BV and infection-related adverse outcomes of pregnancy.

Selective reduction in complicated monochorionic pregnancies: radiofrequency ablation vs. bipolar cord coagulation

OBJECTIVE

To compare radiofrequency ablation (RFA) and bipolar cord coagulation (BPC) methods for selective fetal reduction in the treatment of complicated monochorionic (MC) multifetal gestations.

METHODS

This was a retrospective review of patients who underwent selective reduction by RFA and BPC. Computer-generated random sampling was performed to match patients who had undergone BPC with patients who had undergone RFA, in a 2 : 1 ratio, controlling for gestational age and indication. The primary outcome was fetal survival.

RESULTS

Twenty patients in the RFA group were matched with 40 patients in the BPC group. Fewer additional intra-operative procedures were performed in the RFA group compared with the BPC group: amnioinfusion, 10% vs. 75%, respectively (P < 0.01); and amnioreduction, 5% vs. 40%, respectively (P = 0.004). The overall survival rates were 87.5% in the RFA group and 88% in the BPC group (P = 0.94). Median gestational age at delivery was 36 (range, 26-41) weeks in the RFA group and 39 (range, 19-40) weeks in the BPC group (P = 0.59). Preterm delivery (at < 28, < 32 or < 37 weeks), weeks gained after the procedure and birth weight at delivery were also similar. Although the preterm premature rupture of membranes (PPROM) rate was higher in the BPC group (22.5%) compared with the RFA group (5%), the difference was not statistically significant (P = 0.09).

CONCLUSIONS

Overall fetal survival rate following selective reduction in complicated MC pregnancies is similar whether reduction is performed by RFA or BPC. Fewer additional intraoperative procedures are required for RFA than for BPC. The possibility that RFA is associated with a lower rate of postoperative PPROM than is BPC will have to be confirmed in larger series.

Standardization and application of indirect plate ELISA for immunodiagnosis of paramphistomosis in ruminants

Indirect plate enzyme-linked immunosorbent assay was standardized and evaluated for its effectiveness in immunodiagnosis of paramphistomosis in experimental and clinical cases in sheep, goat, cattle and buffaloes by using somatic whole adult antigen of Paramphistomum epiclitum and Gastrothylax crumenifer. Plate enzymelinked immunosorbent assay (ELISA) was standardized using 2 μg/ml of antigen concentration with 1:200 and 1:1,000 of sera and conjugate dilution. Indirect Plate ELISA was able to demonstrate the antibody titre at different weeks postinfection in experimental sheep. Immune response at weekly interval varied in all the four experimental sheep. A paired t-test between two types of somatic antigens (P. epiclitum and G. crumenifer) showed that experimental sheep sera showed more affinity for homologous antigen as compared to heterologous antigen. A comparison of plate ELISA on suspected field sera and fecal samples examination by sedimentation method revealed that 77 samples were found to be positive by ELISA but only seven by fecal examination. Sensitivity of plate ELISA was found to be 85.71%, whereas specificity was 23.65% indicating that this test is quite sensitive for clinical cases; an early diagnosis, however, lacks specificity. In comparison to ELISA test the sensitivity and specificity of fecal examination were 7.79 and 88%, respectively.

Iliac crest angle: a novel sonographic parameter for the prediction of Down syndrome risk during the second trimester of pregnancy

OBJECTIVES

To validate a new sonographic technique for the display and measurement of fetal iliac crest angle (ICA), and to determine the relative contribution of standardized fetal pelvic measurements for estimating risk of Down syndrome during the second trimester of pregnancy.

METHODS

Three-dimensional ultrasonography of the fetal pelvis was performed during a second-trimester scan for genetic amniocentesis. A coronal view of the 'virtual pelvis' was obtained by applying a maximum intensity projection algorithm to visualize both iliac wings. Two different ICAs were measured from a coronal projection of the fetal pelvis (ICA-coronal 1 and ICA-coronal 2); the latter approach relied on using ischial tuberosities as reference landmarks. Next, a coronal projection of the fetal pelvis was rotated to demonstrate a rendered view of the axial fetal pelvis. Axial inner (ICA-inner), middle (ICA-middle) and outer (ICA-outer) ICAs were measured. The maximum anterior iliac distance measurement was defined as the widest separation between the most anterior points of the rendered iliac crests. The reproducibility of each ICA method was analyzed using Bland-Altman statistics. Simple and multiple logistic regression analysis determined the relative contribution of each parameter as a prenatal predictor of Down syndrome.

RESULTS

Ninety-four normal fetuses and 19 fetuses with Down syndrome were examined. The ICA-middle and ICA-coronal 2 parameters were the most reproducible angle measurements. The mean +/- SD ICA-middle measurement for fetuses with Down syndrome was significantly greater than that for normal subjects (94.5 +/- 9.8 degrees vs. 83.1 +/- 6.5 degrees ; P < 0.001). The mean +/- SD ICA-coronal 2 angle measurement for fetuses with Down syndrome was slightly greater than that for normal subjects (57.9 +/- 5.5 degrees vs. 51.9 +/- 7.1 degrees ; P = 0.0014). A multiple logistic regression model including ICA-middle and ICA-coronal 2 provided a predictive ability of 88.1% based on the area under the receiver-operating characteristics curve. This combination had a sensitivity of 94.4% for a false-positive rate of 5% in the detection of Down syndrome.

CONCLUSIONS

Standardized iliac crest measurements of the fetal pelvis can be used to identify some fetuses at risk for trisomy 21 during the second trimester of pregnancy.

Hydrogen chromate PVC matrix membrane sensor for potentiometric determination of chromium(III) and chromium(VI) ions

A novel potentiometric Cr(6+) PVC matrix membrane sensor incorporating nickel tris(1,10-bathophenanthroline) hydrogen chromate as an electroactive material and 2-nitrophenyl phenyl ether as solvent mediator is described. In a phosphate buffer solution of pH 5, the sensor displays a rapid and linear response for Cr(6-) over the concentration range 2 x 10(-2)-8 x 10(-6) M with an anionic slope of 55.5 +/- 0.2 mV decade(-1) and a detection limit of the order of 0.4 microg ml(-1). The sensor is used for sequential determination of Cr(6+) and Cr(3+) by direct monitoring of Cr(6+) followed by oxidation of Cr(3+) and measurement of the total chromium. The average recoveries of Cr(3+) and Cr(6+) at concentration levels of 0.5-50 microg ml(-1) are 98.1 +/- 0.4% and 99.1 +/- 0.4% respectively. Redox and precipitation titrations involving Cr(6+) as a titrant are monitored with the sensor. Cr(3+) and/or Cr(6+) in wastewaters of some industries (e.g., leather tanning, electroplating, aluminum painting) and the chromium contents of some alloys and refractory bricks are assessed. The results agree fairly well with data obtained using the standard diphenylcarbazide spectrophotometric method.

A new liquid-membrane electrode for selective determination of perchlorate

A new liquid-membrane electrode which responds to perchlorate ion is described. It incorporates a 10(-2)M solution of the nitron-perchlorate ion-pair complex, in nitrobenzene, as a liquid membrane. The electrode exhibits near-Nernstian response for 10(-2)-2 x 10(-5)M perchlorate with an anionic slope of 56 mV pClO (4)). The response time is 20-90 sec, the working pH 2.5-8.5, the lower limit of detection 8 x 10(-6)M perchlorate and the selectivity for perchlorate relative to 27 inorganic and organic anions of different nature is reasonably high. Periodate, permanganate and thiocyanate, however, interfere. Determination of 2-1000 microg ml perchlorate in aqueous solutions shows an average recovery of 98.8% and a mean relative standard deviation of 1.9%. The electrode has been successfully used for direct potentiometric determination of the purity of perchlorate propellants and the solubility products of some sparingly soluble perchlorates.

Ion-selective electrodes in organic functional group analysis: microdetermination of nitrates and nitramines with use of the iodide electrode

A simple, selective and accurate method has been described for the rapid micro and submicro determination of organic nitrates and nitramines. It is based on reaction with mercury-sulphuric acid mixture for 5 min at room temperature followed by potentiometric titration of the mercurous ions released, a solid-state iodide-sensitive electrode being used. Three equivalents of potassium iodide as titrant are consumed per mole of nitrate or nitramine group. The results obtained, with sample sizes ranging from 1.0 to 50 mumole, are precise to +/- 0.2% and the average recovery is 99%. None of the other nitrogenous functional groups responds to this reaction.

Non-invasive fetal lung assessment using diffusion-weighted imaging

OBJECTIVES

The main goal was to develop a reproducible method for estimating the diffusion of water in human fetal lung tissue using diffusion-weighted imaging (DWI). A secondary objective was to determine the relationship of the apparent diffusion coefficients (ADCs) in the fetal lung to menstrual age and total lung volume.

METHODS

Normal pregnant volunteers were scanned on a 1.5-Tesla (T) magnetic resonance imaging (MRI) system. The MRI system was equipped with 40-mT/m gradients (slew rate 200 T/m/s, rise time 0.2 ms). A six-channel body array coil was used for signal reception. Single-shot DWI utilized TE/TR 125/3400 ms, slice thickness 4 mm, field of view 280 mm x 280 mm, interslice gap 0.8 mm and a matrix of 128 x 128. The voxel size was 2.5 mm x 2.5 mm x 4.0 mm. Two b-values (0 and 1000) were chosen along three orthogonal directions. ADC maps were created using assigned b-values. Simple linear regression was performed with Pearson correlation coefficient. Interexaminer and intraexaminer bias, and 95% limits of agreement (LOA) were determined using Bland-Altman plots.

RESULTS

Forty-seven scans were performed at a mean +/- SD of 29.2 +/- 4.5 weeks. The median coefficient of variation for ADC was 5.6% (interquartile range, 4.0-8.1%). No differences in ADC values were found between right and left lungs. Normally distributed ADC measurements were not significantly correlated with either total lung volume (r(2) = 0.0001, P = 0.94) or menstrual age (r(2) = 0.003, P = 0.70). The mean ADC value was 1.75 (95% CI, 1.63-1.86). Mean +/- SD intraexaminer bias was -0.15 +/- 2.3 (95% LOA, -4.7 to + 4.4) and interexaminer bias was 2.2 +/- 3.5 (95% LOA, -4.7 to + 9.1).

CONCLUSIONS

Our findings suggest that ADC measurements of the fetal lung are reproducible between blinded examiners and are independent of menstrual age, as well as lung volume.

New fetal weight estimation models using fractional limb volume

OBJECTIVES

The main goal of this study was to determine the accuracy and precision of new fetal weight estimation models, based on fractional limb volume and conventional two-dimensional (2D) sonographic measurements during the second and third trimesters of pregnancy.

METHODS

A prospective cross-sectional study of 271 fetuses was performed using three-dimensional ultrasonography to extract standard measurements-biparietal diameter (BPD), abdominal circumference (AC) and femoral diaphysis length (FDL)-plus fractional arm volume (AVol) and fractional thigh volume (TVol) within 4 days of delivery. Weighted multiple linear regression analysis was used to develop 'modified Hadlock' models and new models using transformed predictors that included soft tissue parameters for estimating birth weight. Estimated and observed birth weights were compared using mean percent difference (systematic weight estimation error) and the SD of the percent differences (random weight estimation error). The proportion of newborns with estimated birth weight within 5 or 10% of actual birth weight were compared using McNemar's test.

RESULTS

Birth weights in the study group ranged from 235 to 5790 g, with equal proportions of male and female infants. Six new fetal weight estimation models were compared with the results for modified Hadlock models with sample-specific coefficients. All the new models were very accurate, with mean percent differences that were not significantly different from zero. Model 3 (which used the natural logarithms of BPD, AC and AVol) and Model 6 (which used the natural logarithms of BPD, AC and TVol) provided the most precise weight estimations (random error = 6.6% of actual birth weight) as compared with 8.5% for the best original Hadlock model and 7.6% for a modified Hadlock model using sample-specific coefficients. Model 5 (which used the natural logarithms of AC and TVol) classified an additional 9.1% and 8.3% of the fetuses within 5% and 10% of actual birth weight and Model 6 classified an additional 7.3% and 4.1% of infants within 5% and 10% of actual birth weight.

CONCLUSION

The precision of fetal weight estimation can be improved by adding fractional limb volume measurements to conventional 2D biometry. New models that consider fractional limb volume may offer novel insight into the contribution of soft tissue development to weight estimation.

Fetal growth parameters and birth weight: their relationship to neonatal body composition

OBJECTIVES

The main goal was to investigate the relationship between prenatal sonographic parameters and birth weight in predicting neonatal body composition.

METHODS

Standard fetal biometry and soft tissue parameters were assessed prospectively in third-trimester pregnancies using three-dimensional ultrasonography. Growth parameters included biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), mid-thigh circumference and femoral diaphysis length (FDL). Soft tissue parameters included fractional arm volume (AVol) and fractional thigh volume (TVol) that were derived from 50% of the humeral or femoral diaphysis lengths, respectively. Percentage of neonatal body fat (%BF) was determined within 48 h of delivery using a pediatric air displacement plethysmography system based on principles of whole-body densitometry. Correlation and stepwise multiple linear regression analyses were performed with potential prenatal predictors and %BF as the outcome variable.

RESULTS

Eighty-seven neonates were studied with a mean +/- SD %BF of 10.6 +/- 4.6%. TVol had the greatest correlation with newborn %BF of all single-parameter models. This parameter alone explained 46.1% of the variability in %BF and the best stepwise multiple linear regression model was: %BF = 0.129 (TVol) - 1.03933 (P < 0.001). Birth weight similarly explained 44.7% of the variation in %BF. AC and estimated fetal weight (EFW) accounted for only 24.8% and 30.4% of the variance in %BF, respectively. Skeletal growth parameters, such as FDL (14.2%), HC (7.9%) and BPD (4.0%), contributed the least towards explaining the variance in %BF.

CONCLUSIONS

During the late third trimester of pregnancy %BF is most highly correlated with TVol. Similar to actual birth weight, this soft tissue parameter accounts for a significant improvement in explaining the variation in neonatal %BF compared with fetal AC or EFW alone.

Fractional limb volume--a soft tissue parameter of fetal body composition: validation, technical considerations and normal ranges during pregnancy

OBJECTIVES

The main goals were to provide normal reference ranges for fractional limb volume as a new index of generalized fetal nutritional status, to evaluate the reproducibility of fractional fetal limb volume measurements during the second and third trimesters of pregnancy, and to demonstrate technical considerations for this technique.

METHODS

This was a prospective, cross-sectional study of gravid women during mid to late pregnancy. Fractional limb volumes were based on either 50% of humeral or femoral diaphysis length. Each partial volume was subdivided into five equidistant slices that were centered along the mid-arm or mid-thigh. Slices were traced manually to obtain fractional arm (AVol) or fractional thigh (TVol) volume. Reproducibility studies were performed, using Bland-Altman plots, to assess blinded interobserver and intraobserver measurement bias and agreement. Selected images were chosen to demonstrate technical factors for the acquisition and analysis of these parameters. Reference charts were established to describe normal ranges for AVol and TVol.

RESULTS

Three hundred and eighty-seven subjects were scanned to include 380 AVol (range, 1.1-68.3 mL) and 378 TVol (range 2.0-163.2 mL) measurements between 18.0 and 42.1 weeks' menstrual age. No gender differences were found in these soft tissue measurements (AVol, P = 0.90; TVol, P = 0.91; Mann-Whitney test). Intraobserver mean bias +/- SD and 95% limits of agreement (LOA) for fractional limb volumes were: 2.2 +/- 4.2% (95% LOA, - 6.0 to 10.5%) for AVol and 2.0 +/- 4.2% (95% LOA, - 6.3 to 10.3%) for TVol. Interobserver bias and agreement were - 1.9 +/- 4.9% (95% LOA, - 11.6 to 7.8%) for AVol and - 2.0 +/- 5.4% (95% LOA, - 12.5 to 8.6%) for TVol. Technical factors were related to image optimization, transducer pressure, fetal movement, soft tissue compression and amniotic fluid volume.

CONCLUSIONS

Fractional limb volume assessment may improve the detection and monitoring of malnourished fetuses because this soft tissue parameter can be obtained quickly and reproducibly during mid to late pregnancy. Careful attention should be placed on technical factors that can potentially affect optimal acquisition and analysis of these volume measurements.

Adiponectin multimers in maternal plasma

OBJECTIVE

Adiponectin is an anti-diabetic, anti-atherogenic, anti-inflammatory, and angiogenic adipokine that circulates in oligomeric complexes including: low molecular weight (LMW) trimers, medium molecular weight (MMW) hexamers, and high molecular weight (HMW) isoforms. The aim of this study was to determine whether there are changes in adiponectin multimers in pregnancy and as a function of maternal weight.

STUDY DESIGN

In this cross-sectional study, plasma concentrations of total, HMW, MMW, and LMW adiponectin were determined in women included in three groups: (1) normal pregnant women of normal body mass index (BMI) (n = 466), (2) overweight pregnant women (BMI >or=25; n = 257), and (3) non-pregnant women of normal weight (n = 40). Blood samples were collected once from each woman between 11 and 42 weeks of gestation. Plasma adiponectin multimer concentrations were determined by enzyme-linked immunosorbent assay (ELISA). Non-parametric statistics were used for analysis.

RESULTS

(1) The median HMW adiponectin concentration and the median HMW/total adiponectin ratio were significantly higher, and the median LMW adiponectin concentration was significantly lower in pregnant women than in non-pregnant women. (2) Among pregnant women, the median plasma concentration of total, HMW, and MMW adiponectin was significantly higher in normal weight women than in overweight patients. (3) Maternal HMW was the most prevalent adiponectin multimer regardless of gestational age or BMI status. (4) There were no significant differences in the median concentration of total, MMW, and LMW adiponectin and their relative distribution with advancing gestation.

CONCLUSION

Human pregnancy is characterized by quantitative and qualitative changes in adiponectin multimers, especially the most active isoform, HMW adiponectin.

Expression patterns of microRNAs in the chorioamniotic membranes: a role for microRNAs in human pregnancy and parturition

MicroRNAs (miRNAs) are involved in the post-transcriptional regulation of gene expression during development. This study was performed to determine gestational age-dependent changes in miRNA expression in the chorioamniotic membranes and to assess the significance of miRNAs in human pregnancy and parturition. The expression profile of 455 miRNAs was compared between patients at term without labour (TNL: n = 10), in labour (TL: n = 10), and preterm labour (PTL: n = 10) using microarrays. A total of 39 miRNAs were differentially expressed between term and preterm cases, of which 31 (79.5%) were down-regulated at term. Expression of ten miRNAs, including miR-338, differentially expressed between PTL and TL groups was decreased at term. Computational analyses using miRBase Targets have identified PLA2G4B, a phospholipase implicated in parturition, as a putative target of miR-338. Inhibition of endogenous miR-338 with anti-miR-338 increased the mRNA and protein expression of PLA2G4B in decidual cells. Luciferase assay with reporter constructs confirmed that the suppression of PLA2G4B occurs through binding of miR-338 to the 3UTR of PLA2G4B. Interestingly, the expression of Dicer, a key miRNA-processing enzyme, was markedly decreased at term, particularly with labour in the chorioamniotic membranes. Collectively, the novel findings reported herein strongly suggest that post-transcriptional regulation of genes by miRNAs, coupled with the changes of miRNA processing machinery in the chorioamniotic membranes, plays a role in pregnancy and parturition. Furthermore, the expression level of Dicer in the chorioamniotic membranes dichotomizes pathological preterm labour and physiological spontaneous labour at term.

Detection of H5, H7 and H9 subtypes of avian influenza viruses by multiplex reverse transcription-polymerase chain reaction

Subtype-specific multiplex reverse transcription-polymerase chain reaction (RT-PCR) was developed to simultaneously detect three subtypes (H5, H7 and H9) of avian influenza virus (AIV) type A. The sensitivity of the multiplex RT-PCR was evaluated and compared to that of RT-PCR-enzyme-linked immunosorbent assay (ELISA) and conventional RT-PCR. While the sensitivity of the multiplex RT-PCR is as sensitive as the conventional RT-PCR, it is 10 times less sensitive than RT-PCR-ELISA. The multiplex RT-PCR is also as sensitive as the virus isolation method in detecting H9N2 from tracheal samples collected at day 3 and 5 post inoculation. Hence, the developed multiplex RT-PCR assay is a rapid, sensitive and specific assay for detecting of AIV subtypes.

The effect of gestational age and labor on placental growth hormone in amniotic fluid

OBJECTIVE

Placental growth hormone (PGH) is produced by trophoblast. This hormone becomes detectable in maternal serum during the first trimester of pregnancy. Its concentration increases as term approaches and becomes undetectable within one hour of delivery. PGH has important biological properties, including somatogenic (growth promotion), lactogenic, and lipolytic activity. Recently, PGH has been detected in amniotic fluid (AF) of midtrimester pregnancies. The purpose of this study was to determine whether PGH concentrations in AF change with advancing gestational age and in labor at term.

DESIGN

AF was assayed for PGH concentrations in samples obtained from patients undergoing genetic amniocentesis between 14 and 18 weeks of gestation (n=67), normal patients at term not in labor (n=24), and pregnant women at term in labor (n=51). PGH concentrations were determined by ELISA. Non-parametric statistics were used for analysis.

RESULTS

(1) PGH was detected in all AF samples; (2) patients in the midtrimester had a higher median concentration of PGH in AF than those at term (midtrimester: median: 3140.5 pg/ml; range: 1124.2-13886.5 vs. term: median: 2021.1pg/ml; range: 181.6-8640.8; p<0.01); (3) there was no difference in the median concentration of PGH between women at term, not in labor, and those in labor (term not in labor: median: 2113.4pg/ml; range: 449.3-8640.8 vs. term in labor: median: 2004.1pg/ml; range: 181.6-8531.5; p=0.73).

CONCLUSIONS

(1) PGH is detectable in AF at both mid- and third trimesters; (2) the median AF concentration of PGH is significantly lower at term when compared to the second trimester; (3) labor at term is not associated with changes in the AF concentration of PGH. The role of this unique placental hormone now found in the fetal compartment requires further investigation.

Relationship between casual blood sugar and body mass index in a suburban northern Nigerian population: A short communication

BACKGROUND

Obesity is the most important modifiable risk factor in the pathogenesis of type-2 diabetes reported in most cross sectional studies. However, racial factors seem to be important in the relationship between body mass index (BMI) and glucose intolerance. This study aims at defining the relationship between these variables in two suburban populations in Nigeria.

METHOD

A prospective survey of Adults aged 55 years or younger who gave informed consent, in two communities (Makarfi and Giwa) near Zaria, northern Nigeria was done. The BMI and casual blood sugar using capillary blood assessed with the Ames glucometer were determined for all the subjects. Students t-test was used to compare continuous variables while Pearson's correlation coefficient was used for continuous variables; the level of significance was p < 0.05 in each case.

RESULT

Three-hundred and seventeen subjects participated in the study Mean age of subjects was 35.03 +/- 9.79 years (33.0 +/- 9.64 among females and 36.18 +/- 9.59 among males p = 0.1007).

CONCLUSION

Female subjects had significantly higher BMI than their male counter parts, (26.61 +/- 7.19 KgM2 versus 24.01 +/- 5.39, KgM2 p = 0.0341.) Casual blood sugar levels were however similar between males and females 85.21 +/-27.04 mg/dl versus 85.88 +/- 14.74 mg/dl, p = 0.8868. There was a positive but non-significant correlation between casual blood sugar and BMI among female subjects (r = +0.1520, p > 0.05) in the males however, the correlation between these variables was not significant (r = -0.0395, p > 0.5).

Reverse transcriptase-polymerase chain reaction-enzyme linked immunosorbent assay for rapid detection of avian influenza virus subtype H9N2

The performance of a simplified nucleoprotein (NP) and hemagglutinin-subtype-9 (H9) based reverse transcriptase-polymerase chain reaction-enzyme linked immunosorbent assay (RT-PCR-ELISA) for the detection of avian influenza virus (AIV) subtype H9N2 was compared to the standard the virus isolation method and serology testing using hemagglutination (HA) and hemagglutination inhibition (HI) tests. The H9-based RT-PCR-ELISA was 100% sensitive when compared to virus isolation method in detecting H9N2 from experimentally infected specific-pathogen-free (SPF) chickens. The NP- and H9-based RT-PCR-ELISA have a detection limit similar to the virus isolation method in detecting serially diluted tracheal swab samples obtained from chickens inoculated with H9N2. Both RT-PCR-ELISAs were also ten times more sensitive than agarose gel electrophoresis for the detection of PCR products. The result of this study demonstrate that the developed RT-PCR-ELISA is a simple and sensitive assay for the detection of type A influenza virus, particularly AIV subtype H9N2, in chickens.

Evolution and adaptation of H5N1 influenza virus in avian and human hosts in Indonesia and Vietnam

Highly pathogenic avian influenza virus H5N1 is endemic in poultry in East and Southeast Asia with disease outbreaks recently spreading to parts of central Asia, Europe and Africa. Continued interspecies transmission to humans has been reported in Vietnam, Thailand, Cambodia, Indonesia and China, causing pandemic concern. Here, we genetically characterize 82 H5N1 viruses isolated from poultry throughout Indonesia and Vietnam and 11 human isolates from southern Vietnam together with sequence data available in public databases to address questions relevant to virus introduction, endemicity and evolution. Phylogenetic analysis shows that all viruses from Indonesia form a distinct sublineage of H5N1 genotype Z viruses suggesting this outbreak likely originated from a single introduction that spread throughout the country during the past two years. Continued virus activities in Indonesia were attributed to transmission via poultry movement within the country rather than through repeated introductions by bird migration. Within Indonesia and Vietnam, H5N1 viruses have evolved over time into geographically distinct groups within each country. Molecular analysis of the H5N1 genotype Z genome shows that only the M2 and PB1-F2 genes were under positive selection, suggesting that these genes might be involved in adaptation of this virus to new hosts following interspecies transmission. At the amino acid level 12 residues were under positive selection in those genotype Z viruses, in the HA and PB1-F2 proteins. Some of these residues were more frequently observed in human isolates than in avian isolates and are related to viral antigenicity and receptor binding. Our study provides insight into the ongoing evolution of H5N1 influenza viruses that are transmitting in diverse avian species and at the interface between avian and human hosts.

Thoracoscopic management of malignant pleural effusion: technique, complications and prevention

In 1910, Professor H. C. Jacobaeus first described thoracoscopy. He used a modified cystoscope to inspect the pleural cavity. He described his two cannula techniques, one for the light source, and the other for viewing. Later on, the technique was improved, and a single cannula provided the light source and an optic telescope. With the advent of video assisted thoracoscopy, the procedure has gone full circle; once again, two cannulae are used - one to give us a video assisted telescopic picture and the second cannula is used for operational purposes.