Variability in quantifying the Hill-Sachs lesion: A scoping review

Background

Currently, is there no consensus on a widely accepted measurement technique for calculating the Hill-Sachs lesion (HSL). The purpose of this review is to provide an overview of the techniques and imaging modalities to assess the HSL pre-operatively.

Methods

Four online databases (PubMed, Embase, MEDLINE, and COCHRANE) were searched for literature on the various modalities and measurement techniques used for quantifying HSLs, from data inception to 20 November 2021. The Methodological Index for Non-Randomized Studies tool was used to assess study quality.

Results

Forty-five studies encompassing 3413 patients were included in this review. MRA and MRI showed the highest sensitivity, specificity, and accuracy values. Intrarater and interrater agreement was shown to be the highest amongst MRA. The most common reference tests for measuring the HSL were arthroscopy, radiography, arthro-CT, and surgical techniques.

Conclusion

MRA and MRI are reliable imaging modalities with good test diagnostic properties for assessment of HSLs. There is a wide variety of measurement techniques and imaging modalities for HSL assessment, however a lack of comparative studies exists. Thus, it is not possible to comment on the superiority of one technique over another. Future studies comparing imaging modalities and measurement techniques are needed that incorporate a cost-benefit analysis.

Beyond the bones: Extraskeletal osteosarcoma of the thigh

Extraskeletal osteosarcoma (ESOS) is a rare malignant mesenchymal soft tissue tumor that usually arises in the lower extremities. It is typically a high-grade malignancy that represents only around 1%-2% of all soft tissue sarcomas and 2%-4% of all osteosarcomas. In this report, we describe a case of a 67-year-old female who presented with a 4-day history of a painless lump in her posterior right thigh. Workup utilizing different imaging modalities yielded a diagnosis of ESOS. The radiologic features of ESOS, as well as the current treatment paradigm and prognosis of this rare malignancy, will be discussed based on a review of the literature.

Addition of CT to Improve the Diagnostic Confidence for the Detection of Sacroiliac Joint Erosions in Patients with Equivocal MRI Findings

PURPOSE

To determine if CT can improve the diagnostic confidence for the detection of sacroiliac joint (SIJ) erosions in patients with equivocal MRI findings.

METHODS

A retrospective analysis of adult patients who had an SIJ MRI and a subsequent SIJ CT within 12 months was conducted. Using a 5-point Likert scale, two reviewers evaluated the de-identified MRI and CT images in randomized order and in separate sessions to answer the question: "Does the patient have SIJ erosions?". A Fisher's exact test was used to analyze the difference in diagnostic confidence, and intraclass correlation coefficient (ICC) was used to determine interrater reliability.

RESULTS

54 patients were included in the analysis (average age, 43.9 years). The average time interval between initial SIJ MRI and subsequent CT was 14.4 weeks (range, 5.6-50.3 weeks). CT resulted in significantly more cases with definitive diagnostic confidence than cases with probable or equivocal confidence compared to MRI (P < .001). Amongst cases with equivocal findings on MRI, 73.2% of cases had definitive diagnoses on CT. There was moderate interrater agreement for MRI, with an ICC of .490 [95% CI, .258-.669], and excellent agreement for CT, with an ICC of .832 [95% CI, .728-.899].

CONCLUSION

Overall, CT led to significantly increased diagnostic confidence and higher interrater reliability for the detection of SIJ erosions compared to MRI. Judicious use of CT may be useful in detecting SIJ erosions in patients with equivocal MRI findings.

Antibacterial activity of Ricinus communis plant extract against antibiotic resistant Helicobacter pylori and Gluconobacter oxydans isolated from fresh apple juices samples

Bacteria were isolated from samples of Fresh Apple juices from shops of three different localities of Lahore. Analysis of samples from Liberty, Anarkali and Yateem khana Markets show different levels of contamination. There were pathogenic and non-pathogenic bacteria in all samples and were identified by the morphological and biochemical tests. Most of the plasmids of pathogenic bacteria were 4kb in their molecular size. Ribotyping of 16S ribosomal RNA gene sequencing was done to confirm Helicobacter pylori strain and Gluconobacter oxydans. The highest sensitivity of 210mm was shown by Enterobacter sp. against Aztheromysine disk (15µg) while Micrococcus sp. was highly resistant against all of the Antibiotics applied. The antibiotic resistance of pathogenic bacteria was also checked against Ricinus communis plant's extracts, all isolated bacterial pathogens were resistant but only, E.coli was inhibited at 300µl of the extracts. Presence of pathogenic bacteria in Apple juice samples was due to contamination of sewage water in drinking water while some of these pathogenic bacteria came from Apple's tree and other from store houses of fruits.

Snapping Scapula Syndrome in the Setting of Elastofibroma Dorsi: A Case Report

A 54-year-old woman presented with a 15-year history of progressively worsening left snapping scapula syndrome (SSS) in the setting of ipsilateral elastofibroma dorsi. Her pain was refractory to multiple conservative measures. She was successfully treated with focal ultrasound-guided corticosteroid injection to the superomedial border of the scapula. There was demonstrable improvement in findings between pre- and post-procedural MRI examinations. Despite the underlying cause of SSS, trials of nonoperative treatment techniques are warranted before considering surgical options. Focal ultrasound-guided corticosteroid injection, in conjunction with physiotherapy, is one such example.

The histological and elemental characterisation of corrosion particles from taper junctions

OBJECTIVES

This study aimed to characterise and qualitatively grade the severity of the corrosion particles released into the hip joint following taper corrosion.

METHODS

The 26 cases examined were CoC/ABG Modular (n = 13) and ASR/SROM (n = 13). Blood serum metal ion levels were collected before and after revision surgery. The haematoxylin and eosin tissue sections were graded on the presence of fibrin exudates, necrosis, inflammatory cells and corrosion products. The corrosion products were identified based on visible observation and graded on abundance. Two independent observers blinded to the clinical patient findings scored all cases. Elemental analysis was performed on corrosion products within tissue sections. X-Ray diffraction was used to identify crystalline structures present in taper debris.

RESULTS

The CoC/ABG Modular patients had a mean age of 64.6 years (49.4 to 76.5) and ASR/SROM patients had a mean age of 58.2 years (33.3 to 85.6). The mean time in situ for CoC/ABG was 4.9 years (2 to 6.4) and ASR/SROM was 6.1 years (2.5 to 8.1). The blood serum metal ion concentrations reduced following revision surgery with the exception of Cr levels within CoC/ABG. The grading of tissue sections showed that the macrophage response and metal debris were significantly higher for the ASR/SROM patients (p < 0.001). The brown/red particles were significantly higher for ASR/SROM (p < 0.001). The taper debris contained traces of titanium oxide, chromium oxide and aluminium nitride.

CONCLUSION

This study characterised and qualitatively graded the severity of the corrosion particles released into the hip joint from tapers that had corrosion damage.Cite this article: S. Munir, R. A. Oliver, B. Zicat, W. L. Walter, W. K. Walter, W. R. Walsh. The histological and elemental characterisation of corrosion particles from taper junctions. Bone Joint Res 2016;5:370-378. DOI: 10.1302/2046-3758.59.2000507.

Heterosis and correlation in interspecific and intraspecific hybrids of cotton

Interspecific and intraspecific hybrids show varying degrees of heterosis for yield and yield components. Yield-component traits have complex genetic relationships with each other. To determine the relationship of yield-component traits and fiber traits with seed cotton yield, six lines (Bt. CIM-599, CIM-573, MNH-786, CIM-554, BH-167, and GIZA-7) and three test lines (MNH-886, V4, and CIM-557) were crossed in a line x tester mating design. Heterosis was observed for seed cotton yield, fiber traits, and for other yield-component traits. Heterosis in interspecific hybrids for seed cotton yield was more prominent than in intraspecific hybrids. The interspecific hybrid Giza-7 x MNH-886 had the highest heterosis (114.77), while among intraspecific hybrids, CIM-554 x CIM-557 had the highest heterosis (61.29) for seed cotton yield. A major trait contributing to seed cotton yield was bolls/plant followed by boll weight. Correlation studies revealed that bolls/plant, boll weight, lint weight/boll, lint index, seed index, lint/seed, staple length, and staple strength were significantly and positively associated with seed cotton yield. Selection based on boll weight, boll number, lint weight/boll, and lint index will be helpful for improving cotton seed yield.

Characterization of Polyhydroxyalkanoates Produced by Contaminated Soil Bacteria using Wastewater and Glucose as Carbon Sources

Purpose: To isolate polyhydroxyalkanoates (PHA)-producing bacterial strains from contaminated soil using industrial wastewater and glucose as carbon soured by Macrogen sequencing. Two different sources, namely, glucose and wastewater were used to ces.Methods: The strains were isolated and identified as Pseudomonas, Bacillus, Enterobacter, Exiguobacterium and Stenotrophomonas using biochemical tests and further confirmevaluate and  compare the use of wastewater as a carbon source for PHA production. The biomass obtained was analyzed by Fourier transform infra-red (FTIR) to identify the presence of PHA in it. Afterwards, PHA extraction was carried out and then gas chromatography (GC) performed to identify PHA monomers.Results: Utilization of glucose resulted in the production of PHB, while wastewater yielded copolymers poly-3 hydroxybutyrate-co-3hydroxyvalerate P(3HB-co-3HV) due to its content of volatile fatty acids such as acetic acid, propionic acid and butyric acid, which led to the production of different types of polymers. The maximum PHA production was 41 ± 0.22 % obtained for Stenotrophomonas (SM03) using 2 % glucose as carbon source while for wastewater, maximum production was achieved by the Pseudomonas strain (SM01).Conclusion: Wastewater is produced in large quantities daily during various activities and therefore can be used as a cheap carbon source for the production of valuable products such as PHA.Keywords: Polyhydroxyalkanoates, Wastewater, Glucose, Pseudomonas strain, Stenotrophomonas

Functional characterization of Foxp3-specific spontaneous immune responses

Tumor-infiltrating CD4+CD25+ regulatory T cells (Tregs) are associated with an impaired prognosis in several cancers. The transcription factor forkhead box P3 (Foxp3) is generally expressed in Tregs. Here, we identify and characterize spontaneous cytotoxic immune responses to Foxp3-expressing cells in peripheral blood of healthy volunteers and cancer patients. These immune responses were directed against a HLA-A2-restricted peptide epitope derived from Foxp3. Foxp3-reactive T cells were characterized as cytotoxic CD8+ T cells. These cells recognized dendritic cells incubated with recombinant Foxp3 protein indicating that this protein was indeed internalized, processed and cross-presented in the context of HLA-A2. More importantly, however, Foxp3-specific T cells were able to specifically recognize Tregs. Similarly, Foxp3+ malignant T cells established from a Cutaneous T-cell lymphomas (CTCL) patient were readily killed by the Foxp3-specific cytotoxic T lymphocytes. The spontaneous presence of Foxp3-specific cytotoxic T-cell responses suggest a general role of such T cells in the complex network of immune regulation as such responses may eliminate Tregs, that is, suppression of the suppressors. Consequently, induction of Foxp3-specific cytotoxic T-cell responses appears as an attractive tool to boost spontaneous or therapeutically provoked immune responses, for example, for the therapy of cancer.

Shea meal and cotton stalk as potential fuels for co-combustion with coal

The efficient management of waste biomass is an important environmental problem in agricultural countries. Often land-fill is the main disposal route with ramifications including CH(4) release having 21 times greater global warming potential per molecule than CO(2). Biomasses are considered to be CO(2)-neutral fuels when combusted. Moreover, they are renewable and covered by the renewable obligation scheme and eligible for certificates in the UK. The overall objective of the investigation is to assess the performance of selected biomass and coal co-firing under two different modes of operation, air-staging and fuel-staging with the benefit of reduced-NO(x) and SO(2) emissions in power plant. The biomasses chosen for the study, shea meal (SM) and cotton stalk (CS) have very different cellulose/lignin compositions and different reported thermal behaviour. A series of experiments have been carried out in a 20 kW, down fired combustor using coal, shea meal-coal and cotton stalk-coal blends under un-staged, air-staged and fuel-staged co-combustion configurations. For air-staging, an optimum value of primary zone stoichiometry SR(1)=0.9 was found. Keeping it fixed, the shea meal and cotton stalk content in the coal-biomass blends was set to 5%, 10% and 15% on thermal basis. NO reductions of 51% and 60% were achieved using SM and CS, respectively, with an optimum thermal biomass blending ratio (BBR) of 10%. The results obtained were compared with un-staged and air-staged results for coal without the addition of biomass. Similarly for fuel-staging, keeping the length of the reburn and burnout zone fixed, SM and CS were evaluated as reductive fuel using different reburn fuel fractions (R(ff)) of 5%, 10%, 15% and 20%. NO reductions of 83% and 84% were obtained with an optimum R(ff) of 15% with an optimum reburn zone stoichiometry of SR(2)=0.8 for both SM and CS, respectively. SO(2) reduction and char burnout efficiency were also evaluated. It was found that addition of biomass coupled with air and fuel-staging techniques reduced-NO(x) and SO(2) simultaneously while at the same time improving the char burnout efficiency.

Thermal analysis and devolatilization kinetics of cotton stalk, sugar cane bagasse and shea meal under nitrogen and air atmospheres

Thermal degradation, reactivity and kinetics for biomass materials cotton stalk (CS), sugarcane bagasse 1 (SB1), sugarcane bagasse 2 (SB2) and shea meal (SM) have been evaluated under pyrolysis (N(2)) and oxidising (dry air) conditions, using a non-isothermal thermogravimetric method (TGA). In the cases of CS and SB1 the peak temperatures were 51 degrees C higher for pyrolysis compared with oxidative degradation, whereas for SB2 and SM the difference was approximately 38 degrees C. However, the differences in the rates of weight loss were significantly higher under oxidising conditions for all the materials studied. Maximum rate of weight loss (%s(-1)) under pyrolysis conditions ranged from 0.10 to 0.18 whereas these values accelerated to the range of 0.19-0.28 under oxidising conditions, corresponding to respective peak temperatures. Samples ranked in order of reactivity (R(M)x10(3)) (%s(-1) degrees C(-1)) are CS=1.31 approximately SM=1.30>SB2=1.14>SB1=0.94 for air and CS=0.54>SB2=0.49>SB1=0.45>SM=0.31 for nitrogen. Shea meal exhibited a complex char combustion behaviour indicating that there may be two distinct types of char derived from fibrous and woody components in the original material. Activation energy calculations were based on the Arrhenius correlation.

Transcriptional response of human microglial cells to interferon-γ

Microglia, the resident macrophages in the central nervous system (CNS), play a pivotal role in innate and adaptive immune responses in the brain. The immune functions of microglia are regulated by cytokines, including interferon (IFN)-gamma, which is a major mediator of macrophage activation. We describe the transcriptional profile of human fetal microglial cells at 1, 6, and 24 h after IFN-gamma treatment. The results show a change in the expression of 405 genes including transcriptionally induced chemokines, IFN-gamma signaling factors, and major histocompatibility complex genes. Our results demonstrate that activation of microglia by IFN-gamma induces proinflammatory T-lymphocyte-related chemokine genes as well as genes involved in antigen presentation. As a result, signals for T-cell infiltration and antigen presentation are produced to allow for microglia-T-cell interactions that likely contribute to defense against invading pathogens. In sum, our results provide a foundation for the molecular mechanisms of the microglial response to IFN-gamma-a key to understanding cell-mediated immunity of the CNS.

Transcriptional analysis of the response of poultry species to respiratory pathogens

Respiratory tract diseases are the single most important cause of economic loss due to infections among poultry populations worldwide. However, the molecular mechanisms of the host response to infections remain unknown. Here, we review the literature and describe the adoption of a conceptually simple approach to understand the genetic and biochemical responses of host cells during infection with respiratory pathogens, such as avian pneumovirus (APV). The strategy that we have adopted integrates the powerful techniques of cDNA subtraction hybridization and microarray analysis for global transcriptional profiling. The results of our investigations identify the specific transcriptional alterations in host-cell gene expression that result from an attempt by the host to combat and limit the spread of the pathogen or by the pathogen to enhance its own survival and ability to reproduce. Our studies suggest that a molecular description of host-pathogen interactions in terms of differential gene expression will provide key insights on the molecular basis of disease pathogenesis, pathogen virulence, and host immunity. In addition, the results suggest that the identification of genes and pathways with a role in host response to infection has considerable practical implications for the future design and development of effective immunomodulators and vaccines.

Patient empowerment and the electronic health record

This paper presents the results of an investigation into the issue of patients viewing and controlling their Electronic Health Record (EHR), and some of the issues that an EHR would raise in terms of patient empowerment. The research was carried out with a random sample of patients from the Hadfield Medical Centre (HMC), Derbyshire and utilised a survey methodology supplemented by a few interviews. The research investigated the nature and scope of demand from patients for empowerment in terms of their own health, and the EHR. It took into account demographics. It was found that a majority of patients wish to be empowered through viewing their health record, though most prefer to use paper rather than an electronic medium. A significant majority of patients do not want to control their health record. It was found that of the demographic variables investigated, age and level of education were the only ones that had a significant impact on a patient's desire to be empowered and their desire to view their health records. The results have implications both locally and nationally for the development of electronic health records and the ultimate acceptance of such records may be linked to the general extent of computer literacy within the population rather than the views of individuals about their health.

Sequence analysis of the nucleocapsid and phosphoprotein genes of avian pneumoviruses circulating in the US

Avian pneumovirus (APV) has recently been described as the cause of a new respiratory syndrome in turkey flocks in the United States. We here describe the complete sequence of the nucleocapsid (N) and phosphoprotein (P) genes of this emerging APV (APV/US). Our results show 59 and 61% nucleotide sequence identity of the APV/US N gene with N genes of previously described European APV subgroups A and B, respectively. The P gene of APV/US showed only 53% nucleotide sequence identity with the ortholog from APV subgroup A. Phylogenetic analyses of both N and P genes clearly demonstrate that the APV/US lineage is evolutionarily related but distinct from European APVs. Moreover, sequence analysis of the N and P genes from two laboratory adapted isolates of APV/US (APV/MN-1a and APV/MN-1b) and from ten clinical samples from APV-infected turkeys suggests only modest level of amino acid divergence in the N (0-0.3%) and P (0-1.4%) proteins. Taken together, the results of this study indicate support that APV/US represents a new subgroup (subgroup C) of APV and show that there is limited heterogeneity in the N and P genes of APV/US isolates.

Detection of antibodies to U.S. isolates of avian pneumovirus by a recombinant nucleocapsid protein-based sandwich enzyme-linked immunosorbent assay

The nucleocapsid (N) protein of subgroup C (United States-specific) avian pneumovirus (APV/US) was expressed in Escherichia coli, and antibodies to the recombinant N protein were shown to specifically recognize the approximately 47-kDa N protein of APV/US by Western immunoblot analysis. The recombinant APV/US N protein was used in a sandwich-capture enzyme-linked immunosorbent assay (ELISA), and the resulting assay was found to be more sensitive and specific than the routine indirect ELISA for the detection of APV/US antibodies in turkey sera.

PCR-based detection of an emerging avian pneumovirus in US turkey flocks

Avian pneumovirus (APV) or turkey rhinotracheitis virus (TRTV) is an important respiratory pathogen of domesticated poultry in many countries in Europe, Africa, and Asia. Until recently, the United States was considered free of APV. In late 1996, an atypical upper respiratory tract infection appeared in turkey flocks in Colorado and shortly thereafter in turkey flocks in Minnesota. An avian pneumovirus (APV-US) that was serologically distinct from the previously described TRTV was isolated as the primary cause of the new syndrome. The nucleotide sequence of a fragment of the APV-US fusion gene was determined and used to develop a polymerase chain reaction-based assay that specifically detects APV-US viral nucleic acid sequences in RNA extracts of tracheal swabs and turbinate homogenates. The assay is highly sensitive in that it can detect <0.01 TCID50 of APV. The availability of this assay enables the rapid and accurate determination of APV-US in infected poultry flocks.

Difficulties for mothers in using an early intervention service for children with cerebral palsy in Bangladesh

Given the numbers of disabled children in Bangladesh and the lack of trained professionals, innovative forms of service delivery are required. The Bangladesh Protibondhi Foundation has developed an outreach parent training service based at two centres, one urban and one rural. Mothers are shown how to use pictorially based Distance Training Packages (DTP), which they take home. This paper presents findings concerning factors which seem to affect mothers' attendance with their children at DTP advisory sessions. The study followed 47 children with cerebral palsy, aged between 2 and 5.5 years, over a period of around 18 months. The main factors predicting higher attendance were the child's sex (i.e. boys were brought back more often), particularly in the rural area, and lower adaptation to the child reported by the mother. The problems described by mothers in using the DTP advisory service were economic (such as transport costs), cultural (such as mothers not being permitted out alone), and medical (such as the child having repeated fits). The implications for future service development are discussed.

Prenatal and postnatal risk factors for mental retardation among children in Bangladesh

This study evaluated the contribution of prenatal, perinatal, neonatal, and postnatal factors to the prevalence of cognitive disabilities among children aged 2-9 years in Bangladesh. A two-phase survey was implemented in 1987-1988 in which 10,299 children were screened for disability. In multivariate analyses, significant independent predictors of serious mental retardation in rural and urban areas included maternal goiter (rural odds ratio (OR) = 5.14, 95% confidence interval (CI): 1.23, 21.57; urban OR = 4.82, 95% CI: 2.73, 8.50) and postnatal brain infections (rural OR = 29.24, 95% CI: 7.17, 119.18; urban OR = 13.65, 95% CI: 4.69, 39.76). In rural areas, consanguinity (OR = 15.13, 95% CI: 3.08, 74.30) and landless agriculture (OR = 6.02, 95% CI: 1.16, 31.19) were also independently associated with the prevalence of serious mental retardation. In both rural and urban areas, independent risk factors for mild cognitive disabilities included maternal illiteracy (OR = 2.48, 95% CI: 0.86, 7.12), landlessness (OR = 4.27, 95% CI: 1.77, 10.29), maternal history of pregnancy loss (OR = 2.61, 95% CI: 0.95, 7.12), and small for gestational age at birth (OR = 3.86, 95% CI: 1.56, 9.55). Interventions likely to have the greatest impact on preventing cognitive disabilities among children in Bangladesh include expansion of existing iodine supplementation, maternal literacy, and poverty alleviation programs as well as prevention of intracranial infections and their consequences. Further population-based studies are needed to confirm and understand the association between consanguinity and serious cognitive disability.

A randomized controlled trial of alternative modes of service provision to young children with cerebral palsy in Bangladesh

OBJECTIVE

To compare the efficacy of an outreach program for young children with cerebral palsy with center-based and "minimal intervention" control groups.

DESIGN

Randomized controlled trial conducted in a group of 85 children between the ages of 1.5 and 5 years. Urban children were allocated to a daily center-based mother-child group or to monthly training of their parents along with a pictorial guidance manual. Rural children were allocated either to parent training or health advice. Outcome measures were changes in children's adaptive skills, maternal stress and adaptation to the child, satisfaction with social support, and knowledge of handling a physically disabled child.

RESULTS

Fifty-eight children were successfully followed up. The pattern of change in children's adaptive skills was as predicted (ie, least progress in the health advice group). Positive effects of intervention also included increased maternal knowledge and perceived helpfulness of support from formal sources. However, maternal adaptation increased most in the health advice group with minimal intervention. When children had attended a program at least 4 times, their skills improved, and mothers' adaptation did increase.

CONCLUSIONS

Outreach training for mothers in Bangladesh can help them to improve the skills of their young children with cerebral palsy and is perceived as helpful.

Predictors of stress in mothers of children with cerebral palsy in Bangladesh

OBJECTIVE

To identify the stress experienced by mothers of young children with cerebral palsy in Bangladesh and to determine predictive factors.

METHODS

We recruited 91 mothers of children with cerebral palsy ages 1.5 to 5 years as they sought services at an urban and a rural center for their children. Mothers were interviewed with the Self-Report Questionnaire and other family background and child behavior measures. The children were examined by a pediatrician and by a psychologist.

RESULTS

Out of 91, 38 (41. 8%) mothers were at risk for psychiatric morbidity. Significantly associated factors included living in the rural area within a poor family, with a relatively older child. The strongest predictor of maternal stress in multivariate analysis was child behavior problems, especially those related to burden of caring.

CONCLUSIONS

Ensuring practical help for mothers and advice on managing common behavior problems are important components of intervention, as they may directly help to relieve stress on mothers of young disabled children in developing countries.

Pathogenic role of SEF14, SEF17, and SEF21 fimbriae in Salmonella enterica serovar enteritidis infection of chickens

Very little is known about the contribution of surface appendages of Salmonella enterica serovar Enteritidis to pathogenesis in chickens. This study was designed to clarify the role of SEF14, SEF17, and SEF21 fimbriae in serovar Enteritidis pathogenesis. Stable, single, defined sefA (SEF14), agfA (SEF17), and fimA (SEF21) insertionally inactivated fimbrial gene mutants of serovar Enteritidis were constructed. All mutant strains invaded Caco-2 and HT-29 enterocytes at levels similar to that of the wild type. Both mutant and wild-type strains were ingested equally well by chicken macrophage cell lines HD11 and MQ-NCSU. There were no significant differences in the abilities of these strains to colonize chicken ceca. The SEF14(-) strain was isolated in lower numbers from the livers of infected chickens and was cleared from the spleens faster than other strains. No significant differences in fecal shedding of these strains were observed.

Application of recombinant fimbrial protein for the specific detection of Salmonella enteritidis infection in poultry

A number of disease outbreaks of Salmonella enterica serotype enteritidis (SE) in humans have been traced to the consumption of SE-contaminated egg and egg products. A rapid, specific, and inexpensive method of detecting SE infection in poultry is necessary to reduce human outbreaks. We evaluated rSEF14 fimbrial antigen of SE for specific detection of SE-infected birds in latex agglutination test and enzyme-linked immunosorbent assay. rSEF14 antigen was highly specific in identifying birds infected with SE. The sera from birds infected with closely related serogroup-D Salmonella and other avian pathogens did not react with rSEF14 antigen. The rSEF14 antigen identified antibodies in serum of 88% of birds during the first 2 weeks of infection, and 100% of the birds subsequently. The SE-specific antibodies were detected in egg yolk as early as 6 days post-infection in rSEF14-enzyme-linked immunosorbent assay. Our results suggest that rSEF14-based assays could be used as screening tests for detection of SE antibodies and would overcome the cross reactions observed with existing serological tests.

Mortality of urban and rural young children with cerebral palsy in Bangladesh

Bangladesh has a high child mortality rate. However, little is known about the outcome for young children who have cerebral palsy (CP). Ninety-two children with CP with a mean age of 3 years 3 months at entry into the study were followed for up to 3 years as part of an intervention study. Eight children died: two of 49 (4%) from an urban area and six of 43 (14%) from a rural area. Extrinsic factors such as infections and drug reactions preceded all the deaths, but those who died were mostly severely malnourished and among the more severely disabled of the total group. Eighty-nine percent of rural children in the study were from low-income families. Intervention programmes for severely disabled children in developing countries must include primary health care and feeding programmes as well as rehabilitation services to address both the needs of the child and empowerment of the mother and the family.