The objectives of this study were to evaluate the reproducibility of a molecular method for the subtyping of Treponema pallidum subsp. pallidum and to discriminate strains of this microorganism from ...strains from patients with syphilis. We studied 212 specimens from a total of 82 patients with different stages of syphilis (14 primary, 7 secondary and 61 latent syphilis). The specimens were distributed as follows: genital ulcers (n = 9), skin and mucosal lesions (n = 7), blood (n = 82), plasma (n = 82), and ear lobe scrapings (n = 32). The samples were assayed by a PCR technique to amplify a segment of the polymerase gene I (polA). Positive samples were typed on the basis of the analysis of two variable genes, tpr and arp. Sixty-two of the 90 samples positive for polA yielded typeable Treponema pallidum DNA. All skin lesions in which T. pallidum was identified (six of six 100%) were found to contain enough DNA for typing of the organism. It was also possible to type DNA from 7/9 (77.7%) genital ulcer samples, 13/22 (59.1%) blood samples, 20/32 (62.5%) plasma samples, and 16/21 (76.2%) ear lobe scrapings. The same subtype was identified in all samples from the same patient. Five molecular subtypes (subtypes 10a, 14a, 14c, 14f, and 14g) were identified, with the most frequently found subtype being subtype 14a and the least frequently found subtype being subtype 10a. In conclusion, the subtyping technique used in this study seems to have good reproducibility. To our knowledge, subtype 10a was identified for the first time. Further studies are needed to explain the presence of this subtype in Portugal, namely, its relationship to the Treponema pallidum strains circulating in the African countries where Portuguese is spoken.
Context.
Type Ia supernovae (SNe Ia) are useful distance indicators in cosmology, provided their luminosity is standardized by applying empirical corrections based on light-curve properties. One ...factor behind these corrections is dust extinction, which is accounted for in the color–luminosity relation of the standardization. This relation is usually assumed to be universal, which can potentially introduce systematics into the standardization. The “mass step” observed for SN Ia Hubble residuals has been suggested as one such systematic.
Aims.
We seek to obtain a more complete view of dust attenuation properties for a sample of 162 SN Ia host galaxies and to probe their link to the mass step.
Methods.
We inferred attenuation laws toward hosts from both global and local (4 kpc) Dark Energy Survey photometry and composite stellar population model fits.
Results.
We recovered a relation between the optical depth and the attenuation slope, best explained by differing star-to-dust geometry for different galaxy orientations, which is significantly different from the optical depth and extinction slope relation observed directly for SNe. We obtain a large variation of attenuation slopes and confirm these change with host properties, such as the stellar mass and age, meaning a universal SN Ia correction should ideally not be assumed. Analyzing the cosmological standardization, we find evidence for a mass step and a two-dimensional “dust step”, both more pronounced for red SNe. Although comparable, the two steps are not found to be completely analogous.
Conclusions.
We conclude that host galaxy dust data cannot fully account for the mass step, using either an alternative SN standardization with extinction proxied by host attenuation or a dust-step approach.
In this study, polymerase chain reaction (PCR) techniques were used to detect Treponema pallidum DNA in samples from patients with latent syphilis. Sixty-nine patients with latent syphilis and 18 ...with treated syphilis were included. Whole blood, plasma, sera and ear scrapings, totalling 235 samples from patients with latent syphilis, were obtained. Three PCR assays (47-PCR, polA-PCR and M-PCR assays) were performed. The 47-PCR yielded the highest number of positive samples -92/235 (39.1%), followed by M-PCR -90/235 (38.3%) and polA-PCR -73/235 (31.1%). Ear scrapings presented the highest number of positives (47/84 -56%), followed by plasma samples (36/84 -42.9%), whole blood (32/84 -38.1%) and sera (21/84 -25%). In conclusion, we have confirmed that T. pallidum can be found in blood of patients with latent syphilis. The 47-PCR technique was found to be the most sensitive, whereas ear lobe scrapings seem to be the best specimen for detection of T. pallidum DNA in latent syphilis.
Unraveling the drivers of MERS-CoV transmission Cauchemez, Simon; Nouvellet, Pierre; Cori, Anne ...
Proceedings of the National Academy of Sciences - PNAS,
08/2016, Letnik:
113, Številka:
32
Journal Article
Recenzirano
Odprti dostop
With more than 1,700 laboratory-confirmed infections, Middle East respiratory syndrome coronavirus (MERS-CoV) remains a significant threat for public health. However, the lack of detailed data on ...modes of transmission from the animal reservoir and between humans means that the drivers of MERS-CoV epidemics remain poorly characterized. Here, we develop a statistical framework to provide a comprehensive analysis of the transmission patterns underlying the 681 MERS-CoV cases detected in the Kingdom of Saudi Arabia (KSA) between January 2013 and July 2014. We assess how infections from the animal reservoir, the different levels of mixing, and heterogeneities in transmission have contributed to the buildup of MERS-CoV epidemics in KSA. We estimate that 12% 95% credible interval (CI): 9%, 15% of cases were infected from the reservoir, the rest via human-to-human transmission in clusters (60%; CI: 57%, 63%), within (23%; CI: 20%, 27%), or between (5%; CI: 2%, 8%) regions. The reproduction number at the start of a cluster was 0.45 (CI: 0.33, 0.58) on average, but with large SD (0.53; CI: 0.35, 0.78). It was >1 in 12% (CI: 6%, 18%) of clusters but fell by approximately one-half (47% CI: 34%, 63%) its original value after 10 cases on average. The ongoing exposure of humans to MERS-CoV from the reservoir is of major concern, given the continued risk of substantial outbreaks in health care systems. The approach we present allows the study of infectious disease transmission when data linking cases to each other remain limited and uncertain.
Mass drug administration (MDA) has received growing interest to accelerate the elimination of multi-drug resistant malaria in the Greater Mekong Subregion. Targeted MDA, sometimes referred to as ...focal MDA, is the practice of delivering MDA to high incidence subpopulations only, rather than the entire population. The potential effectiveness of delivering targeted MDA was demonstrated in a recent intervention in Kayin State, Myanmar. Policymakers and funders need to know what resources are required if MDA, targeted or otherwise, is to be included in elimination packages beyond existing malaria interventions. This study aims to estimate the programmatic cost and the unit cost of targeted MDA in Kayin State, Myanmar.
We used financial data from a malaria elimination initiative, conducted in Kayin State, to estimate the programmatic costs of the targeted MDA component using a micro-costing approach. Three activities (community engagement, identification of villages for targeted MDA, and conducting mass treatment in target villages) were evaluated. We then estimated the programmatic costs of implementing targeted MDA to support P. falciparum malaria elimination in Kayin State. A costing tool was developed to aid future analyses.
The cost of delivering targeted MDA within an integrated malaria elimination initiative in eastern Kayin State was approximately US$ 910,000. The cost per person reached, distributed among those in targeted and non-targeted villages, for the MDA component was US$ 2.5.
This cost analysis can assist policymakers in determining the resources required to clear malaria parasite reservoirs. The analysis demonstrated the value of using financial data from research activities to predict programmatic implementation costs of targeting MDA to different numbers of target villages.
Background. Nocardiosis is a rare disease that mainly affects severely immunocompromised patients. Symptoms are nonspecific and microbiological isolation is difficult, hiding the diagnosis. Treatment ...should be guided by species and susceptibility testing. Findings. We report a clinical case of a disseminated nocardiosis in a patient with HIV and HVB infections. Interpretation. Diagnosis should be presumed early and microbiological conditions should be optimized, in order to identify the species and achieve antibiotic susceptibility testing. This is a very important step to choose an effective therapeutic regimen or alternative options.
This paper addresses supply risk in the oncological medicine supply chain (SC) in Colombia. A system dynamics model was developed for assessing supply risk impact on SC operation and performance. The ...costs of risk and logistics operation were evaluated in current conditions and in a risk mitigation scenario. The model was based on a systematic analysis of supply networks, mainly concerning the reduction of overall SC costs and improving service, quality and opportunity performance index. This article has resulted from research into SC risk management (SCRM) carried out by the Universidad Nacional de Colombia's SEPRO research group.
In recognition of the centenary of the Fontilles Sanitorium, we present some details of its history. The article discusses the foundation of the sanitorium by some of the numerous lepers with no ...health coverage in the region of Valencia, and Alicante in particular. After a difficult period between 1909 and 1932, the sanitorium was seized by the Republican government. After the civil war, it was returned to the board of trustees, who entrusted administrative tasks to the Compañía de Jesús while health care was overseen by the National Health Board. This coexistence was uneasy, and the board of trustees took over again in 1943. We comment on the transition from a sanitorium and colony into a hospital providing health care, research and training, and treatment with sulfones and subsequently other effective drugs. Also discussed are its role in the elimination of leprosy from Spain, admission to the International Federation of Antileprosy Associations in 1969, and its projects in endemic countries, with the ultimate goal of achieving a world free of leprosy.
To assess management patterns and outcome in patients with glioblastoma multiforme (GBM) treated during 2008-2010 in Spain.
Retrospective analysis of clinical, therapeutic, and survival data ...collected through filled questionnaires from patients with histologically confirmed GBM diagnosed in 19 Spanish hospitals.
We identified 834 patients (23% aged >70 years). Surgical resection was achieved in 66% of patients, although the extent of surgery was confirmed by postoperative MRI in only 41%. There were major postoperative complications in 14% of patients, and age was the only independent predictor (Odds ratio OR, 1.03; 95% confidence interval CI,1.01-1.05; P = .006). After surgery, 57% received radiotherapy (RT) with concomitant and adjuvant temozolomide, 21% received other regimens, and 22% were not further treated. In patients treated with surgical resection, RT, and chemotherapy (n = 396), initiation of RT ≤42 days was associated with longer progression-free survival (hazard ratio HR, 0.8; 95% CI, 0.64-0.99; P = .042) but not with overall survival (HR, 0.79; 95% CI, 0.62-1.00; P = .055). Only 32% of patients older than 70 years received RT with concomitant and adjuvant temozolomide. The median survival in this group was 10.8 months (95% CI, 6.8-14.9 months), compared with 17.0 months (95% CI, 15.5-18.4 months; P = .034) among younger patients with GBM treated with the same regimen.
In a community setting, 57% of all patients with GBM and only 32% of older patients received RT with concomitant and adjuvant temozolomide. In patients with surgical resection who were eligible for chemoradiation, initiation of RT ≤42 days was associated with better progression-free survival.
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