Effect of dapagliflozin against NAFLD and dyslipidemia in type 2 diabetic albino rats: possible underlying mechanisms

OBJECTIVE

The aim was to investigate the effect of dapagliflozin on non-alcoholic fatty liver disease and dyslipidemia in type 2 diabetic rats by studying the histopathological structure of the liver and detecting possible underlying mechanisms for this impact by evaluating the potential anti-inflammatory action of dapagliflozin.

MATERIALS AND METHODS

100 albino rats were used in this work and divided into five equal groups: group I (Control group), group II (Control diabetic group), group III (was administered dapagliflozin, 0.75 mg/kg, p.o.), group IV (was administered dapagliflozin, 1.5 mg/kg, p.o.), and group V (was administered dapagliflozin, 3 mg/kg, p.o.).

RESULTS

In our study, the total body weight, liver weight, liver index, blood glucose level, insulin level, insulin resistance, total cholesterol, triglycerides, liver enzymes, IL-1 β, and MDA were significantly higher in the control diabetic group than the normal group. The dapagliflozin reduced all the above variables significantly in a dose-dependent manner compared to the control diabetic group (p-value = 0.001 for all).

CONCLUSIONS

Dapagliflozin may be a promising novel treatment strategy for treating T2DM-related non-alcoholic fatty liver disease (NAFLD), and dyslipidemia where it possesses anti-oxidative, anti-inflammatory and anti-dyslipidemic effects.

Detection of Cytomegalovirus in Urine Dried on Filter Paper

Urine is the best specimen for the diagnosis of congenital cytomegalovirus, but collection and processing of liquid urine are impractical for screening. Urine dried on filter paper was processed by the same convenient, low-cost method used by newborn screening to test blood spots and showed high sensitivity and specificity.

Sensitivity of Dried Blood Spot Testing for Detection of Congenital Cytomegalovirus Infection

IMPORTANCE

The sensitivity of dried blood spots (DBS) to identify newborns with congenital cytomegalovirus (cCMV) infection has not been evaluated in screening studies using the current, higher-sensitivity methods for DBS processing.

OBJECTIVE

To assess the sensitivity of DBS polymerase chain reaction (PCR) for newborn screening for cCMV infection using saliva as the reference standard for screening, followed by collection of a urine sample for confirmation of congenital infection.

DESIGN, SETTING, AND PARTICIPANTS

This population-based cohort study took place at 5 newborn nurseries and 3 neonatal intensive care units in the Minneapolis/Saint Paul area in Minnesota from April 2016 to June 2019. Newborns enrolled with parental consent were screened for cCMV using DBS obtained for routine newborn screening and saliva collected 1 to 2 days after birth. Dried blood spots were tested for CMV DNA by PCR at both the University of Minnesota (UMN) and the US Centers for Disease Control and Prevention (CDC). Saliva swabs were tested by CMV DNA PCR at the UMN laboratory only. Newborns who screened positive by saliva or DBS had a diagnostic urine sample obtained by primary care professionals, tested by PCR within 3 weeks of birth. Analysis began July 2019.

EXPOSURES

Detection of CMV from a saliva swab using a PCR assay.

MAIN OUTCOMES AND MEASURES

Number of children with urine-confirmed cCMV and the proportion of them who were CMV positive through DBS screening.

RESULTS

Of 12 554 individuals enrolled through June 2019 (of 25 000 projected enrollment), 56 newborns were confirmed to have cCMV (4.5 per 1000 [95% CI, 3.3-5.7]). Combined DBS results from either UMN or CDC had a sensitivity of 85.7% (48 of 56; 95% CI, 74.3%-92.6%), specificity of 100.0% (95% CI, 100.0%-100.0%), positive predictive value (PPV) of 98.0% (95% CI, 89.3%-99.6%), and negative predictive value (NPV) of 99.9% (95% CI, 99.9%-100.0%). Dried blood spot results from UMN had a sensitivity of 73.2% (95% CI, 60.4%-83.0%), specificity of 100.0% (100.0%-100.0%), PPV of 100.0% (95% CI, 91.4%-100.0%), and NPV of 99.9% (95% CI, 99.8%-99.9%). Dried blood spot results from CDC had a sensitivity of 76.8% (95% CI, 64.2%-85.9%), specificity of 100.0% (95% CI, 100.0%-100.0%), PPV of 97.7% (95% CI, 88.2%-99.6%), and NPV of 99.9% (95% CI, 99.8%-99.9%). Saliva swab results had a sensitivity of 92.9% (52 of 56; 95% CI, 83.0%-97.2%), specificity of 99.9% (95% CI, 99.9%-100.0%), PPV of 86.7% (95% CI, 75.8%-93.1%), and NPV of 100.0% (95% CI, 99.9%-100.0%).

CONCLUSIONS AND RELEVANCE

This study demonstrates relatively high analytical sensitivity for DBS compared with previous studies that performed population-based screening. As more sensitive DNA extraction and PCR methods continue to emerge, DBS-based testing should remain under investigation as a potential low-cost, high-throughput option for cCMV screening.

Donor-derived human herpesvirus 8 and development of Kaposi sarcoma among 6 recipients of organs from donors with high-risk sexual and substance use behavior

Kaposi sarcoma (KS) can develop following organ transplantation through reactivation of recipient human herpesvirus 8 (HHV-8) infection or through donor-derived HHV-8 transmission. We describe 6 cases of donor-derived HHV-8 infection and KS investigated from July 2018 to January 2020. Organs from 6 donors, retrospectively identified as HHV-8-positive, with a history of drug use disorder, were transplanted into 22 recipients. Four of 6 donors had risk factors for HHV-8 infection reported in donor history questionnaires. Fourteen of 22 organ recipients (64%) had evidence of posttransplant HHV-8 infection. Lung recipients were particularly susceptible to KS. Four of the 6 recipients who developed KS died from KS or associated complications. The US opioid crisis has resulted in an increasing number and proportion of organ donors with substance use disorder, and particularly injection drug use history, which may increase the risk of HHV-8 transmission to recipients. Better awareness of the risk of posttransplant KS for recipients of organs from donors with HHV-8 infection risk could be useful for recipient management. Testing donors and recipients for HHV-8 is currently challenging with no validated commercial serology kits available. Limited HHV-8 antibody testing is available through some US reference laboratories and the Centers for Disease Control and Prevention.

Epidemiology of cytomegalovirus Infection among mothers and infants in Colombia

We assessed maternal and infant cytomegalovirus (CMV) infection in Colombia. Maternal serum was tested for CMV immunoglobulin G antibodies at a median of 10 (interquartile range: 8-12) weeks gestation (n = 1501). CMV DNA polymerase chain reaction was performed on infant urine to diagnose congenital (≤21 days of life) and postnatal (>21 days) infection. Maternal CMV seroprevalence was 98.1% (95% confidence interval [CI]: 97.5%-98.8%). Congenital CMV prevalence was 8.4 (95% CI: 3.9%-18.3%; 6/711) per 1000 live births. Among 472 infants without confirmed congenital CMV infection subsequently tested at age 6 months, 258 (54.7%, 95% CI: 50.2%-59.1%) had postnatal infection.

Assessment of vaccination with gamma radiationattenuated infective Toxocara canis eggs on murine toxocariasis

Toxocara canis is a major parasite that infects many animals with high risk of human infections. This study aims at assessing the immunization with gamma radiationattenuated infective stage on rats challenged with non-irradiated dose. Level of vaccine protection was evaluated in liver and lung regarding parasitological, histopathological, biochemical and molecular parameters. Fifty rats were enrolled in three groups: group A (10 rats) as normal control; group B (20 rats) subdivided into subgroup B1 (infected control) and subgroup B2 infected then challenged after 14 days with the same dose of infection (challenged infected control); and group C (20 rats) subdivided into subgroup C1 vaccinated with a dose of 800 gray (Gy) gamma-radiated infective eggs (vaccine control) and subgroup C2 vaccinated then challenged on 14^th day with same number of infective eggs (vaccinated-challenged). Tissues were stained with Haematoxylin and Eosin (H and E) for histopathological studies. Biochemical studies through detection of nitric oxide (NO) and Caspase-3 were conducted. Extent of DNA damage by Comet assay was assessed. Vaccinated-challenged subgroup revealed a marked reduction in larvae in tissues with mild associated histological changes. In addition there was accompanied reduction of NO, Casepase-3 level and DNA damage compared to the control infected group. It could be concluded that vaccination of rats with a dose of 800Gy gamma radiation-attenuated infective stage improves immune response to challenge infection and drastically reduces the morbidity currently seen.

Urinary Cytomegalovirus Shedding in the United States: The National Health and Nutrition Examination Surveys, 1999-2004

Background

There are no data on the prevalence of cytomegalovirus (CMV) shedding from a representative sample of the US population. This information is critical for understanding and preventing CMV.

Methods

We tested urine specimens from CMV immunoglobulin (Ig) G-positive participants aged 6-49 years in 3 racial/ethnic groups from the National Health and Nutrition Examination Surveys 1999-2004 for the presence of CMV DNA using real-time polymerase chain reaction assay. We examined the association of sociodemographic characteristics with shedding prevalence and viral loads.

Results

Among 6828 CMV IgG-positive participants tested, 537 had CMV DNA detected in urine-a shedding prevalence of 9.70%. Among persons aged 6-49 years, shedding prevalence was 3.83%. The prevalence of urinary shedding was inversely associated with increasing age (26.60%, 6.50%, and 3.45% in CMV IgG-positive participants aged 6-11, 12-19, and 20-49 years, respectively; P < .001 for trend test and pairwise comparisons). Urinary viral load also decreased significantly with age (mean, 2.97, 2.69, and 2.43 log10 copies/mL in those age groups, respectively; P < .001 for trend test and pairwise comparisons).

Conclusions

Urinary CMV shedding and viral loads decreased dramatically with age, likely reflecting higher rates of primary CMV infection and longer duration of shedding in younger individuals. The findings demonstrate that children aged 6-11 years continue to shed CMV at higher rates and viral loads than adolescents and adults and thus may still be an important source for CMV transmission.

Effect of vaccination with irradiated Toxocara canis larvae or thyme oil treatment on testicular histochemical and immunohistochemical changes of rats

Toxocara canis is widely distributed parasite that not only presents in definitive hosts but also occurs in paratenic hosts including human. Larvae migrate throughout the somatic tissue causing severe inflammatory and pathological reactions. This study aims to detect the effect of infection with Toxocara canis on testis of rats regarding histopathological, histochemical and immunohistochemical changes and amelioration of these changes with either vaccination with gamma radiation-attenuated embryonated eggs or with herbal treatment with thyme. The study was conducted on eighty rats classified into four groups (20 each): Group A (normal control); Group B (infected control); Group C infected and treated with thyme oil (thyme-treated); and Group D vaccinated with 800 Gy gamma radiation-attenuated embryonated eggs, and challenged with the same number of eggs (vaccinated-challenged). Testicular tissues were stained with Haematoxylin and Eosin (H and E) for histopathological study. Periodic acid Schiff's (PAS), bromophenol blue (BPB) and Feulgen's reaction for carbohydrates, proteins and DNA, respectively were done to examine histochemical changes. Immunohistochemical study was done through expression of TGF-β1 and caspase-3. Infected control group B showed severe histopathological changes with marked decrease in PAS +ve materials, total proteins and DNA and enhanced expression of Transforming growth factor- β1 (TGF-β1) and caspase-3. Moderate changes were observed in testicular tissues of group C treated with thyme. Slight changes were detected in vaccinated-challenged group D. It was concluded that Toxocara canis infection causes marked hispathological, histochemical and immunohistochemical changes in testicular tissues of rats that can be ameliorated by vaccination with radiation-attenuated infective stage or treated with thyme; however vaccination is more effective in protection.

CMV on surfaces in homes with young children: results of PCR and viral culture testing

Background

Caring for young children is a known risk factor for cytomegalovirus (CMV) infection mainly through exposure to their saliva and urine. In a previous study, 36 CMV-seropositive children 2 mo. to 4 years old were categorized as CMV shedders (n = 23) or non-shedders (n = 13) based on detection of CMV DNA in their saliva and urine. The current study evaluated the presence of CMV on surfaces in homes of the children.

Methods

Study staff made 4 visits to homes of the 36 enrolled children over 100 days. Saliva was collected by swabbing the mouth and urine was collected on filter paper inserted into diapers. In addition, five surface specimens were collected: three in contact with children’s saliva (spoon, child’s cheek, washcloth) and two in contact with children’s urine (diaper changing table, mother’s hand). Samples were tested by PCR and viral culture to quantify the presence of CMV DNA and viable virus.

Results

A total of 654 surface samples from 36 homes were tested; 136 were CMV DNA positive, 122 of which (90%) were in homes of the children shedding CMV (p < 0.001). Saliva–associated samples were more often CMV positive with higher viral loads than urine-associated samples. The higher the CMV viral load of the child in the home, the more home surfaces that were PCR positive (p = 0.01) and viral culture positive (p = 0.05).

Conclusions

The main source for CMV on surfaces in homes was saliva from the child in the home. Higher CMV viral loads shed by children correlated with more viable virus on surfaces which could potentially contribute to viral transmission.

Fecal microbiota profile in atopic asthmatic adult patients

Summary

Background. Studies proposed a link between gut microbiota and airway tract. Objective. Study the diversity and density of gut microbiota in healthy and asthmatic patients. Method. Semi-quantitative stool cultures were performed from fecal samples collected from 80 adult asthmatic patients and 40 healthy individuals. Data on gender, age, dietetic history, clinical examination and investigations as skin prick test and pulmonary function testing were also collected. Results.Lactobacilli were found to be higher among patient group than control group. E. coli density was statistically higher in patient than control group. No significant difference was detected between male and female patients or controls. Lactobacilli were statistically more prevalent in stool culture of male cases than that of male controls. No difference was found between female cases and controls. There was no relationship between type of microbial growth and disease related parameters including age, duration of illness, number of allergens and pulmonary function test in cases. Conclusion. Atopic asthma is significantly associated with gut microbiota Lactobacilli and E. coli. It is important to determine the organism involved, to focus on microbiome-driven disease and therapies.

Cohort study on maternal cytomegalovirus seroprevalence and prevalence and clinical manifestations of congenital infection in China

Congenital cytomegalovirus (CMV) infection is the leading viral cause of birth defects and developmental disabilities in developed countries. However, CMV seroprevalence and burden of congenital CMV infection are not well defined in China.Cohort of newborns from 5 birthing hospitals in 2 counties of Shandong Province, China, were enrolled from March 2011 to August 2013. Dried blood spots (DBS) and saliva were collected within 4 days after birth for IgG testing for maternal seroprevalence and real-time PCR testing for congenital CMV infection, respectively.Among 5020 newborns tested for CMV IgG, 4827 were seropositive, resulting in CMV maternal seroprevalence of 96.2% (95% confidence interval [CI]:95.6%-96.7%). Of the 10,933 newborns screened for congenital CMV infection, 75 had CMV detected, resulting in an overall prevalence of 0.7% (95% CI: 0.5%-0.9%), with prevalences of 0.4% (14/3995), 0.6% (66/10,857), and 0.7% (52/7761) for DBS, wet saliva, and dried saliva specimens screened, respectively. Prevalence of congenital CMV infection decreased with increasing maternal age (0.9%, 0.6%, and 0.3% among newborns delivered from mothers aged 16-25, 26-35, and >35 years, respectively; P = 0.03), and was higher among preterm infants than full term infants (1.3% vs 0.6%, P = 0.04), infants with intrauterine growth restriction (IUGR) than those without (1.8% vs 0.7%, P = 0.03), and twins or triplets than singleton pregnancies (2.8% vs 0.7%, P = 0.04). None of the 75 newborns exhibited symptomatic congenital CMV infection, and there was no difference in clinical characteristics and newborn hearing screening results between infants with and without congenital CMV infection at birth.Congenital CMV infection prevalence was lower and the clinical manifestations were milder in this relatively developed region of China compared to populations from other countries with similarly high maternal seroprevalence. Follow-up on children with congenital CMV infection will clarify the burden of disabilities from congenital CMV infection in China.

Novel effect of Daflon and low-dose γ-radiation in modulation of thioacetamide-induced hepatic encephalopathy in male albino rats

This study was designed to evaluate the hepato and neuroprotective activity of Daflon and low-dose γ radiation on thioacetamide (TAA)-induced liver damage and hepatic encephalopathy (HE) in rats. Effect of daily Daflon treatment (100 mg/kg body weight, Per OS (p.o.) for consecutive 3 days) and/or fractionated low-dose γ-radiation (LDR; 0.25 Gy, twice the total dose of 0.5 Gy at the 1st and 3rd day, respectively) was evaluated against TAA (300 mg/kg, intraperitoneal × 3) induced liver damage and HE in rats. Serum aspartate transaminase, alanine transaminase, γ-glutamyltransferase, total bilirubin, ammonia, and manganese were estimated to evaluate liver function. In addition, malondialdehyde (MDA) as well as reduced glutathione (GSH), glutathione peroxidase (GPX), superoxide dismutase (SOD), and catalase (CAT) were determined to assess antioxidant capacity in liver tissue. Moreover, hepatic apoptotic markers (cysteine-dependent aspartate-directed proteases 3, 8 (caspase-3, 8) and cytochrome C) were estimated to indicate hepatic apoptosis. HE was evaluated through the determination of whole brain ammonia, manganese, MDA, GSH, GPX, SOD, CAT, and caspase-3. The cognitive and locomotor deficits were assessed via step through passive avoidance test, activity cage (actophotometer), γ-aminobutyric acid, and N-methyl-d-aspartate/adenosine triphosphate-neuronal nitric oxide synthase/nitric oxide-cyclic guanosine monophosphate axis in rats' cerebella and hippocampi. The involvement of hypoxia inducible factor-1α, aquaporine-4, and matrix metalloproteinase 9 in association with the brain water content (%) in the whole brain as an index for brain edema was also evaluated. The obtained results showed a marked amelioration of the aforementioned biochemical parameters and behavioral tasks which is supported by histopathological and immunohistochemical examination. It could be concluded that Daflon and LDR afforded hepatoprotection and neuroprotection against TAA-induced acute liver damage and HE.

Cytomegalovirus IgM Seroprevalence among Women of Reproductive Age in the United States

Cytomegalovirus (CMV) IgM indicates recent active CMV infection. CMV IgM seroprevalence is a useful marker for prevalence of transmission. Using data from the National Health and Nutrition Examination Survey (NHANES) III 1988–1994, we present estimates of CMV IgM prevalence by race/ethnicity, provide a comparison of IgM seroprevalence among all women and among CMV IgG positive women, and explore factors possibly associated with IgM seroprevalence, including socioeconomic status and exposure to young children. There was no difference in IgM seroprevalence by race/ethnicity among all women (3.1%, 2.2%, and 1.6% for non-Hispanic white, non-Hispanic black and Mexican American, respectively; P = 0.11). CMV IgM seroprevalence decreased significantly with increasing age in non-Hispanic black women (P<0.001 for trend) and marginally among Mexican American women (P = 0.07), while no apparent trend with age was seen in non-Hispanic white women (P = 0.99). Among 4001 IgG+ women, 118 were IgM+, resulting in 4.9% IgM seroprevalence. In IgG+ women, IgM seroprevalence varied significantly by age (5.3%, 7.3%, and 3.7% for women of 12–19, 20–29, and 30–49 years; P = 0.04) and race/ethnicity (6.1%, 2.7%, and 2.0% for non-Hispanic white, non-Hispanic black, and Mexican American; P<0.001). The factors reported associated with IgG seroprevalence were not associated with IgM seroprevalence. The patterns of CMV IgM seroprevalence by age, race/ethnicity, and IgG serostatus may help understanding the epidemiology of congenital CMV infection as a consequence of vertical transmission and are useful for identifying target populations for intervention to reduce CMV transmission.

Cytomegalovirus viral and antibody correlates in young children

Background

Young, healthy children shedding cytomegalovirus (CMV) in urine and saliva appear to be the leading source of CMV in primary infection of pregnant women.

Findings

We screened 48 children 6 months – 5 years old for CMV IgG and measured levels of CMV IgG, IgM and IgG avidity antibodies, frequency of CMV shedding, and viral loads in blood, urine, and saliva. Thirteen of the 48 children (27%) were CMV IgG positive, among whom 3 were also CMV IgM positive with evidence of recent primary infection. Nine of the 13 seropositive children (69%) were shedding 10²-10⁵ copies/ml of CMV DNA in one or more bodily fluid. Among seropositive children, low IgG antibody titer (1:20–1:80) was associated with the absence of shedding (p = 0.014), and enrollment in daycare was associated with the presence of CMV shedding (p = 0.037).

Conclusions

CMV antibody profiles correlated with CMV shedding. The presence of CMV IgM more often represents primary infection in children than in adults. Correlating antibodies with primary infection and viral shedding in healthy children adds to the understanding of CMV infection in children that can inform the prevention of CMV transmission to pregnant women.

Measurements of human herpesvirus 8 viral load in blood before and after leukoreduction filtration

BACKGROUND

Human herpesvirus 8 (HHV-8) is likely transmitted through blood transfusion in high-prevalence areas. The efficacy of leukoreduction filtration for reducing HHV-8 in blood has not been reported.

STUDY DESIGN AND METHODS

Blood was drawn from 45 human immunodeficiency virus-positive men either with Kaposi's sarcoma (KS; n=21) or without KS (n=24) and subject to leukoreduction filtration. HHV-8 viral load was measured in plasma and in blood before and after filtration.

RESULTS

Twelve subjects, all with KS, had detectable HHV-8 viremia before filtration with viral loads of 10(2) to 10(5) copies/mL (mean, 3 × 10(4) copies/mL). After filtration, seven of 12 subjects no longer had detectable HHV-8 in their blood, and five of 12 subjects had detectable HHV-8 that was 90% reduced on average from prefiltration levels. The presence of HHV-8 in the blood after filtration was strongly associated with prefiltration viral loads greater than 1000 copies/mL and the presence of cell-free virus in plasma. None of the subjects without KS had detectable levels of HHV-8 virus in blood before or after filtration.

CONCLUSION

Cell-associated HHV-8 appeared to be effectively removed by leukoreduction filtration. Cell-free HHV-8 was present in 42% of subjects as 1% to 20% of the total virus which was not removed by filtration.

Human herpesvirus 8 seropositivity among sexually active adults in Uganda

Introduction

Sexual transmission of human herpesvirus 8 (HHV8) has been implicated among homosexual men, but the evidence for sexual transmission among heterosexual individuals is controversial. We investigated the role of sexual transmission of HHV8 in a nationally representative sample in Uganda, where HHV8 infection is endemic and transmitted mostly during childhood.

Materials and Methods

The study population was a subset of participants (n = 2681) from a population-based HIV/AIDS serobehavioral survey of adults aged 15–59 years conducted in 2004/2005. High risk for sexual transmission was assessed by questionnaire and serological testing for HIV and herpes simplex virus 2. Anti-HHV8 antibodies were measured using two enzyme immunoassays targeting synthetic peptides from the K8.1 and orf65 viral genes. The current study was restricted to 2288 sexually active adults. ORs and 95% CIs for HHV8 seropositivity were estimated by fitting logistic regression models with a random intercept using MPLUS and SAS software.

Results

The weighted prevalence of HHV8 seropositivity was 56.2%, based on 1302 seropositive individuals, and it increased significantly with age (P_trend<0.0001). In analyses adjusting for age, sex, geography, education, and HIV status, HHV8 seropositivity was positively associated with reporting two versus one marital union (OR:1.52, 95% CI: 1.17–1.97) and each unit increase in the number of children born (OR: 1.04, 95% CI: 1.00–1.08), and was inversely associated with ever having used a condom (OR: 0.64, 95% CI: 0.45–0.89). HHV8 seropositivity was not associated with HIV (P = 0.660) or with herpes simplex virus 2 (P = 0.732) seropositivity. Other sexual variables, including lifetime number of sexual partners or having had at least one sexually transmitted disease, and socioeconomic variables were unrelated to HHV8 seropositivity.

Conclusion

Our findings are compatible with the conclusion that sexual transmission of HHV8 in Uganda, if it occurs, is weak.

Comparative study on the different techniques for the preparation of sustained-release hydrophobic matrices of a highly water-soluble drug

The objective of the present study was to control the release of freely water-soluble salbutamol sulphate (SS) over a prolonged period of time by embedding the drug into slowly eroding waxy matrix materials such as Precirol® ATO5, Compritol® 888 ATO, beeswax, paraffin wax, carnauba wax, and stearyl alcohol. The matrices were prepared by either direct compression or hot fusion techniques. The compatibility of the drug with the various excipients was examined using differential scanning calorimetry (DSC). A factorial design was employed to study the effect of polymer type, polymer concentration (15% and 35%), and filler type (Avicel® PH101 and dibasic calcium phosphate dehydrate (DCP) on the in vitro drug release at 6 h. Results of DSC confirmed drugexcipient compatibility. Increasing the polymer ratio resulted in a significant retardation of drug release. The use of DCP resulted in significant retardation and incomplete drug release while the use of Avicel did not. The hot fusion method was found to be more effective than the direct compression method in retarding SS release. A Precirol formulation, prepared using the hot fusion technique, had the slowest drug release, releasing about 31.3% of SS over 6 h. In contrast, Compritol, prepared using the direct compression technique, had the greatest retardation, providing sustained release of 59.3% within 6 h. A hydrophobic matrix system is thus a useful technique for prolonging the release of freely water-soluble drugs such as salbutamol sulphate.

Sex and geographic patterns of human herpesvirus 8 infection in a nationally representative population‐based sample in Uganda

BACKGROUND

Human herpesvirus 8 (HHV8), the infectious cause of Kaposi sarcoma, varies dramatically across Africa, suggesting that cofactors correlated with large-area geographic or environmental characteristics may influence risk of infection. Variation in HHV8 seropositivity across small-area regions within countries in Africa is unknown. We investigated this issue in Uganda, where Kaposi sarcoma distribution is uneven and well described.

METHODS

Archival samples from individuals aged 15-59 years randomly selected from a nationally representative 2004-2005 human immunodeficiency virus-AIDS serobehavioral survey were tested for HHV8 seropositivity with use of enzyme immunoassays based on synthetic peptides from the K8.1 and orf65 viral genes. Adjusted odds ratios and 95% confidence intervals (CIs) of association of HHV8 seropositivity with demographic risk factors were estimated.

RESULTS

Among 2681 individuals tested, HHV8 seropositivity was 55.4%. HHV8 seropositivity was lower in female than in male persons (adjusted odds ratio, 0.82 [95% CI, 0.69-0.97]) and increased 2.2% (95% CI, 1.0%-3.6%) in female persons and 1.2% (95% CI, 1.0%-2.3%) in male persons per year of age. HHV8 seropositivity was inversely associated with education ( P = .01, for trend) and was elevated in the West Nile region, compared with the Central region (adjusted odds ratio, 1.49 [95% CI, 1.02-2.18]) but not with other regions.

CONCLUSIONS

Our findings suggest that HHV8 seropositivity in Uganda may be influenced by cofactors correlated with small-area geography, age, sex, and education.

Use of screening dried blood spots for estimation of prevalence, risk factors, and birth outcomes of congenital cytomegalovirus infection

OBJECTIVES

To determine the birth prevalence of cytomegalovirus (CMV) in a population-based sample of newborns by use of dried blood spots compared with previous studies that used established detection methods, and to evaluate risk factors and birth outcomes for congenital CMV infection.

STUDY DESIGN

A total of 3972 newborn dried blood spots collected for the California Newborn Screening Program were tested for presence of CMV DNA. Demographic and pregnancy data were obtained from linked newborn screening and live-birth records.

RESULTS

CMV prevalence among newborns by maternal race and ethnicity was 0.9% for blacks, 0.8% for Hispanics, 0.6% for whites, and 0.6% for Asians. Among Hispanics (n = 2053), infants who were infected had younger mothers (23 vs 26 years, P = .03), and prevalence was higher for children with no father information provided (2.6% vs 0.6%, P = .03). Overall CMV infection was associated with low birth weight (prevalence ratios [95% CI]: 3.4 [1.4-8.5]) and preterm birth (2.7 [1.4-5.1]). CMV viral loads were inversely related to birth weight and gestational age (both P = .03).

CONCLUSIONS

CMV prevalence measured with dried blood spots was similar to reports using standard viral culture methods. Dried blood spots may be suitable for detection of CMV infection in newborns and warrant further evaluation. Congenital CMV infection may contribute to low birth weight and preterm birth.

Quantitation of human herpesvirus 8 (HHV-8) antibody in patients transfused with HHV-8-seropositive blood

BACKGROUND

Human herpesvirus 8 (HHV-8) is endemic in Uganda where seroprevalence is approximately 40%. In a previous study, Ugandan patients receiving blood transfusions had multiple serum specimens collected for 6 months after transfusion to monitor for HHV-8 infection. It was observed that several HHV-8-seronegative patients were unexpectedly HHV-8 seropositive after blood transfusion.

STUDY DESIGN AND METHODS

This study measured HHV-8 antibody in serially collected serum specimens from 542 patients who received transfusions and evaluated the risk of HHV-8 infection as a function of HHV-8 antibody levels in the donors.

RESULTS

HHV-8 antibody was observed in 52% of patients transfused with HHV-8-seropositive blood in amounts that corresponded with their donor's antibody titer and waned within 40 days. Higher levels of passive HHV-8 antibody in patients who received transfusions appeared to be associated with a lower risk of HHV-8 infection.

CONCLUSION

The source of transient antibody in patients who received transfusions was determined to be the transfused blood. Donors with higher HHV-8 antibody titers may have been less likely to have infectious virus in the blood.

Transmission of human herpesvirus 8 by blood transfusion

BACKGROUND

Whether human herpesvirus 8 (HHV-8) is transmissible by blood transfusion remains undetermined. We evaluated the risk of HHV-8 transmission by blood transfusion in Uganda, where HHV-8 is endemic.

METHODS

We enrolled patients in Kampala, Uganda, who had received blood transfusions between December 2000 and October 2001. Pretransfusion and multiple post-transfusion blood specimens from up to nine visits over a 6-month period were tested for HHV-8 antibody. We calculated the excess risk of seroconversion over time among recipients of HHV-8-seropositive blood as compared with recipients of seronegative blood.

RESULTS

Of the 1811 transfusion recipients enrolled, 991 were HHV-8-seronegative before transfusion and completed the requisite follow-up, 43% of whom received HHV-8-seropositive blood and 57% of whom received seronegative blood. HHV-8 seroconversion occurred in 41 of the 991 recipients. The risk of seroconversion was significantly higher among recipients of HHV-8-seropositive blood than among recipients of seronegative blood (excess risk, 2.8%; P<0.05), and the increase in risk was seen mainly among patients in whom seroconversion occurred 3 to 10 weeks after transfusion (excess risk, 2.7%; P=0.005), a result consistent with the transmission of the virus by transfusion. Blood units stored for up to 4 days were more often associated with seroconversion than those stored for more than 4 days (excess risk, 4.2%; P<0.05).

CONCLUSIONS

This study provides strong evidence that HHV-8 is transmitted by blood transfusion. The risk may be diminished as the period of blood storage increases.

Sero-surveillance for orf antibodies in sheep and goats in Saudi Arabia employing the ELISA technique

A serological survey was conducted on sheep and goats in Saudi Arabia to detect humoral antibodies against the orf virus. The ELISA technique was superior to the AGID and CFT in detecting such antibodies. Of the 239 abattoir serum samples examined, 60 per cent had orf antibodies by ELISA while 94.8 per cent of the convalescent sera had antibodies detectable by ELISA. With the lack of vaccination and the reports that the clinical disease is commonly seen in different parts of the Kingdom, it may be that orf is becoming enzootic in this country. Recommendations for implementing a satisfactory vaccination regimen are given.

Protection conferred by vaccination with Blacksburg and Komarov strains of Newcastle disease virus against Newcastle disease in Bangladesh

An evaluation was undertaken of the efficacy of vaccination of day-old chicks with the Blacksburg (B1) strain of Newcastle disease virus (NDV) followed at various times by vaccination with the Komarov (K) strain. Antibody was detected by the haemagglutination inhibition (HAI) test one week after vaccination with B1 and titres peaked at three weeks and had declined to undetectable levels by nine weeks. After subsequent vaccination with K strain at five, seven or eight weeks of age levels of HAI antibody (titre 80 to 640) were detected after three weeks. Birds vaccinated at seven weeks were tested for antibody and resistance to challenge beyond 19 weeks of age. In this group the HAI titres remained constant (80 to 640) up to 32 weeks of age and then steadily declined to 10 to 20 at 44 weeks of age. A linear relationship between HAI titre and virus neutralising index (VNI) was demonstrated with a range of selected sera. Only birds with an HAI titre of 80 or greater resisted artificial challenge. It is recommended that, following B1 vaccination at day-old and K vaccination at seven weeks old, revaccination with K strain should be performed at intervals of not more than seven months.

Changes in distribution of some crucial elements in masseter myofibers following surgically induced trauma

Experimentally induced surgical trauma of the masseter muscle in rats led to changes in the distribution of some crucial intracellular elements as determined by microprobe analysis. Sulfur, phosphorus, and potassium values were lowered while sodium and chlorine levels were elevated. These changes were accompanied by increased formation of ice crystal artifacts in myofibers. The findings suggest that trauma causes alterations in cytoplasmic macromolecules and in the state of water in the cells. The method of analysis provides a means for the further evaluation of antiinflammatory drugs.

Early organiform impairment test (OFIT). A new performance test for assessment of early cognitive impairment

No satisfactory tests are available to a) document and b) monitor the short term effects of various pharmacological agents on early, and hopefully reversible, organic cognitive impairment in otherwise healthy individuals. A new test battery, Organiform Impairment Test (OFIT), is based on the clinical observation that impairment of the ability to operate simultaneously with a number of mental sets and stimuli is one of the first clinical manifestations in the early stages of organic brain pathology. This battery can be administered in 20-30 minutes and is partly automated. It has been standardized on 167 normal subjects in age ranges from 15 to 80 years. Any score below 50 on the battery in subjects under 80 years of age should be regarded with suspicion.

Evaluation of a surfactant mixture C31G as a teat dip by a modified excised teat model

A mixture of amphoteric surfactants with antimicrobial properties, C31G, was evaluated as a teat dip by a modified excised teat model. The model was modified to avoid misinterpretation of results from indigenous bacterial microflora on teats. In three experiments, bacterial numbers recovered from teats dipped in .75, 1.5, and 3.0% solutions of C31G were compared with bacteria recovered from undipped teats (negative controls) and teats dipped with 1.0% iodophor (an effective teat dip). Mean log reductions of teat end concentrations of Staphylococcus, aureus, Streptococcus fecalis, and Escherichia coli were determined in each experiment. Efficacy was greatest for the 3.0% solution of C31G with mean log reductions (Log reduction = Log 10 of controls - Log 10 of dipped teats) 3.53 for Staphylococcus aureus, 2.89 for Streptococcus fecalis, and 3.16 for Escherichia coli. Iodophor (1%) yielded mean log reductions of 3.26 for Staphylococcus aureus, 2.16 for Streptococcus fecalis, and 2.83 for Escherichia coli. For all three organisms, number of viable organisms decreased with increasing concentrations of C31G. The efficacy of C31G should be evaluated in vivo.

A comparative study of bupropion and amitriptyline in depressed outpatients

A double-blind controlled trial comparing a standard antidepressant drug, amitriptyline, with a new compound, bupropion, was conducted at six centers. There was a placebo washout, after which patients were assigned in a randomized fashion to one of the two treatments. No significant difference was found in therapeutic response to the two drugs after 4 weeks of treatment. Anticholinergic and cardiovascular side effects were less common in the bupropion-treated patients.

Prophylactic use of indomethacin for prevention of postsurgical complications after removal of impacted third molars

Indomethacin (100 mg. per day for 3 days) was tested for its prophylactic effects on the postsurgical complications of pain, swelling, and trismus after removal of impacted teeth. The drug resulted in a significant reduction of the swelling and an analgesic effect which was equal to that of acetaminophen and codeine. Only two minor side effects were encountered.

Effect of indomethacin on postsurgical edema in rats

The effectiveness of intramuscular indomethacin was compared with that of hydrocortisone succinate for the control of edema resulting from experimentally induced surgical trauma in rats. Both drugs produced a significant reduction in tissue water, but no difference could be detected between the effects of the two drugs. These findings indicate the advisability of clinical trials of indomethacin in the control of postsurgical swelling and pain.

Isolation and identification of African horsesickness virus from naturally infected dogs in Upper Egypt

African horsesickness virus was isolated from blood samples of street dogs in Aswan Province in Arab Republic of Egypt. Of six isolated "dog strain" African horsesickness viruses, three viruses designated D2, D6 and D10 have been identified as type 9 African horsesickness virus. Methods of isolation, tissue culture adaptation, serological indentification and typing are described. Horses experimentally infected with dog viruses showed febrile reaction and characteristic clinical and pathological signs of African horsesickness. Reisolation of African horsesickness virus type 9 was achieved from the horses during serial passages.

A survey of Mycoplasma infections in domestic poultry

A survey of mycoplasma infections of chickens, turkeys and ducks was made on tissues from a variety of sources and birds of various ages, and from pipped and dead-in-shell turkey embryos. The tissues examined consisted mainly of respiratory tissue and the cloaca and contents and also a small number of joint lesions and other tissues. From chickens, mycoplasmas were isolated from a total of 138 tissues with Mycoplasma gallisepticum in preponderance. This was followed by M gallinarum, untyped organisms, M synoviae and a number of other mycoplasmas and Acholeplasma laidlawii. From turkeys, poults and embryos, mycoplasmas were recovered from 164 tissues with M meleagridis in preponderance. This was followed by M gallisepticum, serovar I, M synoviae and a number of other species including untyped isolates. From ducks, M gallisepticum and M anatis were recovered in equal numbers. Mycoplasma infections with more than one species occurred in the same tissue in all species of stock but especially in turkeys.

Relationship between sleep deprivation and urinary MHPG levels

A 5-day study, forming the initial part of two 32-day clinical trials and involving 22 unipolar depressed inpatients, was designed to determine the relationship between response to sleep deprivation and 24-hour urinary MHPG levels. A statistically significant, positive relationship was noted between the sleep deprivation, modified total HAM-D scores and MHPG levels at postsleep deprivation, indicating that the greater the severity of depression during sleep deprivation the higher were the MHPG levels after the sleep deprivation period.

Clobazam: uncontrolled and standard controlled clinical trials

1 In an uncontrolled clinical trial, carried out in 11 psychiatric patients with the clinical diagnoses of anxiety neurosis and depressive neurosis, clobazam, a new benzodiazepine preparation, in the dosage range 10-60 mg daily produced statistically significant improvement in the total and both factor scores of the Hamilton Anxiety Scale (HAM-A). The lowest mean total HAM-A scores occurred with a mean clobazam dosage of 48 mg daily. 2 Results of the uncontrolled clinical trial were further substantiated in a standard-controlled clinical study in which no statistically significant difference between the therapeutic effectiveness of clobazam and diazepam could be revealed. The lowest mean total HAM-A scores occurred with a mean clobazam dosage of 49 mg daily. There was a lower incidence of adverse effects reported in patients receiving clobazam than in those taking the control drug (diazepam).

Experimental infection of ducklings with Mycoplasma gallisepticum and Mycoplasma anatis

Two groups of day-old ducklings were infected with Mycoplasma gallisepticum and M anatis respectively by air sac inoculation. Clinical disease was not produced but air sacculitis was produced by both infections. M gallisepticum could be recovered readily from respiratory tissue 10 and 30 days after infections but RSA tests were negative. M anatis was not reisolated from these tissues or from the cloaca but a positive RSA test was observed on the serum of a few ducklings.