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Mislu E, Kumsa H, Arage MW, Tadesse S, Chane F. Prevalence of poor sleep quality among pregnant women in low- and middle-income countries: A systematic review and meta-analysis. Am J Obstet Gynecol MFM 2024:101381. [PMID: 38759871 DOI: 10.1016/j.ajogmf.2024.101381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Esuyawkal Mislu
- School of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Henok Kumsa
- School of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Mulugeta Wodaje Arage
- School of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Shimelis Tadesse
- Department of Midwifery, College of Health Science, Mettu University, Mettu, Ethiopia.
| | - Fiker Chane
- School of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia.
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Tadesse S, Mekete D, Negese S, Belachew DZ, Namara GT. Urinary incontinence following successful closure of obstetric vesicovaginal fistula repair in Southern Ethiopia. BMC Womens Health 2024; 24:164. [PMID: 38454367 PMCID: PMC10919033 DOI: 10.1186/s12905-024-02979-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/17/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) after successful closure of obstetric vesicovaginal fistula (VVF) repair is a widely recognized public health problem. However, there is insufficient research evaluating the factors associated with UI after successful obstetric VVF repair in Ethiopia. OBJECTIVES The main aim of this study was to assess the magnitude and associated factors of UI following the successful closure of obstetric VVF repair at the Yirgalem Hamlin Fistula Center in the Sidama region of southern Ethiopia. METHODS A retrospective cross-sectional analytical study was performed on patients who underwent obstetric VVF repair at the Yirgalem Hamlin Fistula Center between 2016 and 2020. The data were collected from September to October 2021. EPI Data Version 3.1 and SPSS Version 25.0 were used for data entry and analysis. A multivariable binary logistic regression model was used for all variables significant in the bivariate binary logistic analysis to determine the association between the independent variables and outcome variables. The data are presented in tables and figures. Variables with a p-value < 0.05 were considered to be statistically associated with the study outcome. RESULTS In total, 499 study subjects were included. The magnitude of UI after successful closure of obstetric VVF repair was 23.25%. A Goh type 4 fistula (AOR = 4.289; 95% CI 1.431, 12.852), a fistula size > 3 cm (AOR = 8.855; 95% CI 4.786, 16.382), a partially damaged urethra (AOR = 2.810; 95% CI 1.441, 5.479), and a completely destroyed urethra (AOR = 5.829; 95% CI 2.094, 16.228) were found to be significantly associated factors with the outcome variable. CONCLUSIONS Nearly one in four patients who had successful closure of obstetric VVF repair at the Yirgalem Hamlin fistula center had UI, which is above the WHO recommendations. The presence of a Goh type 4 fistula, large fistula size, and damaged urethral status significantly affect the presence of UI. Therefore, interventions are necessary to prevent and manage UI among patients who underwent obstetric VVF repair and had a closed fistula.
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Affiliation(s)
- Shimelis Tadesse
- Department of Midwifery, College of Health Science, Mattu University, P. O. Box 318, Mattu, Ethiopia.
| | - Desta Mekete
- Department of Midwifery, College of Health Science, Mattu University, P. O. Box 318, Mattu, Ethiopia
| | - Shambel Negese
- Department of Midwifery, College of Health Science, Mattu University, P. O. Box 318, Mattu, Ethiopia
| | - Dereje Zeleke Belachew
- Department of Midwifery, College of Medicine and Health Science, Mizan Tepi University, Mizan Tefere, Ethiopia
| | - Galana Takele Namara
- Department of Midwifery, College of Medicine and Health Science, Ambo University, Ambo, Ethiopia
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Ejigu N, Seyoum K, Kene C, Gomora D, Mengistu S, Geta G, Eshetu D, Tadesse S, Mesfin T, Tekalign Y, Atlaw D. Prevalence and associated risk factors for failed obstetric fistula repair in East African countries: A systematic review and meta-analysis. SAGE Open Med 2023; 11:20503121231187742. [PMID: 37492647 PMCID: PMC10363902 DOI: 10.1177/20503121231187742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023] Open
Abstract
Objective Obstetric fistula repair failure is a combination of unsuccessful fistula closure and/or incontinence following a successful closure. There is an inconsistent finding on the failure of obstetric fistula repair in East Africa. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of failed obstetric fistula repair and its associated factors among women who have undergone fistula repair in East Africa. Methods This systematic review and meta-analysis were written following the PRISMA guideline protocol. A web-based electronic search of PubMed, Google Scholar, and HINARI was performed to find primary studies. Additional articles were searched by cross-referencing references. A random-effects model was used to estimate the pooled prevalence of failed obstetric fistula repair. The heterogeneity of studies was weighed using I2 test statistics. Publication bias was assessed by Eggers and funnel plot test. Results The 16 studies that met the inclusion criteria for this systematic review and meta-analysis of failed obstetric fistula repair were included. Nonetheless, one study was used for factor analysis but not in pooled prevalence analysis. The pooled prevalence of obstetric fistula repair failure in East Africa was 26.89% (95% confidence interval: 21.71, 32.07). Labor duration > 48 h (Pooled odds ratio = 2.46; 95% confidence interval 1.58, 3.82), fistula size >3 cm (Pooled odds ratio = 3.92; 95% confidence interval 2.19, 7.05), previous fistula repair (Pooled odds ratio = 3.20; 95% confidence interval 1.94, 5.29), Goh Type 4 fistulas (Pooled odds ratio = 6.07; 95% confidence interval 2.50, 14.75), completely destructed urethra (Pooled odds ratio = 3.35; 95% confidence interval 1.69, 6.65), and severe vaginal scaring (Pooled odds ratio = 3.89; 95% confidence interval 1.99, 7.62) were significantly associated with obstetric fistula repair failure. Conclusions One in four women with obstetric fistula repair experienced repair failure. To fight the problem The Ministry of Health in every part of the country, in collaboration with obstetric care providers, shall intervene on factors affecting obstetric fistula repair failure to reduce or prevent the failure of obstetric fistula repair.
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Affiliation(s)
- Neway Ejigu
- Department of Midwifery, College of Medicine and Health Sciences, Madawalabu University, Robe, Bale Goba, Ethiopia
| | - Kenbon Seyoum
- Department of Midwifery, College of Medicine and Health Sciences, Madawalabu University, Robe, Bale Goba, Ethiopia
| | - Chala Kene
- Department of Midwifery, College of Medicine and Health Sciences, Madawalabu University, Robe, Bale Goba, Ethiopia
| | - Degefa Gomora
- Department of Midwifery, College of Medicine and Health Sciences, Madawalabu University, Robe, Bale Goba, Ethiopia
| | - Shelema Mengistu
- Department of Midwifery, College of Medicine and Health Sciences, Madawalabu University, Robe, Bale Goba, Ethiopia
| | - Girma Geta
- Department of Midwifery, College of Medicine and Health Sciences, Madawalabu University, Robe, Bale Goba, Ethiopia
| | - Derese Eshetu
- Department of Midwifery, College of Medicine and Health Sciences, Madawalabu University, Robe, Bale Goba, Ethiopia
| | - Shimelis Tadesse
- Department of Midwifery, College of Health Sciences, Mattu University, Ethiopia
| | - Telila Mesfin
- Department of Medicine, College of Medicine and Health Sciences, Madawalabu University, Ethiopia
| | - Yohannes Tekalign
- Department of Public Health, College of Medicine and Health Sciences, Madawalabu University, Ethiopia
| | - Daniel Atlaw
- Department of Human Anatomy, College of Medicine and Health Sciences, Madawalabu University, Ethiopia
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Tadesse S, Ejigu N, Edosa D, Ashegu T, Dulla D. Obstetric fistula repair failure and its associated factors among women underwent repair in Yirgalem Hamlin fistula center, Sidama Regional State, Southern Ethiopia, 2021: a retrospective cross sectional study. BMC Womens Health 2022; 22:288. [PMID: 35811314 PMCID: PMC9272558 DOI: 10.1186/s12905-022-01866-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/06/2022] [Indexed: 01/09/2023] Open
Abstract
Background Obstetric fistula repair failure is a combination of unsuccessful fistula closure and/or incontinence following a successful closure. It causes a burden on both the patients and the fistula centers. The aim of this study was to assess the magnitude and associated factors of obstetric fistula repair failure among women who underwent fistula repair at Yirgalem Hamlin fistula center in Southern Ethiopia. Methods A facility-based retrospective cross-sectional study was conducted among women who underwent fistula repair at Yirgalem Hamlin fistula center, Southern Ethiopia, during the period from January 2016 to December 2020. All 562 women who underwent fistula repair in the last 5 years were included in the study. The data were collected using a pre-tested checklist from September 22 to October 22, 2021. The data were then imported into EPI info-data version 3.1, exported to SPSS version 25, and analyzed. Descriptive and logistic regression analyses were performed, and the significant statistical test was assessed at a 95% confidence interval. Variables with a p value of < 0.05 in multivariable logistic regression were regarded to have a statistically significant relationship. Results The magnitude of obstetric fistula repair failure in this study was 28.8%. Obstetric fistula repair failure was found to be associated with labor duration > 48 h (AOR = 2.037; 95% CI 1.268, 3.272), Goh Type 4 fistulas (AOR = 3.939; 95% CI 1.623, 9.560), fistula size > 3 cm (AOR = 6.627; 95% CI 3.802, 11.554), completely destructed urethra (AOR = 3.192; 95% CI 1.234, 8.256), and bladder catheterization > 14 days (AOR = 2.944; 95% CI 1.380, 6.281). Conclusions The magnitude of obstetric fistula repair failure was significantly higher than the World Health Organization standard. Obstetric fistula repair failure had a positive association with a longer duration of labor, Goh Type 4 fistulas, large fistula size, total urethral injury, and a longer period of bladder catheterization. Therefore, the concerned bodies need to implement interventions on factors affecting obstetric fistula repair failure to reduce or prevent the failure of obstetric fistula repair. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01866-z.
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Garone C, Garcia-Diaz B, Emmanuele V, Tadesse S, Akman H, Tanji K, Quinzii C, Hirano M. P17.19 Deoxypyrimidine monophosphates treatment for thymidine kinase 2 deficiency. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hirano M, Martí R, Casali C, Tadesse S, Uldrick T, Fine B, Escolar DM, Valentino ML, Nishino I, Hesdorffer C, Schwartz J, Hawks RG, Martone DL, Cairo MS, DiMauro S, Stanzani M, Garvin JH, Savage DG. Allogeneic stem cell transplantation corrects biochemical derangements in MNGIE. Neurology 2006; 67:1458-60. [PMID: 16971696 PMCID: PMC4345106 DOI: 10.1212/01.wnl.0000240853.97716.24] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a multisystemic autosomal recessive disease due to primary thymidine phosphorylase (TP) deficiency. To restore TP activity, we performed reduced intensity allogeneic stem cell transplantations (alloSCTs) in two patients. In the first, alloSCT failed to engraft, but the second achieved mixed donor chimerism, which partially restored buffy coat TP activity and lowered plasma nucleosides. Thus, alloSCT can correct biochemical abnormalities in the blood of patients with MNGIE, but clinical efficacy remains unproven.
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Affiliation(s)
- M Hirano
- Department of Neurology, Columbia University Medical Center, 630 W. 168 St., P&S 4-443, New York, NY 10032, USA.
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Abstract
An investigation was made into coccidiosis of 190 scavenging indigenous chickens between September 2000 and April 2001 in three selected agroclimatic zones, in central Ethiopia. This was done through clinical, postmortem and microscopic examinations. Data were processed by chi-square and Mantel-Haenzel test. The study indicated that 25.8% (49/190) of the chickens were infected with coccidiosis and found to harbour one to four different species of Eimeria. Of these infected chickens, 30 (15.8%) and 19 (10.0%) were positive for clinical and sub-clinical coccidiosis, respectively. There was a significant altitude difference (chi2 = 14.7, p <0.001) in coccidiosis prevalence: 42.2% in chickens from highland region followed by 21.5% in mid-altitude and 13.1% in low-altitude areas. When quantified, the prevalence of coccidiosis was 2.66 and 4.83 times higher in the high-altitude than in mid-altitude (odds ratio, OR = 2.66, p<0.05) and low-altitude (OR = 4.83, p<0.001) chickens. The pathogenic Eimeria species responsible for clinical coccidiosis were E. necatrix, E. acervulina, E. maxima and E. tenella. With increasing demand for poultry products in developing countries, knowledge of production constraints in traditional management practices could help devise control strategies for constraints on backyard poultry production systems.
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Affiliation(s)
- H Ashenafi
- Faculty of Veterinary Medicine, Addis Ababa University, Debre Zeit, Ethiopia
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Tadesse S, Woldemeskel M, Medhia G, Tibbo M, Molla B, Abate G, Britton S. T-cell responses to Mycobacterium avium PPD antigens in gastro-intestinal helminth co-infected chickens in Central Ethiopia. J Immunoassay Immunochem 2003; 24:57-72. [PMID: 12680607 DOI: 10.1081/ias-120018469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A cross-sectional study was conducted on extensively reared chickens of three selected agro-climatic zones in Central Ethiopia to examine the predisposing effect of gastro-intestinal helminthes to intestinal Mycobacterium avium when it occurs as co-infection. This was done through a Lymphocyte Stimulation Test (LST) using avian PPD on peripheral blood mononuclear cells obtained from the blood of chickens and gross examination of digestive tract for the presence of helminth parasites. Data were analyzed using the statistical softwares SAS (1994) and Intercooled STATA version 6. Fourteen (14.7%) out of the 95 examined chickens were positive in in vitro LST showing stimulation index (SI) > or = 2. There was a significant (chi2 = 9.93, P < 0.01) difference in prevalence of M. avium by altitude: highest in chickens from lowland (27.8%) areas, followed by 13.3% in chickens from mid altitude and none was reacted to LST from highland region. A significant relationship (chi2 = 9.58, P < 0.01) in cestode co-infection with M. avium was found. There was no significant (chi2 = 1.66, P > 0.05) relationship in nematode co-infection with M. avium.
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Affiliation(s)
- S Tadesse
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
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Gamez J, Ferreiro C, Accarino ML, Guarner L, Tadesse S, Martí RA, Andreu AL, Raguer N, Cervera C, Hirano M. Phenotypic variability in a Spanish family with MNGIE. Neurology 2002; 59:455-7. [PMID: 12177387 DOI: 10.1212/wnl.59.3.455] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Clinical, biochemical, and genetic features of a Spanish family with mitochondrial neurogastrointestinal encephalomyopathy are reported. The proband presented with severe gastrointestinal dysmotility and the affected sister had extraocular muscle weakness. In both affected individuals, biochemical defects of thymidine phosphorylase and a pathogenic G-to-A transition mutation at nucleotide 435 in the thymidine phosphorylase gene were identified. The first thymidine phosphorylase mutation identified in Spain showed phenotypic variability at onset.
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Affiliation(s)
- J Gamez
- Department of Neurology, Hospital Gral, Vall d'Hebron, Barcelona, Spain
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Hirano M, Marti R, Ferreiro-Barros C, Vilà MR, Tadesse S, Nishigaki Y, Nishino I, Vu TH. Defects of intergenomic communication: autosomal disorders that cause multiple deletions and depletion of mitochondrial DNA. Semin Cell Dev Biol 2001; 12:417-27. [PMID: 11735376 DOI: 10.1006/scdb.2001.0279] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Depletion and multiple deletions of mitochondrial DNA (mtDNA) have been associated with a growing number of autosomal diseases that have been classified as defects of intergenomic communication. MNGIE, an autosomal recessive disorder associated with mtDNA alterations is due to mutations in thymidine phosphorylase that may cause imbalance of the mitochondrial nucleotide pool. Subsequently, mutations in the mitochondrial proteins adenine nucleotide translocator 1, Twinkle, and polymerase gamma have been found to cause autosomal dominant progressive external ophthalmoplegia with multiple deletions of mtDNA. Uncovering the molecular bases of intergenomic communication defects will enhance our understanding of the mechanisms responsible for maintaining mtDNA integrity.
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Affiliation(s)
- M Hirano
- Department of Neurology, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA.
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Opial D, Boehnke M, Tadesse S, Lietz-Partzsch A, Flammer J, Munier F, Mermoud A, Hirano M, Flückiger F, Mojon DS. Leber's hereditary optic neuropathy mitochondrial DNA mutations in normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol 2001; 239:437-40. [PMID: 11561792 DOI: 10.1007/s004170100309] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND in Leber's hereditary optic neuropathy, increased optic nerve cupping has been reported by several authors. Recently, a mitochondrial DNA (mtDNA) mutation at nucleotide 11778 typically associated with Leber's hereditary optic neuropathy (LHON) was identified in a patient treated for glaucoma but lacking typical signs of LHON. The question arises: should all normal-tension glaucoma patients be further evaluated for LHON? METHODS we screened 54 unselected patients with normal-tension glaucoma (age range 20-96 years, 16 men and 38 women) for the primary mtDNA LHON mutations at nucleotides 3460, 11778 and 14484. RESULTS none of the patients harboured the mtDNA mutations at nucleotides 3460, 11778 or 14484 (95% confidence intervals for each mutation ranged from 0% to 5.3%). CONCLUSIONS primary LHON mtDNA mutations are rare or absent in unselected normal-tension glaucoma patients. Therefore, unselected normal-tension glaucoma patients should not be screened for these mutations. It is probable that only normal-tension glaucoma patients with atypical features (rapid progression, early deep central scotoma, pallor of neuroretinal rim, elevated disc, peripapillary teleangiectasia) or a positive family history of visual loss compatible with a matrilinear transmission should be further evaluated.
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Affiliation(s)
- D Opial
- Department of Ophthalmology, University of Bern, Switzerland.
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Copeland RA, Marcinkeviciene J, Haque TS, Kopcho LM, Jiang W, Wang K, Ecret LD, Sizemore C, Amsler KA, Foster L, Tadesse S, Combs AP, Stern AM, Trainor GL, Slee A, Rogers MJ, Hobbs F. Helicobacter pylori-selective antibacterials based on inhibition of pyrimidine biosynthesis. J Biol Chem 2000; 275:33373-8. [PMID: 10938275 DOI: 10.1074/jbc.m004451200] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
We report the discovery of a class of pyrazole-based compounds that are potent inhibitors of the dihydroorotate dehydrogenase of Helicobacter pylori but that do not inhibit the cognate enzymes from Gram-positive bacteria or humans. In culture these compounds inhibit the growth of H. pylori selectively, showing no effect on other Gram-negative or Gram-positive bacteria or human cell lines. These compounds represent the first examples of H. pylori-specific antibacterial agents. Cellular activity within this structural class appears to be due to dihydroorotate dehydrogenase inhibition. Minor structural changes that abrogate in vitro inhibition of the enzyme likewise eliminate cellular activity. Furthermore, the minimum inhibitory concentrations of these compounds increase upon addition of orotate to the culture medium in a concentration-dependent manner, consistent with dihydroorotate dehydrogenase inhibition as the mechanism of cellular inhibition. The data presented here suggest that targeted inhibition of de novo pyrimidine biosynthesis may be a valuable mechanism for the development of antimicrobial agents selective for H. pylori.
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Affiliation(s)
- R A Copeland
- Department of Chemical Enzymology, the Department of Chemical and Physical Sciences, and the Antimicrobials Group, DuPont Pharmaceuticals Company, Wilmington, Delaware 19880-0400, USA
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Nishino I, Spinazzola A, Papadimitriou A, Hammans S, Steiner I, Hahn CD, Connolly AM, Verloes A, Guimarães J, Maillard I, Hamano H, Donati MA, Semrad CE, Russell JA, Andreu AL, Hadjigeorgiou GM, Vu TH, Tadesse S, Nygaard TG, Nonaka I, Hirano I, Bonilla E, Rowland LP, DiMauro S, Hirano M. Mitochondrial neurogastrointestinal encephalomyopathy: an autosomal recessive disorder due to thymidine phosphorylase mutations. Ann Neurol 2000; 47:792-800. [PMID: 10852545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is an autosomal recessive disorder defined clinically by severe gastrointestinal dysmotility; cachexia; ptosis, ophthalmoparesis, or both; peripheral neuropathy; leukoencephalopathy; and mitochondrial abnormalities. The disease is caused by mutations in the thymidine phosphorylase (TP) gene. TP protein catalyzes phosphorolysis of thymidine to thymine and deoxyribose 1-phosphate. We identified 21 probands (35 patients) who fulfilled our clinical criteria for MNGIE. MNGIE has clinically homogeneous features but varies in age at onset and rate of progression. Gastrointestinal dysmotility is the most prominent manifestation, with recurrent diarrhea, borborygmi, and intestinal pseudo-obstruction. Patients usually die in early adulthood (mean, 37.6 years; range, 26-58 years). Cerebral leukodystrophy is characteristic. Mitochondrial DNA (mtDNA) has depletion, multiple deletions, or both. We have identified 16 TP mutations. Homozygous or compound heterozygous mutations were present in all patients tested. Leukocyte TP activity was reduced drastically in all patients tested, 0.009 +/- 0.021 micromol/hr/mg (mean +/- SD; n = 16), compared with controls, 0.67 +/- 0.21 micromol/hr/mg (n = 19). MNGIE is a recognizable clinical syndrome caused by mutations in thymidine phosphorylase. Severe reduction of TP activity in leukocytes is diagnostic. Altered mitochondrial nucleoside and nucleotide pools may impair mtDNA replication, repair, or both.
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Affiliation(s)
- I Nishino
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
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Phyu S, Tadesse A, Mustafa T, Tadesse S, Jonsson R, Bjune G. Diversity of lung and spleen immune responses in mice with slowly progressive primary tuberculosis. Scand J Immunol 2000; 51:147-54. [PMID: 10652161 DOI: 10.1046/j.1365-3083.2000.00662.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of the present study was to assess the compartmentalized immune response, in terms of cytokine secretion and cell activation, in lungs and spleens of mice with slowly progressive primary tuberculosis. Immunocyte populations from both organs were isolated and stimulated with concanavalin A, purified protein derivatives and MPT 59. Production of interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) was measured using an enzyme-linked immunosorbent assay, and cell activation was measured using a tetrazolium colorimetric assay. The IFN-gamma and IL-4 levels in the supernatants of Mycobacterium tuberculosis antigen (Ag)-stimulated lung immunocytes from infected mice were higher than the levels from uninfected mice. However, only IL-4 levels were raised in the supernatants of Ag-stimulated spleen immunocytes from infected mice. Spontaneous and Ag-stimulated immunocyte activation was lower only in the lungs of infected mice compared with uninfected mice. The level of lung immunocyte activation was inversely associated with the extent of gross pulmonary pathology. In conclusion, cytokine secretion and cell activation were different between lungs and spleens in slowly progressive primary murine tuberculosis. Cytokine diversity may explain the confinement of tuberculous lesions in the lungs and the absence of lesions in the spleens of mice with slowly progressive tuberculosis.
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Affiliation(s)
- S Phyu
- Centre for International Health, Broegelmann Research Laboratory, University of Bergen, Bergen, Norway
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