Influences of high vs. low-intensity exercises on muscle strength, function, and quality of life in post-COVID-19 patients with sarcopenia: a randomized controlled trial

OBJECTIVE

The aim of this study was to compare the effectiveness of high vs. low-intensity exercise training on muscle strength, physical function, and quality of life in post-COVID-19 patients with sarcopenia secondary to chronic kidney disease (CKD).

PATIENTS AND METHODS

82 subjects were randomized into 2 groups: high intensity (HIG, n=42), which received high-intensity resistance training, and low intensity (LIG, n=40), which conducted low-intensity aerobic activities. Exercises were performed for 30 min, 3 times per week for 6 weeks. A handheld dynamometer, pinch press, and 1 min sit-to-stand (STS) test were used to assess muscle strength. Modified physical performance test and sarcopenia Quality of Life questionnaire (SAR-QoL) were used to assess function and quality of life, respectively. Measures were collected before and at the end of the treatment program.

RESULTS

Participants were similar at baseline. The within-group comparisons demonstrated statistically significant improvement in both HIG and LIG groups in all outcome measures (p<0.001). Between groups, comparisons revealed statistically significant better achievements with high effect size in Modified Physical Performance Test (MMPT) (p<0.001, d=1.28), handgrip (p<0.001, d=3.6), STS (p<0.001, d=2.38), and SAR-QoL (p<0.001, d=3.24) in favor of the HIG. On the other hand, pinch press strength was equally improved in both groups (p=0.09, d=0.36).

CONCLUSIONS

High-intensity exercise is better than low-intensity exercises in post-COVID-19 patients with sarcopenia secondary to chronic kidney disease regarding muscle strength, physical function, and quality of life.

Awareness and knowledge of breast cancer rehabilitation among Saudi Arabia physical therapists

OBJECTIVE

This study aimed to evaluate the physical therapists' knowledge and awareness of breast cancer, treatment modalities, contraindications, and clinical guidelines.

SUBJECTS AND METHODS

A cross-sectional survey was conducted from December 2020 to May 2021 in Saudi Arabia. The sample size was determined using the Raosoft sample size calculator, which indicated the need for 67 participants. All physical therapists of both sex in private and public hospitals in Ha'il and non-Ha'il regions were included in the study. Data was collected by a structured Google form questionnaire, consisting of 4 main domains with a maximum score of 43.

RESULTS

57 physical therapists participated in the current study, out of which 31 were from the Ha'il region (42.1% male, 57.9% female) with a mean age of 29±7 years and a mean experience 6±7years. The referral of breast cancer patients was only 22.8%. Interestingly only 22.8% of the hospital has specific setups for oncology rehabilitation, and 12.3% have reported positive about continuing professional development (CPDs) workshops for breast cancer organized by their hospitals. 5.3% of patients with breast cancer are aware of the benefit of oncology rehabilitation, while 22.8% of patients come for follow-up sessions in the rehabilitation department. According to multiple regression, only gender was statistically significant for prediction, p<0.05. Females increased the mean score by 5.996 more than males. Female therapists are 38.2% more aware than males.

CONCLUSIONS

Although physical therapists have a low level of knowledge and an average level of awareness, with a higher number of women than men, attitudes toward physical therapy are quite high, and the profession is practiced exceptionally well.

A randomized controlled trial examining the impact of low vs. moderate-intensity aerobic training in post-discharge COVID-19 older subjects

OBJECTIVE

Post-COVID-19 patients complained of pain, fatigue, breathlessness, and reduction in quality of life which required planned intervention. This study aimed to compare the impact of 10 weeks of low vs. moderate-intensity aerobic training on physical fitness, psychological status, and quality of life in post-COVID-19 older subjects.

PATIENTS AND METHODS

72 patients were randomized into 3 equal groups, moderate-intensity exercise (MIG, n = 24), low-intensity exercise (LIG, n = 24), and control group (CG, n = 24). The exercise was done 40 min/4 times per week for 10 weeks. We measured exercise capacity using the six-minute walking test, 1 min sit-to-stand test, post-COVID-19 functional scale (PCFS), and quality of life using the SF-36 questionnaire and HAMILTON Anxiety and Depression Scale (HADS).

RESULTS

There was no difference between groups regarding the demographic and most clinical characteristics of the subjects. Compared with CG there were statistically significant improvements in studying groups (MIG and LIG) with (p < 0.05) in most outcomes and the improvement was higher in MIG than in LIG in most outcomes.

CONCLUSIONS

10-week moderate-intensity and low-intensity aerobic training programs are effective with superior effect to moderate-intensity. Moderate-intensity aerobic exercise is more effective and feasible in post-discharge COVID-19 older subjects regarding exercise capacity, quality of life, and psychological status than low-intensity aerobic exercise.

Effect of twelve-week concurrent aerobic and resisted exercise training in non-dialysis day on functional capacity and quality of life in chronic kidney disease patients

OBJECTIVE

Several researchers have evaluated the impact of exercise training on patients with chronic kidney disease (CKD). However, few studies have evaluated the impact of concurrent training (aerobic and resisted exercise) on non-dialysis days on the functional capacity and quality of life (QOL) of such patients. Our current study evaluated the effects of concurrent training on functional capacity and QOL of patients with CKD.

PATIENTS AND METHODS

Forty-three patients, aged ≥ 25 years, were recruited in this randomized study. They were divided into intervention and control groups (22 per group). The intervention group received concurrent aerobic and resistance exercises (three sessions per week for twelve weeks on alternative days). The control group continued their regular lifestyle practices and medical treatment without any exercise intervention. Before and after twelve weeks of training, the participant's functional capacity and quality of life (QOL) were measured.

RESULTS

Compared to the control group, the intervention group displayed a significant improvement in the distance walked in the 6-minute walk test and sit-to-stand test (STS1/s and STS-60) with p<0.001; furthermore, a significant improvement was observed in physical function, body pain, general health, role functioning/physical, vitality, and social functioning (p<0.05) of QOL assessed with the SF-36 questionnaire.

CONCLUSIONS

The twelve-week concurrent aerobic and resistance exercise training had a positive impact on functional capacity and QOL in CKD patients. Concurrent exercise training should be recommended as an interventional modality in physical therapy and rehabilitation protocols in CKD patients.

Synchronous occurrence of Hurthle cell carcinoma with Hodgkin's lymphoma; the first reported case with literature review

Introduction

Hurthle cell carcinoma (HCC) is a rare type of thyroid cancer while Hodgkin's lymphoma (HL) is an uncommon cancer of the lymphocytes. The synchronous occurrence of HCC and HL in a single person has not been described in the literature. This report aims to present the first case of synchronous HCC and HL.

Case report

A 31-year-old male presented with a right side neck swelling for three months. Laboratory findings revealed elevated thyroglobulin (286.7 ng/ml). Ultrasound (US) examination showed several enlarged lymph nodes (<20mm) in the right side of the neck with increased vascularity. There was also a solitary solid thyroid nodule (23*20mm) in the right lobe. Fine needle aspiration cytology (FNAC) of the right lobe revealed Hurthle cell neoplasm, and right cervical lymph node was suspicious for Hodgkin's lymphoma. Right lobectomy with right lateral cervical excisional biopsy was performed. Histopathology confirmed HCC and HL.

Discussion

HCC is a differentiated cancer occurring in old age population. Multiple factors increase the risk of HCC, including the excess iodine, history of thyroid diseases, and exposure to radiation. HL is a cancer of the lymphatic system that affects young adults and older population. There is a significant association between excess body weight and cigarette smoking with the risk of HL.

Conclusion

Although extremely rare, occurrence of a few cases of other thyroid carcinomas and HL could occur. However, no relation has been described between the two cancers.

•

Hurthle cell carcinoma is a rare, well-differentiated, and aggressive thyroid cancer.

•

Hodgkin's lymphoma is a cancer of the lymphocytes, associated with good prognosis.

•

This report presents the first case of synchronous Hurthle cell carcinoma and Hodgkin lymphoma.

Abstract P2-02-10: Evaluation of apparent diffusion coefficient to predict grade, micro-invasion and invasion in DCIS

PURPOSE: To evaluate the role of apparent diffusion coefficient (ADC) values in distinguishing DCIS grades and identifying the presence of micro-invasive/invasive disease.

METHODS AND MATERIALS:

REB approved study with informed consent obtained from 70 women (age 36-84) scheduled for core-biopsy with results of 71 non-invasive/high-risk breast lesions. All patients underwent surgery and were assessed pre-operatively using diffusion weighted (DWI)-MRI. Lesion size, morphology and ADC values were recorded. The Kruskal Wallis or one-way ANOVA test and Pearson correlation coefficient were used to study the association between ADC values and the analyzed MRI lesion characteristics. Logistic regression analysis was used to evaluate the ability of ADC values to predict the presence of invasion.

RESULTS:

Of 71 cases, 45.1% were imaged on a 3T magnet and 54.9% on 1.5 T. Final pathology demonstrated invasive cancer in 26.8%, micro-invasion in 18.3% and pure DCIS in 59.2%. On 3T, mean ADC value was 1.20 ×10-3 mm2/s ± 0.48 (SD) (range, 0.47 - 1.78 ×10-3 mm2/s) for non-high grade DCIS, 1.23 × 10-3 mm2/s ± 0.40 (SD) (range, 0.26 - 1.77 ×10-3 mm2/s) for high-grade DCIS, and 1.15 × 10-3 mm2/s ± 0.45 (SD) (range, 0.26 - 1.75 ×10-3 mm2/s) for invasive/microinvasive disease. On 1.5T, mean ADC value was 1.04 × 10-3 mm2/s ± 0.41 (SD) (range, 0.15 - 1.85 ×10-3 mm2/s) for non-high grade DCIS, 1.01 × 10-3 mm2/s ± 0.37 (SD) (range, 0.06 - 1.76 ×10-3 mm2/s) for high-grade DCIS, and 1.11 × 10-3 mm2/s ± 0.30 (SD) (range, 0.64 - 1.76 ×10-3 mm2/s) for invasive/microinvasive disease. Based on logistic regression analysis, mean ADC value was not a significant predictor for invasiveness using 1.5 T [OR = 2.6 (95% CI (0.409, 17.12)), p = 0.3] or 3T [OR = 0.4 (95% CI (0.076, 2.399)), p = 0.3]

CONCLUSION: Mean ADC acquired using a 1.5T or 3T MRI was unable to predict high-grade or invasive disease in biopsy-proven DCIS lesions. Further work is exploring voxel-based approaches that may better appreciate tumor heterogeneity and identify sub-regions of tumor with these higher risk features.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-02-10.

Assessment of platelet inhibition by point-of-care testing in neuroendovascular procedures

Antiplatelet agents are an important component of the preventive strategies currently used in clinical practice to minimize the risk of thromboembolic events during and after endovascular procedures. Because of the variability in the response to antiplatelet agents, measuring the degree of platelet inhibition may help identify and properly treat poor responders. POC testing is defined as diagnostic testing at or near the site of patient care. Knowledge of the specifics of these devices among practicing neurointerventionalists is relatively limited. In this article, the different POC devices available are presented, and their clinical utility in relation to endovascular procedures is discussed.

Laboratory evaluation of Isaria fumosorosea against Spodoptera littoralis

Isaria fumosorosea (syn. Paecilomyces fumosoroseus) is potentially useful for the biological control of economically important agricultural and forest insect pests. We evaluated efficacy of two strains of this entomopathogenic fungus against last instar larvae and pupae of Egyptian cotton leafworm, Spodoptera littoralis. The first strain was Apopka 97 which is an active ingredient of commercial biopesticide PreFeRal WG (Biobest, Belgium). The second strain was isolated from Cameraria ohridella and is currently deposited under number CCM 8367 as a patent culture in the Czech Collection of Microorganisms in Brno. Blastospores of both strains were obtained after 120 hours submerged cultivation in grow media using orbital shaker. The concentration of blastospores was adjusted to 5 x 10(7) spores/ml of suspension. Soaking agent Tween 80 was added to the suspension at concentration 0.02%. Lethal effects of both fungal strains on S. littoralis were evaluated using standard dip test. Treated insects were individually placed into plastic Petri dishes (diam. 9 cm) and kept at constant laboratory conditions (temperature 23 degrees C, R.H. approx. 100%, 16L:8D photoperiod). Virulence of the strains was expressed as percentages of cumulative daily mortality corrected for mortality in the control variant. Obtained results revealed higher virulence of CCM 8367 blastospores to the last instar larvae of S. littoralis (93.1% mortality) on the 7th day after the treatment compared to Apopka 97 (65.5% mortality). Even more obvious difference was found in pupae, where corrected mortality of CCM 8367-treated pupae was 80.0% while mortality in Apopka 97-treated pupae reached only 3.3% on the 8th day after the treatment. We can conclude that the strain I. fumosorosea CCM 8367 has strong insecticidal effects on S. littoralis and has a potential to be implemented as a novel biocontrol agent.

Point-of-care testing for anticoagulation monitoring in neuroendovascular procedures

POC testing is defined as diagnostic testing at or near the site of patient care. Rapid measurement of the intensity of anticoagulation and, more recently, platelet inhibition allows dose titration of adjuvant medications such a heparin and antiplatelet agents during neuroendovascular procedures. However, knowledge among practicing physicians regarding the pathophysiologic basis of these measurements and variations in knowledge about the differences among devices is often limited. This review discusses the role of anticoagulation in endovascular procedures and the currently available POC tests for anticoagulation monitoring.

Occurrence and predictors of futile recanalization following endovascular treatment among patients with acute ischemic stroke: a multicenter study

BACKGROUND AND PURPOSE

Although recanalization is the goal of thrombolysis, it is well recognized that it fails to improve outcome of acute stroke in a subset of patients. Our aim was to assess the rate of and factors associated with "futile recanalization," defined by absence of clinical benefit from recanalization, following endovascular treatment of acute ischemic stroke.

MATERIALS AND METHODS

Data from 6 studies of acute ischemic stroke treated with mechanical and/or pharmacologic endovascular treatment were analyzed. "Futile recanalization" was defined by the occurrence of unfavorable outcome (mRS score of > or = 3 at 1-3 months) despite complete angiographic recanalization (Qureshi grade 0 or TIMI grade 3).

RESULTS

Complete recanalization was observed in 96 of 270 patients treated with IA thrombolysis. Futile recanalization was observed in 47 (49%). In univariate analysis, patients with futile recanalization were older (73 +/- 11 versus 58 +/- 15 years, P < .0001) and had higher median initial NIHSS scores (19 versus 14, P < .0001), more frequent BA occlusion (17% versus 4%, P = .049), less frequent MCA occlusion (53% versus 76%, P = .032), and a nonsignificantly higher rate of symptomatic hemorrhagic complications (2% versus 9%, P = .2). In logistic regression analysis, futile recanalization was positively associated with age > 70 years (OR, 4.4; 95% CI, 1.9-10.5; P = .0008) and initial NIHSS score 10-19 (OR, 3.8; 95% CI, 1.7-8.4; P = .001), and initial NIHSS score > or = 20 (OR, 64.4; 95% CI, 28.8-144; P < .0001).

CONCLUSIONS

Futile recanalization is a relatively common occurrence following endovascular treatment, particularly among elderly patients and those with severe neurologic deficits.

Endovascular interventions following intravenous thrombolysis may improve survival and recovery in patients with acute ischemic stroke: a case-control study

BACKGROUND AND PURPOSE

Since the introduction of recombinant tissue plasminogen activator (rtPA) into clinical practice in the mid 1990s, no adjunctive treatment has further improved clinical outcomes in patients with ischemic stroke. The safety, feasibility, and efficacy of combining intravenous (IV) rtPA with endovascular interventions has been described; however, no direct comparative study has yet established whether endovascular interventions after IV rtPA are superior to IV rtPA alone. A retrospective case-control study was designed to address this issue.

MATERIALS AND METHODS

Between 2003 and 2006, 33 consecutive patients with acute ischemic stroke and National Institutes of Health Stroke Scale (NIHSS) scores >/=10 were treated with IV rtPA in combination with endovascular interventions (IV plus intervention) at a tertiary care facility. Outcomes were compared with a control cohort of 30 consecutive patients treated with IV rtPA (IV only) at a comparable facility where endovascular interventions were not available.

RESULTS

Baseline parameters were similar between the 2 groups. We found that the IV-plus-intervention group experienced significantly lower mortality at 90 days (12.1% versus 40.0%, P = .019) with a significantly greater improvement in NIHSS scores by the time of discharge or follow-up (P = .025). In the IV-plus-intervention group, patients with admission NIHSS scores between 10 and 15 and patients </=80 years of age showed the greatest improvement, with a significant change of the NIHSS scores from admission (P = .00015 and P = .013, respectively).

CONCLUSIONS

In this small case-control study of patients with acute ischemic stroke and admission NIHSS scores >/=10, there was a suggestion of incremental clinical benefit among patients receiving endovascular interventions following standard administration of IV rtPA.

Competitive exclusion ofYersinia enterocoliticabiotype 4, serotype O:3 byYersinia enterocoliticabiotype 1A, serotype O:6,30 in tissue culture and in pigs

AIMS

To study the adhesion properties of a biotype 4, serotype O:3 (human pathogenic) strain of Yersinia enterocolitica and to determine if adhesion in vitro and colonisation in vivo can be prevented by competition with a biotype 1A, serotype O:6,30 (non-pathogenic) strain. To study interaction between Y. enterocolitica biotype 4, serotype O:3 and cultured epithelial cells using the synthetic tripeptide arginine-glycine-aspartic acid (RGD).

METHODS

The human intestinal epithelial (HEp-2) cell line was used for in vitro studies. Inocula of Y. enterocolitica biotype 4, serotype O:3 radiolabelled using tritium were incubated with HEp-2 cells and RGD tripeptide, or with Y. enterocolitica biotype 1A, serotype O:6,30 sequentially or concurrently, then washed and lysed, and radioactivity measured to determine the effect of RGD on adhesion, and competitive exclusion of pathogenic by non-pathogenic bacteria. For in vivo studies, two groups of 5-week-old piglets (n=5/group) were sequentially inoculated orally with 5 x 10(9) colony forming units (cfu) of either a non-pathogenic biotype 1A, serotype O:6,30 strain of Y. enterocolitica followed by a pathogenic biotype 4, serotype O:3 strain, or vice versa. Pigs were monitored for carriage of strains using bacterial culture and a multiplex polymerase chain reaction (PCR).

RESULTS

The RGD tripeptide significantly inhibited adherence of the pathogenic Y. enterocolitica strain to cultured epithelial cells, suggesting that adhesion involved the RGD tripeptide sequence. The non-pathogenic biotype 1A, serotype O:6,30 strain of Y. enterocolitica prevented adhesion of the pathogenic strain to cells in vitro when allowed to adhere first. Pathogenic Y. enterocolitica was consistently isolated from rectal swabs from 80-100% of pigs on all sampling occasions but not from oral swabs after 14 days in pigs first inoculated with the non-pathogenic strain or at 26 days in pigs first inoculated with the pathogenic strain.

CONCLUSIONS

A non-pathogenic strain of Y. enterocolitica reduced adhesion of a human pathogenic strain in vitro but not in vivo.

Occurrence and distribution of Fusarium species in maize fields in New Zealand

Fusarium populations were investigated in maize grains and their husks about six weeks before harvest in three maize fields in the Manawatu region of New Zealand. The role of litter and soil as reservoirs for these fungi was also examined. Two techniques were used to examine populations, dilution plating and direct plating. Using the dilution plating technique the highest overall populations were found in husks (mean 2.2 x 10(5)/g) and litter (mean 1.4 x 10(5)/g), while similar lower numbers of viable propagules were obtained from grain (mean 2.1 x 10(3)/g) and soil (2.8 x 10(3)/g). With this technique five Fusarium spp. were commonly isolated; F. graminearum (Gibberella zeae), F. culmorum, F. subglutinans, F. oxysporum and F. acuminatum, of which F. graminearum was the most abundant. With the direct plating technique 87% of grains were infected with Fusarium spp., with some grains being infected with more than one species. Segments from husks and litter, 70% and 43% respectively, were colonised by Fusariumr spp. F. graminearum was the most frequent species isolated from maize grain and husk segments (48.3 and 37.7% colonisation respectively). Other species, particularly F. culmorum and F. acuminatum, were also found to be common contaminants. A total of 15 Fusarium spp. was recovered from all material examined by both techniques. Cultures with characteristics resembling those of F. moniliforme were rarely observed.

Leiomyoma of the urinary bladder: case report

A case of leiomyoma of urinary bladder, a rare benign tumour, is presented. The patient was a 42 year old female who presented with dysuria and frequency of micturition. The radiological features, diagnosis and management are discussed and the literature on this subject is briefly reviewed.

A rapid and sensitive method for the detection of Yersinia enterocolitica strains from clinical samples

AIMS

To compare three culture methods to detect Yersinia enterocolitica from oral or rectal swabs from experimentally infected pigs.

METHODS AND RESULTS

The three methods used were: direct plating on Cefsulodin-Irgasan-Novobiocin (CIN) agar, cold enrichment in phosphate buffered saline (PBS) followed by plating on CIN agar and selective enrichment with Luria-Bertani-Bile Salts Irgasan (LB-BSI) followed by plating on CIN agar. Selective enrichment with LB-BSI produced the highest recovery rate (63%), when compared with cold enrichment (52%) and plating on CIN agar alone (43%). Selective enrichment with LB-BSI was significantly (P < 0.02) more sensitive than direct plating on CIN agar and more sensitive than cold enrichment (P < 0.1).

CONCLUSIONS, SIGNIFICANCE AND IMPACT OF THE STUDY

Selective enrichment with LB-BSI was more sensitive than the widely accepted method of cold enrichment and it reduced the time required for detection of Y. enterocolitica by three weeks. Selective enrichment with LB-BSI was also compatible with a multiplex PCR technique.

Schistosoma mansoni egg specific antibodies and circulating antigens: assessment of their validity in immunodiagnosis of schistosomiasis

A total of 127 individuals of different age and sex; 92 from Kafr-Sendewa, Qualyobia Governorate, Egypt, in comparison to 23 cases with hydatidosis and fascioliasis as a parasitic control group, and 12 healthy control group from non-endemic area. All cases were screened by clinical examination, urine, stool, rectal snip, abdominal ultrasonographic examination and indirect haemagglutination test (IHAT). Accordingly, they were grouped into active intestinal schistosomiasis group, seropositive group by (IHAT), normal control group from the same endemic area, parasitic control group and normal control group. All cases were subjected to detection of IgG, IgM, IgG4, anti-soluble egg antigen (SEA) and anti-excretory-secretory egg antigen (ESEA) by ELISA tests; and circulating egg antigens by double-sandwich ELISA techniques. The results showed that IgG4 anti-SEA is the best diagnostic test, as it gave the best diagnostic efficacy (90%). Also, it is a good screening test which can be used in endemic area as it gave significant difference between the active intestinal schistosomiasis cases with each of the endemic control group (P < 0.001) and the seropositive cases (P < 0.05). Other valid diagnostic egg specific antibodies tests were IgM anti-SEA and IgG anti-SEA as their diagnostic efficacy were 80% and 76.6% respectively (P < 0.05). The diagnostic efficacy of circulating antigen detection (C.Ag) test was 70% (P < 0.05). In addition, it was the most specific test with 100% specificity. IG4-anti-ESEA gave the least cross-reaction with other parasites (17.3%). The mean optical density (OD) level of circulating antigen detection test was significantly higher in the organomegalic (hepatosplenomegaly) cases than the non-organomegalic cases (P < 0.05).

Host and parasite determinants of morbidity in Egyptian children with schistosomiasis

The relation of morbidity due to schistosomiasis in Egyptian children to egg count, eosinophilic count, antibodies mediating eosinophil damage to schistosomula, total immunoglobulins and specific antischistosomal antibodies IgG and IgM anti-cercarial antigen preparation (CAP), anti-soluble worm antigen preparation (SWAP) and anti-soluble egg antigen preparation (SEA) were evaluated. The behavior of the immune parameters after treatment was also determined. The studied children were 78 males, aged 9-11 years. They were classified to control (14), simple intestinal (26) and hepatosplenic schistosomiasis (38) groups according to the clinical, parasitological and sonographic basis. The egg count was found higher in hepatosplenic schistosomiasis compared to that in simple group. Eosinophilic count did not differ between the two groups. Studies of immune responses revealed that antibodies mediating eosinophil adherence and damage to schistosomula rose in both groups particularly in hepatosplenic group. The levels of total and specific immunoglobulins were not significantly differed in both groups. The immune response was measured 2 months after treatment. The level of total IgA was increased in simple and decreased in hepatosplenic group. Total IgG and IgM were not affected by treatment in simple but IgM increased in hepatosplenic after treatment. Total IgE was decreased after treatment in both groups. This denotes that the behavior of the two groups after treatment was similar as regards the levels of IgG and IgE and differed as regards IgA and IgM. IgG anti-CAP and anti-SEA were declined after treatment but IgG- anti SWAP was elevated after treatment in both groups. The treatment has no effect on the levels of specific IgM against all used antigens. The antibodies mediating eosinophil adherence and damage to schistosomula rose in both groups after treatment. These indicated consistency of specific immune responses after treatment in schistosomal children. It is concluded that high intensity of infection may be one of the determinants of morbidity due to Schistosoma mansoni infection in Egypt. The elevated response of antibodies mediating adherence and damage to schistosomula may be associated or play a role with morbidity. Eosinophilic count, total IgA, IgG, IgM, IgE and specific antischistosomiasis IgG and IgM (Anti-CAP, anti-SWAP and anti-SEA) are not related to morbidity.

Evaluation of the effectiveness of dipstick haematuria and proteinuria in screening Schistosoma haematobium infection among school children in upper Egypt

This study aimed at evaluation of validity and reliability of dipstick haematuria and proteinuria in screening school children for Schistosoma haematobium infection. It included a random sample of 400 school children aged 6-15 years in rural area of Fayoum Governorate, upper Egypt. Urine samples of the studied children were tested parasitologically by urine filtration technique as a reference test and semiquantitatively for haematuria and proteinuria using urine reagent strips as screening tests. Results of the study revealed that haematuria was a better indicator for Schistosoma haematobium infection than proteinuria, as it was more sensitive (85.5% 73.4%, respectively), specific (94.4% 82.9%, respectively) and reliable (kappa=92% 80%, respectively). Moreover, it had stronger relationship with intensity of infection (r=0.88 & 0.67, respectively). A combination of different grades of haematuria and proteinuria did not significantly increase either sensitivity or specificity. Dipstick haematuria could be a valuable technique in screening rural Egyptian school children who are at risk of urinary schistosmiasis.

Time factor and eosinophil count in relation to experimental Schistosoma mansoni infection

The effects of diurnal variations of eosinophils on hostparasite relationship was studied in mice primarily exposed to S. mansoni infection. The eosinophil counts of 20 control normal mice showed different variations at different hours of the day with maximum level at midday and the minimum level at midnight. At these times, 2 groups of mice, each consists of 30 mice, were infected by about 100 S. mansoni cercariae. The infected mice in both groups showed more or less the same results as regards the worm burden, egg counts in tissues and histopathological changes in livers. Both infected groups showed marked eosinophil elevation versus normal control group yet the difference in-between them was insignificant. This means that the normal physiological variation in eosinophils in normal mice is useless in protection against infection. Complete ablation of eosinophils from animal using antieosinophilic sera, is essential for any study on eosinophils in relation to infection.

Adiaspiromycosis in suspected cases of pulmonary tuberculosis in the common brushtail possumTrichosurus vulpecula)

Pulmonary adiaspiromycosis was diagnosed in 15 of 17 common brushtail possums (Trichosurus vulpecula) examined for bovine tuberculosis. Emmonsia crescens was isolated from two of the affected animals. This is the first reported isolation of this dimorphic fungus in New Zealand. The infections varied from light to heavy with sparsely distributed, focal, 1-2 mm diameter, grey-white spherical granulomas in the lightly infected cases to innumerable foci throughout the lungs in the heavily infected cases. Histologically, the lesions were characterised by a central fungal adiaspore consistent in morphology with E. crescens located in alveolar spaces or bronchioles. These were surrounded by a cuff of granulomatous inflammation which varied in density and extent in proportion to the degree of degeneration exhibited by the organism. The lesions in most cases of adiaspiromycosis in the possum are sufficiently distinctive to allow their differentiation from tuberculosis by gross examination, but where any doubt exists over the possibility of dual infection by Emmonsia and Mycobacterium species differentiation should be made on the basis of a histological examination of the tissue and culture for mycobacterial organisms.

Evaluation of cercarien hullen reaction (CHR) as a diagnostic test in chronic schistosomiasis and as a parameter for reinfection in acute cases

CHR was evaluated as a serodiagnostic test in relation to stool analysis, rectal snip and indirect haemagglutination test (IHA) in 25 cases with chronic active mansonian schistosomiasis. Sensitivities of CHR, IHA, rectal snip and stool analysis, respectively, proved to be 68%, 48%, 84% and 52%. Rectal ship showed higher diagnostic efficacy 90% followed by CHR (77.5%), while IHA showed 67.5% diagnostic efficacy. To study CHR as parameter for pattern of reaction after treatment, 120 school children with acute mansonian schistosomiasis were examined CHR was done before and one month after treatment. These children were followed up for one year by stool examination. Results of CHR test after treatment showed that the children who were not reinfected gave the highest degree of reaction, while those of high reinfection showed decrease in reaction. This denotes that anticercarial antibodies may play a role in resistance to reinfection and CHR test could be used as parameter for reinfection in such cases.

Evaluation of an ELISA test in past and present schistosomiasis

An enzyme linked immunosorbent assay (ELISA) was evaluated in relation to an indirect haemagglutination (IHA) test in schistosomiasis patients who were classified by clinical, sonographic and direct methods of diagnosis. Sensitivities of ELISA and IHA respectively proved to be 100% and 69.23% in acute simple intestinal schistosomiasis; 95.5% and 90.4% in chronic active schistosomiasis patients; 86.06% and 67.41% in patients with past history of exposure; 80% and 64.28% in patients with hepatosplenomegaly with past history of schistosomiasis, and 96% and 80% in patients with hepatic fibrosis as shown by sonar. It was apparent that ELISA is more sensitive than IHA in acute simple schistosomiasis in patients with past history of exposure, those with bilharzial hepatosplenomegaly and those with hepatic fibrosis. Both tests were nearly equally sensitive in chronic active schistosomiasis.

The relation between Cimex lectularius antigen and bronchial asthma in Egypt

In bronchial asthma, house dust is one of the important precipitating factor. Cimex lectularius or bedbug is a well known house insect and share in the constitution of house dust. 54 asthmatic patients and 11 control individuals were skin tested using the common environmental inhalant antigens as well as Cimex extracts (Head and thorax, 1st antigen and abdomen, 2nd antigen). Also precipitin test using both Cimex extracts were used. The percentage of positive skin reactions to 1st Cimex antigen was 37.1 as compared to 9.1 in controls The percentage of positivity to Cimex 2nd antigen was 50.1 as compared to 18.2 in controls. On the other hand, the asthmatic patients showed different percentages of positivity to the common environmental inhalant antigens. The whole results were discussed. Of interest was the significant relation between the positivity in asthmatic patients to the antigens of Cimex abdominal extract and cotton dust extract. On the other hand, the precipitin tests gave negative results in both the asthmatic and control group.

Mycotoxin production by Fusarium species isolated from New Zealand maize fields

Forty Fusarium isolates obtained from maize fields were screened for moniliformin production on maize kernels. Twelve isolates, including seven of F. subglutinans, were found to produce moniliformin at levels ranging from 0.4 to 64 ppm. Twenty six isolates were also screened for production of deoxynivalenol, diacetoxyscirpenol, T-2 toxin and zearalenone. Of these, 22, including all 11 isolates of F. graminearum, produced zearalenone at levels ranging from 0.1 to 96.0 ppm, while 13 produced T-2 toxin at low levels, (less than 1.1 ppm). Deoxynivalenol and diacetoxyscirpenol were each produced by six isolates, also at low levels (less than 1.0 ppm). Three isolates of F. graminearum and one of F. sambucinum produced four toxins simultaneously.

Naturally occurring Fusarium toxins in New Zealand maize

Twenty samples of maize collected from healthy growing crops and at harvest time and during storage were screened for four Fusarium toxins (deoxynivalenol, diacetoxyscirpenol, T-2 toxin and zearalenone) by gas chromatography-mass spectrometry and thin-layer chromatography. Seventeen samples (85%) contained one or more of these toxins. Zearalenone was present in 15 samples at levels ranging between 0.1 and 16 ppm. Deoxynivalenol, diacetoxyscirpenol and T-2 toxin were found in 11, 6 and 13 samples respectively, all at levels below 1 ppm. This work documents the first reported natural occurrence of Fusarium toxins in New Zealand maize, and it is concluded that all four of the mycotoxins studied are prevalent in apparently healthy standing crops as well as in stored maize.