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Holt GS, Batty LE, Alobaidi BKS, Smith HE, Oud MS, Ramos L, Xavier MJ, Veltman JA. Phasing of de novo mutations using a scaled-up multiple amplicon long-read sequencing approach. Hum Mutat 2022; 43:1545-1556. [PMID: 36047340 PMCID: PMC9826063 DOI: 10.1002/humu.24450] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
De novo mutations (DNMs) play an important role in severe genetic disorders that reduce fitness. To better understand their role in disease, it is important to determine the parent-of-origin and timing of mutational events that give rise to these mutations, especially in sex-specific developmental disorders such as male infertility. However, currently available short-read sequencing approaches are not ideally suited for phasing, as this requires long continuous DNA strands that span both the DNM and one or more informative single-nucleotide polymorphisms. To overcome these challenges, we optimized and implemented a multiplexed long-read sequencing approach using Oxford Nanopore technologies MinION platform. We focused on improving target amplification, integrating long-read sequenced data with high-quality short-read sequence data, and developing an anchored phasing computational method. This approach handled the inherent phasing challenges of long-range target amplification and the normal accumulation of sequencing error associated with long-read sequencing. In total, 77 of 109 DNMs (71%) were successfully phased and parent-of-origin identified. The majority of phased DNMs were prezygotic (90%), the accuracy of which is highlighted by an average mutant allele frequency of 49.6% and standard error of 0.84%. This study demonstrates the benefits of employing an integrated short-read and long-read sequencing approach for large-scale DNM phasing.
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Affiliation(s)
- Giles S. Holt
- Biosciences Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Lois E. Batty
- Biosciences Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Bilal K. S. Alobaidi
- Biosciences Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Hannah E. Smith
- Biosciences Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Manon S. Oud
- Department of Human Genetics, Donders Institute for BrainCognition and Behaviour, RadboudumcNijmegenThe Netherlands
| | - Liliana Ramos
- Department of Obstetrics and Gynecology, Division of Reproductive MedicineRadboudumcNijmegenThe Netherlands
| | - Miguel J. Xavier
- Biosciences Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Joris A. Veltman
- Biosciences Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
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Long MK, Vohra MK, Bonnette A, Parra PDV, Miller SK, Ayub E, Wang HE, Cardenas‐Turanzas M, Gordon R, Ugalde IT, Allukian M, Smith HE. Focused assessment with sonography for trauma in predicting early surgical intervention in hemodynamically unstable children with blunt abdominal trauma. J Am Coll Emerg Physicians Open 2022; 3:e12650. [PMID: 35128532 PMCID: PMC8795205 DOI: 10.1002/emp2.12650] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 06/13/2021] [Revised: 12/04/2021] [Accepted: 12/28/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The predictive accuracy and clinical role of the focused assessment with sonography for trauma (FAST) exam in pediatric blunt abdominal trauma are uncertain. This study investigates the performance of the emergency department (ED) FAST exam to predict early surgical intervention and subsequent free fluid (FF) in pediatric trauma patients. METHODS Pediatric level 1 trauma patients ages 0 to 15 years with blunt torso trauma at a single trauma center were retrospectively reviewed. After stratification by initial hemodynamic (HD) instability, the association of a positive FAST with (1) early surgical intervention, defined as operative management (laparotomy or open pericardial window) or angiography within 4 hours of ED arrival and (2) presence of FF during early surgical intervention was determined. RESULTS Among 508 salvageable pediatric trauma patients with an interpreted FAST exam, 35 (6.9%) had HD instability and 98 (19.3%) were FAST positive. A total of 42 of 508 (8.3%) patients required early surgical intervention, and the sensitivity and specificity of FAST predicting early surgical intervention were 59.5% and 84.3%, respectively. The specificity and positive predictive value of FF during early surgical intervention in FAST-positive HD unstable patients increased from 50% and 90.9% at 4 hours after ED arrival to 100% and 100% at 2 hours after ED arrival, respectively. CONCLUSIONS In this large series of injured children, a positive FAST exam improves the ability to predict the need for early surgical intervention, and accuracy is greater for FF in HD unstable patients 2 hours after arrival to the ED.
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Affiliation(s)
- Megan K. Long
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
| | - Mohammed K. Vohra
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
| | - Austin Bonnette
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
| | - Pablo D. Vega Parra
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
| | - Sara K. Miller
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
| | - Emily Ayub
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
| | - Henry E. Wang
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
| | - Marylou Cardenas‐Turanzas
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
| | - Richard Gordon
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
| | - Irma T. Ugalde
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
| | - Myron Allukian
- Department of PediatricsChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Hannah E. Smith
- Department of Emergency MedicineThe University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTexasUSA
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Abstract
Back and neck pain have become primary reasons for disability and healthcare spending globally. While the causes of back pain are multifactorial, intervertebral disc degeneration is frequently cited as a primary source of pain. The annulus fibrosus (AF) and nucleus pulposus (NP) subcomponents of the disc are common targets for regenerative therapeutics. However, disc degeneration is also associated with degenerative changes to adjacent spinal tissues, and successful regenerative therapies will likely need to consider and address the pathology of adjacent spinal structures beyond solely the disc subcomponents. This review summarises the current state of knowledge in the field regarding associations between back pain, disc degeneration, and degeneration of the cartilaginous and bony endplates, the AF-vertebral body interface, the facet joints and spinal muscles, in addition to a discussion of regenerative strategies for treating pain and degeneration from a whole motion segment perspective.
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Affiliation(s)
| | | | | | - S E Gullbrand
- Corporal Michael J. Crescenz VA Medical Centre, Research, Building 21, Rm A214, 3900 Woodland Ave, Philadelphia, PA 19104,
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Smith HE, Hoover SR, Salmon M, Seaman H, Coppenrath CM, Hirsch SE, Perrault JR. Impact of the fire ant pesticide AMDRO on loggerhead turtle nest productivity and seafinding orientation. ENDANGER SPECIES RES 2020. [DOI: 10.3354/esr01033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Invasive fire ants prey on a variety of organisms in the southeastern USA, including the pipped eggs and hatchlings within sea turtle nests. The granular fire ant bait AMDRO® (active ingredient hydramethylnon) is currently used at some rookeries to protect nests, but no studies have been conducted to determine if the pesticide negatively impacts the eggs or the hatchlings. We examined the pesticide’s effect on loggerhead (Caretta caretta) nests at Juno Beach, Florida, USA, specifically targeting how exposure affected hatching success, hatchling emergence success, and the ability of the turtles to orient visually from the nest to the sea. Pesticide granules were placed within a 30 cm diameter circle on the sand directly above the nest during the final 5-10 days of incubation, representative of its typical application at nesting beaches. Cornmeal granules in soybean oil and untreated natural nests served as controls. AMDRO had no significant effect on hatching success or emergence success, nor did it result in any deficiencies in hatchling orientation accuracy. However, the pesticide and cornmeal control attracted other predators (Atlantic ghost crabs and avian species), in addition to fire ants, to the nest site, thus revealing the nest’s location and potentially increasing its vulnerability. Consequently, we suggest that its usage may not be beneficial at sites where predators other than ants are especially abundant.
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Affiliation(s)
- HE Smith
- Department of Biological Sciences, Florida Atlantic University, Boca Raton, Florida 33431, USA
| | - SR Hoover
- Department of Biological Sciences, Florida Atlantic University, Boca Raton, Florida 33431, USA
| | - M Salmon
- Department of Biological Sciences, Florida Atlantic University, Boca Raton, Florida 33431, USA
| | - H Seaman
- Loggerhead Marinelife Center, 14200 U.S. Highway 1, Juno Beach, Florida 33408, USA
| | - CM Coppenrath
- Department of Biological Sciences, Florida Atlantic University, Boca Raton, Florida 33431, USA
- Loggerhead Marinelife Center, 14200 U.S. Highway 1, Juno Beach, Florida 33408, USA
| | - SE Hirsch
- Loggerhead Marinelife Center, 14200 U.S. Highway 1, Juno Beach, Florida 33408, USA
| | - JR Perrault
- Loggerhead Marinelife Center, 14200 U.S. Highway 1, Juno Beach, Florida 33408, USA
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Wong SKW, Smith HE, Chua JJS, Griva K, Cartwright EJ, Soong AJ, Dalan R, Tudor Car L. Effectiveness of self-management interventions in young adults with type 1 and 2 diabetes: a systematic review and meta-analysis. Diabet Med 2020; 37:229-241. [PMID: 31769532 DOI: 10.1111/dme.14190] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2019] [Indexed: 12/27/2022]
Abstract
AIM Diabetes in young adulthood has been associated with poor outcomes. Self-management is fundamental to good diabetes care, and self-management interventions have been found to improve outcomes in older adults. We performed a systematic review and meta-analysis to assess the effectiveness of self-management interventions in young adults (aged 15-39 years) with type 1 or type 2 diabetes. METHODS We searched five databases and two clinical trial registries from 2003 to February 2019, without language restrictions. We included randomized controlled trials (RCTs) comparing the effectiveness of self-management interventions with usual care or enhanced usual care in young adults. Outcomes of interest included clinical outcomes, psychological health, self-care behaviours, diabetes knowledge and self-efficacy. Pairwise meta-analysis was conducted using a random effects model and quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria. We followed Cochrane gold standard systematic review methodology and reported this systematic review according to PRISMA guidelines. The protocol was registered with PROSEPRO (CRD42018110868). RESULTS In total, 13 studies (1002 participants) were included. Meta-analysis showed no difference between self-management interventions and controls in post-intervention HbA1c levels, BMI, depression, diabetes-related distress, overall self-care, diabetes knowledge and self-efficacy. Quality of evidence ranged from very low to moderate due to study limitations, inconsistency and imprecision. CONCLUSIONS Current self-management interventions did not improve outcomes in young adults with diabetes. Our findings, which contrast with those from systematic reviews in older adults, highlight the need for the development of more effective interventions for young adults with diabetes.
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Affiliation(s)
- S K W Wong
- Lee Kong Chian School of Medicine, Singapore
- National Healthcare Group Polyclinics, Singapore
| | - H E Smith
- Lee Kong Chian School of Medicine, Singapore
| | - J J S Chua
- Lee Kong Chian School of Medicine, Singapore
| | - K Griva
- Lee Kong Chian School of Medicine, Singapore
| | | | - A J Soong
- Lee Kong Chian School of Medicine, Singapore
| | - R Dalan
- Lee Kong Chian School of Medicine, Singapore
- Tan Tock Seng Hospital, Singapore
| | - L Tudor Car
- Lee Kong Chian School of Medicine, Singapore
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Teo LM, Smith HE, Lwin MO, Tang WE. Attitudes and perception of influenza vaccines among older people in Singapore: A qualitative study. Vaccine 2019; 37:6665-6672. [PMID: 31542261 PMCID: PMC7130882 DOI: 10.1016/j.vaccine.2019.09.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 09/08/2019] [Accepted: 09/10/2019] [Indexed: 11/06/2022]
Abstract
Background Despite recommendations for influenza vaccination of people aged 65 and above, uptake rate of influenza vaccines remains low. This study aims to understand barriers and motivators behind older adult’s decision on influenza vaccination. Methods Face to face interviews with participants aged 65 and above were conducted and audio recorded in Geylang polyclinic in Singapore. Thematic content analysis was used to organise the data. Results 15 older adults were interviewed, aged between 66 and 85 years old. 6 were vaccine refusers, 3 defaulters and 6 acceptors. A perceived lack of vulnerability, fear of side effects, and trivialisation of influenza were common reasons for not taking the vaccine. Encouragement from family and friends, travel and previous positive vaccination experiences were motivators for getting vaccinated. Healthcare workers played a role in influencing many of the participants’ decision-making. Common misconceptions included vaccines considered as necessary only before travel and as a cure rather than prevention. Most participants exhibited ambivalence, giving reasons both for and against vaccine uptake. Discussion Most older adults do not perceive influenza as a potentially serious disease nor trust in influenza vaccines’ efficacy. Misconceptions played a significant role in vaccine decline. Novel findings include the importance of the family unit in decision making, prioritization of chronic health problems over vaccination and misconception that vaccines are only needed when travelling out of country. Healthcare workers and family members appear to be important influencers in the decision making of older adults and should be actively engaged in future health promotion initiatives.
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Affiliation(s)
- L M Teo
- Lee Kong Chian School of Medicine Nanyang Technological University, Singapore
| | - H E Smith
- Lee Kong Chian School of Medicine Nanyang Technological University, Singapore.
| | - M O Lwin
- Wee Kim Wee School of Communications and Information, Nanyang Technological University, Singapore
| | - W E Tang
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore
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Meaney PA, Joyce CL, Setlhare S, Smith HE, Mensinger JL, Zhang B, Kalenga K, Kloeck D, Kgosiesele T, Jibril H, Mazhani L, de Caen A, Steenhoff AP. Knowledge acquisition and retention following Saving Children's Lives course for healthcare providers in Botswana: a longitudinal cohort study. BMJ Open 2019; 9:e029575. [PMID: 31420392 PMCID: PMC6701641 DOI: 10.1136/bmjopen-2019-029575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES Millions of children die every year from serious childhood illnesses. Most deaths are avertable with access to quality care. Saving Children's Lives (SCL) includes an abbreviated high-intensity training (SCL-aHIT) for providers who treat serious childhood illnesses. The objective of this study was to examine the impact of SCL-aHIT on knowledge acquisition and retention of providers. SETTING 76 participating centres who provide primary and secondary care in Kweneng District, Botswana. PARTICIPANTS Doctors and nurses expected by the District Health Management Team to provide initial care to seriously ill children, completed SCL-aHIT between January 2014 and December 2016, submitted demographic data, course characteristics and at least one knowledge assessment. METHODS Retrospective, cohort study. Planned and actual primary outcome was adjusted acquisition (change in total knowledge score immediately after training) and retention (change in score at 1, 3 and 6 months), secondary outcomes were pneumonia and dehydration subscores. Descriptive statistics and linear mixed models with random intercept and slope were conducted. Relevant institutional review boards approved this study. RESULTS 211 providers had data for analysis. Cohort was 91% nurses, 61% clinic/health postbased and 45% pretrained in Integrated Management of Childhood Illness (IMCI). A strong effect of SCL-aHIT was seen with knowledge acquisition (+24.56±1.94, p<0.0001), and loss of retention was observed (-1.60±0.67/month, p=0.018). IMCI training demonstrated no significant effect on acquisition (+3.58±2.84, p=0.211 or retention (+0.20±0.91/month, p=0.824) of knowledge. On average, nurses scored lower than physicians (-19.39±3.30, p<0.0001). Lost to follow-up had a significant impact on knowledge retention (-3.03±0.88/month, p=0.0007). CONCLUSIONS aHIT for care of the seriously ill child significantly increased provider knowledge and loss of knowledge occurred over time. IMCI training did not significantly impact overall knowledge acquisition nor retention, while professional status impacted overall score and lost to follow-up impacted retention.
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Affiliation(s)
- Peter Andrew Meaney
- Pediatrics, Stanford University, Stanford, California, USA
- Critical Care, Lucile Salter Packard Children's Hospital at Stanford, Palo Alto, California, USA
| | - Christine Lynn Joyce
- Critical Care, Cornell University Department of Pediatrics, New York, New York, USA
| | - Segolame Setlhare
- Helping Children Survive, American Heart Association Inc, Gaborone, Gaborone, Botswana
| | - Hannah E Smith
- Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Bingqing Zhang
- Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kitenge Kalenga
- Kweneng District Health Management Team, Molepolole, Kweneng, Botswana
| | - David Kloeck
- Critical Care, University of the Witwatersrand, Johannesburg-Braamfontein, Gauteng, South Africa
| | - Thandie Kgosiesele
- Clinical Services, Botswana Ministry of Health and Wellness, Gaborone, Botswana
| | - Haruna Jibril
- Clinical Services, Botswana Ministry of Health and Wellness, Gaborone, Botswana
| | - Loeto Mazhani
- Pediatrics, University of Botswana Faculty of Health Sciences, Gaborone, Gaborone, Botswana
| | - Allan de Caen
- Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Andrew P Steenhoff
- Infectious Diseases, Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Yorke J, Fleming S, Shuldham C, Rao H, Smith HE. Nonpharmacological interventions aimed at modifying health and behavioural outcomes for adults with asthma: a critical review. Clin Exp Allergy 2016; 45:1750-64. [PMID: 25675860 DOI: 10.1111/cea.12511] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Evidence suggests that living with asthma is linked with psychological and behavioural factors including self-management and treatment adherence, and therefore, there is a reasonable hypothesis that nonpharmacological treatments may improve health outcomes in people living with this condition. A systematic review of randomized controlled trials (RCTs) of nonpharmacological interventions for adults with asthma was designed. Databases searched included The Cochrane Airways Group Register of trials, CENTRAL and Psychinfo. The literature search was conducted until May 2014. Twenty-three studies met the inclusion criteria and were organized into four groups: relaxation-based therapies (n = 9); mindfulness (n = 1), biofeedback techniques (n = 3); cognitive behavioural therapies (CBT) (n = 5); and multicomponent interventions (n = 5). A variety of outcome measures were used, even when trials belonged to the same grouping, which limited the ability to conduct meaningful meta-analyses. Deficiencies in the current evidence base, notably trial heterogeneity, means that application to clinical practice is limited and clear guidelines regarding the use of nonpharmacological therapies in asthma is limited. Relaxation and CBT, however, appear to have a consistent positive effect on asthma-related quality of life and some psychological outcomes, and lung function (relaxation only). Future trials should be informed by previous work to harmonize the interventions under study and outcome measures used to determine their effectiveness; only then will meaningful meta-analyses inform clinical practice.
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Affiliation(s)
- J Yorke
- Nursing, University of Manchester, Manchester, UK
| | - S Fleming
- Nursing Research, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - C Shuldham
- Nursing and Quality, Royal Brompton and Harefield Foundation Trust, London, UK
| | - H Rao
- Public Health and Primary Care, University of Brighton, Brighton, UK
| | - H E Smith
- Public Health and Primary Care, University of Brighton, Brighton, UK
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Smith HE, Borowski W, Bohm M, Kata SG. Ultrasound-guided selective block of the anterior branch of the obturator nerve for transurethral resection of bladder tumour. Journal of Clinical Urology 2016. [DOI: 10.1177/2051415816632076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: Bladder perforation is a serious complication of transurethral resection of bladder tumour (TURBT). One of the risk factors is an “obturator jerk”, caused by stimulation of the obturator nerve, causing powerful adduction of the leg. As almost half of all bladder tumours are located on the lateral wall and 55–100% of resections on the lateral wall can result in obturator jerk; this is not an insignificant risk. Patients: We have introduced regional anaesthetic nerve block of the anterior branch of the obturator nerve in patients with known lateral wall tumours undergoing TURBT. Methods: This procedure was performed by two consultant anaesthetists in our unit. Patients are positioned supine with the leg slightly abducted and laterally rotated. Ultrasound (US) is used to identify the anterior branch of the adductor longus, brevis and magnus muscles in the medial thigh, 2–3 cm inferior to the inguinal crease. The obturator nerve is situated in the plane between adductor longus and adductor brevis, medial to pectineus. An insulated needle is passed under US guidance and a nerve stimulator is used to elicit a twitch. Levobupivicaine is used to infiltrate the anterior branch of the obturator nerve to achieve motor block of the adductor brevis, adductor longus and gracillis muscles. TURBT is then performed. Results: This prospective pilot series includes 18 TURBT procedures. These were performed under spinal anaesthetic ( n=16) or general anaesthetic without muscle relaxant ( n=2). Tumours characteristics were; large flat areas of re-resection ( n=5), flat bladder lesions ( n=1) or exophytic lesions ( n=12). There were no incidences of obturator jerk observed during TURBT (0/18). There were no intra or post-operative complications. Conclusion: This simple technique can be easily applied to patients undergoing TURBT. Larger studies are required, but our series supports the use of this technique to reduce obturator jerk, which is an important risk factors for bladder perforation.
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Affiliation(s)
- HE Smith
- Scottish Regional Treatment Centre, Stracathro Hospital, Brechin, UK
| | - W Borowski
- Scottish Regional Treatment Centre, Stracathro Hospital, Brechin, UK
| | - M Bohm
- Scottish Regional Treatment Centre, Stracathro Hospital, Brechin, UK
| | - SG Kata
- Scottish Regional Treatment Centre, Stracathro Hospital, Brechin, UK
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Willemse N, Howell KJ, Weinert LA, Heuvelink A, Pannekoek Y, Wagenaar JA, Smith HE, van der Ende A, Schultsz C. An emerging zoonotic clone in the Netherlands provides clues to virulence and zoonotic potential of Streptococcus suis. Sci Rep 2016; 6:28984. [PMID: 27381348 PMCID: PMC4933891 DOI: 10.1038/srep28984] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/13/2016] [Indexed: 01/03/2023] Open
Abstract
Streptococcus suis is a zoonotic swine pathogen and a major public health concern in Asia, where it emerged as an important cause of bacterial meningitis in adults. While associated with food-borne transmission in Asia, zoonotic S. suis infections are mainly occupational hazards elsewhere. To identify genomic differences that can explain zoonotic potential, we compared whole genomes of 98 S. suis isolates from human patients and pigs with invasive disease in the Netherlands, and validated our observations with 18 complete and publicly available sequences. Zoonotic isolates have smaller genomes than non-zoonotic isolates, but contain more virulence factors. We identified a zoonotic S. suis clone that diverged from a non-zoonotic clone by means of gene loss, a capsule switch, and acquisition of a two-component signalling system in the late 19th century, when foreign pig breeds were introduced. Our results indicate that zoonotic potential of S. suis results from gene loss, recombination and horizontal gene transfer events.
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Affiliation(s)
- N Willemse
- Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.,Department of Global Health-Amsterdam Institute for Global Health and Development, Academic Medical Center, University of Amsterdam, 1105 BM Amsterdam, The Netherlands
| | - K J Howell
- Department of Paediatrics, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - L A Weinert
- Department of Veterinary Medicine, School of Biological Sciences, University of Cambridge, Cambridge CB3 0ES, United Kingdom
| | - A Heuvelink
- GD Animal Health, 7400 AA Deventer, The Netherlands
| | - Y Pannekoek
- Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - J A Wagenaar
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands.,Central Veterinary Institute part of Wageningen UR, 8221 RA Lelystad, The Netherlands
| | - H E Smith
- Central Veterinary Institute part of Wageningen UR, 8221 RA Lelystad, The Netherlands
| | - A van der Ende
- Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.,National Reference Laboratory of Bacterial Meningitis, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - C Schultsz
- Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.,Department of Global Health-Amsterdam Institute for Global Health and Development, Academic Medical Center, University of Amsterdam, 1105 BM Amsterdam, The Netherlands.,Oxford University Clinical Research Unit, Centre for Tropical Medicine, District 5, Ho Chi Minh City, Vietnam
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Collis VL, Cunningham JO, Dumble S, Tavendale R, Vijverberg SJH, Maitland-van der Zee AH, Smith HE, Turner SW, Palmer CNA, Mukhopadhyay S. S14* Cumulative Genetic Risk of Asthma Severity in Children and Young People: Abstract S14 Table 1. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.20] [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: 11/03/2022]
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Smith HE, Ryan KN, Stephenson KB, Westcott C, Thakwalakwa C, Maleta K, Cheng JY, Brenna JT, Shulman RJ, Trehan I, Manary MJ. Multiple micronutrient supplementation transiently ameliorates environmental enteropathy in Malawian children aged 12-35 months in a randomized controlled clinical trial. J Nutr 2014; 144:2059-65. [PMID: 25411039 DOI: 10.3945/jn.114.201673] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Environmental enteropathy (EE) is subclinical, diffuse villous atrophy characterized by T cell infiltration of the small intestinal mucosa associated with nutrient malabsorption and stunting. EE is assessed by the lactulose:mannitol (L:M) test, whereby nonmetabolized sugars are ingested and quantified in the urine. Multiple micronutrient (MN) deficiency morphologically mimics EE, and ω-3 (n-3) polyunsaturated fatty acids reduce mucosal inflammation in Crohn disease. OBJECTIVE We tested the hypothesis that supplementary MNs, with or without fish oil (FO), would improve L:M in rural Malawian children aged 1-3 y compared with a control (C) group receiving a placebo. METHODS The MNs and FO provided the Recommended Dietary Intake for 26 vitamins, minerals, eicosapentaenoic acid, and docosahexaenoic acid. This was a 3-arm, randomized, double-blind, placebo-controlled clinical trial, with the primary outcomes being the change in L:M (ΔL:M) after 12 and 24 wk of supplementation. Comparisons were made for ΔL:M after 12 and 24 wk within each group by using a Wilcoxon matched pairs signed rank test, because the data are not normally distributed. RESULTS A total of 230 children had specimens adequate for analysis; all had an abnormal baseline L:M, defined as >0.10. After 12 wk, children who received MNs + FO had a ΔL:M [mean (95% CI)] of -0.10 (-0.04, -0.15; P = 0.001), and children receiving only MNs had ΔL:M of -0.12 (-0.03, -0.21; P = 0.002). After 24 wk, children who received MNs + FO had a ΔL:M of -0.09 (-0.03, -0.15; P = 0.001); children receiving only MNs had a ΔL:M of -0.11 (-0.02, -0.20; P = 0.001), and the C group had ΔL:M of -0.07 (0.02, -0.16); P = 0.002). Linear growth was similar in all groups, ∼4.3 cm over 24 wk. CONCLUSION Although the effect was modest, these data suggest MNs can transiently ameliorate EE in rural African children. The trial was registered at clinicaltrials.gov as NCT01593033.
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Affiliation(s)
- Hannah E Smith
- Department of Pediatrics, Washington University, St. Louis, MO
| | - Kelsey N Ryan
- Department of Pediatrics, Washington University, St. Louis, MO
| | | | - Claire Westcott
- Department of Pediatrics, Washington University, St. Louis, MO
| | | | - Ken Maleta
- College of Medicine, University of Malawi, Blantyre, Malawi
| | | | - J Thomas Brenna
- Division of Nutritional Sciences, Cornell University, Ithaca, NY; and
| | - Robert J Shulman
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Indi Trehan
- Department of Pediatrics, Washington University, St. Louis, MO; College of Medicine, University of Malawi, Blantyre, Malawi
| | - Mark J Manary
- Department of Pediatrics, Washington University, St. Louis, MO; College of Medicine, University of Malawi, Blantyre, Malawi; Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
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13
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Cassell JA, Dodds J, Lanza S, Low N, Roberts T, Smith HE, Rait G. P3.385 Comparative Experience and Outcomes of Clinic Staff Versus Intensive Researcher Led Recruitment to a Sexual Health Intervention in UK Primary Care. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0838] [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: 11/03/2022]
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14
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Abstract
Measuring quality of life (QoL) has become an increasingly important dimension of assessing patient well-being and drug efficacy. As there are now several asthma QoL questionnaires to choose from, it is important to appreciate their strengths and weaknesses. To assist in this choice, we have reviewed the existing questionnaires in a structured way. Information relating to the conceptual and measurement model, reliability, validity, interpretability, burden, administration format and translations was extracted from the published literature. The instruments differ in almost all criteria considered, and therefore it cannot be assumed that they measure the same thing. We recommend the selection of questionnaires that are designed only for asthma and that do not assess symptoms as part of QoL. Only two of the questionnaires reviewed fulfill these requirements: the Sydney Asthma QoL Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ). However, for multinational studies, it may be convenient or practical to use questionnaires that have been linguistically validated in many languages (AQLQ-J, SGRQ). It remains unclear which of these questionnaires best reflects patient perceptions of QoL. Our review did not involve patients, so for the time being choosing from existing questionnaires requires a compromise based on the rigor of the development process and the target patient group.
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Affiliation(s)
- C J Apfelbacher
- Division of Public Health and Primary Care, Brighton and Sussex Medical School, Falmer, UK.
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15
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Jordan KM, Sawyer S, Coakley P, Smith HE, Cooper C, Arden NK. The use of conventional and complementary treatments for knee osteoarthritis in the community. Rheumatology (Oxford) 2003; 43:381-4. [PMID: 14623948 DOI: 10.1093/rheumatology/keh045] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.3] [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: 11/14/2022] Open
Abstract
OBJECTIVES The aim of the survey was to assess the prevalence of clinically diagnosed knee osteoarthritis (OA) in two general practice populations in the Wessex region (practice A: a deprived urban population and practice B: an affluent rural population) and to assess both conventional and complementary therapy use in these two populations. METHODS All patients over 55 yr with a clinical diagnosis of knee OA, as identified from the practice computerized records, were sent a questionnaire about their knee pain and their use of conventional and complementary treatments. RESULTS A total of 4566 patients over 55 yr were registered in the two practices. Of these, 828 (18.13%) had a clinical diagnosis of knee OA and 240 (29%) patients were asymptomatic at the time of survey. Physiotherapy was under-utilized with only 13.1% of patients having received either hospital- or GP-based physiotherapy. There was a high prevalence of non-steroidal anti-inflammatory drug (NSAID) use, being significantly more in the affluent population (P < 0.05). In the affluent population there were statistically more social class groups 1-3a; statistically more NSAIDs, glucosamine and chondroitin sulphate were also used. The median amount spent on complementary medicine per month was 5.00 UK pounds, with the affluent population spending significantly more (P < 0.05). CONCLUSIONS In this population, physiotherapy is an under-utilized treatment for knee OA, in spite of its recommendation as first-line treatment in all guidelines. Complementary medicines and therapies are commonly used, particularly in affluent populations.
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Affiliation(s)
- K M Jordan
- MRC Epidemiology Resource Centre, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
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16
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Baele M, Chiers K, Devriese LA, Smith HE, Wisselink HJ, Vaneechoutte M, Haesebrouck F. The gram-positive tonsillar and nasal flora of piglets before and after weaning. J Appl Microbiol 2001; 91:997-1003. [PMID: 11851806 DOI: 10.1046/j.1365-2672.2001.01463.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [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
AIMS To investigate gram-positive nasal and tonsillar microbial flora of piglets before and after weaning. METHODS AND RESULTS The nasal and tonsillar gram-positive bacterial flora of 20 non-weaned piglets (2 weeks of age) and 20 weaned piglets (6 weeks of age), obtained from four different piggeries, was quantified by culture and identified by tDNA-PCR. The most widely occurring species from nasal conchae before as well as after weaning in the different piglets investigated were Streptococcus suis and Rothia nasimurium. After weaning a wide variety of Lactobacillus species appeared but in low numbers. In the tonsils, Strep. suis, Strep. dysgalactiae, S. hyicus, S. aureus, Arcanobacterium pyogenes and Actinomyces hyovaginalis were the species isolated from the largest number of pigs before and after weaning. S. aureus and most lactobacilli became more prevalent after weaning. Bacteria not known to be associated with pigs found in the present study included R. nasimurium, Strep. gallolyticus, Pediococcus pentosaceus and some Lactobacillus species. CONCLUSIONS Over 30 different gram-positive bacterial species may occur in nasal conchae and tonsils of unweaned piglets at 2 weeks of age and of 6-week-old weaned piglets. SIGNIFICANCE AND IMPACT OF THE STUDY This study demonstrated that weaning is associated with changes in prevalence of only a small minority of the highly diversified bacterial flora of the nares and tonsils of pigs.
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Affiliation(s)
- M Baele
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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17
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Smith HE, Mosher TJ, Dardzinski BJ, Collins BG, Collins CM, Yang QX, Schmithorst VJ, Smith MB. Spatial variation in cartilage T2 of the knee. J Magn Reson Imaging 2001; 14:50-5. [PMID: 11436214 DOI: 10.1002/jmri.1150] [Citation(s) in RCA: 248] [Impact Index Per Article: 10.8] [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: 11/12/2022] Open
Abstract
Technical limitations imposed by resolution and B1 homogeneity have thus far limited quantitative in vivo T2 mapping of cartilage to the patella. The purpose of this study is to develop T2 mapping of the femoral/tibial joint and assess regional variability of cartilage T2 in the knee. Quantitative in vivo T2 mapping of the knee was performed on 15 asymptomatic adults (age, 22-44) using a 3T MR scanner. There is a consistent pattern of spatial variation in cartilage T2 with longer values near the articular surface. The greatest variation occurs in the patella, where T2 increases from 45.3 +/- 2.5 msec at a normalized distance of 0.33-67 +/- 5.5 msec at a distance of 1.0. These results demonstrate feasibility of performing in vivo T2 mapping of femoral tibial cartilage. Except for the superficial 15% where T2 values are lower, the spatial variation in T2 of femoral and tibial cartilage is similar to patellar cartilage.
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Affiliation(s)
- H E Smith
- Center for NMR Research, Department of Radiology, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
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18
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Lammers A, van Vorstenbosch CJ, Erkens JH, Smith HE. The major bovine mastitis pathogens have different cell tropisms in cultures of bovine mammary gland cells. Vet Microbiol 2001; 80:255-65. [PMID: 11337141 DOI: 10.1016/s0378-1135(01)00305-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 10/18/2022]
Abstract
We previously showed that Staphylococcus aureus cells adhered mainly to an elongated cell type, present in cultures of bovine mammary gland cells. Moreover, we showed that this adhesion was mediated by binding to fibronectin. The same in vitro model was used here, to study adhesion of other important mastitis pathogens. Like the S. aureus strains, the Streptococcus dysgalactiae strains adhered mainly to elongated cells, which seemed to be mediated by fibronectin binding. In contrast, Streptococcus uberis strains adhered mainly to cubic cells. Since the cubic cells did not express fibronectin and S. uberis cells bound fibronectin less efficiently, the adhesion of S. uberis cells was independent of fibronectin binding. Streptococcus agalactiae strains adhered poorly to both cell types. The specificity and efficiency of adhesion of Escherichia coli strains was strongly strain dependent. None of the S. agalactiae and E. coli strains tested was able to bind fibronectin efficiently. The results suggest that the different mastitis pathogens have different target cell specificities and use different mechanisms to adhere to cells of the bovine mammary gland.
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Affiliation(s)
- A Lammers
- Department of Bacteriology, Institute for Animal Science and Health, P.O. Box 65, 8200 AB Lelystad, The Netherlands.
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19
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Wisselink HJ, Vecht U, Stockhofe-Zurwieden N, Smith HE. Protection of pigs against challenge with virulent Streptococcus suis serotype 2 strains by a muramidase-released protein and extracellular factor vaccine. Vet Rec 2001; 148:473-7. [PMID: 11334073 DOI: 10.1136/vr.148.15.473] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [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: 11/03/2022]
Abstract
The efficacy of a muramidase-released protein (MRP) and extracellular factor (EF) vaccine in preventing infection and disease in pigs challenged either with a homologous or a heterologous Streptococcus suis serotype 2 strain (MRP+EF+) was compared with the efficacy of a vaccine containing formalin-killed bacterin of S. suis serotype 2 (MRP+EF+). The enhancement of the immune response by different adjuvants (a water-in-oil emulsion [WO] and an aluminium hydroxide-based adjuvant [AH]) and their side effects were also studied. The MRP and EF were purified by affinity chromatography. Pigs were vaccinated twice at three weeks and six weeks of age and challenged intravenously with virulent S. suis serotype 2 strains (MRP+EF+) at eight weeks of age. At challenge, the pigs vaccinated with MRP+EF/WO had high anti-MRP and anti-EF titres and were protected as effectively as pigs vaccinated with WO-formulated vaccines with bacterin. Eight of the nine pigs survived the challenge and almost no clinical signs of disease were observed. The titres obtained with the MRP+EF/AH vaccine were low and only two of the five pigs were protected. Pigs vaccinated with either MRP or EF were less well protected; three of the four pigs died after challenge but the clinical signs of disease were significantly less severe than those observed in the placebo-vaccinated pigs. The protective capacity of the bacterin/AH vaccine was very low, and the mortality among these pigs was as high as in the placebo-vaccinated pigs (80 per cent). Postmortem histological examination revealed meningitis, polyserositis and arthritis in the clinically affected pigs. The results demonstrate that a subunit vaccine containing both MRP and EF, formulated with the WO adjuvant, protected pigs against challenge with virulent S. suis type 2 strains.
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Affiliation(s)
- H J Wisselink
- Division of Infectious Diseases and Food Chain Quality, Institute for Animal Science and Health, Lelystad, The Netherlands
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20
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Abstract
Recent claims have been made that sublingual immunotherapy (SLIT) may be a viable alternative to injection immunotherapy (SIT). Animal studies show that when allergens are administered topically, they are handled differently, and IgE responses can be reduced. Most published studies of human SLIT have been small but show fairly consistent benefits on symptom scores, with few systemic side effects. Objective measures of allergen reactivity usually do not change. Relatively few subjects have been treated in SLIT trials compared with the numbers that would be required to validate new drug therapies. On the plus side, SLIT appears to work in adults and in children; it offers some logistic advantages and seems to be safe. Giving allergen by mouth rather than by injection should decrease the costs of immunotherapy, but the cumulative dose of allergen used in SLIT has been between 20 to 375 times the dose given in conventional SIT. Further cost-benefit analysis is needed. On the other hand, standard SIT is effective and is supported by better clinical and experimental evidence. The balance sheet for SLIT is improving, but on the current evidence, SLIT requires further evaluation before it could be recommended for use in routine clinical practice.
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Affiliation(s)
- A J Frew
- Department of Medical Specialties, School of Medicine, University of Southampton, UK
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21
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Smith HE, Buijs H, Wisselink HJ, Stockhofe-Zurwieden N, Smits MA. Selection of virulence-associated determinants of Streptococcus suis serotype 2 by in vivo complementation. Infect Immun 2001; 69:1961-6. [PMID: 11179384 PMCID: PMC98113 DOI: 10.1128/iai.69.3.1961-1966.2001] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [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] Open
Abstract
Within Streptococcus suis serotype 2, pathogenic, weakly pathogenic, and nonpathogenic strains can be found. We introduced a genomic library of a pathogenic strain into a weakly pathogenic strain. After infection of the library into young piglets pathogenic transformants were selected. One specific transformant containing a 3-kb fragment of the pathogenic strain appeared to be dominantly enriched in diseased pigs. The observed enrichment was not tissue specific. The selected fragment, when introduced into two different weakly pathogenic strains, increased the virulence of these strains considerably. In contrast, introduction of the corresponding fragment of a weakly pathogenic strain had only minor effects on virulence. Nucleotide sequence analysis of the selected fragment of the pathogenic strain revealed the presence of two potential open reading frames, both of which were found to be mutated in the corresponding fragment of the weakly pathogenic strain. These data strongly suggest that the selected fragment contains determinants important for virulence.
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Affiliation(s)
- H E Smith
- Department of Bacteriology, Pathology, and Epidemiology, Institute for Animal Science and Health, 8200 AB Lelystad, The Netherlands.
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22
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Allgaier A, Goethe R, Wisselink HJ, Smith HE, Valentin-Weigand P. Relatedness of Streptococcus suis isolates of various serotypes and clinical backgrounds as evaluated by macrorestriction analysis and expression of potential virulence traits. J Clin Microbiol 2001; 39:445-53. [PMID: 11158088 PMCID: PMC87757 DOI: 10.1128/jcm.39.2.445-453.2001] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [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] Open
Abstract
We evaluated the genetic diversity of Streptococcus suis isolates of different serotypes by macrorestriction analysis and elucidated possible relationships between the genetic background, expression of potential virulence traits, and source of isolation. Virulence traits included expression of serotype-specific polysaccharides, muramidase-released protein (MRP), extracellular protein factor (EF), hemolysin activity, and adherence to epithelial cells. Macrorestriction analysis of streptococcal DNA digested with restriction enzymes SmaI and ApaI allowed differentiation of single isolates that could be assigned to four major clusters, named A1, A2, B1, and B2. Comparison of the genotypic and phenotypic features of the isolates with their source of isolation showed that (i) the S. suis population examined, which originated mainly from German pigs, exhibited a genetic diversity and phenotypic patterns comparable to those found for isolates from other European countries; (ii) certain phenotypic features, such as the presence of capsular antigens of serotypes 2, 1, and 9, expression of MRP and EF, and hemolysin activity (and in particular, combinations of these features), were strongly associated with the clinical background of meningitis and septicemia; and (iii) isolates from pigs with meningitis and septicemia showed a significantly higher degree of genetic homogeneity compared to that for isolates from pigs with pneumonia and healthy pigs. Since the former isolates are considered highly virulent, this supports the theory of a clonal relationship among highly virulent strains.
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Affiliation(s)
- A Allgaier
- Institut fuer Mikrobiologie und Tierseuchen, Tieraerztliche Hochschule Hannover, Hannover, Germany
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23
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Reinke V, Smith HE, Nance J, Wang J, Van Doren C, Begley R, Jones SJ, Davis EB, Scherer S, Ward S, Kim SK. A global profile of germline gene expression in C. elegans. Mol Cell 2000; 6:605-16. [PMID: 11030340 DOI: 10.1016/s1097-2765(00)00059-9] [Citation(s) in RCA: 463] [Impact Index Per Article: 19.3] [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]
Abstract
We used DNA microarrays to profile gene expression patterns in the C. elegans germline and identified 1416 germline-enriched transcripts that define three groups. The sperm-enriched group contains an unusually large number of protein kinases and phosphatases. The oocyte-enriched group includes potentially new components of embryonic signaling pathways. The germline-intrinsic group, defined as genes expressed similarly in germlines making only sperm or only oocytes, contains a family of piwi-related genes that may be important for stem cell proliferation. Finally, examination of the chromosomal location of germline transcripts revealed that sperm-enriched and germline-intrinsic genes are nearly absent from the X chromosome, but oocyte-enriched genes are not.
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Affiliation(s)
- V Reinke
- Department of Developmental Biology, Stanford University School of Medicine, California 94305, USA
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24
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Smith HE, de Vries R, van't Slot R, Smits MA. The cps locus of Streptococcus suis serotype 2: genetic determinant for the synthesis of sialic acid. Microb Pathog 2000; 29:127-34. [PMID: 10906268 DOI: 10.1006/mpat.2000.0372] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [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: 11/22/2022]
Abstract
The capsule of S. suis serotype 2 is composed of glucose, galatose, N-acetylglucosamine, rhamnose and sialic acid. Recently, we described a major part of the cps2 locus of S. suis serotype 2. Based on sequence homology genes encoding potential glucosyl-, galactosyl-, N-acetylglucosaminyl- and rhamnosyltransferase activities could be identified. However, we did not find genes involved in the synthesis of sialic acid. Here, we describe the cloning and characterization of a remaining part of the cps2 locus. Based on the establish sequence 11 potential genes, designated orf2L, orf2M, orf2N, cps2O to cps2T, orf2U and orf2V were identified. A gene homologous to genes involved in the polymerization of the repeating oligosaccharide unit (cps2O) as well as genes involved in the synthesis of sialic acid (cps2P to cps2T) were identified. Moreover, hybridizing experiments showed that the genes involved in the sialic acid synthesis are present in S. suis serotype 1, 2, 14, 27 and 1/2. The orf2M and orf2N regions showed similarity to proteins involved in the polysaccharide biosynthesis of other Gram-positive bacteria. However, these regions seemed to be truncated or were non-functional as the result of frame-shift or point mutations. At its 3;-end the cps2 locus contained two insertional elements (orf2U and orf2V), both of which seemed to be non-functional.
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Affiliation(s)
- H E Smith
- Department of Bacteriology, Institute for Animal Science and Health, Lelystad, The Netherlands.
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25
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Abstract
A semisynthetic antibody phage display library was used to select recombinant antibodies directed against surface components of a pathogenic strain of Streptococcus suis serotype 2 and against extracellular factor (EF), a protein known to be exclusively associated with pathogenic S. suis serotype 2 strains. Three distinct monoclonal phage antibodies directed against conformational epitopes of surface protein components of S. suis were selected. In addition, three different monoclonal phage antibodies were isolated that recognized EF. To isolate antibody fragments that recognize epitopes specific for a pathogenic S. suis serotype 2 strain, compared to a nonpathogenic serotype 2 strain, we applied a subtractive selection procedure. With this procedure, only one distinct phage antibody was found, and it was shown to be directed against EF. This demonstrates the selectivity of the applied procedure and confirms that EF is indeed differentially expressed by pathogenic and nonpathogenic strains. It also shows that EF is a very dominant antigen in phage antibody selections.
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Affiliation(s)
- A de Greeff
- Department of Medical Microbiology, University of Amsterdam, Academical Medical Center, Amsterdam, The Netherlands.
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26
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Wisselink HJ, Smith HE, Stockhofe-Zurwieden N, Peperkamp K, Vecht U. Distribution of capsular types and production of muramidase-released protein (MRP) and extracellular factor (EF) of Streptococcus suis strains isolated from diseased pigs in seven European countries. Vet Microbiol 2000; 74:237-48. [PMID: 10808092 DOI: 10.1016/s0378-1135(00)00188-7] [Citation(s) in RCA: 162] [Impact Index Per Article: 6.8] [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: 10/18/2022]
Abstract
Streptococcus suis strains (n=411), isolated from diseased pigs in seven European countries were serotyped using specific antisera against serotype 1 to 28, and were phenotyped on the basis of their muramidase-released-protein (MRP) and extracellular-factor protein (EF) production. Overall, S. suis serotype 2 appeared to be most prevalent (32%), followed by serotype 9 (20%) and serotype 1 (12%). Serotype 2 was most frequently isolated in France, Italy and Spain, whereas serotype 9 was most frequently isolated in Belgium, The Netherlands and Germany. In the United Kingdom serotypes 1 and 14 were most frequently isolated. High percentages of S. suis serotype 1, 2, 1/2 and 14 strains, isolated from tissues associated with S. suis infections such as brain, serosa, joint, heart and organs expressed the EF-protein, indicating that in these serotypes expression of EF is likely to be associated with virulence. In contrast, strains belonging to serotype 7 and 9, isolated from tissues associated with S. suis infections did not produce EF. These results strongly suggest that in the serotypes 7 and 9 EF expression is not related to virulence. More than 80% of the S. suis serotype 9 strains produced an MRP* protein, a high molecular variant of the 136kDa MRP. Expression of MRP* in serotype 9 strains is possibly associated with virulence.
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Affiliation(s)
- H J Wisselink
- Department of Bacteriology, Institute for Animal Science and Health, P.O. Box 65, 8200 AB, Lelystad, Netherlands.
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27
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Lammers A, Nuijten PJ, Smith HE. The fibronectin binding proteins of Staphylococcus aureus are required for adhesion to and invasion of bovine mammary gland cells. FEMS Microbiol Lett 1999; 180:103-9. [PMID: 10547450 DOI: 10.1111/j.1574-6968.1999.tb08783.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.1] [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: 11/30/2022] Open
Abstract
We recently described adhesion to and invasion of bovine mammary gland cells by Staphylococcus aureus in vitro. Here, we show that the levels of adhesion and invasion are dependent on the bacterial growth phase and are controlled by the agr locus. Incubation of exponential growth phase cells of S. aureus with mammary gland cells resulted in bacterial cell clumping. Strains of S. aureus deficient in expression of the fibronectin binding proteins (FnBPA and FnBPB) failed to clump and their ability to adhere to and to invade the bovine mammary gland cells is strongly reduced. This indicates that the fibronectin binding proteins are essential for S. aureus adhesion to and invasion of bovine mammary gland cells.
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Affiliation(s)
- A Lammers
- Department of Bacteriology, Institute for Animal Science and Health, P.O. Box 65, 8200 AB, Lelystad, The Netherlands.
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28
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Smith HE, Veenbergen V, van der Velde J, Damman M, Wisselink HJ, Smits MA. The cps genes of Streptococcus suis serotypes 1, 2, and 9: development of rapid serotype-specific PCR assays. J Clin Microbiol 1999; 37:3146-52. [PMID: 10488168 PMCID: PMC85514 DOI: 10.1128/jcm.37.10.3146-3152.1999] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.8] [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] Open
Abstract
We developed three type-specific PCR assays for the rapid and sensitive detection of Streptococcus suis serotype 1 (plus 14), serotype 2 (plus 1/2), and serotype 9 strains in tonsillar specimens from pigs. The PCR primers were based on the sequences of type-specific capsular genes of S. suis serotype 1, 2, and 9 strains. We recently characterized a major part of the capsular biosynthesis (cps) locus of S. suis serotype 2. Here we extended these studies and characterized major parts of the cps loci of S. suis serotypes 1 and 9. Type-specific genes were identified by cross-hybridization experiments between the individual cps genes and chromosomal DNAs from the 35 different serotypes. Four genes of S. suis serotype 1 specifically hybridized with serotype 1 and 14 strains only. Five genes of S. suis serotype 2 specifically hybridized with serotype 2 and 1/2 strains only, and two genes of S. suis serotype 9 specifically hybridized with serotype 9 strains. Until now rapid and sensitive diagnostic tests were available only for pathogenic strains of serotype 2 and highly pathogenic strains of serotype 1. The serotype-specific PCR assays can therefore be useful tools for the identification of serotype 1, 14, 2, 1/2, and 9 strains both for diagnostic purposes and in epidemiological and transmission studies. Therefore, these tests may facilitate control and eradication programs.
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Affiliation(s)
- H E Smith
- Department of Bacteriology, DLO-Institute for Animal Science and Health, 8200 AB Lelystad, The Netherlands.
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Abstract
Recent epidemiological studies on Streptococcus suis infections in pigs indicated that, besides serotypes 1, 2 and 9, serotype 7 is also frequently associated with diseased animals. For the latter serotype, however, no rapid and sensitive diagnostic methods are available. This hampers prevention and control programs. Here, we describe the development of a type-specific PCR test for the rapid and sensitive detection of S. suis serotype 7. The test is based on DNA sequences of capsular (cps) genes specific for serotype 7. These sequences were identified by cross-hybridization of several individual cps genes with the chromosomal DNAs of 35 different S. suis serotypes.
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Affiliation(s)
- H E Smith
- Department of Bacteriology, DLO-Institute for Animal Science and Health, AB Lelystad, The Netherlands.
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Bolhuis A, Tjalsma H, Smith HE, de Jong A, Meima R, Venema G, Bron S, van Dijl JM. Evaluation of bottlenecks in the late stages of protein secretion in Bacillus subtilis. Appl Environ Microbiol 1999; 65:2934-41. [PMID: 10388686 PMCID: PMC91439 DOI: 10.1128/aem.65.7.2934-2941.1999] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.2] [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: 11/20/2022] Open
Abstract
Despite a high capacity for secretion of homologous proteins, the secretion of heterologous proteins by Bacillus subtilis is frequently inefficient. In the present studies, we have investigated and compared bottlenecks in the secretion of four heterologous proteins: Bacillus lichenifomis alpha-amylase (AmyL), Escherichia coli TEM beta-lactamase (Bla), human pancreatic alpha-amylase (HPA), and a lysozyme-specific single-chain antibody. The same expression and secretion signals were used for all four of these proteins. Notably, all identified bottlenecks relate to late stages in secretion, following translocation of the preproteins across the cytoplasmic membrane. These bottlenecks include processing by signal peptidase, passage through the cell wall, and degradation in the wall and growth medium. Strikingly, all translocated HPA was misfolded, its stability depending on the formation of disulfide bonds. This suggests that the disulfide bond oxidoreductases of B. subtilis cannot form the disulfide bonds in HPA correctly. As the secretion bottlenecks differed for each heterologous protein tested, it is anticipated that the efficient secretion of particular groups of heterologous proteins with the same secretion bottlenecks will require the engineering of specifically optimized host strains.
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Affiliation(s)
- A Bolhuis
- Department of Genetics, Groningen Biomolecular Sciences and Biotechnology Institute, University of Groningen, 9751 NN Haren, The Netherlands
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Lammers A, Nuijten PJ, Kruijt E, Stockhofe-Zurwieden N, Vecht U, Smith HE, van Zijderveld FG. Cell tropism of Staphylococcus aureus in bovine mammary gland cell cultures. Vet Microbiol 1999; 67:77-89. [PMID: 10414363 DOI: 10.1016/s0378-1135(99)00018-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [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: 11/26/2022]
Abstract
Staphylococcus aureus is one of the most important pathogens of the bovine mammary gland. The interaction of S. aureus with cells of the bovine mammary gland is considered to play an essential role in the pathogenesis. In this study, we identified a new target cell for S. aureus adhesion and invasion. For that purpose, cells which compose the alveoli of the mammary gland were cultured. In these cultures, two morphologically different cell types, elongated and cubic cells, were observed. Adhesion and invasion of S. aureus was studied using microscopical and microbiological methods. S. aureus adhered specifically and in large numbers (about 300 bacteria/cell) to the elongated cell type. No adhesion to the cubic cell type was observed. In addition, bacteria were also found intracellularly in the elongated cells, and enclosed in membrane vesicles. Adhesion and invasion were time dependent and reached maximum levels after 4 h. Invasion was strongly reduced by staurosporine and genistein. The newly identified target cell was further characterized.
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Affiliation(s)
- A Lammers
- Department of Bacteriology, DLO-Institute for Animal Science and Health, Lelystad, The Netherlands.
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Wisselink HJ, Reek FH, Vecht U, Stockhofe-Zurwieden N, Smits MA, Smith HE. Detection of virulent strains of Streptococcus suis type 2 and highly virulent strains of Streptococcus suis type 1 in tonsillar specimens of pigs by PCR. Vet Microbiol 1999; 67:143-57. [PMID: 10414368 DOI: 10.1016/s0378-1135(99)00036-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [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: 11/18/2022]
Abstract
We developed a PCR assay for the rapid and sensitive detection of virulent Streptococcus suis type 2 and highly virulent S. suis type 1 in tonsillar specimens from pigs. The PCR primers were based on the sequence of the gene encoding the EF-protein of virulent S. suis type 2 strains (MRP+EF+) and highly virulent S. suis type 1 strains (MRP(s)EF+) and of the EF protein of weakly virulent S. suis type 2 strains (MRP+EF). The latter strains give rise to larger PCR products than the virulent strains of S. suis type 1 and 2. A positive control template was included in the assay to identify false negative results. The PCR was evaluated using tonsillar specimens from herds known (or suspected) to be infected and herds without an S. suis history. The results obtained with the PCR assay were compared with the results obtained with a newly developed bacteriological examination. In this bacteriological examination we were able to identify the EF-positive strains directly in the tonsillar specimens. From the 99 tonsils examined, 48 were positive in the PCR and 51 negative. All specimens from which EF-positive S. suis strains were isolated were also positive in the PCR assay. Three samples were positive in the PCR, but negative by bacteriological examination. The results demonstrated that the PCR is a highly specific and sensitive diagnostic tool for the detection of pigs carrying virulent strains of S. suis type 2 and highly virulent strains of type 1. Application of the assay may contribute to the control of S. suis infections.
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Affiliation(s)
- H J Wisselink
- Department of Bacteriology, DLO-Institute for Animal Science and Health, Lelystad, The Netherlands.
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Smith HE, Damman M, van der Velde J, Wagenaar F, Wisselink HJ, Stockhofe-Zurwieden N, Smits MA. Identification and characterization of the cps locus of Streptococcus suis serotype 2: the capsule protects against phagocytosis and is an important virulence factor. Infect Immun 1999; 67:1750-6. [PMID: 10085014 PMCID: PMC96524 DOI: 10.1128/iai.67.4.1750-1756.1999] [Citation(s) in RCA: 290] [Impact Index Per Article: 11.6] [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: 11/20/2022] Open
Abstract
To study the role of the capsule of Streptococcus suis serotype 2 in virulence, we generated two isogenic mutants disturbed in capsule production. For that purpose, we first cloned and characterized a major part of the capsular polysaccharide biosynthesis (cps) locus of S. suis serotype 2. Based on the established sequence, 14 open reading frames (ORFs), designated Orf2Z, Orf2Y, Orf2X, and Cps2A to Cps2K, were identified. Twelve ORFs belonged to a single transcriptional unit. The gene products of 11 of these ORFs showed similarity to proteins involved in polysaccharide biosynthesis of other gram-positive microorganisms. Nonencapsulated isogenic mutants were generated in the cps2B and cps2EF genes by insertional mutagenesis. In contrast to the wild-type S. suis serotype 2 strain, the nonencapsulated strains were highly sensitive to ingestion by porcine alveolar lung macrophages in vitro. More importantly, the nonencapsulated mutant strains were completely avirulent in young germfree pigs after intranasal inoculation. These observations indicate that the capsule of S. suis serotype 2 plays an essential role in the pathogenesis of S. suis serotype 2 infections.
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Affiliation(s)
- H E Smith
- Department of Bacteriology, Pathobiology and Epidemiology, DLO-Institute for Animal Science and Health, 8200 AB Lelystad, The Netherlands.
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Stewart M, Werneke U, MacFaul R, Taylor-Meek J, Smith HE, Smith IJ. Medical and social factors associated with the admission and discharge of acutely ill children. Arch Dis Child 1998; 79:219-24. [PMID: 9875016 DOI: 10.1136/adc.79.3.219] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To examine medical and sociodemographic factors involved in acute paediatric admission. To compare outcome of admission with factors present at time of admission. METHODS Prospective questionnaire based study of 887 consecutive emergency general paediatric admissions to five Yorkshire hospitals during two separate three week periods in summer and winter. MAIN OUTCOME MEASURES Discharge diagnosis, length of stay. RESULTS Most admissions (53%) occurred "out of hours" with a peak during the evening. Two thirds (64%) of patients were under 3 years of age and clinical problems varied with age. Self referral via an accident and emergency department occurred in one third and was more likely after a fit in older children and in more socioeconomically deprived children. The most frequent presenting problems were breathing difficulty (24%), fit (16%), and feverish illness (15%). One quarter (24%) were discharged within 24 hours and 61% spent, at most, one night in hospital. Length of stay was shorter for night admissions and longer for children with a discharge diagnosis of asthma. Although most children had mild, self limiting illnesses, serious illness was subsequently found in 13% and could not be predicted from the presenting problems. CONCLUSIONS Current demand on emergency paediatric admission is mainly from young children with mild self limiting illnesses who spend one night or less in hospital. Changes in delivery of care to acutely ill children must take account of the pattern and nature of presenting problems and be rigorously audited to ensure that improvements in the health of children continue.
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Affiliation(s)
- M Stewart
- Nuffield Department of Child Health, Queen's University of Belfast, UK
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MacFaul R, Stewart M, Werneke U, Taylor-Meek J, Smith HE, Smith IJ. Parental and professional perception of need for emergency admission to hospital: prospective questionnaire based study. Arch Dis Child 1998; 79:213-8. [PMID: 9875015 PMCID: PMC1717678 DOI: 10.1136/adc.79.3.213] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To compare views of parents, consultants, and general practitioners on severity of acute illness and need for admission, and to explore views on alternative services. METHOD Prospective questionnaire based study of 887 consecutive emergency paediatric admissions over two separate three week periods in summer and winter of five Yorkshire hospitals, combined with a further questionnaire on a subsample. OUTCOME MEASURES Parental scores of need for admission and parent and consultant illness severity scores out of 10. Consultant judgment of need for admission. Alternatives to admission considered by consultants and, for a subsample, by parents and family GP. RESULTS Ninety nine per cent of parents thought admission was needed. Parents scored need for admission more highly than severity of illness with no association observed between severity and presenting problem or diagnosis. High parental need score was associated with a fit, past illness, and length of stay. Consultant illness severity scores were skewed to the lower range. Consultants considered admission necessary in 71%, especially for children aged over 1 year, presentation with breathing difficulty or fit, and after a longer stay. More admissions in the evening were considered unnecessary as were admissions after longer preadmission illness, gastroenteritis, or upper respiratory tract infection. Of a subsample of parents, 81% preferred admission during the acute stage of illness even if home nursing had been available. Similar responses were obtained from GPs. Alternative services could have avoided admission for 19% of children, saving 15.6% of bed days used. CONCLUSIONS Medical professionals and parents differ in their views about admission for acute illnesses. More information is needed on children not admitted. Alternative services should take account of patterns of illness and should be acceptable to parents and professionals; cost savings may be marginal.
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Affiliation(s)
- R MacFaul
- Health Services Committee, Royal College of Paediatrics and Child Health, London, UK
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Trieman N, Smith HE, Kendal R, Leff J. The TAPS Project 41: homes for life? Residential stability five years after hospital discharge. Team for the Assessment of Psychiatric Services. Community Ment Health J 1998; 34:407-17. [PMID: 9693869 DOI: 10.1023/a:1018792108559] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This paper describes pathways followed by 567 long-stay patients who were resettled into the community, as part of a program to close two psychiatric hospitals in London and replace them with community-based services. Sixty-one percent of the former patients remained in their original placement--mostly group homes--over the five-year follow-up. Transition from one house to another mostly took a direct course, with only 27 patients changing houses by way of long intermediate hospitalisation. Change of residence was at the same level of support, with only a slight trend towards less supervised facilities. Ten patients could not be traced and have possibly become homeless. Only 3 patients were in prison during the five-year follow-up. More than a third of the sample were readmitted at least once during that period. It is concluded that community residences established under the resettlement program served as relatively stable homes for the majority of patients.
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Abstract
In nematodes, sperm are amoeboid cells that crawl via an extended pseudopod. Unlike those in other crawling cells, this pseudopod contains little or no actin; instead, it utilizes the major sperm protein (MSP). In vivo and in vitro studies of Ascaris suum MSP have demonstrated that motility occurs via the regulated assembly and disassembly of MSP filaments. Filaments composed of MSP dimers are thought to provide the motive force. We have employed the yeast two-hybrid system to investigate MSP-MSP interactions and provide insights into the process of MSP filament formation. Fusions of the Caenorhabditis elegans msp-142 gene to both the lexA DNA binding domain (LEXA-MSP) and a transcriptional activation domain (AD-MSP) interact to drive expression of a lacZ reporter construct. A library of AD-MSP mutants was generated via mutagenic PCR and screened for clones that fail to interact with LEXA-MSP. Single missense mutations were identified and mapped to the crystal structure of A. suum MSP. Two classes of mutations predicted from the structure were recovered: changes in residues critical for the overall fold of the protein, and changes in residues in the dimerization interface. Multiple additional mutations were obtained in the two carboxy-terminal beta strands, a region not predicted to be involved in protein folding or dimer formation. Size fractionation of bacterially expressed MSPs indicates that mutations in this region do not abolish dimer formation. A number of compensating mutations that restore the interaction also map to this region. The data suggest that the carboxy-terminal beta strands are directly involved in interactions required for MSP filament assembly.
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Affiliation(s)
- H E Smith
- Department of Molecular and Cellular Biology, University of Arizona, Tucson 85721, USA
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Abstract
A murine model for Streptococcus suis infection in pigs was validated by inoculating groups of 5 BALB/c and 5 CF1 mice with 10(7) CFU/ml of 13 different S. suis serotype 2 strains. The pathogenicity of these strains had been established in a standardized pig model of S. suis infection using one-week-old gnotobiotic pigs. We inoculated groups of mice intraperitoneally with 4 strains that were highly virulent for pigs and belonged to the phenotype MRP+EF+, with 4 strains, that were weakly virulent for pigs and belonged to the phenotype MRP+EF+, and with 5 strains that were non-virulent for pigs and belonged to phenotype MRP-EF-. The S. suis strains that were highly virulent for pigs caused high morbidity and an intermediate mortality in mice, the S. suis strains that were weakly virulent for pigs caused high morbidity but low mortality, and the strains that were non-virulent for pigs, induced highest morbidity and mortality. These results were comparable in both breeds of mice. In contrast to the pathology of S. suis infection in pigs with specific lesions, lesions in mice were histologically often characterized as non-specific, i.e., necrotizing encephalitis and focal or diffuse hepatitis sometimes with abscesses. Irrespective of breed (BALB/c vs. CF1), the murine model used for S. suis infection was incompatible with the pig model. This indicates that virulence of S. suis type 2 for mice and pigs is host-specific. Therefore, we regard the presently available murine models unsuitable for studying S. suis infections in pigs.
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Affiliation(s)
- U Vecht
- Department of Bacteriology, DLO-Institute for Animal Science and Health, Lelystad, Netherlands
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Vecht U, Stockhofe-Zurwieden N, Tetenburg BJ, Wisselink HJ, Smith HE. Murine and pig models of Streptococcus suis type 2 infections are incompatible. Adv Exp Med Biol 1997; 418:827-9. [PMID: 9331780 DOI: 10.1007/978-1-4899-1825-3_196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- U Vecht
- Department of Bacteriology, DLO-Institute for Animal Science and Health, Lelystad, Netherlands
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Affiliation(s)
- H E Smith
- Department of Bacteriology, DLO-Institute for Animal Science and Health, Lelystad, The Netherlands
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Smith HE, Rijnsburger M, Stockhofe-Zurwieden N, Wisselink HJ, Vecht U, Smits MA. Virulent strains of Streptococcus suis serotype 2 and highly virulent strains of Streptococcus suis serotype 1 can be recognized by a unique ribotype profile. J Clin Microbiol 1997; 35:1049-53. [PMID: 9114379 PMCID: PMC232701 DOI: 10.1128/jcm.35.5.1049-1053.1997] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [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: 02/04/2023] Open
Abstract
The ribotype profiles of 42 different Streptococcus suis strains were studied. These strains belonged to five serotypes and differed in their virulence for pigs as well as in the expression of the muramidase-released protein and the extracellular protein factor. For the ribotyping, chromosomal DNAs were digested with EcoRI and were hybridized with a 1,066-bp ribosomal DNA probe. The hybridization patterns showed genetic heterogeneity within and between the serotypes. Pathogenic strains of serotype 2 and highly pathogenic strains of serotype 1 could be recognized by their unique ribotype profiles. Nonpathogenic strains showed a high degree of genetic heterogeneity. Moreover, by comparing the 16S ribosomal DNA sequences of a number of S. suis strains, we were able to design two DNA probes which specifically hybridized with S. suis strains.
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Affiliation(s)
- H E Smith
- Department of Bacteriology, DLO-Institute for Animal Science and Health, Lelystad, The Netherlands.
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Smith HE, Pryce A, Carlisle L, Jones JM, Scarpello J, Pantin C. Appropriateness of acute medical admissions and length of stay. J R Coll Physicians Lond 1997; 31:527-32. [PMID: 9429190 PMCID: PMC5420957] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To use the Appropriateness Evaluation Protocol (AEP) to assess the extent of inappropriate utilisation of hospital beds by acute medical patients. To determine whether clinicians viewed the AEP decisions as valid. DESIGN Retrospective review of the medical records of a 10% random sample of 8,210 patients admitted as medical emergencies. An objective independent review instrument (AEP) was used to assess the medical necessity for hospitalisation at admission and on each subsequent day. To test the validity of the screening instrument, a subsample of the reviewed records was further assessed by a panel of physicians. SETTING A district general hospital in the West Midlands region of England. SUBJECTS Eight hundred and twenty-one adult patients admitted to general medicine during one calendar year. MAIN OUTCOME MEASURES Proportions of admissions and days of care for which inpatient medical care was judged appropriate. Reasons for inappropriate utilisation and potential bed-days that could be saved by the development and use of alternative services were also considered. Validity of the AEP was tested by assessing agreement between the majority decision of an expert panel and the criterion-based AEP decision. RESULTS AEP identified 51/821 (6%) admissions and 2,195/4,885 (45%) days of care as inappropriate. Over half the patients had a hospital stay in which at least half the days were judged inappropriate. The commonest reason for inappropriate days was remaining in hospital after the medical purpose for admission had been accomplished. This accounted for 38% of inappropriate days reviewed. In validity testing there was a high level of agreement between the physicians and the AEP, with kappa values greater than 0.80 for admissions and days of care. CONCLUSIONS The AEP is a valid and useful instrument for assessing the utilisation of acute medical beds in a NHS hospital. In this study acute medical admissions were largely appropriate at the time of admission but a substantial proportion of subsequent days of care was considered inappropriate by AEP criteria. Most inappropriate utilisation was due to organisational issues within the hospital. As a result of this study, several service and policy developments were identified that should improve the efficiency of bed utilisation at the hospital.
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Rokni SH, Benson EC, Burke DL, Jenkins TM, Liu JC, Nelson G, Nelson WR, Smith HE, Tenenbaum P, Vylet V, Walz DR. Radiation protection systems for the final focus test beam at SLAC. Health Phys 1996; 71:786-794. [PMID: 8887529 DOI: 10.1097/00004032-199611000-00024] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The Final Focus Test Beam (FFTB) is a new beam line at the Stanford Linear Accelerator Center designed to test new beam optics concepts, hardware, and techniques necessary to achieve and measure the small spot sizes required for future generations of high-energy e+e- linear colliders. The FFTB takes a 47 GeVc-1, 1 kW electron beam at the end of the Stanford Linear Accelerator Center linear accelerator and transports it to the FFTB beam dump. A radiation protection system was designed and installed for the FFTB with the primary goal that the integrated dose equivalent outside the shielding resulting from beam loss would not exceed 10 mSv y-1. This system is comprised of shielding, a beam containment system and a personnel protection system. This paper presents various aspects of radiation safety at Stanford Linear Accelerator Center that were considered in the design of the FFTB radiation protection system. Beam tests were conducted in which the performance of various beam containment devices and the shielding effectiveness were evaluated. Preliminary results from these tests are presented.
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Affiliation(s)
- S H Rokni
- Stanford Linear Accelerator Center, Stanford University, California 94309, USA
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Smith HE, Vecht U, Wisselink HJ, Stockhofe-Zurwieden N, Biermann Y, Smits MA. Mutants of Streptococcus suis types 1 and 2 impaired in expression of muramidase-released protein and extracellular protein induce disease in newborn germfree pigs. Infect Immun 1996; 64:4409-12. [PMID: 8926123 PMCID: PMC174391 DOI: 10.1128/iai.64.10.4409-4412.1996] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.8] [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: 02/03/2023] Open
Abstract
The contribution of muramidase-released protein (MRP) and extracellular factor (EF) to the virulence of Streptococcus suis type 1 and 2 infections was studied. For that aim, we constructed mutants of S. suis types 1 and 2 by inactivating the genes encoding MRP and EF. Moreover, we changed a type 2 strain producing the 110-kDa EF protein into a strain producing a modified protein (EF*) of increased molecular mass. The chromosomally located mrp and epf genes were inactivated by replacement recombination by using nonreplicative plasmids. Newborn germfree pigs were inoculated with pathogenic type 1 and 2 strains and with the isogenic mutant strains. Wild-type as well as mutant strains induced fever, specific signs of disease, and lesions. Moreover, all mutant strains could be reisolated from the central nervous system of infected pigs. These results showed that inactivation or alteration of the mrp and epj genes had no measurable effect on the pathogenicity of S. suis types 1 and 2.
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Affiliation(s)
- H E Smith
- Department of Bacteriology, DLO Institute for Animal Science and Health, Lelystad, The Netherlands
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Vecht U, Wisselink HJ, Stockhofe-Zurwieden N, Smith HE. Characterization of virulence of the Streptococcus suis serotype 2 reference strain Henrichsen S 735 in newborn gnotobiotic pigs. Vet Microbiol 1996; 51:125-36. [PMID: 8828129 DOI: 10.1016/0378-1135(96)00028-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [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: 02/02/2023]
Abstract
Strain Henrichsen S 735 (NCTC 10234) of Streptococcus suis serotype 2 reference and three other such strains (strains S 4005, S 3921 and T 141) were tested for virulence by inoculating pigs intranasally and intravenously. The taxonomical properties of each strain were determined. Phenotypes were determined by Western blotting based on MRP and EF protein expression and genotypes were determined by Southern hybridization analysis of the mrp and epf genes. Reference strain S 735 and strain S 3921 produced the 136 kDa MRPh and a 180 kDa form of EF, and hence these strains belong to the MRP + EF phenotype. In accordance with previous experiments with this phenotype, strains S 735 and S 3921 appeared to be only weakly virulent for newborn gnotobiotic pigs. Strain S 4005 produced the 136 kDa MRP and the 110 kDa form of EF, hence it belongs to the MRP + EF + phenotype. This strain was highly virulent for pigs. Strain T 141 did not produce MRP or EF, and hence belongs to the MRP-EF- phenotype. It was nonvirulent for pigs. The route of inoculation did not influence the frequency or severity of clinical signs of disease or lesions, which demonstrated that the 110 kDa EF is not essential during invasion. Southern blot analysis showed that all four S. suis type 2 strains contain sequences that are homologous to the epf and mrp genes. For studies on pathogenesis of S. suis type 2 infections in pigs, we recommend the use of strains that have been tested in a standardized pig model and that belong to the MRP + EF + phenotype, such as strain S 4005.
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Affiliation(s)
- U Vecht
- Department of Bacteriology, DLO-Institute for Animal Science and Health, Lelystad Netherlands.
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Levick MP, Blackwell JM, Connor V, Coulson RM, Miles A, Smith HE, Wan KL, Ajioka JW. An expressed sequence tag analysis of a full-length, spliced-leader cDNA library from Leishmania major promastigotes. Mol Biochem Parasitol 1996; 76:345-8. [PMID: 8920026 DOI: 10.1016/0166-6851(95)02569-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- M P Levick
- Department of Pathology, University of Cambridge, UK
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Jacobs RM, McCutcheon LJ, Valli VE, Smith HE. Histopathological changes in the lymphoid tissues of sheep exposed to the bovine immunodeficiency-like virus. J Comp Pathol 1996; 114:23-30. [PMID: 8729077 DOI: 10.1016/s0021-9975(96)80059-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 02/01/2023]
Abstract
Six yearling sheep were inoculated intraperitoneally with peripheral blood from two sheep infected with the bovine immunodeficiency-like virus (BIV) strain R29. An additional five sheep served as sham-inoculated controls. Of the six sheep given BIV, five seroconverted, one of them remaining seropositive for the duration of the study. The polymerase chain reaction demonstrated BIV provirus in three of the five serologically positive animals. At necropsy, 1 year after inoculation, histological changes were found only in the lymphoid tissues. In sheep exposed to BIV, mild though significant increases were seen in the (1) number of splenic periarteriolar lymphoid sheaths, (2) number of secondary follicles in hilar and prescapular or popliteal lymph nodes, and (3) medullary sinus cellularity in prescapular and popliteal lymph nodes.
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Affiliation(s)
- R M Jacobs
- Department of Pathology, Ontario Veterinary College, University of Guelph, Canada
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Smith HE, Frew AJ. Getting research into practice. J R Coll Physicians Lond 1996; 30:385-9. [PMID: 8999131 PMCID: PMC5401605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H E Smith
- Wessex Research Network, University of Southampton
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Reek FH, Smits MA, Kamp EM, Smith HE. Use of Multiscreen plates for the preparation of bacterial DNA suitable for PCR. Biotechniques 1995; 19:282-5. [PMID: 8527150] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
A rapid and inexpensive method for isolating bacterial DNA for use in PCR is described. The method is based on the guanidinium thiocyanate (GuSCN)-lysis method of Boom et al. (J. Clin. Microbiol. 28:495-503, 1990) and enables a multiple of 96 samples to be prepared in only one hour. We use Multiscreen plates and a vacuum manifold from Millipore. Clinical samples are lysed and washed in the wells of a Multiscreen plate, and DNA is eluted in a standard microplate. Purified DNA was recovered with high yields (over 25%). The method allows multichannel or robotic pipetting for both the sample preparation as well as for the PCR step. The method has been applied successfully to detect pathogenic Streptococcus suis type 2 in nasal and tonsil swab specimens of pigs.
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Affiliation(s)
- F H Reek
- Institute for Animal Science and Health (ID-DLO), Lelystad, The Netherlands
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