Can Google Trends analysis confirm the public's need for information about the rare association of facial nerve paralysis with COVID-19 or the COVID-19 vaccination?

Facial nerve paralysis or Bell's palsy have been suggested as possible consequences of SARS-CoV-2 infections, as well as possible side effects of COVID-19 vaccinations. Google Trends data have been used to evaluate worldwide levels of public awareness for these topics for pre- and post-pandemic years. The results demonstrate a relatively low public interest in facial nerve paralysis in comparison to other more common COVID-19 related topics. Some peaks of interest in Bell's palsy can most likely be explained as triggered by the media. Therefore, Google Trends has shown public's relatively low awareness of this rare neurological phenomenon during the pandemic.

A Qualitative Exploration of the Potential Role of Using Online Social Media Support Communities to Increase Initiation of Medications for Opioid Use Disorder (MOUD)

Objectives

This study sought to explore the potential role of peer-led online communities to increase use of medications for opioid use disorder.

Methods

From January through March 2020, participants with opioid use disorder and their family members/friends were recruited from paid Facebook ads; public health key stakeholders were recruited from referrals from the study team and opioid experts. Thirty participants from California were interviewed; 23 persons reporting opioid misuse, 3 family members/friends of persons misusing opioids, and 4 public health key stakeholders. We conducted semi-structured interviews asking about preferences, barriers and facilitators of treatment options for opioid use disorder, and perspectives around the use of digital/online communities. The categories of participants interviewed were each asked slightly different questions depending upon their role.

Results

Results suggest that participants who misuse opioids (1) may prefer to engage in online communities rather than in-person meetings to discuss their opioid use, (2) generally prefer to receive opioid-related information from other patients with opioid use disorder and/or those in recovery rather than from health providers or other individuals, and (3) thought that an online community could be beneficial for helping address their opioid use.

Conclusion

Results suggest an openness and interest in a peer-led online community to discuss opioid use and treatment among people who misuse opioids.

Individual and poly-substance use and condomless sex among HIV-uninfected adults reporting heterosexual sex in a multi-site cohort

BACKGROUND

We analyzed the association between substance use (SU) and condomless sex (CS) among HIV-negative adults reporting heterosexual sex in the Seek, Test, Treat, and Retain (STTR) consortium. We describe the impact of SU as well as person/partner and context-related factors on CS, identifying combinations of factors that indicate the highest likelihood of CS.

METHODS

We analyzed data from four US-based STTR studies to examine the effect of SU on CS using two SU exposures: 1) recent SU (within 3 months) and 2) SU before/during sex. Behavioral data were collected via 1:1 or self-administered computerized interviews. Adjusted individual-study, multivariable relative risk regression was used to examine the relationship between CS and SU. We also examined interactions with type of sex and partner HIV status. Pooled effect estimates were calculated using traditional fixed-effects meta-analysis. We analyzed data for recent SU (n = 6781; 82% men, median age = 33 years) and SU before/during sex (n = 2915; 69% men, median age = 40 years).

RESULTS

For both exposure classifications, any SU other than cannabis increased the likelihood of CS relative to non-SU (8-16%, p-values< 0.001). In the recent SU group, however, polysubstance use did not increase the likelihood of CS compared to single-substance use. Cannabis use did not increase the likelihood of CS, regardless of frequency of use. Type of sex was associated with CS; those reporting vaginal and anal sex had a higher likelihood of CS compared to vaginal sex only for both exposure classifications (18-21%, p < 0.001). Recent SU increased likelihood of CS among those reporting vaginal sex only (9-10%, p < 0.001); results were similar for those reporting vaginal and anal sex (5-8%, p < 0.01). SU before/during sex increased the likelihood of CS among those reporting vaginal sex only (20%; p < 0.001) and among those reporting vaginal and anal sex (7%; p = 0.002). Single- and poly-SU before/during sex increased the likelihood of CS for those with exclusively HIV-negative partners (7-8%, p ≤ 0.02), and for those reporting HIV-negative and HIV-status unknown partners (9-13%, p ≤ 0.03).

CONCLUSION

Except for cannabis, any SU increased the likelihood of CS. CS was associated with having perceived HIV-negative partners and with having had both anal/vaginal sex.

Dosimetric benefits of daily treatment plan adaptation for prostate cancer stereotactic body radiotherapy

BACKGROUND

Hypofractionation is increasingly being applied in radiotherapy for prostate cancer, requiring higher accuracy of daily treatment deliveries than in conventional image-guided radiotherapy (IGRT). Different adaptive radiotherapy (ART) strategies were evaluated with regard to dosimetric benefits.

METHODS

Treatments plans for 32 patients were retrospectively generated and analyzed according to the PACE-C trial treatment scheme (40 Gy in 5 fractions). Using a previously trained cycle-generative adversarial network algorithm, synthetic CT (sCT) were generated out of five daily cone-beam CT. Dose calculation on sCT was performed for four different adaptation approaches: IGRT without adaptation, adaptation via segment aperture morphing (SAM) and segment weight optimization (ART1) or additional shape optimization (ART2) as well as a full re-optimization (ART3). Dose distributions were evaluated regarding dose-volume parameters and a penalty score.

RESULTS

Compared to the IGRT approach, the ART1, ART2 and ART3 approaches substantially reduced the V37Gy(bladder) and V36Gy(rectum) from a mean of 7.4cm3 and 2.0cm3 to (5.9cm3, 6.1cm3, 5.2cm3) as well as to (1.4cm3, 1.4cm3, 1.0cm3), respectively. Plan adaptation required on average 2.6 min for the ART1 approach and yielded doses to the rectum being insignificantly different from the ART2 approach. Based on an accumulation over the total patient collective, a penalty score revealed dosimetric violations reduced by 79.2%, 75.7% and 93.2% through adaptation.

CONCLUSION

Treatment plan adaptation was demonstrated to adequately restore relevant dose criteria on a daily basis. While for SAM adaptation approaches dosimetric benefits were realized through ensuring sufficient target coverage, a full re-optimization mainly improved OAR sparing which helps to guide the decision of when to apply which adaptation strategy.

Impact of Abstinence and of Reducing Illicit Drug Use Without Abstinence on Human Immunodeficiency Virus Viral Load

BACKGROUND

Substance use is common among people living with human immunodeficiency virus (PLWH) and a barrier to achieving viral suppression. Among PLWH who report illicit drug use, we evaluated associations between HIV viral load (VL) and reduced use of illicit opioids, methamphetamine/crystal, cocaine/crack, and marijuana, regardless of whether or not abstinence was achieved.

METHODS

This was a longitudinal cohort study of PLWH from 7 HIV clinics or 4 clinical studies. We used joint longitudinal and survival models to examine the impact of decreasing drug use and of abstinence for each drug on viral suppression. We repeated analyses using linear mixed models to examine associations between change in frequency of drug use and VL.

RESULTS

The number of PLWH who were using each drug at baseline ranged from n = 568 (illicit opioids) to n = 4272 (marijuana). Abstinence was associated with higher odds of viral suppression (odds ratio [OR], 1.4-2.2) and lower relative VL (ranging from 21% to 42% by drug) for all 4 drug categories. Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with VL suppression (OR, 2.2, 1.6, respectively). Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with lower relative VL (47%, 38%, respectively).

CONCLUSIONS

Abstinence was associated with viral suppression. In addition, reducing use of illicit opioids or methamphetamine/crystal, even without abstinence, was also associated with viral suppression. Our findings highlight the impact of reducing substance use, even when abstinence is not achieved, and the potential benefits of medications, behavioral interventions, and harm-reduction interventions.

Optimization of makerspace microfabrication techniques and materials for the realization of planar, 3D printed microelectrode arrays in under four days

Conventional two-dimensional microelectrode arrays (2D MEAs) in the market involve long manufacturing timeframes, have cleanroom requirements, and need to be assembled from multiple parts to obtain the final packaged device. For MEAs to be “used and tossed”, manufacturing has to be moved from the cleanroom to makerspaces. In order to enable makerspace fabricated MEAs comparable to conventional MEAs, the microfabrication processes must be optimized to have similar electrical properties along with biocompatibility and number of recording sites. This work presents a makerspace microfabricated 2D MEA having electrode densities up to a commercially popular 8 × 8 array, all fabricated under four days. Additive manufacturing-based realization of the MEA devices provides immense flexibility in terms of meeting distinct design requirements. A unique non-planar MEA having meso-scale electrodes on the top side of a chip transitioning to traces onto the bottom side through electrical vias is presented in this work. This allows for (a) monolithic integration of a culture well for devices having up to a 6 × 6 MEA array, (b) selective electroplating of the meso-scale electrodes (500 μm diameter) defined by silver ink casting followed by pulsed electroplating of gold or platinum without any masking procedure, (c) casting of a uniform and planar insulation layer via a novel process of confined precision spin coating (CPSC) of SU-8 which acts as a biocompatible insulation atop the meso-scale electrodes; and (d) selective laser micromachining to define the 50 μm × 50 μm microelectrodes. For an 8 × 8 array, the culture well and MEA chip framework are 3D printed as two separate parts and sealed together with a biocompatible epoxy as in commercially available MEAs. The fabricated MEAs have an average 1 kHz impedance of 36.8 kΩ/16 kΩ with a double layer capacitance of 400 nF cm⁻²/520 nF cm⁻² for nano-porous platinum/nano-gold which is comparable to the state-of-art commercially available 2D MEAs. Additionally, it was found out that our 3D printing-based process compares very favorably with traditional glass MEAs in terms of design to device while representing a dramatic reduction in cost, timeline for fabrication, reduction in the number of steps and the need for sophisticated microfabrication and packaging equipment.

“Makerspace microfabrication” with the use of simple tools and materials is used to demonstrate the realization of 2D microelectrode arrays (MEAs) having a density of up to 8 × 8 MEAs in under four days which are comparable to conventional MEAs.

Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss program

OBJECTIVE

Genetics contribute to variability in individual response to weight-loss interventions. The objective of this study was to determine the efficacy of a commercially available exercise and weight-loss program and whether alignment of diet to genotype related to lipid metabolism promotes greater success.

DESIGN

Sedentary women with obesity (n = 63) had genotype (FABP2rs1799883, PPARG2rs1801282, ADRB3rs4994C3, ADRB2rs1042713, rs1042714) determined using a direct-to-consumer genetic screening kit purported to promote greater weight-loss success through dietary recommendations based on these genes. Participants were randomly assigned to follow a moderate carbohydrate (MC) or lower carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24 weeks while participating in a resistance training and walking program. Data were analysed by general linear model repeated measures adjusted for baseline variables and are presented as mean (95% confidence interval) changes from baseline.

RESULTS

Participants in the LC group experienced greater improvements (p = 0.051, ηp 2 = 0.025) in per cent changes in body composition (weight: MC -3.32 [-1.4, -5.2], LC -5.82 [-4.1, -7.6]; fat mass: MC -7.25 [-3.2, -11.2], LC -10.93 [-7.3, -14.5]; fat-free mass: MC -0.32 [1.4, -2.0], LC -1.48 [0.7, -3.0]; and body fat percentage: MC -4.19 [-1.6, -6.8], LC -5.60 [-3.3, -7.9] %). No significant differences were observed between genotype groups (weight: A -5.00 [-3.3, -6.7], NA -4.14 [-2.2, -6.1]; fat mass: A -10.15 [-7.0, -13.6], NA -8.02 [-4.0, -12.0]; fat-free mass: A -1.23 [0.3, -2.8], NA -0.56 [1.12, -2.3]; and body fat: A -5.28 [-3.0, -7.6], NA -4.51 [-1.9, -7.1] %).

CONCLUSIONS

Adherence to this exercise and weight-loss program promoted improvements in body composition and health outcomes. While individuals following the LC diet experienced greater benefits, alignment of these diets to this genetic profile did not promote greater health outcomes.

Vorkommen und Bekämpfung des Clostridium-perfringens-Typ-A-assoziierten Durchfalls der Saugferkel unter besonderer Berücksichtigung der Immunprophylaxe

Gegenstand und Ziel: Clostridium perfringens Typ A wird häufig in Verbindung mit Durchfällen von Saugferkeln isoliert. Die Bedeutung des Alpha-(α-) und Beta(β)2-Toxins für die Pathogenese der Erkrankung ist nicht abschließend geklärt. Zur Bekämpfung der Erkrankung wurden in der Vergangenheit insbesondere stallspezifische Impfstoffe eingesetzt. Ziel der Untersuchungen war die Typisierung und quantitative Bestimmung des α- und β2-Toxins von C.-perfringens-Stämmen, die im Rahmen der Herstellung bestandsspezifischer Impfstoffe isoliert wurden. Mithilfe eines Intoxikationsmodells wurde weiterhin die Wirksamkeit eines kommerziell erhältlichen Impfstoffs gegen den C.-perfringens-Typ-A-assoziierten Durchfall der Saugferkel geprüft. Material und Methoden: Im ersten Teil der Untersuchungen wurden 1434 C.-perfringens-Stämme, die von an Durchfall erkrankten Ferkeln stammten, mithilfe einer Multiplex-PCR typisiert. Gleichzeitig wurde das α- und β2-Toxin-Bildungsvermögen der Stämme mittels ELISA-Tests untersucht. Zur Prüfung der α- und β2-toxoidhaltigen C.-perfringens-Typ-A-Vakzine für Schweine (Clostriporc A, IDT Biologika GmbH) wurden im zweiten Teil der Untersuchungen 18 Jungsauen im letzten Drittel der Trächtigkeit zweimal im Abstand von 3 Wochen immunisiert. Ergebnisse: 87,9% der Stämme gehörten zur Toxovar A (cpa, cpb2), 6,3% zur Toxovar A (cpa) und 5,8% zur Toxovar C (cpa, cpb, cpb2). Bei der quantitativen Untersuchung des Toxinbildungsvermögens der C.-perfringens-Typ-A-Stämme (cpa, cpb2) zeichneten sich Stämme, die geringe oder mittlere Gehalte des α-Toxins bildeten, häufig durch eine starke Expression des β2-Toxins aus. Die geimpften Sauen bildeten Antikörper gegen das α- und β2-Toxin, die über das Kolostrum auf die Nachzucht übertragen wurden und neugeborene Ferkel signifikant (p < 0,05) vor einer Intoxikation mit einem α- und β2-toxinhaltigen Überstand eines heterologen C.-perfringens-Typ-A-Stammes schützten. Schlussfolgerung und klinische Relevanz: Die Ergebnisse unterstreichen die Bedeutung von α- und β2-toxinbildenden C.-perfringens-Typ-A-Stämmen im Durchfallgeschehen der Saugferkel. Im Intoxikationsmodell ließ sich eine deutliche Schutzwirkung der eingesetzten Vakzine vor dem α- und β2-Toxin nachweisen.

Co-calibration of two self-reported measures of adherence to antiretroviral therapy

Adherence to antiretroviral therapy (ART) is an important determinant of clinical success assessed in many HIV studies. Harmonizing adherence data from studies that use different measures is difficult without a co-calibration equation to convert between validated instruments. Our purpose was to co-calibrate two commonly used adherence measures: the AIDS Clinical Trials Group (ACTG) questionnaire and the Visual Analog Scale (VAS). We used robust linear regression to develop a co-calibration equation in a clinical care cohort. The outcome was the 30-day VAS percentage of ART taken and the predictors were ACTG questions. We evaluated the equation's goodness of fit in five STTR (Seek, Test, Treat, Retain) consortium studies where individuals completed both measures: 2 criminal justice; 2 international; and 1 other high-risk vulnerable population. We developed a three-phase decision rule to convert ACTG to VAS in 1045 participants. First, when the last missed dose on the ACTG was reported as >30 days ago, the VAS was set to 100% (N = 582). Second, if "doses missed" was zero for all items, VAS was 100% (N = 104). Third, among remaining participants (N = 359), VAS was estimated as 96.8% minus 2.9% times the number of missed doses ("doses per day" was non-significant). Correlation between predicted and reported VAS was r = 0.80 in the criminal justice group (N = 446), r = 0.46 in the international group (N = 311), r = 0.32 in the other vulnerable population (N = 63), and r = 0.66 overall. When outliers due to inversion of the VAS scale were excluded (n = 25), these correlations were 0.88, 0.78, 0.80, and 0.86, respectively. We concluded that a simple decision rule and equation allowed us to co-calibrate between two widely used adherence measures thus combining data from studies with different instruments. This study highlighted issues with VAS inversions and its limitations as a single item. Combining studies using different instrument facilitates larger pooled datasets to address key research questions.

Bacterial mutagenicity assays: Vehicle and positive control results from the standard Ames assay, the 6- and 24-well miniaturized plate incorporation assays and the Ames II™ assay

Bacterial mutation assays are conducted routinely as part of the safety assessment of new chemicals. The OECD Test Guideline (TG) 471 describes the conduct of the standard agar plate Ames assay, required for regulatory submissions. Higher throughput non-OECD 471 TG assays, such as the miniaturized plate incorporation and Ames II™ assays, can be used for prescreening purposes. We have compiled historical vehicle and positive control data generated using these methods. The historical database is comprised from experiments spanning 9 years and includes >1000 experiments from the standard Ames assay using the plate incorporation and pre-incubation methods (TA98, TA100, TA1535, TA1537, and WP2 uvrA), >50 experiments from the 6-well (TA98, TA100, TA1535, TA97a, and WP2 uvrA) and >100 experiments from the 24-well (TA98, TA100, TA102, TA1535, TA1537, and TA97a) plate incorporation assays, and >1000 experiments from the Ames II™ assay (TA98 and TAMix). Although miniaturization to a 24-well format made the measurement of control revertant colonies in TA1537 and TA1535 more difficult; this can be overcome by using an alternative strain with a higher spontaneous reversion rate (i.e., using TA97a instead of TA1537) or by increasing the number of replicate wells to 12 (for TA1535). All three miniaturized methods, including the Ames II™ assay, were responsive to known mutagens and the responses were reproducible over years of use. These data demonstrate the excellent reproducibility of the standard and miniaturized bacterial mutation assays using positive control chemicals. Environ. Mol. Mutagen. 57:483-496, 2016. © 2016 Wiley Periodicals, Inc.

[Breastfeeding Rates and Duration in Germany - A Systematic Review]

Aim: 20 years after establishment of the National Breastfeeding Committee, the present work, based on published data on breastfeeding, is aimed at providing insight into the development of breastfeeding behaviour in Germany. Methods: To identify relevant publications, a comprehensive literature search was conducted in PubMed and Web of Science using the search terms "breast feeding" or "breastfeeding" in combination with "Germany". The publication period was limited to the period 1995-2014. Results: A total of 35 studies with data on breastfeeding for the birth cohorts of 1990-2012 were identified. Most of the data had been collected in regional or local surveys, often retrospectively. About 60% of the studies had been conducted with the primary aim of collecting data on breastfeeding or infant nutrition. Over the past 2 decades, breastfeeding rates were always relatively high at the beginning (72-97%). However, they declined significantly within the first 2 months, and by the age of 6 months, only about 50% of infants were still breastfed. Conclusion: Breastfeeding support and early assistance should be offered to a greater extent in order to achieve sustainable improvement of breastfeeding frequency and duration in Germany. Regarding the quality of data collected on breastfeeding, it seems crucial to implement standardised approaches to monitor breastfeeding in Germany.

[On the seasonality of dermatoses: a retrospective analysis of search engine query data depending on the season]

BACKGROUND

The volume of search engine queries about disease-relevant items reflects public interest and correlates with disease prevalence as proven by the example of flu (influenza). Other influences include media attention or holidays.

STUDY GOAL

The present work investigates if the seasonality of prevalence or symptom severity of dermatoses correlates with search engine query data.

METHODS

The relative weekly volume of dermatological relevant search terms was assessed by the online tool Google Trends for the years 2009-2013. For each item, the degree of seasonality was calculated via frequency analysis and a geometric approach.

RESULTS

Many dermatoses show a marked seasonality, reflected by search engine query volumes. Unexpected seasonal variations of these queries suggest a previously unknown variability of the respective disease prevalence. Furthermore, using the example of allergic rhinitis, a close correlation of search engine query data with actual pollen count can be demonstrated.

DISCUSSION

In many cases, search engine query data are appropriate to estimate seasonal variability in prevalence of common dermatoses. This finding may be useful for real-time analysis and formation of hypotheses concerning pathogenetic or symptom aggravating mechanisms and may thus contribute to improvement of diagnostics and prevention of skin diseases.

[Childhood craniopharyngioma with hypothalamic obesity - no long-term weight reduction due to rehabilitation programs]

BACKGROUND

Severe obesity due to hypothalamic involvement has major impact on prognosis in long-term survivors of childhood craniopharyngioma. The long-term effects of rehabilitation efforts on weight development and obesity in these patients are not analyzed up to now.

PATIENTS AND METHODS

108 patients with childhood craniopharyngioma recruited in HIT Endo before 2001 were included in the study. Long-term weight development (BMI SDS after >10 yrs follow-up) was analyzed in regard to rehabilitation, which was performed in 31 of 108 (29%) patients (one rehabilitation in 4 patients (13%), more than one in 21 patients (68%), 6 patients unknown) in 13 German rehabilitation -clinics.

RESULTS

84% of patients underwent rehabilitation in order to reduce hypothalamic obesity (BMI>+ 2 SD), whereas 12% of patients were normal weight. Childhood craniopharyngioma pa-tients with rehabilitation presented with higher BMI at diagnosis (median BMI: +1.32 SD; range: -1.08 to + 7.00 SD) and at last evaluation (median BMI: +4.93 SD; range: -0.20 to + 13.13 SD) when compared with patients without rehabilitation (median BMI at diagnosis: +0.24 SD; range: -2.67 to + 6.98 SD; BMI at evaluation: +2.09 SD; range: -1.48 to + 10.23 SD). A long-term weight reducing effect of rehabilitation was no detectable regardless of degree of obesity, frequency of rehabilitation, and hospital of rehabilitation.

CONCLUSION

Treatment options for hypothalamic obesity in terms of rehabilitation are limited. Accordingly, strategies for prevention of hypothalamic lesions and psychosocial effects of rehabilitation are currently in focus for improvement of prognosis in childhood craniopharyngioma patients.

Vehicle and positive control values from the in vivo rodent comet assay and biomonitoring studies using human lymphocytes: historical database and influence of technical aspects

There is increased interest in the in vivo comet assay in rodents as a follow-up approach for determining the biological relevance of chemicals that are genotoxic in in vitro assays. This is partly because, unlike other assays, DNA damage can be assessed in this assay in virtually any tissue. Since background levels of DNA damage can vary with the species, tissue, and cell processing method, a robust historical control database covering multiple tissues is essential. We describe extensive vehicle and positive control data for multiple tissues from rats and mice. In addition, we report historical data from control and genotoxin-treated human blood. Technical issues impacting comet results are described, including the method of cell preparation and freezing. Cell preparation by scraping (stomach and other GI tract organs) resulted in higher % tail DNA than mincing (liver, spleen, kidney etc) or direct collection (blood or bone marrow). Treatment with the positive control genotoxicant, ethyl methanesulfonate (EMS) in rats and methyl methanesulfonate in mice, resulted in statistically significant increases in % tail DNA. Background DNA damage was not markedly increased when cell suspensions were stored frozen prior to preparing slides, and the outcome of the assay was unchanged (EMS was always positive). In conclusion, historical data from our laboratory for the in vivo comet assay for multiple tissues from rats and mice, as well as human blood show very good reproducibility. These data and recommendations provided are aimed at contributing to the design and proper interpretation of results from comet assays.

Improved ankle and knee control with a dual-channel functional electrical stimulation system in chronic hemiplegia. A case report

The aim of tis report is to describe the effects of a dual-channel functional electrical stimulation (FES) system applied daily as an orthotic device to the dorsiflexors and hamstrings muscles in a subject with chronic hemiparesis. Prior to the application of FES, the patient's gait was characterized by a footdrop and knee hyperextension during stance. measurements of gait performance were collected before FES application, after a conditioning period of six weeks, and following ten months of daily use. Outcomes included lower limb kinematics and temporal gait measures. The kinematic assessments indicated significant benefits for gait with the dorsiflexors and hamstrings FES, as compared to no stimulation and peroneal FES alone. In addition ot improved ankle control, knee hyperextension was reduced during stance, and the self-selected comfortable gait velocity increased following ten months of daily use. The results of this report suggest that dual-channel FES for the dorsiflexors and hamstrings muscles may affect ankle and knee control beyond that witch can be attributed to peroneal stimulation alone. The positive effects observed in this case study point to the potential of dual-channel FES as a viable treatment options in the rehabilitation of patients with similar impairments.

Prenatal microarray analysis as second-tier diagnostic test: single-center prospective study

OBJECTIVE

To evaluate the usefulness of chromosome microarrays as a second-tier test in prenatal genetic testing.

METHODS

We prospectively analyzed 75 high-risk pregnancies undergoing invasive prenatal genetic testing in which the karyotype either was normal or had findings other than a common non-mosaic autosomal aneuploidy.

RESULTS

Chromosomal microarray analysis (CMA) was performed successfully in all cases. Pathological copy-number variations (CNVs) explaining the phenotypes were found in 11 cases (14.7%). Four cases were detected with an unbalanced translocation. In three of these cases, subsequent genetic analysis demonstrated that a parent was an unknown carrier of a balanced translocation. Among the 67 cases with normal karyo-types, submicroscopic rearrangements with pathological significance were detected in five (7.5%) and CNVs of unclear significance were detected in one (1.5%). CMA was able to discriminate correctly between true mosaicism and confined or pseudomosaicism in all six mosaic cases.

CONCLUSION

CMA is a valuable second-tier test in high-risk pregnancies for which identification or further delineation of genetic aberrations is important. Its higher resolution results in a higher detection rate of aberrant cases, with a clear clinical benefit for estimation of risk of recurrence.

[Occurrence and control of the Clostridium perfringens type A associated diarrhea of the suckling pigs with special consideration of the immunoprophylaxis]

OBJECTIVE

Clostridium (C.) perfringens type A is often associated with diarrhoea in suckling piglets. The impact of the alpha (α) and beta (β)2 toxins on the pathogenesis of the disease has not been conclusively answered. Previously, autologous vaccines were used to control this disease. The aim of our investigation was the classification of C. perfringens strains and the quantitative determination of the α and β2 toxins during the production of autologous vaccines. The efficacy of a commercial vaccine against the C. perfringens type A associated diarrhoea was tested using an animal intoxication model.

MATERIAL AND METHODS

A total of 1,434 C. perfringens strains from piglets with diarrhoea were classified using a multiplex PCR in the first part of the examination. In parallel, the α and β2 toxin content was determined quantitatively using ELISA tests. In the second part of the study 18 gilts were vaccinated twice in the last third of gestation to evaluate the α and β2 toxoid containing C.perfringens type A vaccine (Clostriporc A, IDT Biologika GmbH).

RESULTS

Of the C. perfringens strains which were found, 87.9% were type A ( cpa , cpb2 ), 6.3% type A ( cpa ), and 5.8% type C ( cpa , cpb , cpb2 ). Low to middle a toxin-producing strains often strongly expressed the β2 toxin. The vaccination led to the production of antibodies against the α and β2 toxins, which were transferred to the offspring by colostrum. Piglets were significantly protected (p<0.05) by the antibodies after having been challenged with an α and β2-containing supernatant of a heterologous C. perfringens type A strain.

CONCLUSION AND CLINICAL RELEVANCE

These results underline the importance of α and β2 toxin producing C.perfringens type A strains in diarrhoea in suckling piglets. Using the intoxication model, this vaccine showed significant protective effects against the α and β2 toxins.

Assessment of genotoxicity induced by 7,12-dimethylbenz(a)anthracene or diethylnitrosamine in the Pig-a, micronucleus and Comet assays integrated into 28-day repeat dose studies

As part of the Stage 3 of the Pig-a international trial, we evaluated 7,12-dimethylbenz(a)anthracene (DMBA) for induction of Pig-a gene mutation using a 28-day repeat dose study design in Sprague-Dawley rats. In the same study, chromosomal damage in peripheral blood and primary DNA damage in liver were also investigated by the micronucleus (MN) assay and the Comet assay, respectively. In agreement with previously published data (Dertinger et al., [2010]: Toxicol Sci 115:401-411), DMBA induced dose-dependent increases of CD59-negative erythrocytes/reticulocytes and micronucleated reticulocytes (MN-RETs). However, there was no significant increase in DNA damage in the liver cells when tested up to 10 mg/kg/day, which appears to be below the maximum tolerated dose. When tested up to 200 mg/kg/day in a follow-up 3 dose study, DMBA was positive in the liver Comet assay. Additionally, we evaluated diethylnitrosamine (DEN), a known mutagen/hepatocarcinogen, for induction of Pig-a mutation, MN and DNA damage in a 28-day study. DEN produced negative results in both the Pig-a mutation assay and the MN assay, but induced dose-dependent increases of DNA damage in the liver and blood Comet assay. In summary, our results demonstrated that the Pig-a mutation assay can be effectively integrated into repeat dose studies and the data are highly reproducible between different laboratories. Also, integration of multiple genotoxicity endpoints into the same study not only provides a comprehensive evaluation of the genotoxic potential of test chemicals, but also reduces the number of animals needed for testing, especially when more than one in vivo genotoxicity tests are required.

Changes in quality of life of patients with lymphedema after lymphatic vessel transplantation

There are multiple treatment options for patients with chronic lymphedema, and one successful approach is lymph vessel transplantation. As quality of life assessments are frequently not utilized in standard treatment regimes, we investigated the change in quality of life for patients with chronic lymphedema (total = 212) who had undergone lymphatic vessel transplantation and conservative therapy for at least 6 months prior to operation. Quality of life was assessed by a modified standard questionnaire examining the physiological and psychological status of the patients. Results document a significant improvement in quality of life and underscore success of autologous lymphatic vessel transplantation as a therapy for lymphedema.