Resistance to antiparasitic drugs: The role of molecular diagnosis

Chemotherapy is central to the control of many parasite infections of both medical and veterinary importance. However, control has been compromised by the emergence of drug resistance in several important parasite species. Such parasites cover a broad phylogenetic range and include protozoa, helminths and arthropods. In order to achieve effective parasite control in the future, the recognition and diagnosis of resistance will be crucial. This demand for early, accurate diagnosis of resistance to specific drugs in different parasite species can potentially be met by modern molecular techniques. This paper summarises the resistance status of a range of important parasites and reviews the available molecular techniques for resistance diagnosis. Opportunities for applying successes in some species to other species where resistance is less well understood are explored. The practical application of molecular techniques and the impact of the technology on improving parasite control are discussed. (C) 2002 Australian Society for Parasitology Inc. Published by Elsevier Science Ltd. All rights reserved.

Diagnosis and management of unusual dental abscesses in children

Although the majority of dental abscesses in children originate from dental caries or trauma, a few are associated with unusual conditions which challenge diagnosis and management. Recent research findings have shed light on these unusual entities and greatly improved understanding of their clinical implications. These conditions include developmental abnormalities such as dens invaginatus in which there is an invagination of dental tissues into the pulp chamber and dens evaginatus in which a tubercle containing pulp is found on the external surface of a tooth crown. In addition, inherited conditions which show abnormal dentine such as dentine dysplasia, dentinogenesis imperfecta, and osteogenesis imperfecta predispose the dentition to abscess formation. Furthermore, 'spontaneous' dental abscesses are frequently encountered in familial hypophosphataemia, also known as vitamin D-resistant rickets, in which there is hypomineralization of dentine and enlargement of the pulp. In addition to developmental conditions, there are also acquired conditions which may cause unusual dental abscesses,. These include pre-eruptive intracoronal resorption which was previously known as 'pre-eruptive caries' or the 'fluoride bomb'. In addition, some undiagnosed infections associated with developing teeth are now thought to be the mandibular infected buccal cysts which originate from infection of the developing dental follicles. In the present paper, these relatively unknown entities Which cause unusual abscesses in children are reviewed with the aim of updating the general practitioner in their diagnosis and management.

Zygosity Diagnosis in the Absence of Genotypic Data: An Approach Using Latent Class Analysis

For zygosity diagnosis in the absence of genotypic data, or in the recruitment phase of a twin study where only single twins from same-sex pairs are being screened, or to provide a test for sample duplication leading to the false identification of a dizygotic pair as monozygotic, the appropriate analysis of respondents' answers to questions about zygosity is critical. Using data from a young adult Australian twin cohort (N = 2094 complete pairs and 519 singleton twins from same-sex pairs with complete responses to all zygosity items), we show that application of latent class analysis (LCA), fitting a 2-class model, yields results that show good concordance with traditional methods of zygosity diagnosis, but with certain important advantages. These include the ability, in many cases, to assign zygosity with specified probability on the basis of responses of a single informant (advantageous when one zygosity type is being oversampled); and the ability to quantify the probability of misassignment of zygosity, allowing prioritization of cases for genotyping as well as identification of cases of probable laboratory error. Out of 242 twins (from 121 like-sex pairs) where genotypic data were available for zygosity confirmation, only a single case was identified of incorrect zygosity assignment by the latent class algorithm. Zygosity assignment for that single case was identified by the LCA as uncertain (probability of being a monozygotic twin only 76%), and the co-twin's responses clearly identified the pair as dizygotic (probability of being dizygotic 100%). In the absence of genotypic data, or as a safeguard against sample duplication, application of LCA for zygosity assignment or confirmation is strongly recommended.

Pasture grazing by black-striped wallabies (Macropus dorsalis) in central Queensland

Black-striped wallabies (Macropus dorsalis) are uncommon to rare in most of their former range, yet in parts of central Queensland where they are still locally common they are regarded as a serious pasture pest. There is considerable pressure from cattle graziers to reduce their density because of the putative damage that they cause to cattle pasture. Here we examined the effects of this species and other herbivores on pasture by monitoring vegetation cover between 1993 and 1998 in exclosures in brigalow, and poplar box communities on three grazing properties in the Maranoa region. The exclosures selectively allowed access to either: all vertebrate grazers including cattle; rabbits, bettongs, and wallabies; rabbits and bettongs; no vertebrate grazers. The greatest effects on the structure and species composition of pasture were caused by cattle, but wallabies did consume commercially important quantities of grass at some times of the year. This conflicts with local opinion that sees wallabies as the major cause of pasture degradation. Herein lies the management problem that sees continued reduction in wallaby habitat, and fragmentation of the species.

Perceived stress as a predictor of the self-reported new diagnosis of symptomatic CHD in older women

This article describes one aspect of a prospective cohort study of 10,432 women aged between 70 and 75 years. After a 3-year period, 503 women self-reported a new diagnosis by a doctor of angina or myocardial infarction (symptomatic coronary heart disease [CHD]). Time one psychosocial variables (Duke Social Support Index, time pressure, Perceived Stress Scale, Mental Health Index, having a partner, educational attainment, and location of residence) were analyzed using univariate binary logistic regression for their ability to predict subsequent symptomatic CHD. Of these variables, the Duke Social Support Index, Perceived Stress Scale and the Mental Health Index were found to be significant predictors of symptomatic CHID diagnosis. Only the Perceived Stress Scale, however, proved to be a significant independent predictor. After controlling for time one nonpsychosocial variables, as well as the frequency of family doctor visits, perceived stress remained a significant predictor of the new diagnosis of symptomatic CHD in this cohort of older women over a 3-year period.

Black and white and re(a)d all over again: Indigenous minstrelsy in contemporary Canadian and Australian theatre

This essay considers processes by which community identities are challenged by discussing the use of whiteface as an activist strategy in recent indigenous theatre in Canada and Australia. To understand whiteface, I employ Susan Gubar's notion of racechange, processes that test and even transgress racial borders. I also situate whiteface in relation to the history of blackface minstrelsy. Noting the ways these racial performances affirm the hierarchies of color and how power becomes invested in such color codings, the essay highlights indigenous employment of whiteface as a potential form of critical historiography. I then analyze how whiteface functions in two productions, Daniel David Moses's Almighty Voice and His Wife (1991) in Canada and the Queensland Theatre Company's 2000 revival of George Landen Dann's Fountains Beyond in Australia. My analysis posits that such indigenous performances of whiteface can affirm the identity of the marginalized other even as they destabilize the fixity of race and its meanings.

Diagnosis of Helicobacter pylori infection in adults with intellectual disability

Helicobacter pylori infection is common among adults with intellectual disability. The acceptabilities and accuracies of different diagnostic tests in this population are unknown. We aimed to determine (i) patient acceptability and (ii) performance characteristics of serology, fecal-antigen, and urea breath tests among adults with intellectual disability. One hundred sixty-eight such adults underwent H. pylori testing with serology and fecal-antigen tests, and a portion underwent treatment. One year later, the participants were retested with fecal-antigen, serology, and urea breath tests. The numbers of specimens obtained and difficulties in collection reported by caregivers were noted. Test performance characteristics were assessed among participants and 65 of their caregivers, using serology as the reference. All participants provided at least one specimen, despite reported collection difficulties for 23% of fecal and 27% of blood specimens. Only 25% of the participants provided breath specimens; failure to perform this test was associated with lower intellectual ability and higher maladaptive behavior. The sensitivity, specificity, and positive and negative predictive values of the fecal test (baseline and 12 months versus caregivers) were 70 and 63 versus 81, 93 and 95 versus 98, 96 and 92 versus 93, and 53 and 74 versus 93%, respectively; those of the urea breath test (12 months versus caregivers) were 86 versus 100, 88 versus 95, 75 versus 89, and 94 versus 100%, respectively. With assistance, fecal or blood specimens for H. pylori assessment can be provided by most patients with intellectual disability regardless of their level of function or behavior. Only those with greater ability can perform the urea breath test. Using serology as the reference test, the limitations of performance characteristics of the fecal-antigen and urea breath tests are similar to those among a control group of caregivers.

Quantification of Listeria spp. contamination on shell and flesh of cooked black tiger prawns (Penaeus monodon)

Aims: To quantify Listeria levels on the shell and flesh of artificially contaminated cooked prawns after peeling, and determine the efficacy of Listeria innocua as a model for L. monocytogenes in this system. Methods and Results: A L. monocytogenes and L. innocua strain were inoculated separately onto cooked black tiger prawns using two protocols ( immersion or swabbing with incubation). Prawns were peeled by two methods ( gloved hand or scalpel and forceps) and numbers of Listeria on shells, flesh and whole prawn controls were determined. Prawns were exposed to crystal violet dye to assess the penetration of liquids. Regardless of preparation method or bacterial strain there were ca 1log(10) CFU more Listeria per shell than per peeled prawn. Dye was able to penetrate to the flesh in all cases. Conclusions: Shell-on prawns may be only slightly safer than shell-off prawns. Listeria innocua is an acceptable model for L. monocytogenes in this system. Significance and Impact of the Study: Reduced risk from L. monocytogenes on prawns can only be assured by adequate hygiene or heating.

A new species of Solepyris Azevedo (Hymenoptera, Bethylidae) from Brazil, with amended diagnosis of the genus

Solepyris Azevedo é um gênero neotropical raramente coletado. O gênero é reconhecido dentre os gêneros de Sclerodermini por possuir a nervação das asas anteriores com apenas uma célula fechada grande. É descrita e ilustrada uma segunda espécie, Solepyris montuosus, sp. nov., do Brasil. Esta espécie é caracterizada por possuir a nervura radial da asa anterior longa. É incluída uma diagnose emendada de Solepyris unicus Azevedo. Foi fornecida uma chave para as duas espécies de Solepyris.

Desenvolvimento e avaliação da acurácia do sistema de filtração (BacFil 6.0) na detecção de bacilos álcool-ácido resistentes em amostras de lavado broncoalveolar de pacientes com suspeita de tuberculose

A baciloscopia é o principal método diagnóstico da tuberculose (TB) em razão do seu baixo custo, rapidez e facilidade de execução. Porém sua sensibilidade é baixa, principalmente nas formas paucibacilares da doença. Nesse sentido, novas metodologias que resultem no aumento da sensibilidade da baciloscopia tornam-se absolutamente necessárias. Neste estudo, nos propusemos a aprimorar e padronizar o sistema de filtração BacFil e avaliar sua performance e acurácia em amostras paucibacilares (lavado broncoalveolar). Para alcançar esses objetivos desenvolvemos o estudo em duas fases. Na primeira fase, foram realizados ensaios para definir: 1) utilização de membranas brancas para visualização de BAAR corados por Auramina-O; 2) aumento do volume de NALC, utilização de pérolas de vidro no processo de digestão das amostras e mudança no sistema do suporte do pré-filtro; 3) meios de fixação da membrana de filtração na lâmina de microscopia; 4) limite de detecção da técnica; 5) aumento do volume de NaOCl e a influência desse aumento na visualização de BAAR na membrana. Verificou-se que: a membrana de policarbonato branca tem a mesma eficiência da membrana de policarbonato preta na visualização de BAAR fluorescentes; o método modificado utilizando maior concentração de NALC, pérolas de vidro e sistema de pré-filtro baseado em orifícios obteve 98% de passagem das amostras pelo sistema; a melhor forma de fixação da membrana na lâmina foi obtida por intermédio da utilização de fita dupla face; o limite de detecção da técnica de filtração utilizando o sistema BacFil versão 6.0 foi de 2 a 9 BAAR por mililitro de suspensão bacteriana com D.O de 0,250 ± 0,01 a 625nm; o aumento da concentração de NaOCl para 10% ajuda na passagem de um maior volume de amostra pelo sistema, porém ocasiona a diminuição da quantidade BAAR na membrana de filtração após o período necessário para todo o processo. Na segunda fase foi avaliado acurácia da técnica padronizada em 101 amostras de lavado broncoalveolar (LBA) de pacientes com suspeita de TB provenientes do Hospital Universitário Cassiano Antônio de Moraes. Observou-se que a sensibilidade da técnica de filtração (BacFil versão 6.0) foi de 76% e especificidade de 95%. A sensibilidade obtida foi significativamente maior do que a observada na baciloscopia após centrifugação que foi de 59% (p = 0,001). No entanto, constatou-se uma diminuição de especificidade na técnica de filtração (95%) em relação a técnica de 8 centrifugação (99%). Concluímos que as modificações realizadas nos sistema de filtração permitiu sanar os problemas técnicos apresentados nas versões anteriores e aumentar a sensibilidade da baciloscopia de amostras paucibacilares (lavado broncoalveolar) para o diagnóstico da TB pulmonar.