Good outcomes of Lyme arthritis in 24 patients in an endemic area of Switzerland

RESUME : But : Décrire l'évolution après traitement de l'arthrite de Lyme dans une zone d'endémie de l'Ouest de la Suisse, région où certains parmi les premiers cas d'arthrite de Lyme en dehors des Etats-Unis (USA) ont été rapportés. Patients et méthodes : Une évaluation rétrospective a été faite à partir d'un groupe de 24 patients (15 H, 9 F; âge moyen :38,7 ans) qui ont présenté une arthrite monoarticulaire (20 cas) ou oligoarticulaire (4 cas) causée par une infection à Borrelia burgdorferi (Bb). Ces patients ont été recrutés par l'intermédiaire de rhumatologues entre 1994 et 1999. Le genou était touché dans 85 % des cas. Une histoire de piqûre de tique était décrite dans 9 cas et un érythème chronique migrant dans 4 cas. Tous les patients avaient un titre d'anticorps pour Bb élevé, dosé par ELISA.Dans 20 cas, un immunoblot était positif pour Bb, la majorité étant positif pour les 3 sous-types de Bb présents en Suisse ; un seul cas était positif pour Bb sensu stricto. Neuf liquides synoviaux ont été examinés par PCR afin de détecter la présence de BbDNA (6 cas positifs). Résultats : Tous les patients ont reçu des antibiotiques soit oralement (10 cas), soit par voie parentérale (14 cas). Une deuxième cure d'antibiotiques a été administrée à 4 patients en raison de persistance de l'arthrite. On a observé une évolution rapidement favorable chez 13 patients et dans 9 cas, il a fallu, pour obtenir la guérison, réaliser une injection intraarticulaire de glucocorticoïdes ou une synoviorthèse. Après une période d'observation de 40 mois en moyenne (de 6 à 84 mois), aucun patient n'a présenté de signe d'arthrite chronique, mais 2 patients se plaignaient encore de myalgies ou d'arthralgies. Conclusion : Nous n'avons pas trouvé dans notre étude d'arthrite récidivante ou chronique après traitement comme on l'a décrit aux USA. Ceci est peut-être lié au fait que les types de Bb observés en Europe sont différents des USA où on trouve seulement Bb sensu stricto. ABSTRACT: Objective: To describe outcomes of treated Lyme arthritis in an endemic area of western Switzerland, where some of the first cases of Lyme disease outside the United States were reported. Patients and methods: We retrospectively studied 24 patients (15 males and nine females, mean age 38.7 years) managed by rheumatologists between 1994 and 1999 for Borrelia burgdotferi arthritis manifesting as monoarthritis (a = 20), oligoarthritis (a = 3), or polyarthritis (a = 1). The knee was affected in 20 (85%) patients. Nine patients reported a history of tick bite and four of erythema chronicum migrans. All the patients but one had a high titer of antibodies to B. burgdoiferi by ELISA and all but two had a positive immunoblot test (22 positive for all three types of B. burgdorferi found in Switzerland and one positive only for B. burgdoiferi sensu stricto). Joint fluid PCR for B. burgdorferi was done in nine patients and was positive in six. Results: All 24 patients received antibiotic therapy, orally (a= 10) or parenterally (n= 14). A second course of antibiotic therapy was used in four patients with persistent arthritis. A rapid response was noted in 13 patients. IntraarticUlar glucocorticoid therapy or a synoviorthesis was required in nine patients. After a mean follow-up of 40 months (range, 6-84 months), none of the patients had chronic arthritis but two reported persistent muscle or joint pain. Conclusion: Recurrent or chronic arthritis, which has been reported in treated patients in the United States, did not occur in our series. This may be ascribable to differences in B. burgdolferi subtypes, as in the United States only B. burgdoiferi sensu stricto is found.

Information from single-cell bacterial biosensors: what is it good for?

Bacterial reporter cells (i.e. strains engineered to produce easily measurable signals in response to one or more chemical targets) can principally be used to quantify chemical signals and analytes, physicochemical conditions and gradients on a microscale (i.e. micrometer to submillimeter distances), when the reporter signal is determined in individual cells. This makes sense, as bacterial life essentially thrives in microheterogenic environments and single-cell reporter information can help us to understand the microphysiology of bacterial cells and its importance for macroscale processes like pollutant biodegradation, beneficial bacteria-eukaryote interactions, and infection. Recent findings, however, showed that clonal bacterial populations are essentially always physiologically, phenotypically and genotypically heterogeneous, thus emphasizing the need for sound statistical approaches for the interpretation of reporter response in individual bacterial cells. Serious attempts have been made to measure and interpret single-cell reporter gene expression and to understand variability in reporter expression among individuals in a population.

Diabetes and immune thrombocytopenic purpura: a new association with good response to anti-CD20 therapy.

Type 1 diabetes (T1D) is rarely a component of primary immune dysregulation disorders. We report two cases in which T1D was associated with thrombocytopenia. The first patient, a 13-year-old boy, presented with immune thrombocytopenia (ITP), thyroiditis, and, 3 wk later, T1D. Because of severe thrombocytopenia resistant to immunoglobulins, high-dose steroids, and cyclosporine treatment, anti-cluster of differentiation (CD20) therapy was introduced, with consequent normalization of thrombocytes and weaning off of steroids. Three and 5 months after anti-CD20 therapy, levothyroxin and insulin therapy, respectively, were stopped. Ten months after stopping insulin treatment, normal C-peptide and hemoglobin A1c (HbA1c) levels and markedly reduced anti-glutamic acid decarboxylase (GAD) antibodies were measured. A second anti-CD20 trial for relapse of ITP was initiated 2 yr after the first trial. Anti-GAD antibody levels decreased again, but HbA1c stayed elevated and glucose monitoring showed elevated postprandial glycemia, demanding insulin therapy. To our knowledge, this is the first case in which insulin treatment could be interrupted for 28 months after anti-CD20 treatment. In patient two, thrombocytopenia followed a diagnosis of T1D 6 yr previously. Treatment with anti-CD20 led to normalization of thrombocytes, but no effect on T1D was observed. Concerning the origin of the boys' conditions, several primary immune dysregulation disorders were considered. Thrombocytopenia associated with T1D is unusual and could represent a new entity. The diabetes manifestation in patient one was probably triggered by corticosteroid treatment; regardless, anti-CD20 therapy appeared to be efficacious early in the course of T1D, but not long after the initial diagnosis of T1D, as shown for patient two.

An analysis of patients' understanding of 'routine' preoperative blood tests and HIV screening. Is no news really good news?

OBJECTIVES: Many patients may believe that HIV screening is included in routine preoperative work-ups. We examined what proportion of patients undergoing preoperative blood testing believed that they had been tested for HIV. METHODS: All patients hospitalized for elective orthopaedic surgery between January and December 2007 were contacted and asked to participate in a 15-min computer-assisted telephone interview (n = 1330). The primary outcome was to determine which preoperative tests patients believed had been performed from a choice of glucose, clotting, HIV serology and cholesterol, and what percentage of patients interpreted the lack of result communication as a normal or negative test. The proportion of patients agreeable to HIV screening prior to future surgery was also determined. RESULTS: A total of 991 patients (75%) completed the questionnaire. Three hundred and seventy-five of these 991 patients (38%) believed incorrectly that they had been tested for HIV preoperatively. Younger patients were significantly more likely to believe that an HIV test had been performed (mean age 46 vs. 50 years for those who did not believe that an HIV test had been performed; P < 0.0001). Of the patients who believed that a test had been performed but received no result, 96% interpreted lack of a result as a negative HIV test. Over 80% of patients surveyed stated that they would agree to routine HIV screening prior to future surgery. A higher acceptance rate was associated with younger age (mean age 47 years for those who would agree vs. 56 years for those who would not; P < 0.0001) and male sex ( P < 0.009). CONCLUSIONS: Many patients believe that a preoperative blood test routinely screens for HIV. The incorrect assumption that a lack of result communication indicates a negative test may contribute to delays in HIV diagnoses.

General electromagnetic simulation tool to predict the microwave nonlinear response of planar, arbitrarily-shaped HTS structures

This work describes a simulation tool being developed at UPC to predict the microwave nonlinear behavior of planar superconducting structures with very few restrictions on the geometry of the planar layout. The software is intended to be applicable to most structures used in planar HTS circuits, including line, patch, and quasi-lumped microstrip resonators. The tool combines Method of Moments (MoM) algorithms for general electromagnetic simulation with Harmonic Balance algorithms to take into account the nonlinearities in the HTS material. The Method of Moments code is based on discretization of the Electric Field Integral Equation in Rao, Wilton and Glisson Basis Functions. The multilayer dyadic Green's function is used with Sommerfeld integral formulation. The Harmonic Balance algorithm has been adapted to this application where the nonlinearity is distributed and where compatibility with the MoM algorithm is required. Tests of the algorithm in TM010 disk resonators agree with closed-form equations for both the fundamental and third-order intermodulation currents. Simulations of hairpin resonators show good qualitative agreement with previously published results, but it is found that a finer meshing would be necessary to get correct quantitative results. Possible improvements are suggested.

Mycelial compatibility and aggressiveness of Sclerotinia sclerotiorum isolates from Brazil and the United States

The objective of this work was to evaluate the genetic diversity among Sclerotinia sclerotiorum isolates from Brazil and the USA, assess their aggressiveness variability, and verify the existence of an isolate-cultivar interaction. Isolate variability was determined by mycelial compatibility grouping (MCG), and isolate aggressiveness by cut-stem inoculations of soybean cultivars. Two experiments for MCGs and two for aggressiveness were conducted with two sets of isolates. The first set included nine isolates from the same soybean field in Brazil and nine from the Midwest region of the USA. The second set included 16 isolates from several regions of Brazil and one from the USA. In the first set, 18 isolates formed 12 different MCGs. In the second set, 81% of the isolates from Brazil grouped into a single MCG. No common MCGs were observed among isolates from Brazil and the USA. The isolates showed aggressiveness differences in the first set, but not in the second. Although aggressiveness differed in the first set, soybean cultivars and isolates did not interact significantly. Cultivar rank remained the same, regardless of the genetic diversity, aggressiveness difference, and region or country of origin of the isolate. Results from screening of soybean cultivars, performed by the cut-stem method in the USA, can be used as reference for researchers in Brazil.

Characteristics of a good customer reference for a process equipment supplier

Työn tavoitteena oli tutkia hyvän asiakasreferenssin ominaisuuksia suodatinvalmistaja Laroxin myynnin ja huollon sekä yrityksen asiakkaiden näkökulmasta. Larox voi käyttää saatua tietoa referenssien tehokkaampaan valintaan ja hyödyntämiseen. Kaksi internet-kyselyä toteutettiin, välineenä Webropol. Alustava kysely sunnattiin Laroxin myynnille ja huollolle. Kysely koostui viidestä kategoriasta asiakasreferenssejä, joiden tärkeyttä arvioitiin, sekä vapaista vastauksista. Tunnistettuja hyvän asiakasreferenssin ominaisuuksia ovat hyvä suhde referenssiasiakkaaseen, positiiviset jarehelliset suosittelut asiakkaalta, referenssilaitteen hyvä toimintakyky ja asiakas joka ymmärtää huollon tärkeyden. Pääkysely suunnattiin Laroxin asiakkaille. Tilastollisilla analyyseilla tutkittiin koetun riskin mallinmuuttujien välisiä yhteyksiä. Analyysit eivät paljastaneet merkittäviä riippuvuuksia asiakasreferenssin ominaisuuksien tärkeydessä eritaustaisten vastaajien tai tilannetekijöiden välillä, mutta asiakasreferenssin ominaisuuksien faktorit tukevat mallia. Referenssilaitteiden toimintakyky vaikuttaa tärkeimmältä ja huollon tärkeys on myös merkittävä.

Promoting good practices for handling nanomaterials : an international wiki project

As production and use of nanomaterials in commercial products grow it is imperative to ensure these materials are used safely with minimal unwanted impacts on human health or the environment. Foremost among the populations of potential concern are workers who handle nanomaterials in a variety of occupational settings, including university laboratories, industrial manufacturing plants and other institutions. Knowledge about prudent practices for handling nanomaterials is being developed by many groups around the world but may be communicated in a way that is difficult for practitioners to access or use. The GoodNanoGuide is a collaborative, open-access project aimed at creating an international forum for the development and discussion of prudent practices that can be used by researchers, workers and their representatives, occupational safety professionals, governmental officials and even the public. The GoodNanoGuide is easily accessed by anyone with access to a web browser and aims to become a living repository of good practices for the nanotechnology enterprise. Interested individuals are invited to learn more about the GoodNanoGuide at http://goodnanoguide.org.

DFM(A)-Aspects of an Advanced Cable Gland Design

Nowadays typical motor junction boxes do not incorporate cable glands, which would provide good electrical performance interms of electromagnetic compatibility. In this paper, a manufacturability and assembly analysis for the new construction of a rigid body feeder cable junction of an electric motor is presented especially for converter drives (practical tests were carried out at LUT during 2007). Although the cable junction should also clamp the cable to provide enough tensile strength, the phase conductors should not get squashed by the groundingconnection. In order to ensure good performance in an electrical mean especially in converter drives, the grounding of the cable should be connected 360 degrees around the cable. In this paper, following manufacturing technologies are discussed: traditional turning, precision and centrifugal casting, and rotation moulding. DFM(A)-aspects are presented in detail.

The ‘Dys-Appearing’ Body in Doris Lessing’s The Diary of a Good Neighbour and Margaret Forster’s Have the Men Had Enough?

If the old body is usually read as a synonym of fragility and upcoming illness, even though not the case for most elderly citizens, the reality is that the longer we live, the increased probability of being affected by different illnesses cannot be eluded or denied. In Doris Lessing’s The Diary of a Good Neighbour and Margaret Forster’s Have the Men Had Enough? the reader is invited to participate in the day-to-day routines of two aged female protagonists, as well as to empathize with their inner feelings as they go through their last life stage. In fact, their ‘dys-appearing’ bodies, marked by their respective terminal illnesses, force these characters to grow closer to those around them and to accept the help of their families and friends, despite their desire to keep their free will and independence until the very end. The analysis of the two novels within the framework of ageing studies aims to show the contradictions existing between a growing ageing society and the negative cultural connotations of old age in Western society and the need to revise them.

Breeding, genetic and genomic of citrus for disease resistance

Although the citriculture is one of the most important economic activities in Brazil, it is based on a small number of varieties. This fact has contributed for the vulnerability of the culture regarding the phytosanitary problems. A higher number of varieties/genotypes with potential for commercial growing, either for the industry or fresh market, has been one of the main objectives of citrus breeding programs. The genetic breeding of citrus has improved, in the last decades, due to the possibility of an association between biotechnological tools and classical methods of breeding. The use of molecular markers for early selection of zygotic seedlings from controlled crosses resulted in the possibility of selection of a high number of new combination and, as a consequence, the establishment of a great number of hybrids in field experiments. The faster new tools are incorporated in the program, the faster is possibility to reach new genotypes that can be tested as a new variety. Good traits should be kept or incorporate, whereas bad traits have to be excluded or minimized in the new genotype. Scion and rootstock can not be considered separately, and graft compatibility, fruit quality and productivity are essential traits to be evaluated in the last stages of the program. The mapping of QTLs has favored breeding programs of several perennial species and in citrus it was possible to map several characteristics with qualitative and quantitative inheritance. The existence of linkage maps and QTLs already mapped, the development of EST and BAC library and the sequencing of the Citrus complete genome altogether make very demanding and urgent the exploration of such data to launch a wider genetic study of citrus. The rising of information on genome of several organisms has opened new approaches looking for integration between breeding, genetic and genome. Genome assisted selection (GAS) involves more than gene or complete genome sequencing and is becoming an import support in breeding programs of annual and perennial species. An huge information amount can be derivate from genome analysis. The use and benefit of such informations will depend on the genetic basis of the breeding program.

Fruits of Butia capitata (Mart.) Becc as good sources of β -carotene and provitamina

Butia capitata is a palm tree, widely found in the Brazilian savanna. Their fruits are largely used by local communities to prepare juices, jellies and ice-creams. The main objective of this work was to determine the carotenoids profile of Butia capitata fruits and their provitamin A values. Total carotenoids content ranged from 11.1 to 43.9 μg.g-1; β-carotene was the predominant carotenoid (5.2-22.8 μg.g-1), followed by γ-carotene, phytoene, phytofluene, ζ-carotene, α-cryptoxanthin (or zeinoxanthin) and α-carotene. Provitamin A values varied from 50 to 200 RAE.100g-1. This result suggests that B. capitata pulp may be a good source of β-carotene and provitamin A.