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Cytomegalovirus (CMV) enzyme-linked immunosorbent spot (ELISPOT) and CMV QuantiFERON assays were examined as potential biomarkers predictive of congenital CMV (cCMV) transmission. Fifty-seven pregnant women with primary CMV infection and 23 with nonprimary CMV infection were recruited in the study. Maternal age, CMV IgG avidity, viremia, and viruria were also included among the potential predictors. Spearman's statistical correlation analysis revealed a positive correlation between the CMV ELISPOT and CMV QuantiFERON assay results (P < 0.001), but only the CMV ELISPOT assay correlated with cCMV (P < 0.001). cCMV was positively correlated with maternal viremia and viruria (P < 0.05) and negatively correlated with CMV IgG avidity (P < 0.01). Maternal age and CMV QuantiFERON assay results were not statistically associated with cCMV. CMV-specific cell-mediated immunity detected by the CMV ELISPOT assay plays a critical role in cCMV., (Copyright © 2016, American Society for Microbiology. All Rights Reserved.)

Pyrofomins A-D, four polyoxygenated sesquiterpenoids have been isolated from the methanolic extract of the fruit bodies of Pyrofomes demidoffii. Their structures are elucidated by IR, HR-FTICR-MS, and 2D NMR spectroscopy. Furthermore, the cedrane carbon skeleton of pyrofomin A (1) is confirmed by X-ray crystallographic analysis. The sesquiterpenoids 1-4 show neither cytotoxicity against KB cells nor antimicrobial activity., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Human cytomegalovirus (CMV) infection is a major cause of congenital infection leading to birth defects and sensorineural anomalies, including deafness. Recently, cell-mediated immunity (CMI) in pregnant women has been shown to correlate with congenital CMV transmission. In this study, two interferon gamma release assays (IGRA), the CMV enzyme-linked immunosorbent spot (ELISPOT) and CMV QuantiFERON assays, detecting CMV-specific CMI were compared. These assays were performed for 80 CMV-infected (57 primarily and 23 nonprimarily) pregnant women and 115 controls, including 89 healthy CMV-seropositive pregnant women without active CMV infection, 15 CMV-seronegative pregnant women, and 11 seropositive or seronegative nonpregnant women. Statistical tests, including frequency distribution analysis, nonparametric Kruskal-Wallis equality-of-populations rank test, Wilcoxon rank sum test for equality on unmatched data, and lowess smoothing local regression, were employed to determine statistical differences between groups and correlation between the assays. The CMV ELISPOT and CMV QuantiFERON assay data were not normally distributed and did not display equal variance. The CMV ELISPOT but not CMV QuantiFERON assay displayed significant higher values for primarily CMV-infected women than for the healthy seropositive pregnant and nonpregnant groups (P = 0.0057 and 0.0379, respectively) and those with nonprimary infections (P = 0.0104). The lowess local regression model comparing the assays on an individual basis showed a value bandwidth of 0.8. Both assays were highly accurate in discriminating CMV-seronegative pregnant women. The CMV ELISPOT assay was more effective than CMV-QuantiFERON in differentiating primary from the nonprimary infections. A substantial degree of variability exists between CMV ELISPOT and CMV QuantiFERON assay results for CMV-seropositive pregnant women., (Copyright © 2016, American Society for Microbiology. All Rights Reserved.)

Background: Lithiasis during pregnancy can be a serious problem representing a danger to both the mother and the fetus. Surgical intervention is needed in approximately one-third of patients reporting pain despite analgesia and/or signs of persistent infection and obstruction, but there is a lack of consensus in the scientific literature as to the use of the most appropriate procedure to treat this condition., Case Presentation: We describe our experience in the treatment of a complicated reno-ureteral lithiasis in a 27-year-old patient in the first trimester of pregnancy. The patient had a calcified ureteral stent with associated stone formation in the right kidney and a bladder stone at the distal extremity of the stent. She was treated by a combined approach by percutaneous nephrolithotripsy and transurethral cystolithotripsy. The procedure we performed was effective., Conclusion: Our experience reinforces the feasibility and safety of the kidney stone removal by the percutaneous approach also in a pregnant patient and supports the recommendations of the European guidelines: "in experienced centers, where necessary, percutaneous nephrolithotripsy should be considered." The technical precautions taken have proven to be valid and are supported by the current literature. Therefore, we feel they can be recommended.

Aim: This study aimed to determine the morphological renal impairment in pregnant rats spontaneously hypertensive (SHR) submitted to swimming when compared with those who did not perform the activity, and to analyze the relationship of expression of cytokines in inflammatory fibrotic and protrained and sedentary animals., Methods: SHRs and their respective control normotensive rats (WKY) were submitted or not to a swimming protocol during 9 weeks, resulting in four pregnant experimental groups: sedentary hypertensive (HS), trained hypertensive (HT), sedentary normotensive (NS), and trained normotensive (NT)., Results: Pregnant untrained hypertensive rats presented higher resting mean blood pressure (MAP) compared with both sedentary and trained normotensive groups (P<0.05). We can observe too, that the exercise training did not change the heart rate (HR) in both hypertensive and normotensive groups (P=0.127). The HT rats showed lower area of mesangial matrix (MM) compared to NT group (P=0.018). The perceptual of fibrosis (%F) in hypertensive rats was significantly higher compared with the % F in normotensive rats (P<0.001). The rats in the HT group showed higher expression of TGF-b (P<0.001) and of IL-10 (P<0.001) when compared with the other groups., Conclusion: The main conclusion is that in SHR rats it is shown a greater expression of TGF-beta, resulting in increased fibrosis in renal parenchyma due to the increased number of inflammatory cells that secrete this cytokine, and thus the practice of swimming can attenuate inflammatory processes, and mitigate the blood pressure of these animals.

Gummy stem blight caused by Didymella bryoniae (anamorph Phoma cucurbitacearum) is a major fungal disease of watermelon (Citrullus lanatus) and other cucurbits. Thirty-five isolates of Didymella and Phoma spp. associated with symptoms of gummy stem blight on watermelon, Canary melon (Cucumis melo), muskmelon (C. melo), and winter squash (Cucurbita maxima) from Florida and Georgia were characterized based on morphology on agar media, pathogenicity on 'Melody' watermelon, the internal transcribed spacer (ITS) sequence of ribosomal DNA (rDNA), random amplified polymorphic DNA (RAPD) analysis, and polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) analysis. All of the isolates were pathogenic on watermelon but differed in virulence. RAPD and ITS sequence analysis indicated genetic variability among the isolates but PCR-RFLP analysis did not show any variability. ITS sequence phylogenetic analysis identified two isolates, DB-05 and DB-33, which had a greater identity to that of D. bryoniae isolates from China (98 to 100% sequence homology) than other isolates from Florida and Georgia (95 to 98%). These two isolates possessed a single nucleotide substitution of A to G at position 131 of the ITS1 region. The study characterized the genetic profile of a collection of D. bryoniae isolates from Florida and Georgia in relation to isolates from other U.S. states and countries.

Background: Human cytomegalovirus (CMV) represents one of the leading causes of congenital infections worldwide. Early diagnosis of fetal infection and consequent rapid therapeutic intervention with immunoglobulin treatment may prevent fetal transmission and virus-related sequelae. In this study, the cell-mediated immunity and immunoglobulin avidity were evaluated as potential predictors of congenital transmission of the infection., Methods: CMV immunoglobulin G (IgG) avidity and CMV enzyme-linked immunospot (ELISpot) assays were employed in 80 pregnant women including 57 primary and 23 nonprimary CMV infections. Congenital infection was assessed using CMV DNA quantitative polymerase chain reaction on amniotic fluid or offspring urine. Logistic regression and receiver operating characteristic statistical methods were employed to determine the association with congenital infection., Results: Low CMV IgG avidity (25%) alone correlated with a probability of congenital transmission of 18.2% (95% confidence interval, 7.7%-28.8%). In contrast to the expectations, an increase in CMV ELISpot levels was statistically associated with congenital transmission (P = .006). The combined use of CMV ELISpot and low CMV IgG avidity resulted in a higher level of association than either method alone with the incidence of fetal transmission (area under the curve, 0.8685)., Conclusions: CMV-specific cell-mediated immunity represents a relevant marker in assessing the likelihood of congenital CMV transmission, particularly in combination with CMV IgG avidity., (© The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

The influence of vegetation and soil texture on the concentration and character of dissolved organic matter (DOM) present in runoff from the surface and sub-surface of zero order catchments of the Myponga Reservoir-catchment (South Australia) was investigated to determine the impacts of catchment characteristics and land management practices on the quality of waters used for domestic supply. Catchments selected have distinct vegetative cover (grass, native vegetation or pine) and contrasting texture of the surface soil horizon (sand or clay loam/clay). Water samples were collected from three slope positions (upper, middle, and lower) at soil depths of ~30 cm and ~60 cm in addition to overland flows. Filtered (0.45 μm) water samples were analyzed for dissolved organic carbon (DOC) and UV-visible absorbance and by F-EEM and HPSEC with UV and fluorescence detection to characterize the DOM. Surface and sub-surface runoff from catchments with clay soils and native vegetation or grass had lower DOC concentrations and lower relative abundances of aromatic, humic-like and high molecular weight organics than runoff from sandy soils with these vegetative types. Sub-surface flows from two catchments with Pinus radiata had similar DOC concentrations and DOM character, regardless of marked variation in surface soil texture. Runoff from catchments under native vegetation and grass on clay soils resulted in lower DOC concentrations and hence would be expected to have lower coagulant demand in conventional treatment for potable water supply than runoff from corresponding sandy soil catchments. However, organics in runoff from clay catchments would be more difficult to remove by coagulation. Surface waters from the native vegetation and grass catchments were generally found to have higher relative abundance of organic compounds amenable to removal by coagulation compared with sub-surface waters. Biophysical and land management practices combine to have a marked influence on the quality of source water used for domestic supply., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: To evaluate the in vitro activities of Ethiopian Thymus schimperi with other three hydro distilled essential oils against Dermatophytes (Tricophyton spp. and Microsporum spp.) and other pathogenic micro organisms., Methods: The studies were carried out using Agar disk diffusion method for screening the most effective essential oils and Agar dilution to determine Minimum Inhibitory Concentration (MIC) of the essential oils., Results: Essential oils of T. schimperi and Cinnamomum zeylanicum were highly active against tested organisms. The MIC were in the range of 0.08 μl/ml to 0.31 μl/ml for T. schimperi, 0.31 μl/ml to 0.16 μl/ml for C. zeylanicum, 2.5 μl/ml to1.25 μl/ml for Citrus limon and 5 μl/ml to 2.5 μl/ml for Eucalyptus camaldulensis against Tricophyton spp. and Microsporum spp. T. schimperi and C. zeylanicum oils also showed antimicrobial effect against Candida albicans, Aspegilus niger, Rhodotorula rubra, Escherichia coli, Shigella spp., Bacillus spp. and Streptococci., Conclusions: The Ethiopian T. schimperi oil had pronounced antifungal and antibacterial activities against all the tested microbes. Therefore, it is required further investigation in order to identify the active compounds and their clinical applications for treatment of tested organisms.

Objective: We investigated the kinetics of cytomegalovirus (CMV) clearance in blood and urine and the relationship between the viral load in blood at birth and the development of late-onset sequelae in asymptomatic congenital CMV infection., Methods: Thirty-three newborns with congenital asymptomatic CMV infection born to women with primary CMV infection during pregnancy were enrolled. CMV infection was monitored by polymerase chain reaction analysis of blood and urine. The follow-up examination was concluded at 6 years of age., Results: Ten infants developed postnatal sequelae, whereas twenty-three infants remained asymptomatic. Fifty percent of babies cleared CMV in blood and urine within 3 and 36 months, respectively. Logistic multivariate regression revealed that the risk of neonatal clinical disease crossed the level of 50% with a DNAemia at birth of ≥ 12,000 copies/mL (P = .0002). The risk of hearing deficit crossed the level of 50% with a DNAemia at birth of ≥ 17,000 copies/mL (P = .0001). No significant difference was found between the kinetics of CMV clearance in asymptomatic children as compared to babies with late-onset disease., Conclusions: Asymptomatic newborns with a CMV DNAemia at birth of ≥ 12,000 copies/mL were more likely to experience CMV-related sequelae. The risk of hearing deficit increased with a viral load in blood of ≥ 17,000 copies/mL., (© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

Background: In hematopoietic stem cell transplantation (HSCT), late hemorrhagic cystitis (HC) has been associated with BK virus (BKV) infection. We assessed the value of plasma BKV load in predicting HC., Methods: Plasma and urine BKV-DNA load were assessed prospectively in 107 pediatric patients., Results: Twenty patients developed grade II and III HC, with 100-day cumulative incidence of 18.8%. At diagnosis of HC, the median load of BKV DNA was 2.3 × 10(3) copies/mL. A plasma BKV-DNA load of 10(3) copies/mL had a sensitivity of 100% and a specificity of 86% with a negative predictive value (NPV) of 100% and a positive predictive value (PPV) of 39% for HC. A urine BKV-DNA load of >10(7) copies/mL had a sensitivity of 86% and a specificity of 60% with a NPV of 98% and a PPV of 14% for HC. A BKV load of 10(3) copies/mL on plasma was significantly associated with HC in multivariate analysis (hazard ratio [HR], 6.1; P = .0006). Patients with HC had a significantly higher risk of mortality than patients who did not have HC (HR, 2.6; P = .018)., Conclusions: The above values were used to monitor plasma BKV-DNA load, and they provided a better prediction of patients at risk of HC than urine BKV-DNA load., (© The Author 2014. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

Psoriasis was previously considered to be mostly a Th1 cell-related disorder, but Th17 cell has recently emerged as an important player in the pathogenesis of psoriasis. The Th17 immune pathway is increased in psoriatic patients, both in peripheral circulation and in skin lesions, and positively correlates with the Psoriasis Area and Severity Index. Anti-tumor necrosis factor alpha (TNF-α) agents, in addition to potent inhibition of TNF-α activity, are able to decrease IL-17 levels and Th17 cells in the skin and plasma of patients with moderate-to-severe psoriasis. We found a decrease in the median Th17 cell count in peripheral blood after 4 months' therapy with anti-TNF-α compared with baseline values, but the difference did not reach statistical significance, probably due to the small cohort size. Our data suggest that anti-TNF-α treatment for psoriasis is able to achieve a substantial Th17 cell count reduction in the peripheral blood of patients and that this decrease is significantly associated with an adequate response to biologic therapy, as previous studies in rheumatoid arthritis have shown., (© 2014 Wiley Periodicals, Inc.)

Purpose: Burkholderia cepacia complex (Bcc) infections of the head and neck have been infrequently reported in immunocompetent patients, while their association with cystic fibrosis is quite well known. One of the main problems associated with Bcc is their intrinsic resistance to most clinically-available antimicrobials. Bcc has already been isolated in sinonasal polyposis, while here we report for the first time on its isolation in patients with chronic rhinosinusitis (CRS) but no nasal polyposis., Materials and Methods: Thirty-four consecutive surgically-treated CRS patients without cystic fibrosis were recruited., Results: Bcc was isolated in 4 cases of CRS without polyposis, and in another case in sinonasal polyposis. All tested Bcc strains isolated in non-polypotic CRS were resistant to ciprofloxacin, amikacin, ertapenem, amoxicillin/clavulanate, cefotaxime, and gentamicin., Conclusions: The novel finding of Bcc species in CRS without polyposis as well suggests that the mechanism by which these bacteria adhere to the epithelium of the upper respiratory tract may be important in the host's colonization., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Two cultivated (P. ostreatus and L. edodes) and five wild (L. sulphureus, A. campestris, T. clypeatus, T. microcarpus and T. letestui) edible mushrooms were analyzed for their antioxidant activities, total phenolics, total flavonoids, phenolic profile and ergothioneine content. Results showed that A. campestris had the greatest antioxidant activity in all assays with lower EC50 (mg/ml) values of 1.4, 3.6 and 0.035 for scavenging, reducing and chelating activities, respectively. To correlate well with activities, A. campestris also exhibited greater total phenolics and total flavonoids content of 14.6 mg GAE/g and 1.97 mg CE/g, respectively. The maximum concentration (μg/g) of the individual phenolic compounds were 7.80 (P. ostreatus) for caffeic acid, 4.55 (T. letestui) for chlorogenic acid, 15.8 (T. microcarpus) for p-coumaric acid, 20.3 (A. campestris) for ferulic acid, 561.9 (A. campestris) for gallic acid, 38.7 (A. campestris) for p-hydroxybenzoic acid and 7.08 (A. campestris) for myricetin. All samples tested contained different amounts of ergothioneine ranging from 0.08 (L. sulphureus) to 3.78 (P. ostreatus) mg/g in dry weight., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Assessing the CMV specific CMI in transplant subjects represents a promising strategy to determine the risk of infection on individual basis. In this study 61 adult CMV IgG seropositive solid organ transplant recipients were examined in order to improve the efficacy of CMI detection. For this purpose, pair-wise comparisons were conducted comparing positive control stimuli PWM and PMA/iono and CMV stimuli, pp65 peptide pool and whole CMV particle. Rosette pre-depletion of blood was also investigated for detecting CD4+ or CD8+ T-cell responses using the IFN-g ELISPOT assay. In the time-points 30-180 days after transplantation, PMA/iono produced statistically significant higher responses compared to PWM, probably because PMA/iono activation pathway is independent from the effect of immunosuppressive drugs. The data showed that 11% of transplant patients displayed very low or undetectable responses to pp65 peptide pool antigen while having sustained high responses to whole CMV particle. In addition, in all the subjects analyzed, CMI responses to CMV particle produced a statistically significant higher number of spots compared to pp65 peptide pool antigen. Rosette pre-depletion of whole blood proved to be effective in detecting CD4+ or CD8+ T-cell responses similarly to flow cytometry. Taken together, the following recommendations are suggested to optimize the CMV-ELISPOT for transplantation settings: (1) use PMA/iono as positive control; (2) whole virus particle should be used to avoid peptide-related false negative responses; (3) a rosette pre-depletion step may be useful to detect CD4+ or CD8+ T-cell responses., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Assessing cytomegalovirus (CMV)-specific cell-mediated immunity (CMI) represents an appealing strategy for identifying transplant recipients at risk of infection. In this study, we compared two gamma interferon-releasing assays (IGRAs), Quantiferon-CMV and CMV enzyme-linked immunosorbent spot (ELISPOT), to determine the ability of each test to predict protective CMV-specific T-cell responses. Two hundred twenty-one Quantiferon-CMV and ELISPOT tests were conducted on 120 adult kidney transplant recipients (KTRs), including 100 CMV-seropositive transplant recipients (R+) and 20 CMV-seronegative transplant recipients of a CMV-positive donor (D+/R-). As a control cohort, 39 healthy adult subjects (including 33 CMV-seropositive and 6 CMV-seronegative subjects) were enrolled. CMV IgG serology was used as a reference for both tests. In the CMV-seropositive individuals, the ELISPOT and Quantiferon-CMV assays provided 46% concordance with the serology, 12% discordance, 18% disagreement between ELISPOT or Quantiferon-CMV and the serology, and 24% gray areas when one or both tests resulted in weak positives. None of the CMV-seronegative subjects showed detectable responses in the ELISPOT or the Quantiferon-CMV test. In transplant recipients, both the ELISPOT and Quantiferon-CMV assays positively correlated with each other and negatively correlated with CMV DNAemia in a significant way (P<0.05). During the antiviral prophylaxis, all 20 D+/R- KTRs we examined displayed undetectable Quantiferon-CMV and ELISPOT results, and there was no evidence of CMV seroconversion. The receiving operator curve (ROC) statistical analysis revealed similar specificities and sensitivities in predicting detectable viremia (areas under the curve [AUC], 0.66 and 0.62 for Quantiferon-CMV and ELISPOT, respectively). ELISPOT and Quantiferon-CMV values of >150 spots/200,000 peripheral blood mononuclear cells (PBMCs) and >1 to 6 IU gamma interferon (IFN-γ) were associated with protection from CMV infection (odds ratios [OR], 5 and 8.75, respectively). In transplant recipients, the two tests displayed similar abilities for predicting CMV infection. Both the ELISPOT and Quantiferon-CMV assays require several ameliorations to avoid false-negative results.

Background. Intestinal parasitic infection affects the health and quality of life of people living with HIV. This study was aimed to determine the prevalence of intestinal parasites among HIV positive individuals who are naive and who are on antiretroviral treatment (ART) in Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Methods. A comparative cross-sectional study was conducted on 371 (112 ART-naive group and 259 on ART) HIV positive individuals. Stool specimens were collected and examined by direct wet mount, formol ether concentration technique, and modified ziehl-Neelsen methods. Results. The overall prevalence of intestinal parasitic infections was 33.7%; it was significantly higher among the study participants who were ART-naive group (45.5%) (AOR: 2.60(1.56,4.34)) and diarrheic (53.3%) (AOR: 2.30(1.34,3.96)) and with CD4 count <200 cells/ μ L (46%) (AOR: 2.07(1.06,4.04)). The most commonly identified parasites were Entamoeba histolytica/E. dispar (13.5%), Giardia lamblia (8.1%), Strongyloides stercoralis (4.0%), and Cryptosporidium species (2.2%). Conclusion. HIV positive individuals with diarrhea and low CD4 count and ART naive groups were more infected with intestinal parasites than their counterparts. Early stool examination and treatment of intestinal parasites for HIV/AIDS patients is essential.

Background: Drug-resistant TB has emerged as a major challenge facing TB prevention and control efforts. In Ethiopia, the extent/trend of drug resistance TB is not well known. The aim of this study was to determine the pattern and trend of resistance to first line anti-TB drugs among culture positive retreatment cases at St.Peter's TB Specialized Hospital., Findings: A hospital based retrospective study was used to assess the pattern of anti-TB drug resistance among previously treated TB patients referred to St.Peter's TB Specialized Hospital from January 2004-December 2008 Gregorian calendar(GC) for better diagnosis and treatment. Among 376 culture positive for M. tuberculosis one hundred and two (27.1%) were susceptible to all of the four first line anti-TB drugs -Isoniazid (INH), Rifampicin (RIF), Ethambutol (ETB) & Streptomycin (STM). While 274 (72.9%) were resistant to at least one drug. Any resistance to STM (67.3%) was found to be the most common and the prevalence of MDR-TB was 174 (46.3%). Trend in resistance rate among re-treatment cases from 2004 to 2008 showed a significant increase for any drug as well as for INH, RIF, and MDR resistance (P <0.05 for trend)., Conclusions: There has been an increasing trend in drug resistance in recent years, particularly in retreatment cases. Therefore, establishing advanced diagnostic facilities for early detection of MDR-TB and expanding second line treatment center to treat MDR-TB patients and to prevent its transmission is recommended.

Human cytomegalovirus (CMV) infection represents a major threat for heart transplant recipients (HTXs). CMV-specific T cells effectively control virus infection, and thus, assessment of antiviral immune recovery may have clinical utility in identifying HTXs at risk of infection. In this study, 10 CMV-seropositive (R(+)) pretransplant patients and 48 preemptively treated R(+) HTXs were examined before and after 100 days posttransplant. Preemptive treatment is supposed to favor the immune recovery. CMV DNAemia and gamma interferon enzyme-linked immunosorbent spot (ELISPOT) assay were employed to assess the viremia and immune reconstitution. HTXs could be categorized into three groups characterized by high (>100), medium (50 to 100), and low (<50) spot levels. Early-identified high responders efficiently controlled the infection and also maintained high immunity levels after 100 days after transplant. No episodes of grade ≥2R rejection occurred in the high responders. Midresponders were identified as a group with heterogeneous trends of immune reconstitution. Low responders were 41% and 21% of HTXs before and after 100 days posttransplant, respectively. Low responders were associated with a higher incidence of infection. The effect of viremia on immune recovery was investigated: a statistically significant inverse correlation between magnitude of viremia and immune recovery emerged; in particular, each 10-fold increase in viremia (>4 log(10) DNAemia/ml) was associated with a 36% decrease of the ELISPOT assay spot levels. All episodes of high viremia (>4 log(10) DNAemia/ml) occurred from 1 to 60 days after transplant. Thus, the concomitant evaluation of viremia and CMV immune reconstitution has clinical utility in identifying HTXs at risk of infection and may represent a helpful guide in making therapeutic choices.

Background: Several studies proved that virus-specific T-cells play a pivotal role in controlling cytomegalovirus (CMV) infection in adult allogeneic hematopoietic stem-cell transplant (HSCT) patients. Fewer data are available in pediatric HSCT settings, when immature and inexperienced immune system may affect antiviral immune reconstitution., Methods: We analyzed prospectively the CMV-specific T-cell reconstitution in a cohort of 31 pediatric allogeneic HSCT recipients at 30, 60, 90, 120, 180, and 360 days after HSCT., Results: Depending on donor-recipient CMV serostatus, we observed distinct patterns and kinetics of CMV-specific T-cell immune reconstitution: during the early time-points, patients displayed a severe reduction in CMV-specific T-cell recovery in both CMV seropositive donor (D+) group and CMV seronegative donor (D-) on CMV seropositive recipients (R+). From day 90 onward, statistical significant differences in the profile of T-cell immune reconstitution emerged between D+ and D-. The pattern of immune reconstitution was characterized by heterogeneous kinetics and efficiencies: we report cases of: (1) spontaneous antiviral T-cell recovery with no previous viremia, (2) immune T-cell recovery anticipated by CMV viremia, and (3) no T-cell immune reconstitution despite previous viremia episodes., Conclusions: Given the heterogeneous scenarios of antiviral T-cell immune recovery in pediatric allogeneic HSCT, we conclude that the evaluation of the antiviral immune reconstitution is a promising and appealing system for identifying patients at higher risk of CMV infection. The use of interferon-γ ELISPOT test is a valid tool for immunological monitoring and predicting CMV viremia in pediatric HSCT.

Background: Genomic analysis of high-altitude populations residing in the Andes and Tibet has revealed several candidate loci for involvement in high-altitude adaptation, a subset of which have also been shown to be associated with hemoglobin levels, including EPAS1, EGLN1, and PPARA, which play a role in the HIF-1 pathway. Here, we have extended this work to high- and low-altitude populations living in Ethiopia, for which we have measured hemoglobin levels. We genotyped the Illumina 1M SNP array and employed several genome-wide scans for selection and targeted association with hemoglobin levels to identify genes that play a role in adaptation to high altitude., Results: We have identified a set of candidate genes for positive selection in our high-altitude population sample, demonstrated significantly different hemoglobin levels between high- and low-altitude Ethiopians and have identified a subset of candidate genes for selection, several of which also show suggestive associations with hemoglobin levels., Conclusions: We highlight several candidate genes for involvement in high-altitude adaptation in Ethiopia, including CBARA1, VAV3, ARNT2 and THRB. Although most of these genes have not been identified in previous studies of high-altitude Tibetan or Andean population samples, two of these genes (THRB and ARNT2) play a role in the HIF-1 pathway, a pathway implicated in previous work reported in Tibetan and Andean studies. These combined results suggest that adaptation to high altitude arose independently due to convergent evolution in high-altitude Amhara populations in Ethiopia.

Background: Posttransplant lymphoproliferative disease caused by Epstein-Barr virus (EBV-PTLD) is a severe complication after allogeneic hematopoietic stem-cell transplantation (HSCT). We evaluated whether the modulation of immunosuppression (IS) guided by quantitative polymerase chain reaction for EBV (EBV-PCR) was effective as a first-line therapeutic approach for EBV reactivation., Methods: Eighty-nine pediatric patients who received an HSCT from an unrelated donor were prospectively assessed by quantitative EBV-PCR. The EBV-PCR threshold to modulate IS was set to more than 300 genomic copies (gc)/10 peripheral blood mononuclear cells., Results: EBV-PCR positivity was observed in 56 (63%) of 89 patients at a median time of 44 days after HSCT. The variables associated with EBV-PCR positivity were bone marrow stem cells (P=0.047) and a lower total dose of nuclear cells reinfused (P=0.03). Thirty-one patients (35%) had more than or equal to 300 gc. IS was withdrawn or reduced in 18 (58%) and 13 (42%) of the 31 patients, respectively. EBV viral load (EBV-VL) less than 300 gc was achieved in 30 of these 31 patients at a median of 25 days. Only 1 (1%) of the 89 patients progressed to EBV-PTLD. The patients with EBV-VL more than 300 gc had a lower incidence of acute graft versus host disease III-IV than patients with EBV-VL less than 300 gc: 13% vs. 36%, P=0.02. No differences in terms of chronic graft versus host disease, overall survival, event-free survival and transplant-related mortality were observed between the two groups., Conclusions: We conclude that PCR-guided modulation of IS may play a role in early intervention for EBV-PTLD and a prospective, randomized study is needed.

The study was conducted at Sinana Agricultural Research Center, Ethiopia to assess the supplementation of graded levels of vetch (Vicia dasycarpa 'lana') and lucerne (Medicago sativa,' Hunter river') hay on feed intake, digestibility and body weight (BW) change of Arsi-Bale sheep fed urea treated barley straw (UTBS). A 7 day- digestibility and a 90 day- feed intake trials were conducted using 28 and 35 sheep, respectively. The experimental design was a randomized complete block design with seven dietary treatments that consisted of feeding UTBS (T1) as the control treatment, UTBS plus 150, 250 and 350 g dry matter (DM) per day of vetch for T2, T3, T4, respectively and UTBS plus 150, 250 and 350 g DM per day of lucerne for T5, T6 and T7, respectively. Intake of UTBS was not affected (P > 0.05) by inclusion of lucerne hay at 25-35% of daily DM intake. The supplements increased daily intake of total DM, organic matter (OM), neutral detergent fiber (NDF), acid detergent fiber (ADF) and metabolizable energy (ME) (P < 0.001) as well as apparent digestibility of DM, OM (P < 0.001), NDF (P < 0.01), ADF, crude protein (CP) (P < 0.05) and daily BW gain (P < 0.001). Supplementation with lucerne than vetch hay promoted higher (P < 0.001) CP and ME intakes and daily BW gain. Feeding with the UTBS without supplementation was enough to meet the maintenance requirements of the sheep and allow small BW gain. The results of the study showed that urea treatment of barley straw in conjunction with supplementation of lucerne or vetch hay could serve as a useful strategy in improving smallholder sheep production in the tropics.

The occurrence of mycotoxins in barley, sorghum, teff (Eragrostis tef) and wheat from Ethiopia has been studied. Samples were analyzed for aflatoxin B(1) (AFB1), ochratoxin A (OTA), deoxynivalenol (DON), nivalenol (NIV) and zearalenone (ZEN) using high performance liquid chromatography (HPLC) and for fumonisins (FUM) using enzyme linked immunosorbent assay (ELISA). AFB1 and OTA were detected in samples of all the four crops. AFB1 was detected in 8.8% of the 352 samples analyzed at concentrations ranging from trace to 26 microg kg(-1). OTA occurred in 24.3% of 321 samples at a mean concentration of 54.1 microg kg(-1) and a maximum of 2106 microg kg(-1). DON occurred in barley, sorghum and wheat at 40-2340 microg kg(-1) with an overall incidence of 48.8% among the 84 mainly 'suspect' samples analyzed; NIV was co-analyzed with DON and was detected at 40 microg kg(-1) in a wheat sample and at 50, 380, and 490 microg kg(-1) in three sorghum samples. FUM and ZEN occurred only in sorghum samples with low frequencies at concentrations reaching 2117 and 32 microg kg(-1), respectively. The analytical results indicate higher mycotoxin contamination in sorghum, which could be related to the widespread storage of sorghum grain in underground pits leading to elevated seed moisture contents. This is the first report on the occurrence of OTA in teff.

P. hsyterophorus is an exotic invasive annual weed now causing severe infestation in Ethiopia. Studies on diagnosis, incidence and distribution of pathogens associated with parthenium weed in Ethiopia were carried out from 1998-2002. Several fungal isolates were obtained from seed and other parts of parthenium plants. Among them were putative pathogenic fungal species of the genus Helminthosporium, Phoma, Curvularia, Chaetomium, Alternaria, and Fusarium. However, pathogenecity test of the isolates obtained showed no or non-specific symptoms. It was concluded that these pathogens could be opportunistic with insignificant potential for biological control of parthenium. Two most important diseases associated with parthenium were a rust disease, caused by Puccinia abrupta var. partheniicola, and a phyllody disease, caused by a phytoplasma of fababean phyllody (PBP) phytoplasma group. The rust was commonly found in cool mid altitude (1500-2500 m) areas while phyllody was observed in low to mid altitude regions (900-2500 m) of Ethiopia, with a disease incidence up to 100% and 75%, respectively, in some locations. Study of the individual effects of the rust and phyllody diseases under field conditions showed a reduction on weed morphological parameters (plant height, leaf area, and dry matter yield). Parthenium seed production was reduced by 42% and 85% due to rust and phyllody, respectively. Phyllody and rust diseases of parthenium showed significant potential for classical biological control of parthenium after further confirmation of insect vectors that transmit phyllody and host range of phyllody disease to the related economic plants in Ethiopia.

Objective: To determine the botanical identity, cytotoxicity, and antibacterial property of the commonly used toothbrush sticks in Ethiopia., Setting: Research laboratories of the departments of Biology and Chemistry, Addis Ababa University between December 1993 and May 1995., Methods: The study was performed by purchasing the commonly used toothbrush sticks from street markets in various towns of Ethiopia. Voucher specimens were collected and their botanical identity was determined following floral keys. The toothbrush sticks were ground in a mill and soaked in absolute methanol for 24 hours and filtered. The filtrates were dried in a rotary evaporator and the crude extracts were stored at 4 degrees C. The crude methanol extracts were used to test their antibacterial activity by impregnating into filter paper discs and placing on test plates of Staphylococcus aureus and Bacillus cerues. Their lethality to brine shrimp (Artemia salina) was performed following standard procedures., Results: Twenty different species of plant used as toothbrush were collected and their botanical identity determined. Crude methanol extracts of only Agave sisalana, Birbira and Hypericum revolutum test concentrations up to 500 micrograms/ml showed weak toxicity to brine shrimp. All the extracts showed antibacterial activity against Staphylococcus aureus and Bacillus cereus by agar diffusion method., Conclusion: Toothbrush sticks can be used by the vast majority of people who cannot afford buying the commercial toothbrush and toothpaste. The toothbrush sticks may be important for the oral and dental hygiene of the users and hence may be useful in decreasing dental caries. Further studies should focus on the effect of the toothbrush sticks against other common bacteria that are associated with dental diseases.

Previous studies have demonstrated that maturation of cytomegalovirus (CMV)-specific antibodies in solid organ transplant recipients is delayed after primary CMV infection. To investigate the clinical significance of this finding, the avidity indices of anti-CMV antibody were determined in parallel with other serologic and virologic parameters in serial serum samples from 24 solid organ transplant recipients who had primary CMV infection that began during the first 3 months after transplantation. The data obtained show that a delay in antibody maturation is significantly correlated with a long persistence of positive antigenemia.

Characterization of Candida albicans isolates from the oral cavity of Ethiopian Human Immunodeficiency Virus (HIV)-positive patients and HIV-negative individuals was undertaken. After identification of isolates using conventional methods and determination of carbohydrate assimilation profiles, serotyping was performed by slide agglutination with the Iatron IF6 serotyping system. Sensitivity of the isolates to 5-Fluorocytosine (5-FC) was assessed using the broth macrodilution method. There was no difference in phenotype, by any of the three methods used, between the HIV-positive and HIV-negative individuals. Serotype A was found to be dominant in strains isolated from both HIV-positive (34/40 = 85%) and HIV-negative (17/20 = 85%) study subjects. These data suggest that the C. albicans strains causing oral candidiasis in patients with HIV infection are identical to the commensal ones found in healthy individuals.

The diagnostic problems linked to human cytomegalovirus (HCMV) in pregnancy are many and not all have been fully defined. In long-term seropositive women there is a tacit agreement that no laboratory testing for HCMV should be carried out. In seronegative women a test for HCMV-specific IgG should be performed at least twice during the first 4 months of pregnancy, and if the seronegativity persists, further follow-up might be stopped. On the other hand, if a seropositivity appears the diagnosis of a primary HCMV infection is established and prenatal diagnosis should be offered to the mother. Finally, in the case of a pregnant woman with unknown serological status, the diagnosis of HCMV infection is a complex problem and several different questions need to be addressed. In our opinion they should be screened with a reliable IgM test (confirmed by blot if necessary) followed, in the case of positivity, by an avidity assay. Pregnant women undergoing a primary HCMV infection should be encouraged to seek prenatal diagnosis to be performed by PCR and virus isolation from amniotic fluid at the 21st to 23rd week of gestation.

Diagnosis of primary human cytomegalovirus (HCMV) infection is accomplished exclusively by serologic testing. Among the possible methods, the determination of immunoglobulin G (IgG) avidity is one of the least explored. In this work, we used a commercially available kit to test anti-HCMV IgG avidity in 336 serum samples from pregnant women and transplant recipients undergoing virologically proven HCMV primary or nonprimary infections and from latently infected blood donors. Our results demonstrate that the anti-HCMV IgG avidity test differentiates primary from nonprimary HCMV infections in both pregnant women and solid organ transplant recipients. In fact, 88.6% of primary infections and no secondary infections showed low-avidity IgG to HCMV. In particular, low IgG avidity is a marker of primary infection for 18 to 20 weeks after onset of symptoms in both immunocompromised and immunocompetent subjects.

Objective: Microalbuminuria is an early and sensible marker of renal impairment; furthermore, many authors consider it an independent predictive index for cardiovascular morbidity and mortality. In our study we observed this parameter in hypertensive patients treated respectively with ACE-inhibitors, calcium channel blockers and their combination., Experimental Design: Open comparative trial, 6 months follow-up., Environment: Outpatients, with no changes from usual lifestyle; office measurements., Patients: Forty patients (22 men and 18 women) aged 52-78 years, with essential hypertension and microalbuminuria; diabetics and subjects with renal impairment were excluded., Treatment: Chronic antihypertensive drug therapy, respectively with nitrendipine 20 mg/die (Group A, n = 10), lisinopril 20 mg/die (Group B, n = 20), and lisinopril 20 mg/die+nitrendipine 20 mg/die (Group C, n = 10); all drugs were administered orally., Measurements: Detection of urinary albumin excretion with immunochemical method (Micral Test); urine samples were taken immediately after arousal for three consecutive days; office blood pressure monitoring (sitting and standing) during the same day, with at least 2 separate readings., Results: Out of 34 patients examined at follow-up, (8 from Group A, 17 from Group B and 9 from Group C) urinary albumin excretion rates were as follows: Group A: reduction (but not disappearance) in 3 patients (37%), no change in 4 patients (50%), increase in 1 patient (13%); Group B: disappearance in 11 patients (65%), reduction in 3 patients (17.5%), no changes in 3 patients (17.5%); Group C: reduction (but not disappearance) in 5 patients (55.5%), no changes in 4 patients (44.5%)., Conclusions: In hypertensive patients not diabetics and not renally impaired with microalbuminuria, ACE-inhibitors appear to be a move suitable drug therapy than calcium channel blockers or the combination ACE-inhibitor+calcium channel blocker.

This clinical study was carried out in our division on 106 patients undergoing surgery for various pathologies in the period from May to September 1991; the aim of this study was the evaluation of short-term antibiotic prophylaxis before and after surgery: either imipenem-cilastatin, or cephalosporin or no treatment. Imipenem-cilastatin was found to be the antibiotic of choice for short-term prophylaxis.

Previous reports have suggested that patients with heart failure and coexistent ventricular tachyarrhythmias have a 1-year mortality of 40% to 60%. To assess whether an antiarrhythmic management program could reduce mortality, we studied 20 consecutive patients with ventricular fibrillation (12) or ventricular tachycardia (eight) and heart failure. Coronary disease was the most common underlying cardiac disorder (85%). Heart failure was managed with digoxin (16), diuretics (16), and vasodilators (seven). All patients received antiarrhythmic drug therapy guided by both noninvasive and invasive studies. This included single (10) or combination drug therapy (10). Beta blockers were used alone or in combination for arrhythmia control in 11 patients. One-year survival was 89%. We conclude that an effective program can be developed for patients with life-threatening ventricular tachyarrhythmias and heart failure. Combination antiarrhythmic drug therapy is often required. Despite impaired left ventricular function, beta-blocking drugs can be used, and may be important.

The combined occurrence of impaired left ventricular function and ventricular tachyarrhythmias portend a high annual mortality. Although antiarrhythmic drugs can reduce ventricular arrhythmias, the prognosis may be unchanged. We administered propafenone to 12 patients with ventricular tachyarrhythmias and left ventricular ejection fractions less than 40%. Propafenone significantly reduced isolated ventricular premature depolarizations, couplets, and ventricular tachycardia on ambulatory monitoring. Propafenone eliminated all exercise provocable ventricular tachycardia. Propafenone additionally abolished ventricular tachycardia inducible by programmed stimulation in five of six patients. In eight patients studied before and during therapy, there was no significant change in left ventricular ejection fraction determined by nuclear ventriculography. Propafenone was discontinued in three patients due to side effects. All patients remain alive and without recurrence of clinically significant arrhythmia over a mean follow-up period of 14 months. Propafenone is an effective drug for the management of ventricular tachyarrhythmias, and may be used in patients with impaired left ventricular function.