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Enzyme-linked immunosorbent assays (ELISAs) were developed for the detection of Ig G, Ig G4 and Ig E antibodies against Strongyloides stercoralis. A commercial ELISA ( IVD Research, USA) was also used, and the sensitivities and specificities of the four assays were determined. Serum samples from 26 patients with S. stercoralis infection and 55 patients with other infections or no infection were analysed. Sensitivities of the Ig G4, Ig G, Ig E and Ig G ( IVD) assays were 76·9%, 84·6%, 7·7% and 84·6%, respectively, while the specificities were 92·7%, 81·8%, 100% and 83·6%, respectively. If filariasis samples were excluded, the specificities of the Ig G4- ELISA and both Ig G- ELISAs increased to 100% and 98%, respectively. A significant positive correlation was observed between Ig G- and Ig G4- ELISAs ( r = 0·4828; P = 0·0125). Ig G- and Ig G- ( IVD) ELISAs ( r = 0·309) were positively correlated, but was not significant ( P = 0·124). Meanwhile there was no correlation between Ig G4- and Ig G- ( IVD) ELISAs ( r = 0·0042; P = 0·8294). Sera from brugian filariasis patients showed weak, positive correlation between the titres of antifilarial IgG4 and the optical densities of anti- Strongyloides Ig G4- ELISA ( r = 0·4544, P = 0·0294). In conclusion, the detection of both anti- Strongyloides Ig G4 and Ig G antibodies could improve the serodiagnosis of human strongyloidiasis. Furthermore, patients from lymphatic filariasis endemic areas who are serologically diagnosed with strongyloidiasis should also be tested for filariasis. [ABSTRACT FROM AUTHOR]

A single extreme point that plots outside of the 3σ control limits for the Shewhart charts indicate one possible out-of-control signal for the presence of assignable causes. Assignable causes can also cause unusual variation within the control limits. Runs rules have been used widely to detect patterns in successive observations. Excellent discussions about runs rules can be found in Nelson (Nelson, L. S. (1984). The Shewhart control chart—tests for special causes. Journal of Quality Technology 16:237–239.), Champ and Woodall (Champ, C. W., Woodall, W. H. (1987). Exact results for Shewhart control charts with supplementary runs rules. Technometrics 29:393–399.), Klein (Klein, M. (2000). Two alternatives to the Shewhart [Xbar] control chart. Journal of Quality Technology 32:427–431.), and Khoo (Khoo, B. C. Michael. (2003). Design of runs rules schemes. Quality Engineering 16, (27–43)). In this article, enhanced rules for the Hotelling'sχ2 chart will be suggested to increase the chart's sensitivity. [ABSTRACT FROM AUTHOR]

The index used in process capability is proposed as an optimization criterion in this article. This index can be viewed as an extension of mean squared error (MSE). Thus, the index allows practitioners to find an optimal setting with the mean responses close to their respective target values, Ti, while the standard deviations (or variance) of the responses are kept small. The index as an optimization criterion is applicable when upper specification limits, target values, and lower specification limits of mean responses are available. However, it also can be applied to mean responses with only target values and lower specification limits (or upper specification limits) in specific situations. An example will be used to illustrate this proposal. [ABSTRACT FROM AUTHOR]

Objectives: Human papillomavirus (HPV)-associated cancers disproportionately affect those infected with HIV despite effective combination antiretroviral therapy (cART). The primary aim of this study was to quantify HPV16 and HPV52 E6-specific interferon (IFN)-γ enzyme-linked immunospot (ELISPOT) T-cell responses, a correlate of protective immunity, in the first year following cART initiation and subsequently in those patients with suboptimal (sIR) and optimal (oIR) immune reconstitution., Methods: Ninety-four HIV-infected patients were recruited to the study; a longitudinal cohort of patients recruited just prior to commencing cART and followed up for 48 weeks (n = 27), and a cross-sectional cohort (n = 67) consisting of patients with sIR (CD4 T-cell count < 350 cells/μL) and oIR (CD4 T-cell count > 500 cells/μL) after a minimum of 2 years on cART. Controls (n = 29) consisted of HIV-negative individuals. IFN-γ ELISPOT responses against HPV16 and HPV52 E6 were correlated to clinical characteristics, anal and oral HPV carriage, T-cell maturational subsets, markers of activation, senescence and T-regulatory cells., Results: HPV16 and HPV52 E6-specific T-cell responses were detected in only one of 27 patients (3.7%) during the initial phase of immune recovery. After at least 2 years of cART, those who achieved oIR had significantly higher E6-specific responses (9 of 34; 26.5%) compared with those with sIR (2 of 32; 6.3%) (P = 0.029). Apart from higher CD4 T-cell counts and lower CD4 T-cell activation, no other immunological correlates were associated with the detection of HPV16 and HPV52 E6-specific responses., Conclusions: HPV16 and HPV52 E6-specific IFN-γ T-cell responses, a correlate of protective immunity, were detected more frequently among HIV-infected patients who achieved optimal immune recovery on cART (26.5%) compared with those with suboptimal recovery (6.3%)., (© 2016 British HIV Association.)

Ascaris lumbricoides infestations are endemic in tropical countries. Ascaris lumbricoides can occasionally cause biliary obstruction and result in obstructive jaundice or pancreatitis. We present a 34-year-old Bangladeshi woman with biliary ascariasis, resulting in recurrent pancreatitis. Her diagnosis was made with endoscopic retrograde cholangiopancreatography performed during an acute attack of pain.

There are no definite reports regarding the effects of chronic fluoxetine on animal models of epilepsy. Since chronically administered fluoxetine, in comparison to acutely administered fluoxetine has different effects on CNS, the present study was undertaken to investigate the effect of acute and chronic fluoxetine pretreatment, on a median anticonvulsant dose (ED50) of phenytoin in male ICR albino mice. Additionally, the effects of fluoxetine pretreatment on median convulsive current (CC50) in the presence and absence of phenytoin were investigated and results were compared. The maximal electroshock seizure (MES) test was used to estimate the ED50of phenytoin. The electroshock threshold test was used to estimate CC50. ED50and CC50values were calculated by probit analysis. The effects of the chronic and acute fluoxetine groups on the ED50of phenytoin were significantly different (P<0.05), and on CC50this difference was not statistically significant. Chronic fluoxetine insignificantly increased the ED50of phenytoin and decreased the CC50while acute fluoxetine decreased the ED50of phenytoin and increased the CC50. Our results indicate that chronic fluoxetine does not have an antiepileptic property and it may have dubious proconvulsant properties, contrary to acute fluoxetine., (Copyright 1999 Academic Press.)

The method of backcalculation estimates past HIV infection rates from available AIDS incidence data and an estimate of the incubation period. The method is used on the Malaysian data to model the AIDS epidemic because it makes use of the Malaysian AIDS incidence data which is fairly reliable and is more reflective of the trend of the epidemic as compared to the HIV infection rate recorded. An application is made on the monthly AIDS incidence data in Malaysia from January 1995 until August 1996 released by the Ministry of Health, Malaysia using the backcalculation program from Bacchetti et al and the incubation period distribution from Brookmeyer to generate the current HIV infection rate for Malaysia (until August 1996).

Retinal changes are common in adult acute leukaemia patients at presentation, but whether they correlate with the risk of subsequent intracranial haemorrhage is unknown. A 4-year study has been carried out in 82 newly-diagnosed acute leukaemia patients, aged 12-77 years, who were studied prospectively for the presence of intra-retinal haemorrhages (IRH), white-centred haemorrhages (WCH), cotton-wool spots (CWS) and macular haemorrhages (MH). Groups with and without these features were compared for their risk of intra-cranial haemorrhage (ICH) within the first 30 d following diagnosis. There was no association between the incidence of ICH and the presence of IRH, WCH or CWS. However, 6/13 of those with MH developed ICH, compared to 6/69 of those without MH (relative risk 5.0, CI 95% [2.03-12.33], P=0.003). The only other identifiable risk factor for ICH was the M3 subtype of AML, but if the four cases of M3-AML were discounted from analysis, MH remained a highly significant risk factor for ICH. Patients with MH should be monitored intensively for the development of ICH, and receive priority in the allocation of platelets where these are in short supply.

Colorectal carcinoma usually spreads along predictable routes to the abdominal lymph nodes, liver and lungs. Documented cases of metastatic spread to skeletal muscle are uncommon. To the knowledge of the authors, only four cases have been previously reported in the literature. This is a report of a case of advanced carcinoma of the descending colon with metastases to the left tibialis anterior muscle. This case is unusual in that the patient first presented with a symptomatic secondary deposit and the primary lesion is only discovered after the histology of the left leg tumour is known.

One hundred and thirteen patients sustaining blunt abdominal trauma over a 24-month period were retrospectively divided into three groups to assess parameters of three diagnostic methods and the time-lapse before implementing surgical treatment. Diagnosis was based in group A patients (n = 20) on physical findings, plain radiology, and blood and urine examinations. Diagnostic methods in group B patients (n = 35) and in group C patients (n = 58) were as in group A but with the addition of diagnostic peritoneal lavage (DPL) in group B or with the addition of diagnostic abdominal ultrasonography (DAU) in group C. Sixty-five patients underwent abdominal exploration. The time-lag from commencement of examination to surgery was 332.33 +/- 48.90 min, 251.82 +/- 29.08 min and 570.89 +/- 133.80 min respectively in groups A, B and C. It was significantly shorter in group B compared with group C (P = 0.03). DPL had a sensitivity of 95%, a specificity of 81% and an accuracy of 89% whilst DAU had a sensitivity of 79%, a specificity of 85% and an accuracy of 83% in detecting significant injury. The conclusion is that DPL in combination with DAU would facilitate early assessment and treatment of intra-abdominal injuries.

The outcome of 109 patients with severe head injury was studied in relation to clinical and computed tomographic (CT) criteria on admission, after resuscitation. Age, Glasgow Coma Score (GCS) and state of pupils strongly correlated with outcome. The presence of hypothalamic disturbances, hypoxia and hypotension were associated with an adverse outcome. The CT indicators associated with poor outcome were perimesencephalic cistern (PMC) obliteration, subarachnoid haemorrhage, diffuse axonal injury and acute subdural haematoma. The prognostic value of midline shift and mass effect were influenced by concomitant presence of diffuse brain injury. For the subset of patients aged < 20 years, with GCS 6-8 and patent PMC (n = 21), 71.4% correct predictions were made for a good outcome. For the subset of patients aged > 20 years, with GCS 3-5 and partial or complete obliteration of PMC (n = 28), 89.3% correct predictions were made for a poor outcome.

Nonrandom inheritance of the two HLA haplotypes of Chromosome 6, available from each parent among siblings affected by certain diseases, has afforded evidence of HLA-linked disease-susceptibility genes. Two algebraically equivalent measures of HLA haplotype concordance (that is, the excessive sharing of certain haplotypes among affected siblings) are used for family studies designed to test whether or not there is significant evidence of the existence of an HLA-linked disease-susceptibility gene or for inferring the mode of inheritance when this is already believed to apply. The distributions of these measures are derived under the null hypothesis of random inheritance of HLA haplotypes, and there is a short discussion of the case in which inheritance of a diseased gene causes a change, from the purely random case, in the distribution of haplotype concordance among affected siblings.

A method, using the GLIM computer package, for determining primary and secondary HLA associations with disease is described and is applied to data from patients with psoriasis and psoriatic arthritis.