(57/548) High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP study).

A total of 685 clinical Streptococcus pneumoniae isolates from patients with pneumococcal diseases were collected from 14 centers in 11 Asian countries from January 2000 to June 2001. The in vitro susceptibilities of the isolates to 14 antimicrobial agents were determined by the broth microdilution test. Among the isolates tested, 483 (52.4%) were not susceptible to penicillin, 23% were intermediate, and 29.4% were penicillin resistant (MICs >/= 2 mg/liter). Isolates from Vietnam showed the highest prevalence of penicillin resistance (71.4%), followed by those from Korea (54.8%), Hong Kong (43.2%), and Taiwan (38.6%). The penicillin MICs at which 90% of isolates are inhibited (MIC(90)s) were 4 mg/liter among isolates from Vietnam, Hong Kong, Korea, and Taiwan. The prevalence of erythromycin resistance was also very high in Vietnam (92.1%), Taiwan (86%), Korea (80.6%), Hong Kong (76.8%), and China (73.9%). The MIC(90)s of erythromycin were >32 mg/liter among isolates from Korea, Vietnam, China, Taiwan, Singapore, Malaysia, and Hong Kong. Isolates from Hong Kong showed the highest rate of ciprofloxacin resistance (11.8%), followed by isolates from Sri Lanka (9.5%), the Philippines (9.1%), and Korea (6.5%). Multilocus sequence typing showed that the spread of the Taiwan(19F) clone and the Spain(23F) clone could be one of the major reasons for the rapid increases in antimicrobial resistance among S. pneumoniae isolates in Asia. Data from the multinational surveillance study clearly documented distinctive increases in the prevalence rates and the levels of antimicrobial resistance among S. pneumoniae isolates in many Asian countries, which are among the highest in the world published to date.  (+info)

(58/548) Phylogeography of Y-chromosome haplogroup I reveals distinct domains of prehistoric gene flow in europe.

To investigate which aspects of contemporary human Y-chromosome variation in Europe are characteristic of primary colonization, late-glacial expansions from refuge areas, Neolithic dispersals, or more recent events of gene flow, we have analyzed, in detail, haplogroup I (Hg I), the only major clade of the Y phylogeny that is widespread over Europe but virtually absent elsewhere. The analysis of 1,104 Hg I Y chromosomes, which were identified in the survey of 7,574 males from 60 population samples, revealed several subclades with distinct geographic distributions. Subclade I1a accounts for most of Hg I in Scandinavia, with a rapidly decreasing frequency toward both the East European Plain and the Atlantic fringe, but microsatellite diversity reveals that France could be the source region of the early spread of both I1a and the less common I1c. Also, I1b*, which extends from the eastern Adriatic to eastern Europe and declines noticeably toward the southern Balkans and abruptly toward the periphery of northern Italy, probably diffused after the Last Glacial Maximum from a homeland in eastern Europe or the Balkans. In contrast, I1b2 most likely arose in southern France/Iberia. Similarly to the other subclades, it underwent a postglacial expansion and marked the human colonization of Sardinia approximately 9,000 years ago.  (+info)

(59/548) Rapid assessment tool for Haemophilus influenzae type b disease in developing countries.

Haemophilus influenzae type b (Hib) still causes a substantial number of deaths among children in developing countries, despite the availability of effective conjugate vaccines. A major obstacle in developing a Hib vaccine has been limited awareness about the impact of Hib disease. A tool was developed to estimate the national rates of Hib meningitis and pneumonia by assessing retrospective local data over 7 to 10 days. Data from 11 countries in Africa, the Middle East, and Asia were studied and showed rates of Hib meningitis from >50 cases per 100,000 children >5 years in Ghana and Uganda to <15 per 100,000 in Iran, Jordan, and Uzbekistan. Results were affected by the quality of available data. The Hib rapid assessment tool can be useful to countries that desire a timely assessment of Hib disease rates.  (+info)

(60/548) How to improve organ donation in the MESOT countries.

There are more than 29 countries that have membership of the Middle East Society for Organ Transplantation (MESOT) with more than 600 million populations. These include all Arab countries, Iran, Turkey, Pakistan and countries of Central Asia. There are common features of organ transplantation in the Middle East Countries that include inadequate preventive medicine, uneven health infrastructure, poor awareness of the medical community and public at large of the importance of the organ donation and transplantation, high level of ethnicity and poor government support of organ transplantation. In addition, there is lack of team spirit among transplant physicians, lack of planning for organ procurement and transplant centers and lack of effective health insurance. Patients seek commercial transplantation most of the time. Patients on waiting lists for organ transplantation increase with time and there is a considerably growing gap between supply and demand of organs in the MESOT countries. Living organ donation is the most widely practiced type of donation in the Middle East and includes kidney and partial liver. Cadaver organ donation has a great potential in the Middle East. Nevertheless, this source is still not utilized properly due to the continued debate in the medical community about the concept of brain death and inadequate awareness of the public of the importance of organ donation and transplantation in many countries in this region.. There are three dominant and distinctive models for practice including the Saudi, Iranian and Pakistani models. The Saudi model includes the presence of a national organ procurement center as a governmental agency to supervise organ donation and transplantation. The Iranian model consists of renal grafts donation from the living genetically unrelated persons to the benefit of patients with end-stage renal disease. The Pakistani model is an interesting funding model for management of end-stage organ failure in the developing countries. We conclude that organ donation and transplantation are hampered with obstacles in the MESOT countries. Solutions need continuous work on many fronts. Local experiences can be implemented into new improved models that can help overcoming current obstacles.  (+info)

(61/548) Introductory keynote. The state of the art in animal experimentation.

This issue of Annali dell'Istituto Superiore di Sanita critically evaluates the progression in the ethical relationship between humans and animals (i.e., between biomedical researchers and laboratory animals). The main goal of this publication is in fact to provide a basis for an in-depth discussion of highly debated topics in the contemporary bioethics of animal experimentation, with particular focus on ethological issues and the question of minimal sample size and its contribution to reducing the number of experimental animals. The ethological issues addressed in this publication cover all behavioural patterns specifically moulded by the phylogenetic and ontogenetical history of a given species, a perspective that is often neglected when discussing the promotion of animal welfare.  (+info)

(62/548) Immunoproliferative small intestinal disease (IPSID): a model for mature B-cell neoplasms.

Immunoproliferative small intestinal disease (IPSID) was recently added to the growing list of infectious pathogen-associated human lymphomas. Molecular and immunohistochemical studies demonstrated an association with Campylobacter jejuni. IPSID is a variant of the B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), which involves mainly the proximal small intestine resulting in malabsorption, diarrhea, and abdominal pain. Geographically, IPSID is most prevalent in the Middle East and Africa. IPSID lymphomas reveal excessive plasma cell differentiation and produce truncated alpha heavy chain proteins lacking the light chains as well as the first constant domain. The corresponding mRNA lacks the variable heavy chain (V(H)) and the constant heavy chain 1 (C(H)1) sequences and contains deletions as well as insertions of unknown origin. The encoding gene sequence reveals a deletion of V region and parts of C(H)1 domain. Cytogenetic studies demonstrated clonal rearrangements involving predominantly the heavy and light chain genes, including t(9;14) translocation involving the PAX5 gene. Early-stage IPSID responds to antibiotics (30%-70% complete remission). Most untreated IPSID patients progress to lymphoplasmacytic and immunoblastic lymphoma invading the intestinal wall and mesenteric lymph nodes, and may metastasize to a distant organ. IPSID lymphoma shares clinical, morphologic, and molecular features with MALT lymphoma, lymphoplasmacytic lymphoma, and plasma cell neoplasms.  (+info)

(63/548) Self-rated health in a population of expatriate workers and partners in Riyadh, Saudi Arabia.

BACKGROUND: Anthropological theory suggests that expatriate workers progress through a sequence of adaptive stages during their adjustment to a new environment. The psychological and physiological effects of this adaptation process may be reflected in changes in self-rated general health. AIMS: To explore the relationship between self-rated general health, duration of expatriate assignment and two health-related behaviours: physical exercise and cigarette smoking. METHOD: A self-administered questionnaire recorded the demographics, self-rated general health, exercise and smoking behaviours of the adult non-Saudi residents of an expatriate compound in Riyadh, Saudi Arabia. RESULTS: The mean self-rated general health of the study group was better than comparable UK and New Zealand population norms. Self-rated general health was not associated with duration of assignment, but was associated with physical exercise, including a dose-response effect. Middle Eastern expatriates had lower self-rated health scores and a higher prevalence of cigarette smoking than other expatriates. CONCLUSIONS: While the sampling frame limits generalization, physical exercise may promote expatriates' general health. Middle Eastern expatriates may be a target group for smoking health education.  (+info)

(64/548) Heterogeneity of hepatitis C virus genotype 4 strains circulating in south-western France.

Hepatitis C virus (HCV) is a major cause of liver disease. Knowledge of HCV variability is crucial for clinical and epidemiological analysis. HCV genotype 4 (HCV-4) has become increasingly prevalent in European countries, including France, in recent years. The present study investigates the heterogeneity of HCV-4 in south-western France by phylogenetic analysis of NS5B sequences from 166 patients. The E2 region of 90 strains was also analysed. Genotype 4 accounts for 7.4 % of HCV infections in this area. Analysis of the NS5B region revealed 12 subtypes and the NS5B and E2 phylogeny data were congruent, except for one strain. The epidemiological data indicated two main groups of patients. One included intravenous drug users (IVDUs) of French origin, who were infected by homogeneous strains of subtypes 4a or 4d. The second group comprised non-IVDU patients who were infected with heterogeneous strains. This group was subdivided into patients of French origin, who were infected with eight subtypes, and patients from non-European countries (Central Africa or the Middle East), who were mainly infected with 4f, 4k, 4r and other subtypes; they showed the greatest genetic heterogeneity. This study of a large cohort of patients shows the great diversity of HCV-4 strains, and that these subtypes have spread differently.  (+info)