Ear presentation of Lyme borreliosis in a child.

Objective: This case report aims to raise awareness amongst clinicians of ear presentation of cutaneous borrelia.

Case Report: We report a recent case of borrelia lymphocytoma cutis benigna in a child presenting with unilateral earlobe swelling, who was otherwise well. A review of the English language literature, including management of the disease, is also presented.

A cost-effective protocol for screening patients for methicillin-resistant Staphylococcus aureus.

The incidence of hospital-acquired infection with methicillin-resistant Staphylococcus aureus (MRSA) is rising worldwide. Rapid identification of MRSA carriers is an important step in reducing the risk of transmission to other patients. Molecular methods are increasingly popular but are technically demanding and expensive.

Changes in Toxoplasma diagnosis.

The serological laboratory workload in detecting toxoplasma infection may be expected to change with changes in the clinical profile of patient populations. We have examined the clinical information and laboratory results for patients referred to the Scottish Toxoplasma Reference Laboratory in April-March 1999-2000 and 2009-2010. Numbers of patient sera submitted for testing were similar (1624 and 1552) but there was a change in the clinical profile, with a significant fall in patients with symptoms of current infection (612 versus 335; P<0.

Interpretation criteria in Western blot diagnosis of Lyme borreliosis.

This study reviews the Lyme borreliosis Western blot interpretation process, including what bands are classed as specific, the number of bands needed for a positive result, the role of band intensity and the use of clinical information. In 2008, 3688 patients (4223 serum samples) were tested by enzyme immunoassay (EIA), with 832 patients tested by confirmatory in-house IgG Western blot: 272 patients were Western blot-positive, 170 were weak positive, 156 were equivocal and 234 were negative. These results were assessed, and a review of interpretation criteria from both the USA and Europe was carried out.

Is Tayside becoming a Scottish hotspot for Lyme borreliosis?

The epidemiology of Lyme borreliosis (LB) in Tayside was studied and compared with Highland (an area of high endemicity) and the rest of Scotland. From April 2001 to March 2008 the incidence of LB in Tayside rose from an estimated 2.57 to 5.

The United Kingdom National External Quality Assessment Service for parasitology: toxoplasma serology scheme.

Aim: To examine performance in the UK National External Quality Assessment Scheme (UKNEQAS) for toxoplasma serology for evidence of discrepant results as compared with the predistribution and postdistribution results supplied by the toxoplasma reference laboratories.

Methods: Analysis of performance in the toxoplasma IgG and IgM schemes was made for the period 1994-2008 to look for trends in performance.

Results: For the IgG scheme, a mean of 98% of participants obtained the correct result for detection of toxoplasma-specific antibody.

More specific bands in the IgG western blot in sera from Scottish patients with suspected Lyme borreliosis.

Aims: To identify further Western blot bands that may be specific in the diagnosis of Lyme borreliosis.

Methods: The Borrelia burgdorferi antibody profiles of 270 western blot positive patients and 241 western blot negative patients from 2008 were examined.

Results: 27 different non-specific bands were detected in both groups.

Toxoplasma tachyzoites from cell culture are more appropriate in some situations.

Background: Laboratories traditionally culture toxoplasma tachyzoites in animals for testing and experimental use. This article considers why available cell culture methods are not used more often.

Aim: To compare HeLa cell culture and animal culture for production of toxoplasma tachyzoites.

Endogenous regulation of cardiovascular function by apelin-APJ.

Studies have shown significant cardiovascular effects of exogenous apelin administration, including the potent activation of cardiac contraction. However, the role of the endogenous apelin-APJ pathway is less clear. To study the loss of endogenous apelin-APJ signaling, we generated mice lacking either the ligand (apelin) or the receptor (APJ).

Learning to cope with chronic illness. Efficacy of a multi-component treatment for people with chronic fatigue syndrome.

Objective: The aim of this study was to determine the efficacy of an out-patient, multi-component programme developed for patients with chronic fatigue syndrome (CFS).

Methods: Twenty-two patients were assessed before and after six months of treatment. Findings were compared with 22 individuals on the waiting list.

Urban and rural risks of Lyme disease in the Scottish Highlands.

Background: This paper investigates the pattern of Lyme disease testing and infection within the Highland region of Scotland.

Methods: Data from all Highland samples tested during 2004-2006 were analysed according to result and patient's residence in relation to the eight fold Scottish Executive's urban/rural classification, and distance from woodland.

Results: In total, 1602 patients were tested for Lyme disease, 0.

Local Borrelia burgdorferi sensu stricto and Borrelia afzelii strains in a single mixed antigen improves western blot sensitivity.

Aims: This study evaluates the use of local Borrelia burgdorferi sensu stricto and Borrelia afzelii strains in a single mixed antigen for in-house IgG western blots in the routine diagnostic setting by comparing it with the current in-house protocol.

Methods: Sera from 233 patients from areas of Scotland with low and high prevalence for Lyme borreliosis were tested by western blots prepared from reference strain antigen (B burgdorferi sensu stricto) and mixed antigen (B burgdorferi sensu stricto and B afzelii). Results were scored using original and revised criteria, and results were compared.

Chlamydia infection among pregnant women and those seeking termination.

A total of 60 women tested positive for chlamydia during the study period. Of these, 75% (n = 45) were pregnant and were divided into those seeking termination (38%) and the antenatal group (62%). Of all pregnant chlamydia-positive women, 35% were teenagers.

Development of real time PCR to detect Toxoplasma gondii and Borrelia burgdorferi infections in postal samples.

Background: Most of the samples sent to reference laboratories are delivered by post. Thus, diagnostic PCR tests on blood samples have to be performed using methods which are optimised and validated for such conditions. There is a low probability that the organisms Toxoplasma gondii and Borrelia burgdorferi will be present.

The use of local isolates in Western blots improves serological diagnosis of Lyme disease in Scotland.

Nine Scottish Borrelia burgdorferi isolates were investigated in IgG Western blot tests. Sera previously found to be positive and negative when tested by routine Western blots prepared from reference strain B. burgdorferi sensu stricto antigen had different outcomes with these isolates.

Comparison of mumps-IgM ELISAs in acute infection.

Background: In Scotland there has been an outbreak of mumps with over 4000 confirmed cases in the last 2 years. As laboratory diagnosis is usually requested on patients with symptoms, a prompt diagnosis early in the illness is required.

Objectives: To assess the performance of the five different commercial IgM-ELISAs used in Scottish Virus laboratories.

Audit of the laboratory diagnosis of Lyme disease in Scotland.

An audit was performed on the laboratory diagnosis of lyme disease in Scotland. The problem of a significant number of patients with clinical symptoms of lyme disease being reported as seronegative or equivocal by the confirmatory Western blot test was identified. Comparisons of current practice were made with American and European standards, and the Western blot scoring system revised.

Do Toxoplasma gondii RH strain tachyzoites evolve during continuous passage?

Aim: To examine three lineages of Toxoplasma gondii RH strain in terms of performance in the dye test, culture, and gene expression.

Methods: Historical data (culture growth and performance in the dye test) from three lineages of RH strain tachyzoites (B, J, and Q) that had been continuously cultured in HeLa cells was assessed. Tachyzoite harvests obtained during continuous cell culture were retrieved from liquid nitrogen and cultured in HeLa cells, providing mRNA that was extracted and used to study gene expression using random amplified polymorphic DNA analysis at different stages of lineage adaptation to continuous culture.