Transmission of Mycobacterium tuberculosis undetected by tuberculin skin testing.

Rationale: The development of tuberculin skin test (TST) positivity following infection by Mycobacterium tuberculosis is not invariable and may depend on bacillary as well as host factors.

Objectives: First, to compare the diagnostic performance of the TST and a form of in vitro IFN-gamma release assay (IFNGRA) in the circumstances of a contact investigation prompted by an unusually severe index case of infectious pulmonary tuberculosis. Second, to investigate the ability of the strain of M.

Promoting adequate nutrition: using artificial feeding.

An earlier article in this series (Holman et al 2005a) identified that in some circumstances the decision is made to administer artificial feeding. Here, Cheryl Holman, Sally Roberts and Maggie Nicol describe the reasons why artificial feeding may be necessary in older people and how it can be administered.

The positional magnetic resonance imaging changes in the lumbar spine following insertion of a novel interspinous process distraction device.

Study Design: Patients with symptomatic lumbar spinal stenosis underwent magnetic resonance imaging to study changes in the lumbar spine in various postures before and after implantation of the X STOP Interspinous Process Distraction Device (St. Francis Medical Technologies, Concord, CA).

Objective: To visualize the effect of the device in vivo.

Distribution of strain families of Mycobacterium tuberculosis causing pulmonary and extrapulmonary disease in hospitalized children in Cape Town, South Africa.

We studied the association between strain family and extrapulmonary tuberculosis among 285 children presenting to a pediatric hospital. Extrapulmonary disease occurred in 56% of children without known human immunodeficiency virus infection, with meningitis accounting for 22% of the cases. Two strain families, LAM3/F11 and W-Beijing, predominated; but there was no overall association with extrapulmonary disease.

Genomics in nursing education.

Purpose: To review international efforts to incorporate genetics content into nursing education curricula.

Organizing Framework: A discussion of the progress in nursing education programs in selected countries to educate students for genomics-based health care. Information is based on review of the literature and curriculum change efforts by the authors.

Acquired predisposition to mycobacterial disease due to autoantibodies to IFN-gamma.

Genetic defects in the IFN-gamma response pathway cause unique susceptibility to intracellular pathogens, particularly mycobacteria, but are rare and do not explain mycobacterial disease in the majority of affected patients. We postulated that acquired defects in macrophage activation by IFN-gamma may cause a similar immunological phenotype and thus explain the occurrence of disseminated intracellular infections in some patients without identifiable immune deficiency. Macrophage activation in response to IFN-gamma and IFN-gamma production were studied in whole blood and PBMCs of 3 patients with severe, unexplained nontuberculous mycobacterial infection.

Strategies for reducing preferred orientation and strain in powder samples for high-pressure synchrotron X-ray diffraction in diamond-anvil cells.

Among the many problems associated with high-pressure X-ray diffraction from polycrystalline samples in the diamond-anvil cell are strain and preferred orientation. A method is presented for efficiently reducing preferred orientation of powder samples compressed in diamond-anvil cells to pressures in excess of 20 GPa. This method may be successfully applied to samples of yield strength higher than alkalihalides.

Lack of adult-type salivary cortisol circadian rhythm in hospitalized preterm infants.

Background/aims: Knowledge of the presence or absence of cortisol (F) circadian rhythm in preterm infants is important for the interpretation of F measurements made in samples taken for both clinical and research purposes. Little is known about its emergence in very preterm infants. This study examines circadian rhythm in F secretion in hospitalized infants born before 30 weeks' gestation.

Enzyme-linked immunospot assay responses to early secretory antigenic target 6, culture filtrate protein 10, and purified protein derivative among children with tuberculosis: implications for diagnosis and monitoring of therapy.

Background: The ability to detect tuberculosis-specific lymphocytes by enzyme-linked immunospot (ELISPOT) assay may have important implications for the diagnosis and monitoring of tuberculosis in children, for which routine methods lack sensitivity. We conducted a study to determine the presence and time course of ELISPOT responses in children with tuberculosis.

Methods: Blood samples were obtained from children with a clinical diagnosis of tuberculosis, and interferon-gamma ELISPOT assays were performed using purified protein derivative (PPD), early secretory antigenic target 6 (ESAT-6), and culture filtrate protein 10 (CFP10) as stimulants.

Promiscuous 3beta-hydroxysteroid dehydrogenases: testosterone 17beta-hydroxysteroid dehydrogenase activities of mouse type I and VI 3beta-hydroxysteroid dehydrogenases.

3Beta-hydroxysteroid dehydrogenase (3beta-HSD) activity is essential for the synthesis of all classes of steroid hormones, converting various delta5-3beta-hydroxysteroids into hormonally active delta4-3-ketosteroids in NAD+ -dependent reactions. Certain 3beta-HSD isoforms have been reported to exhibit additional dehydrogenase character (e.g.

Dose response of CRM197 and tetanus toxoid-conjugated Haemophilus influenzae type b vaccines.

High vaccine cost has limited use of conjugate vaccines in the developing world where the disease burden is greatest. Fixed fractional doses of Haemophilus influenzae type b (Hib) vaccines have been shown to be immunogenic, but dose responses of these vaccines in humans are needed to determine the lowest immunogenic dose as an option for lowering vaccine cost. We randomized children to receive one of five doses (0.

Vasoactive intestinal peptide (VIP) stimulates cortisol secretion from the H295 human adrenocortical tumour cell line via VPAC1 receptors.

Vasoactive intestinal peptide (VIP) shows a wide tissue distribution and exerts numerous physiological actions. VIP was shown in a dose-dependent manner to increase cortisol secretion in the NCI-H295R human adrenocortical carcinoma (H295) cell line (threshold dose 3.3x10(-10) M, maximal dose 10(-7) M), coupled with a parallel increase in cAMP accumulation.

The variation of response to pharmacotherapy: pharmacogenetics--a new perspective to 'the right drug for the right person'.

Not all individuals respond to drug therapy equally, nor do they all experience the adverse effects that are reported to occur with specific medications. Current prescribing practices, which use medications shown to be safe and effective in selected patient populations, vary in their efficacy and also in the development of adverse effects among individual patients. The new and rapidly evolving discipline of pharmacogenetics has the potential to match specific drugs to the genetic profile of the individual.

A glycine to aspartic acid substitution of COL2A1 in a family with the Strudwick variant of spondyloepimetaphyseal dysplasia.

Background: Spondyloepimetaphyseal dysplasia (SEMD) is one of a clinically heterogeneous group of skeletal disorders, characterized by defective growth and modelling of the spine and long bones. Common clinical features include disproportionate short stature, malformed vertebrae and abnormal epiphyses or metaphyses. Some cases have been associated with mutations in the COL2A1 gene.

Employment and chronic non-cancer pain: insights into work retention and loss.

Objectives: To explore the work experiences of three individuals who have chronic non-cancer pain and to identify factors which may affect their ability to remain in employment.

Methods: Three cases were selected from a data set of six, to illustrate distinct employment history scenarios. All participants had a diagnosis of rheumatoid arthritis.

"Why haven't you taken any pain killers?" A patient focused study of the walking wounded in an urban emergency department.

Objectives: (1) To assess the proportion of patients of triage category 3-5 presenting to the minor side of an urban emergency department who present without taking prior pain relief, and (2) to describe the reasons why they do not take pain relief for their presenting complaint

Method: By patient interview of a convenience sample of 60 adult patients in the setting of an urban emergency department.

Results: Fifteen of 60 patients had taken analgesia and 45 of 60 (75%) had not. Sixteen reasons were volunteered to the interviewer.

Failure to control growth of mycobacteria in blood from children infected with human immunodeficiency virus and its relationship to T cell function.

The mechanisms of protective immunity to tuberculosis remain poorly understood in humans. A whole-blood infection model that employs a luminescent readout was used to analyze the role of T cells in control of mycobacterial infection. Control of mycobacterial growth in blood from healthy tuberculin-positive individuals was shown to be mediated predominantly by CD4(+) T cells.

Ovine steroid 17alpha-hydroxylase cytochrome P450: characteristics of the hydroxylase and lyase activities of the adrenal cortex enzyme.

The steroid 17-hydroxylase cytochrome P450 (CYP17) found in mammalian adrenal and gonadal tissues typically exhibits not only steroid 17-hydroxylase activity but also C-17,20-lyase activity. These two reactions, catalyzed by CYP17, allow for the biosynthesis of the glucocorticoids in the adrenal cortex, as a result of the 17-hydroxylase activity, and for the biosynthesis of androgenic C(19) steroids in the adrenal cortex and gonads as a result of the additional lyase activity. A major difference between species with regard to adrenal steroidogenesis resides in the lyase activity of CYP17 toward the hydroxylated intermediates and in the fact that the secretion of C(19) steroids takes place, in some species, exclusively in the gonads.

The teaching of genetics in New Zealand undergraduate nursing programmes.

This paper reports the results of a survey to determine how much genetics is taught in the bioscience component of the three-year Bachelor of Nursing degree offered by 16 tertiary education institutes in New Zealand. A questionnaire was mailed to the bioscience lecturers seeking information on the bioscience and genetics content of current programmes. They were also asked to indicate their perception of the impact and relevance of new genetic knowledge on health care and nursing education.