Metagenomic Analysis Identifying a Rare Leishmania Infection in an Adult With AIDS

Leishmania belongs to a genus of the protozoan parasites that causes leishmaniasis, and includes cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL). In this case, Leishmania amastigotes were found on cytomorphology examination of the bone marrow specimen, followed by 1,076 Leishmania donovani reads using metagenomic next generation sequencing (mNGS). Since being definitely diagnosed with VL/HIV coinfection, the patient was treated with liposomal amphotericin B as the parasite-resistant therapy and was discharged after clinical cure. But nearly a year later, on the mNGS follow-up, L. donovani was detected in the patient’s blood plasma specimen with 941 reads, suggesting that a relapse of leishmaniasis had occurred. These results indicate that leishmaniasis still exists in China and may represent a public health concern. This case could be helpful in the differential diagnosis of leishmaniasis, and for determining disease progression, prevention, and control of vectors and reservoir hosts.

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Evaluation of cellular immune response in Golden Hamsters experimentally infected with Leishmania donovani comparing with cellular immune response against chicken Red Blood Cells.

Baghdad Science Journal ◽

10.21123/bsj.9.1.23-30 ◽

2012 ◽

Vol 9 (1) ◽

pp. 23-30

Author(s):

Baghdad Science Journal

Keyword(s):

Immune Response ◽

Red Blood Cells ◽

Skin Test ◽

Blood Cells ◽

Cellular Immune Response ◽

Leishmania Donovani ◽

Cellular Immune ◽

And Control ◽

Delayed Type Of Hypersensitivity

The Evaluation of the immune response in Golden Hamsters experimentally infected with Leishmania donovani was determined in this study, particularly, the cellular immune response. Follow up has maintained to determine the Delayed Type of Hypersensitivity using skin test both in infected and control lab animals. Chicken red blood cells were used as a parameter to evaluate the immune system; they are dull and have the ability of immunization. Two concentrations of chicken R.B.C were examined to determine which gives the higher titration in Hamsters and those were 1.5 X 109 cell/ml and 3 X 109 cell/ml , the second concentration gave the maximum titration where then used in this work. After sensitization with Chicken R.B.C for both infected and control groups, delayed type of hypersensitivity has been used against Leishmania donovani antigen and 4 days of follow up were adopted and they were (14, 30, 60, 90) day after infection. Results showed that skin test against both antigens ( L.donovani and chicken R.B.C) was significantly higher than normal at the first day of follow up ( day 14) then gradual decreasing were noticed till the last day of follow up (90). This can indicate that the infection with L.donovani activated the immune response at the beginning of infection, then leads to cellular immune suppression against both L.donovani antigen and chicken R.B.C., so that this immunosuppression is not specific.

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Molecular detection of Leishmania donovani, Leishmania major, and Trypanosoma species in Sergentomyia squamipleuris sand flies from a visceral leishmaniasis focus in Merti sub-County, eastern Kenya

Parasites & Vectors ◽

10.1186/s13071-020-04517-0 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Barrack O. Owino ◽

Jackline Milkah Mwangi ◽

Steve Kiplagat ◽

Hannah Njiriku Mwangi ◽

Johnstone M. Ingonga ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Mus Musculus ◽

Blood Meal ◽

Leishmania Donovani ◽

Leishmania Major ◽

Sand Fly ◽

Health Concern ◽

Sand Flies ◽

Reservoir Hosts ◽

Blood Meals

Abstract Background Visceral leishmaniasis (VL) and zoonotic cutaneous leishmaniasis (ZCL) are of public health concern in Merti sub-County, Kenya, but epidemiological data on transmission, vector abundance, distribution, and reservoir hosts remain limited. To better understand the disease and inform control measures to reduce transmission, we investigated the abundance and distribution of sand fly species responsible for Leishmania transmission in the sub-County and their blood-meal hosts. Methods We conducted an entomological survey in five villages with reported cases of VL in Merti sub-County, Kenya, using CDC miniature light traps and castor oil sticky papers. Sand flies were dissected and identified to the species level using standard taxonomic keys and PCR analysis of the cytochrome c oxidase subunit 1 (cox1) gene. Leishmania parasites were detected and identified by PCR and sequencing of internal transcribed spacer 1 (ITS1) genes. Blood-meal sources of engorged females were identified by high-resolution melting analysis of vertebrate cytochrome b (cyt-b) gene PCR products. Results We sampled 526 sand flies consisting of 8 species, Phlebotomus orientalis (1.52%; n = 8), and 7 Sergentomyia spp. Sergentomyia squamipleuris was the most abundant sand fly species (78.71%; n = 414) followed by Sergentomyia clydei (10.46%; n = 55). Leishmania major, Leishmania donovani, and Trypanosoma DNA were detected in S. squamipleuris specimens. Humans were the main sources of sand fly blood meals. However, we also detected mixed blood meals; one S. squamipleuris specimen had fed on both human and mouse (Mus musculus) blood, while two Ph. orientalis specimens fed on human, hyrax (Procavia capensis), and mouse (Mus musculus) blood. Conclusions Our findings implicate the potential involvement of S. squamipleuris in the transmission of Leishmania and question the dogma that human leishmaniases in the Old World are exclusively transmitted by sand flies of the Phlebotomus genus. The presence of Trypanosoma spp. may indicate mechanical transmission, whose efficiency should be investigated. Host preference analysis revealed the possibility of zoonotic transmission of leishmaniasis and other pathogens in the sub-County. Leishmania major and L. donovani are known to cause ZCL and VL, respectively. However, the reservoir status of the parasites is not uniform. Further studies are needed to determine the reservoir hosts of Leishmania spp. in the area.

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Molecular detection of Leishmania donovani, Leishmania major, and Trypanosoma spp. in Sergentomyia squamipleuris sandflies from a visceral leishmaniasis focus in Merti sub-County, eastern Kenya

10.1101/2020.07.29.226191 ◽

2020 ◽

Author(s):

Barrack O. Owino ◽

Jackline Milkah Mwangi ◽

Steve Kiplagat ◽

Hannah Njiriku Mwangi ◽

Johnstone M. Ingonga ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Mus Musculus ◽

Leishmania Donovani ◽

Leishmania Major ◽

Control Measures ◽

Health Concern ◽

Coi Gene ◽

Pcr Analysis ◽

Mechanical Transmission ◽

Reservoir Hosts

AbstractBackgroundVisceral leishmaniasis (VL) and zoonotic cutaneous leishmaniasis (ZCL) are of public health concern in Merti sub-County, Kenya, but epidemiological data on transmission, vector abundance, distribution, and reservoir hosts remains limited. To better understand the disease and inform control measures to reduce transmission, we investigated the abundance and distribution of sandfly species responsible for Leishmania transmission in the sub-County, and their blood-meal hosts.MethodsWe conducted an entomological survey in five villages with reported cases of VL in Merti sub-County, Kenya, using CDC miniature light traps and castor oil sticky papers. Sandflies were dissected and identified to the species level using standard taxonomic keys and PCR analysis of the cytochrome c oxidase subunit 1 (COI) gene. Leishmania parasites were detected and identified by PCR and sequencing of internal transcribed spacer 1 (ITS1) genes. Bloodmeal sources of engorged females were identified by high-resolution melting analysis of vertebrate cytochrome b (cyt-b) gene PCR products.ResultsWe sampled 526 sandflies consisting of eight species, Phlebotomus orientalis (1.52%; n = 8) and seven Sergentomyia spp. Sergentomyia squamipleuris was the most abundant sandfly species (78.71%; n = 414) followed by Sergentomyia clydei (10.46%; n = 55). Leishmania major, Leishmania donovani, and Trypanosoma DNA were detected in S. squamipleuris specimens. Humans were the main sources of sandfly bloodmeals. However, we also detected mixed bloodmeals; one S. squamipleuris specimen had fed on both human and mouse (Mus musculus) blood, while two Ph. orientalis specimens fed on human, hyrax (Procavia capensis), and mouse (Mus musculus) blood.ConclusionsOur findings implicate the potential involvement of S. squamipleuris in the transmission of Leishmania and question the dogma that human leishmaniases in the Old World are exclusively transmitted by sandflies of the Phlebotomus genus. The presence of Trypanosoma spp. may indicate mechanical transmission, whose efficiency should be investigated. Host preference analysis revealed the possibility of zoonotic transmission of leishmaniasis and other pathogens in the sub-County. Leishmania major causes ZCL while L. donovani is responsible for VL. However, the reservoir status of the parasites is not uniform. Further studies are needed to determine the reservoir hosts of Leishmania spp. in the area.

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Research Participation Experiences of Informants of Suicide and Control Cases

Crisis ◽

10.1027/0227-5910/a000025 ◽

2010 ◽

Vol 31 (5) ◽

pp. 238-246 ◽

Cited By ~ 9

Author(s):

Paul W. C. Wong ◽

Wincy S. C. Chan ◽

Philip S. L. Beh ◽

Fiona W. S. Yau ◽

Paul S. F. Yip ◽

...

Keyword(s):

Ethical Issues ◽

Research Participation ◽

Self Report ◽

Initial Contact ◽

Psychological Autopsy ◽

Autopsy Study ◽

The People ◽

And Control ◽

The Impact

Background: Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. Aims: (1) To investigate whether informants of suicide cases recruited by two approaches (coroners’ court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. Methods: A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. Results: The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. Limitations: The acceptance rate for our original psychological autopsy study was modest. Conclusions: The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

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Obesity management through Ayurveda - A Case Study

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i4.9377 ◽

2017 ◽

Vol 2 (4) ◽

Author(s):

Dheeraj Kumar Tyagi ◽

Shivakumar .

Keyword(s):

Clinical Findings ◽

Dietary Habit ◽

Unhealthy Lifestyle ◽

Lifestyle Management ◽

Before And After ◽

Effect Of Treatment ◽

And Control

Lifestyle disorders are one of the biggest threats for the population living unhealthy lifestyle. Sthoulya (Obesity) is one such disorder which creates lot of physical as well as mental disorder to the sufferer. Due to changing lifestyle, comforts and dietary habit lots of individuals changed their life totally. Obesity is a growing disease in developed and developing countries. Prevalence is drastically hike in past few years. Ayurveda, the science of life with which we can manage and control lots of lifestyle disorders. Focusing on dietary and lifestyle management along with treatment, we can overcome the hazards of obesity which is growing in a uncontrolled manner. The available data is based on the clinical findings only. Aim and objective: To assess the effect of “Guru Cha Atarpanam Chikitsa” in the management of Sthoulya. Setting: Swastharakshana evam Yoga, OPD and IPD, SDMCAH, Hassan. Method: Udwarthana, Parisheka, Shamana Aushadhis, Ahara, and Vihara was followed within the treatment duration and effect of treatment was assessed before and after treatment, advised for follow up. Results: The treatment adopted is effective in the management of Sthoulya and to improve the quality of life.

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A Legionnaires’ Disease Cluster in a Private Building in Italy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136922 ◽

2021 ◽

Vol 18 (13) ◽

pp. 6922

Author(s):

Maria Luisa Ricci ◽

Maria Cristina Rota ◽

Maria Grazia Caporali ◽

Antonietta Girolamo ◽

Maria Scaturro

Keyword(s):

Severe Pneumonia ◽

Control Measures ◽

Health Concern ◽

Human Consumption ◽

Domestic Water ◽

Quality Of Water ◽

Legionnaires Disease ◽

Prevention And Control Measures ◽

Private Homes ◽

And Control

Legionnaires’ disease (LD) is a severe pneumonia caused by bacteria belonging to the genus Legionella. This is a major public health concern and infections are steadily increasing worldwide. Several sources of infection have been identified, but they have not always been linked to human isolates by molecular match. The well-known Legionella contamination of private homes has rarely been associated with the acquisition of the disease, although some patients never left their homes during the incubation period. This study demonstrated by genomic matching between clinical and environmental Legionella isolates that the source of an LD cluster was a private building. Monoclonal antibodies and sequence-based typing were used to type the isolates, and the results clearly demonstrated the molecular relationship between the strains highlighting the risk of contracting LD at home. To contain this risk, the new European directive on the quality of water intended for human consumption has introduced for the first time Legionella as a microbiological parameter to be investigated in domestic water systems. This should lead to a greater attention to prevention and control measures for domestic Legionella contamination and, consequently, to a possible reduction in community acquired LD cases.

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A case of hypereosinophilic syndrome with STAT5b N642H mutation

Oxford Medical Case Reports ◽

10.1093/omcr/omaa129 ◽

2021 ◽

Vol 2021 (1) ◽

Author(s):

Feihong Ding ◽

Chaoping Wu ◽

Yun Li ◽

Sudipto Mukherjee ◽

Subha Ghosh ◽

...

Keyword(s):

Complete Blood Count ◽

Hypereosinophilic Syndrome ◽

Organ Damage ◽

Myeloid Neoplasm ◽

Acute Eosinophilic Pneumonia ◽

Myeloid Neoplasms ◽

Somatic Signal ◽

Generation Sequencing

ABSTRACT Hypereosinophilia is defined as persistent eosinophilia (>1.5 × 109/L). Hypereosinophilic syndrome (HES) is a term used to describe a group of disorders characterized by sustained hypereosinophilia associated with end-organ damage. Based on underlying molecular mechanism of eosinophilia, there are different subtypes of HES. Diagnosis of HES subtype can be challenging, especially in the absence of overt lymphoid/myeloid neoplasms or discernable secondary causes. Long-term outpatient follow-up with periodic complete blood count and repeated bone marrow biopsy may be needed to monitor disease activity. Somatic signal transducer and activation transcription 5b (STAT5b) N642H mutation was recently found to be associated with myeloid neoplasms with eosinophilia. We report a case of HES who presented with pulmonary embolism and acute eosinophilic pneumonia, found to have recurrent STAT5b N642H mutation by next-generation sequencing, suggesting possible underlying myeloid neoplasm.

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Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial

Journal of Interpersonal Violence ◽

10.1177/08862605211004177 ◽

2021 ◽

pp. 088626052110041

Author(s):

Roos Ruijne ◽

Cornelis Mulder ◽

Milan Zarchev ◽

Kylee Trevillion ◽

Roel van Est ◽

...

Keyword(s):

Mental Health ◽

Domestic Violence ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Referral Rates ◽

Randomized Controlled ◽

Cluster Randomized ◽

And Control ◽

Domestic Violence And Abuse

Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care. To estimate the effectiveness of a system provider level training intervention by comparing the detection and referral rates of DVA of intervention community mental health (CMH) teams with rates in control CMH teams. We also aimed to determine whether improvements in knowledge, skills and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams. We conducted a cluster randomized controlled trial in two urban areas of the Netherlands. Detection and referral rates were assessed at baseline and at 6 and 12 months after the start of the intervention. DVA knowledge, skills and attitudes were assessed using a survey at baseline and at 6 and 12 months after start of the intervention. Electronic patient files were used to identify detected and referred cases of DVA. Outcomes were compared between the intervention and control teams using a generalized linear mixed model. During the 12-month follow-up, detection and referral rates did not differ between the intervention and control teams. However, improvements in knowledge, skills and attitude during that follow-up period were greater in intervention teams than in control teams: β 3.21 (95% CI 1.18-4.60). Our trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and attitude towards DVA. However, our intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. A low detection rate of DVA remains a major problem. Interventions with more obligatory elements and a focus on improving communication between CMH teams and DVA services are recommended.

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Mindfulness and Behaviour Therapy for Insomnia: An Assessment of Treatment Effect in a Sleep Disorders Clinic Population with Insomnia

Behaviour Change ◽

10.1017/bec.2020.18 ◽

2020 ◽

pp. 1-15

Author(s):

Allie Peters ◽

John Reece ◽

Hailey Meaklim ◽

Moira Junge ◽

David Cunnington ◽

...

Keyword(s):

Sleep Disorders ◽

Treatment Effect ◽

Sleep Onset ◽

Sleep Efficiency ◽

Health Concern ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Subjective Sleep ◽

Sleep Parameters

Abstract Insomnia is a common major health concern, which causes significant distress and disruption in a person's life. The objective of this paper was to evaluate a 6-week version of Mindfulness-Based Therapy for Insomnia (MBTI) in a sample of people attending a sleep disorders clinic with insomnia, including those with comorbidities. Thirty participants who met the DSM-IV-TR diagnosis of insomnia participated in a 6-week group intervention. Outcome measures were a daily sleep diary and actigraphy during pre-treatment and follow-up, along with subjective sleep outcomes collected at baseline, end-of-treatment, and 3-month follow-up. Trend analyses showed that MBTI was associated with a large decrease in insomnia severity (p < .001), with indications of maintenance of treatment effect. There were significant improvements in objective sleep parameters, including sleep onset latency (p = .005), sleep efficiency (p = .033), and wake after sleep onset (p = .018). Significant improvements in subjective sleep parameters were also observed for sleep efficiency (p = .005) and wake after sleep onset (p < .001). Overall, this study indicated that MBTI can be successfully delivered in a sleep disorders clinic environment, with evidence of treatment effect for both objective and subjective measures of sleep.

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Does transcranial direct current stimulation affect selective visual attention in children with left-sided infantile hemiplegia? A randomized, controlled pilot study

Brain Impairment ◽

10.1017/brimp.2020.20 ◽

2020 ◽

pp. 1-13

Author(s):

Raed A. Alharbi ◽

Saleh A. Aloyuni ◽

Faizan Kashoo ◽

Mohamed I. Waly ◽

Harpreet Singh ◽

...

Keyword(s):

Pilot Study ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Repeated Measures ◽

Sham Group ◽

Time Points ◽

Selective Visual Attention ◽

Subject Factor ◽

And Control

Abstract Objective: Infantile hemiplegia due to brain injury is associated with poor attention span, which critically affects the learning and acquisition of new skills, especially among children with left-sided infantile hemiplegia (LSIH). This study aimed to improve the selective visual attention (SVA) of children with LSIH through transcranial direct current stimulation (tDCS). Methods: A total of 15 children participated in this randomized, double-blinded, pilot study; of them, 10 experienced LSIH, and the remaining 5 were healthy age-matched controls. All the children performed the Computerized Stroop Color-Word Test (CSCWT) at baseline, during the 5th and 10th treatment sessions, and at follow-up. The experimental (n = 5) and control groups (n = 5) received tDCS, while the sham group (n = 5) received placebo tDCS. All three groups received cognitive training on alternate days, for 3 weeks, with the aim to improve SVA. Results: Two-way repeated measures analysis of variance (ANOVA) showed a statistically significant change in the mean scores of CSCWT between time points (baseline, 5th and 10th sessions, and follow-up) within-subject factor, group (experimental, sham) between-subject factor and interaction (time points X group) (p < 0.005). Furthermore, a one-way repeated measures ANOVA showed significant differences between time point (p < 0.005) for the experimental and control group but not the sham group. Conclusion: These pilot results suggest that future research should be conducted with adequate samples to enable conclusions to be drawn.

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