Outbreak of Ichthyophthirius multifiliis associated with Aeromonas hydrophila in Pangasianodon hypophthalmus: The role of turmeric oil in enhancing immunity and inducing resistance against co-infection.

Ichthyophthirius multifiliis, a ciliated parasite causing ichthyophthiriasis (white spot disease) in freshwater fishes, results in significant economic loss to the aquaculture sector. One of the important predisposing factors for ichthyophthiriasis is low water temperature (i.e., below 20°C), which affects the health and makes freshwater fishes more susceptible to parasitic infections. During ichthyophthiriasis, fishes are stressed and acute immune reactions are compromised, which enables the aquatic bacterial pathogens to simultaneously infect the host and increase the severity of disease. In the present work, we aimed to understand the parasite-bacteria co-infection mechanism in fish. Later, Curcuma longa (turmeric) essential oil was used as a promising management strategy to improve immunity and control co-infections in fish. A natural outbreak of I. multifiliis was reported (validated by 16S rRNA PCR and sequencing method) in Pangasianodon hypophthalmus from a culture facility of ICAR-CIFRI, India. The fish showed clinical signs including hemorrhage, ulcer, discoloration, and redness in the body surface. Further microbiological analysis revealed that Aeromonas hydrophila was associated (validated by 16S rRNA PCR and sequencing method) with the infection and mortality of P. hypophthalmus, confirmed by hemolysin and survival assay. This created a scenario of co-infections, where both infectious agents are active together, causing ichthyophthiriasis and motile Aeromonas septicemia (MAS) in P. hypophthalmus. Interestingly, turmeric oil supplementation induced protective immunity in P. hypophthalmus against the co-infection condition. The study showed that P. hypophthalmus fingerlings supplemented with turmeric oil, at an optimum concentration (10 ppm), exhibited significantly increased survival against co-infection. The optimum concentration induced anti-stress and antioxidative response in fingerlings, marked by a significant decrease in cortisol and elevated levels of superoxide dismutase (SOD) and catalase (CAT) in treated animals as compared with the controls. Furthermore, the study indicated that supplementation of turmeric oil increases both non-specific and specific immune response, and significantly higher values of immune genes (interleukin-1ß, transferrin, and C3), HSP70, HSP90, and IgM were observed in P. hypophthalmus treatment groups. Our findings suggest that C. longa (turmeric) oil modulates stress, antioxidant, and immunological responses, probably contributing to enhanced protection in P. hypophthalmus. Hence, the application of turmeric oil treatment in aquaculture might become a management strategy to control co-infections in fishes. However, this hypothesis needs further validation.

Use of systemic corticosteroids for atopic dermatitis: International Eczema Council consensus statement.

BACKGROUND: Guidelines discourage the use of systemic corticosteroids for atopic dermatitis (AD), but their use remains widespread. OBJECTIVES: To reach consensus among an international group of AD experts on the use of systemic corticosteroids for AD. METHODS: A survey consisting of statements accompanied by visual analogue scales ranging from 'strongly disagree' to 'neutral' to 'strongly agree' was distributed to the International Eczema Council (IEC). Consensus was reached in agreement on a statement if < 30% of respondents marked to the left of 'neutral' towards 'strongly disagree'. RESULTS: Sixty of 77 (78%) IEC members participated. Consensus was reached on 12 statements, including that systemic corticosteroids should generally be avoided but can be used rarely for severe AD under certain circumstances, including a lack of other treatment options, as a bridge to other systemic therapies or phototherapy, during acute flares in need of immediate relief, in anticipation of a major life event or in the most severe cases. If used, treatment should be limited to the short term. Most respondents agreed that systemic corticosteroids should never be used in children, but consensus was not reached on that statement. The conclusions of our expert group are limited by a dearth of high-quality published evidence. If more stringent consensus criteria were applied (e.g. requiring < 20% of respondents marking towards 'strongly disagree'), consensus would have been reached on fewer statements. CONCLUSIONS: Based on expert opinion from the IEC, routine use of systemic corticosteroids for AD is generally discouraged and should be reserved for special circumstances.

Significant differences among physician specialties in management recommendations of BRCA1 mutation carriers.

The National Comprehensive Cancer Network (NCCN) has published guidelines for hereditary breast and ovarian cancer syndrome (HBOCS) management. Little data exist on compliance with these guidelines among different physician specialties. We performed an on-line case-based survey by randomly sampling physicians from five specialties, Family Medicine (FM), Obstetrics and Gynecology (OG), General Surgery (GS), Internal Medicine (IM), and Hematology and Oncology (HO). The physicians (n = 225) were asked to provide HBOCS management of healthy women ages 40-42 in the presence of a familial BRCA1 mutation. For women negative for the BRCA1 mutation, 59% of the physicians recommended appropriate surveillance although with significant differences among specialties; P = 0.01. Using an aggregate screening intensity score, physicians clearly recommended more intense screening for mutation positive than negative women (P < 0.0001), but only 16% of physicians followed NCCN guidelines for BRCA1-positive women. Seventy-six percent of all physicians recommended breast MRI with significant variation among specialties ranging from 62% of FM to 89% of OG (P = 0.0020). Similarly, 63% of physicians recommended prophylactic oophorectomy, with 76 and 78% of GS and OG compared to 38% of IM (P < 0.0001) and 57% recommended prophylactic mastectomy ranging from 84% of HO to 32% of FM (P < 0.0001). Independent of specialty, respondents with BRCA testing experience recommended more intense management than those without; P = 0.021. Management recommendations of BRCA1 mutation carriers are not consistent with NCCN guidelines and vary by medical specialty and genetic testing experience. Targeted education of physicians by specialty is needed, so that optimal management is offered to these high-risk women.

Exploring the relationship between physiological measures of cochlear and brainstem function.

OBJECTIVE: Otoacoustic emissions and the speech-evoked auditory brainstem response are objective indices of peripheral auditory physiology that are used clinically for assessing hearing function. While each measure has been extensively explored, their interdependence and the relationships between them remain relatively unexplored. METHODS: Distortion product otoacoustic emissions (DPOAEs) and speech-evoked auditory brainstem responses (sABRs) were recorded from 28 normal-hearing adults. Through correlational analyses, DPOAE characteristics were compared to measures of sABR timing and frequency encoding. Data were organized into two DPOAE (Strength and Structure) and five brainstem (Onset, Spectrotemporal, Harmonics, Envelope Boundary, and Pitch) composite measures. RESULTS: DPOAE Strength shows significant relationships with sABR Spectrotemporal and Harmonics measures. DPOAE Structure shows significant relationships with sABR Envelope Boundary. Neither DPOAE Strength nor Structure is related to sABR Pitch. CONCLUSIONS: The results of the present study show that certain aspects of the speech-evoked auditory brainstem responses are related to, or covary with, cochlear function as measured by distortion product otoacoustic emissions. SIGNIFICANCE: These results form a foundation for future work in clinical populations. Analyzing cochlear and brainstem function in parallel in different clinical populations will provide a more sensitive clinical battery for identifying the locus of different disorders (e.g., language based learning impairments, hearing impairment).

Progress in chip-scale photonic sensing.

Chip-scale integrated planar photonic sensing systems for portable diagnostics and monitoring are emerging, as photonic components are integrated into systems with silicon (Si), Si complementary metal-oxide semiconductor, and fluidics. This paper reviews progress in these areas. Medical and environmental applications, candidate photonic sensors, integration methodologies, integrated subsystem demonstrations, and challenges facing this emerging field are discussed in this paper.

Comparison of performance across three directional hearing aids.

This study compared the speech recognition performance of 12 hearing-impaired listeners fit with three commercially available behind-the-ear hearing aids in both directional and omnidirectional modes. One digitally programmable analog and two "true digital" hearing aids were selected as test instruments. Testing was completed in both "living room" and anechoic room environments. Speech recognition was examined using modified forms of the Hearing in Noise Test and the Nonsense Syllable Test. The single competing stimuli of these tests were replaced with five uncorrelated competing sources. Results revealed a significant speech recognition in noise advantage for all directional hearing aids in comparison to their omnidirectional counterparts. Maximum performance of the directional hearing aids did not significantly vary across circuit type, suggesting that processing differences did not affect maximum directional hearing aid performance. In addition, the results suggest that performance in one reverberant environment cannot be used to accurately predict performance in an environment with differing reverberation.

Effect of a new herbo-mineral hypolipidemic agent on plasma lipoprotein pattern in rat atherosclerosis.

Hyperlipidemia was induced in rats by feeding an atherogenic diet for 5 months. The effect of administration of an indigenous hypolipidemic agent, Anna Kaara Raaja Sindhooram (AKRS) on the plasma lipoprotein profile was studied in the presence and absence of dietary lipid stimuli. Hyperlipidemia produced an enormous increase in the cholesterol and triglyceride contents of the low density (LDL) and very low density (VLDL) lipoprotein fractions and reduced the level of the putative non-atherogenic high density cholesterol (HDL-C). The agarose gel electrophoretic pattern showed a decrease in alpha-lipoproteins and an increase in beta-lipoproteins in the hyperlipidemic rats. AKRS treatment for 5 months altered the lipoprotein pattern favourably by raising HDL-C and lowering LDL-C in the treated rats.

Toxicity studies with potassium embelate, a new analgesic compound.

Potassium embelate, 2,5-dihydroxy, 3-undecyl-1, 4-benzoquinone, from Embelia ribes Burm. was subjected to toxicity evaluation which included subacute, chronic, reproductive toxicity testing and teratological investigations in laboratory animals (mice, rats and monkeys). The results did not indicate adverse effects suggesting that potassium embelate is a safe compound.

Molecular characteristics of soluble arthritic collagens.

The molecular characteristics of acid-soluble collagen prepared from animals rendered adjuvant arthritis and matched controls have been thoroughly investigated. The arthritic process was induced in rats by the injection of paraffin oil containing the suspension of heat-killed Mycobacterium tuberculosis at the dorsum of the tail root. In comparison to the normal, the arthritic collagens consistently demonstrated increased solubility of reconstituted fibrils and marked decrease in intrinsic viscosity. Digestion of arthritic collagens with various proteolytic enzymes showed an increased susceptibility over normal collagens. Electrophoresis on SDS-polyacrylamide gels revealed a marked decrease in the concentration of beta-components of arthritic collagens and appreciable increase in the ratio of alpha to beta subunit component. The data clearly indicate that the arthritic collagens are very poor in polymerization due to the impairment of intra and inter-molecular interactions. These changes could explain in part, the altered response of the connective tissues to inflammation and arthritis.

Studies on the metabolism of glycosaminoglycans under the influence of new herbal anti-inflammatory agents.

The in vivo effect of an herbal based, non-steroidal anti-inflammatory product, salai guggal, prepared from the gum resin exudate of Boswellia serrata and its active principle "boswellic acids" on glycosaminoglycan metabolism has been studied in male albino rats. The biosynthesis of sulfated glycosaminoglycans, as evaluated by the uptake of [35S]sulfate, and the content of glycosaminoglycans were measured in specimens of skin, liver, kidney and spleen. Statistical analysis of the data obtained with respect to the boswellic acids and salai guggal were compared with those of ketoprofen. A significant reduction in glycosaminoglycan biosynthesis was observed in rats treated with all of the drugs. Glycosaminoglycan content was found to be decreased in the ketoprofen-treated group, whereas that of the boswellic acids or salai guggal treated groups remained unaltered. The catabolism of glycosaminoglycans was followed by estimating the activities of lysosomal glycohydrolases, namely beta-glucuronidase, beta-N-acetylglucosaminidase, cathepsin B1, cathepsin B2 and cathepsin D, in tissues and by estimating the urinary excretion and hexosamine and uronic acid. The degradation of glycosaminoglycans was found to be reduced markedly in all drug-treated animals as compared to controls. The potential significance of boswellic acids and salai guggal was discussed in the light of changes in the metabolism of glycosaminoglycans.

Metabolism of collagen in bone of adjuvant induced arthritic rat.

The metabolism of collagen was examined in bones of rats rendered adjuvant arthritis and matched controls using radioactive isotopic tracer techniques. The rate of the synthesis was studied after the incorporation of tritiated labeled proline into the total bone collagen and determining the content of total hydroxyproline and estimating the specific and total activities of radioactive labeled hydroxyproline. The rate of the catabolism was examined by measuring the activities of various collagen degrading proteolytic enzymes in the bone extract and by estimating the total content of hydroxyproline excreted in the urine. The degradation of collagen was also followed by measuring the specific and total radioactivities of (3H)-hydroxyproline in the urine. When (3H)-proline was injected into the adjuvant arthritic rat, the specific and total radioactivities of (3H)-hydroxyproline in bone collagen were reduced significantly in diseased bone. The activities of various enzymes involved in the catabolism of collagen and other extracellular matrix components were appreciably elevated (about 2-3 fold) in the bone extract of arthritic rat. Similarly, the specific and total activities of (3H)-hydroxyproline in urine samples were also greatly increased in arthritic rats. In addition, the decreased content of hydroxyproline in total bone collagen was accompanied by the increased excretion of urinary hydroxyproline in adjuvant arthritic rats. The results clearly suggest that the arthritic disease induces the qualitative and quantitative changes in bone composition and causes the alteration in the metabolism of collagen in diseased tissue. These observations could therefore, explain in part, the altered response of connective tissue of bone to inflammation and arthritis.

Studies on carbohydrate moieties of glycoproteins in established adjuvant induced arthritis.

The investigation presents the metabolic changes in the carbohydrate components of glycoproteins in several tissues of adjuvant arthritic rats. The experimental arthritis induces a significant modification of total carbohydrate moieties of glycoproteins in arthritic tissues. In both acute and chronic phases of the disease, the adjuvant arthritis caused a significant increase in the levels of carbohydrate moieties of tissue glycoproteins viz. total hexose, hexosamine, fucose, sialic acid, total neutral sugar content and neutral sugar monosaccharides. In addition, the urinary excretions of hexosamine and uronic acid in arthritic rats were found to be elevated significantly. The data from the investigation clearly indicate that the experimental arthritis induces an increased glycoprotein synthesis in most of the tissues examined.

Studies on the physico-chemical properties of alhagain.

The protease isolated jawasee shrub was found to hydrolyze egg albumin, casein, haemoglobin and gelatin optimally near neutral pH. Fibrin, bovin serum albumin, skin albumin and skin mucoids were hydrolyzed at slightly alkaline pH, while skin globulins were hydrolyzed at slightly acidic pH. The enzyme had no effect of fibrous collagen. The optimum conditions for the hydrolysis of 50 mg of egg albumin were found to be 50 mg of alhagain at pH 6.0 and 45 degrees C for 30 minutes. A Km value of 4.4 X 10(-3) M was obtained from the Lineweaver-Burk plot for the hydrolysis of egg albumin. The enzyme was found to be comparatively thermostable and was most stable at pH 4.7. Ultraviolet irradiation exhibited no appreciable effect on the enzyme activity. The ultraviolet absorption spectrum of alhagain in bi-distilled water resembles those of bromelain and trypsin. The sugar-containing enzyme was found to have a molecular weight of 20,650. The enzymeconsists of 189 amino acid residues per molecule, neutral and acidic amino acids being present in high concentrations. The partial specific volume of alhagain was calculated to be 0.743 ml/g from its amino acid composition. Phenylalnine and arginine formed the amino terminal amino acids of alhagain, while aspartic acid and serine were identified as its carboxy terminal amino acids. Results are discussed with relation to other plant proteases.