Acanthamoeba spp. in river water samples from the Black Sea region, Turkey.

The present study aims to investigate the occurrence of free living amoeba (FLA) in water resources (rivers and tap water) in Samsun in the Black Sea. The presence of Acanthamoeba spp. was confirmed in 98 of 192 water samples collected from 32 sites of Samsun province (Samsun centre, Terme, Carsamba, Tekkekoy, Bafra) by PCR. Acanthamoeba spp. were found in 15/36 river samples from Samsun, in 58/90 from Terme, in 12/30 from Carsamba, in 7/18 from Tekkekoy and in 6/18 from Bafra. No Acanthamoeba species were detected in tap water samples. The highest rate in river waters contaminated with Acanthamoeba species was in Terme followed by Samsun centre (41.7%), Carsamba (40%), Tekkekoy (38.9%) and Bafra districts (33.3%), respectively. The result of the subsequent sequence analysis showed Haplotype I (A. triangularis) in 5%, Haplotype II (A. polyphaga) in 29.6%, Haplotype III (Acanthamoeba spp.) in 62% and Haplotype IV (A. lenticulata) in 3%. The most common genotype was Acanthamoeba T4 (Acanthamoeba spp., A. polyphaga, A. triangularis) and T5 genotype was also found in 3%. The T4 genotype is the most common genotype associated with Acanthamoeba keratitis (AK) worldwide; therefore, humans and animals living in the area are at risk after contact with such waters.

Detection of Acanthamoeba spp. in two major water reservoirs in the Philippines.

Water reservoirs are important manmade structures providing water security to deliver clean and safe water for drinking and other purposes to the community. Eighty water samples were collected from Magat and Ipo water reservoirs using purposive sampling between November 2018 and January 2019. Water samples were collected in sterile containers for testing. The samples were cultured in non-nutrient agar and lawned with Escherichia coli and incubated at 33 °C. Twelve out of the 80 (15%) water samples were positive for amoebic growth. Light and scanning electron microscopy (SEM) revealed double-walled cystic stages and were initially identified as Acanthamoeba spp. based on morphological characteristic in reference to Page's established criteria. Their extracted DNAs were used in polymerase chain reaction using JDP1 and JDP2 primers and confirmed the presence of Acanthamoeba DNA in agarose gel electrophoresis. Aligned sequences from PCR products were deposited in GenBank under accession numbers MK886460, MK909919, MK905437, MK910997, MK911021 and MK886514. The presence of potentially pathogenic Acanthamoeba spp. in water reservoirs is considered a potential risk for public health, requiring appropriate processing of water in treatment plants.

Intestinal protozoan and helminthic infections among hemodialysis and cancer patients.

Intestinal parasitic infections (IPIs) can be a severe threat to immunocompromised patients. This is particularly true for those undergoing chemotherapy and hemodialysis. The present research is aimed at identifying intestinal parasites that might be present in immunocompromised patients. In this cross-sectional study 1040 stool samples were collected from March to September 2017. Six hundred and forty-one stool samples from immunocompromised patients (279 samples from hemodialysis patients and 362 samples from chemotherapy patients) and 399 samples from the control group were collected in Guilan province, Iran. The samples were tested by direct, formalin-ether methods for protozoa and ova of intestinal parasites and Ziehl-Neelsen staining methods for coccidian parasites such as Cryptosporidium species. The overall parasitic infection rate was highest (15%) in hemodialysis patients and 11.3% in chemotherapy patients, whereas the lowest rate was observed (7.3%) in the control group. The infectivity rates were statistically significant (P = 0.008) when compared with the control group. The parasites found were Blastocystis hominis (8.9% of the cases), Entamoeba coli (1.6%), Iodamoeba butschlii (0.8%), Endolimax nana (0.6%), Chilomastix mesnili (0.5%), Strongyloides stercoralis (0.5%), and Taenia species (0.15%), whereas Giardia lamblia was detected only in the control group. There was not a correlation between prevalence of parasites with age or education levels of the infected individuals. Results of the present study suggest that periodic stool examinations in special parasitological laboratories should be included as part of routine and general medical care.

Drinking vessel preferences in older nursing home residents: optimal design and potential for increasing fluid intake.

BACKGROUND:: residents in nursing and residential care homes are at risk of dehydration due to both resident and institutional factors. Previous studies have focused on improving fluid intakes by concentrating on types of fluids offered and assisting residents to drink. AIM:: to determine resident opinion of the optimal features of drinking vessels and evaluate the impact of improving vessel design on fluid consumption. METHODS:: residents from two units (25-bed and 21-bed) in one nursing home evaluated a range of drinking vessels. Vessels with preferred features were introduced on a 25-bed unit. The effect was tested by observing residents' fluid consumption during breakfast on three consecutive days and comparing with baseline intakes. FINDINGS:: vessels that received the highest ratings were lightweight, had large handles and held 200-300 ml of fluid. Following the introduction of the new drinking vessels, mean fluid intakes at breakfast increased from 139 ml (±84 ml) to 205 ml (±12 ml, n=65), p=0.003. CONCLUSION:: some drinking vessels used in nursing homes may be difficult for residents to handle. Making improvements to the design of drinking vessels has the potential to increase fluid intakes without increasing staff workload.

Plasma total homocysteine status of vegetarians compared with omnivores: a systematic review and meta-analysis.

There is strong evidence indicating that elevated plasma total homocysteine (tHcy) levels are a major independent biomarker and/or a contributor to chronic conditions, such as CVD. A deficiency of vitamin B12 can elevate homocysteine. Vegetarians are a group of the population who are potentially at greater risk of vitamin B12 deficiency than omnivores. This is the first systematic review and meta-analysis to appraise a range of studies that compared the homocysteine and vitamin B12 levels of vegetarians and omnivores. The search methods employed identified 443 entries, from which, by screening using set inclusion and exclusion criteria, six eligible cohort case studies and eleven cross-sectional studies from 1999 to 2010 were revealed, which compared concentrations of plasma tHcy and serum vitamin B12 of omnivores, lactovegetarians or lacto-ovovegetarians and vegans. Of the identified seventeen studies (3230 participants), only two studies reported that vegan concentrations of plasma tHcy and serum vitamin B12 did not differ from omnivores. The present study confirmed that an inverse relationship exists between plasma tHcy and serum vitamin B12, from which it can be concluded that the usual dietary source of vitamin B12 is animal products and those who choose to omit or restrict these products are destined to become vitamin B12 deficient. At present, the available supplement, which is usually used for fortification of food, is the unreliable cyanocobalamin. A well-designed study is needed to investigate a reliable and suitable supplement to normalise the elevated plasma tHcy of a high majority of vegetarians. This would fill the gaps in the present nutritional scientific knowledge.

Discovering and Mapping Colloquial Terminologies Describing Underutilized and Neglected Food Crops-A Comprehensive Review.

Global levels of biodiversity and dietary diversity are decreasing, leading to food and nutrition insecurity. This is partially due to the homogenization of the global food supply with commodity crops. The reintroduction or introduction of neglected and underutilized species, minor, forgotten, and indigenous crops and landrace varieties to the wider food systems and further diversification have been outlined as the future strategies for tackling the above by the United Nations and the Food and Agriculture Organization in their policy frameworks. Most of the above species/crops are marginalized and only used across local food systems and in research. With over 15,000 different seed banks and repositories worldwide, information transparency and communication are crucial for database searching and their effective utilization. Much confusion persists around the true nature of those plants, and this prohibits the efficient utilization of their economic potential. A linguistic corpus search and a systematic literature review were conducted using the six most popular collocates to the above terms, which were as follows: ancient, heirloom, heritage, traditional, orphan, and the more distinct term 'landrace'. The results were interpreted using the Critical Discourse Analysis method. The definitions' findings show that heirloom, heritage, and ancient are mainly used in the United Kingdom and USA, where they are used to describe 'naturalized' and 'indigenized' or 'indigenous' food crops with a strong affiliation to 'family' and the 'act of passing seeds down from generation to generation'. Orphan crops, on the other hand, are often described as being 'overlooked' by growers and 'underfunded' by researchers. Landrace is most strongly affiliated with 'locality', 'biocultural diversity', and 'indigenous', and with genomics literature, where the characteristics are often discussed in the context of genetics and population biology. Contextualizing, most of the terms were found to be 'arbitrary' and 'undefinable' due to their continuing evolution in the socially accepted form of language, perhaps apart from landrace. The review has retrieved 58 definitions for the mentioned 6 terms, together with the primary key terms creating a tool to facilitate a better inter-sector communication and aid in policy.

A review of the use of bromelain in cardiovascular diseases.

BACKGROUND: In 2004 an estimated 17.1 million people died from cardiovascular diseases (CVDs) worldwide, representing 29% of all global deaths. According to the American Heart Association, heart disease and stroke are the main cause of death and disability among people with type 2 diabetes. Additional safe and effective approaches are needed for the prevention and management of CVDs which may include nutritional supplements. OBJECTIVE: To identify the potential of bromelain (a food supplement) on the risk factors associated with CVDs. SEARCH STRATEGY: An electronic and manual search was conducted during November 2009 to March 2010. The databases searched included: Ovid MEDLINE; All EBM Reviews-Cochrane Database of Systematic Reviews (Cochrane DSR), American College of Physicians (ACP) Journal Club, Database of Abstracts of Reviews of Effects (DARE), Cochrane Central Register of Controlled Trials (CCTR), Cochrane Methodology Register (CMR), Health Technology Assessment (HTA) and National Health Service Economic Evaluation Database (NHSEED); Allied and Complementary Medicine (AMED); British Nursing Index and Archive; EMBASE; Health Management Information Consortium (HMIC); Science Direct and Electronic Thesis Online Services (ETHOS). Only papers in the English language were included. INCLUSION CRITERIA: Randomised controlled trials (RCTs), human studies, animal studies and experimental studies related to bromelain for CVDs. DATA EXTRACTION AND ANALYSIS: The quality assessment of all the selected studies was conducted by the authors. Data from 3 animal trials and 3 human trials were included in the review. Data collected included: type of trial, drug dosage, duration, outcome measures, characteristics of bromelain used, significance of results and conclusion. RESULTS: Out of 223 papers retrieved, 6 papers met the inclusion criteria and could be included in the review. These comprised of 3 animal and 3 human trials, each of which investigated the use of bromelain for CVDs. Results suggested that bromelain could be used for treating acute thrombophlebitis, as it decreases aggregation of blood platelets, has a cardio-protective effect, ameliorates rejection-induced arterial wall remodelling, prevents thrombin-induced human platelet aggregation as well as reduces thrombus formation. CONCLUSION: No substantive study of bromelain and clinical CVDs has been carried out in human populations. Only a few studies on bromelain and CVDs were published from 1948 to 2010. This may be an area worthy to be explored in future CVDs research.

Global prevalence of Cryptosporidium spp. in cats: A systematic review and meta-analysis.

The One-Health approach highlights that the health of human populations is closely connected to the health of animals and their shared environment. Cryptosporidiosis is an opportunistic zoonotic disease considering as global public health concern. Cats are considered as one of potential host for transmitting the Cryptosporidium spp. infection to humans. A random-effects meta-analysis model was used to estimate the overall and the subgroup-pooled prevalence of Cryptosporidium spp. across studies, and the variance between studies (heterogeneity) were quantified by I2 index. Eighty articles (including 92 datasets), from 29 countries met eligibility criteria for analysis. The pooled global prevalence (95% CI) of Cryptosporidium spp. in cats was 6% (4-8%), being highest in Africa 14% (0-91%) and lowest in South and Central America 4% (3-7%) countries. Considering the detection methods, the pooled prevalence was estimated to be 26% (1-67%) using serological detection methods, 6% (3-10%) using coproantigen detection methods, 5% (3-7%) using molecular detection methods, and 4% (3-7%) using microscopic detection methods. The highest prevalence of Cryptosporidium spp. was found in stray cats 10% (5-17%), while pet (domestic) cats 4% (3-7%) had the lowest prevalence. These results emphasize the role of cats as reservoir hosts for human-infecting Cryptosporidium spp. Prevention and control of this zoonosis in cats should receive greater attention by health officials and health policymakers, especially in countries where prevalence are highest.

Waterborne protozoan pathogens in environmental aquatic biofilms: Implications for water quality assessment strategies.

Biofilms containing pathogenic organisms from the water supply are a potential source of protozoan parasite outbreaks and a significant public health concern. The aim of the present study was to demonstrate the simultaneous and multi-spatial occurrence of waterborne protozoan pathogens (WBPP) in substrate-associated biofilms (SAB) and compare it to surface water (SW) and sediments with bottom water (BW) counterparts using manual filtration and elution from low-volume samples. For scenario purposes, simulated environmental biofilm contamination was created from in-situ grown one-month-old SAB (OM-SAB) that were spiked with Cryptosporidium parvum oocysts. Samples were collected from the largest freshwater reservoirs in Luzon, Philippines and a University Lake in Thailand. A total of 69 samples (23 SAB, 23 SW, and 23 BW) were evaluated using traditional staining techniques for Cryptosporidium, and Immunofluorescence staining for the simultaneous detection of Cryptosporidium and Giardia. WBPP were found in 43% SAB, 39% SW, and 39% BW of the samples tested in the present study with SAB results reflecting SW and BW results. Further highlights were demonstrated in the potential of using low-volume samples for the detection of parasites in source water. Scanning electron microscopy of OM-SAB samples revealed a naturally-associated testate amoeba shell, while Cryptosporidium oocysts spiked samples provided a visual profile of what can be expected from naturally contaminated biofilms. This study provides the first evidence for the simultaneous and multi-spatial occurrence of waterborne protozoan pathogens in low-volume aquatic matrices and further warrants SAB testing along with SW and BW matrices for improved water quality assessment strategies (iWQAS).

First report of Cryptosporidium hominis in a freshwater sponge.

Identification of Cryptosporidium oocyst is essential in ensuring water quality fit for human use, consumption, and recreation. This communication proposes the supplemental analysis of substrate-associated biofilms, in particular, freshwater sponges in improving case finding of waterborne-protozoan pathogens (WBPP) in environmental aquatic samples. In this study, a small portion of a mature freshwater sponge under the Genus Spongilla was subjected to microscopic and molecular analysis to identify the presence of Cryptosporidium. Microscopic screening with modified Kinyoun's staining (MK) and microscopic confirmation using direct antibody fluorescent testing (IFT) returned with Cryptosporidium spp. positive findings. Molecular investigation resulted in the confirmation of Cryptosporidium hominis upon sequencing of PCR products and phylogenetic analysis. This is the first report of a pathogenic protozoan, C. hominis isolated from a freshwater sponge. The results of this study provide evidence of the value of expanding water quality assessment strategies to the analysis of substrate-associated biofilms and sponges in improving case finding of WBPP in natural aquatic environments.

Improving hydration of care home residents by increasing choice and opportunity to drink: A quality improvement study.

BACKGROUND & AIMS: Dehydration is recognised as an important problem among care home residents and can be associated with severe consequences. Insufficient provision of fluids to meet resident preferences and lack of assistance to drink have been identified as key factors driving under-hydration of care home residents. Using targeted interventions, this study aimed to optimise hydration care for frail older people in a care home setting. METHODS: The study used quality improvement methods to develop and test interventions to extend drinking opportunities and choice in two care homes. Changes were made and evaluated using Plan-Do-Study-Act (PDSA) cycles. Data were captured on the amount of fluids served and consumed, and staff and resident feedback. The long-term impact of the interventions was assessed by measuring daily laxative and antibiotic consumption, weekly incidence of adverse health events, and average fluid intake of a random sample of six residents captured monthly. RESULTS: The interventions were associated with an increase in the amount and range of fluids consumed, in one home mean fluid intakes exceeded 1500 ml for three consecutive months. Laxative use decreased significantly in both homes. A number of practical and organisational barriers affected the sustainability of interventions. CONCLUSIONS: Interventions to optimise the hydration of care home residents can be effective. Plan-Do-Study-Act cycles provide an effective methodology to implement new interventions into existing practice in care homes. Sustainable change requires strong leadership, organisational support and teamwork.

I-Hydrate training intervention for staff working in a care home setting: An observational study.

BACKGROUND: Dehydration is a complex and well-recognised problem for older people residing in care homes. Within the social care sector support staff provide the majority of direct care for residents, and yet receive minimal training. OBJECTIVES: To design, deliver and evaluate a hydration specific training session for care home staff to develop their knowledge and skills in supporting the hydration of care home residents. DESIGN: An observational study comprising a pre-test post-test survey of staff knowledge following a training intervention. PARTICIPANTS AND SETTINGS: Training of care home staff took place in two care homes in North West London. METHODS: An interactive training session was developed and delivered, with content informed by observations of hydration care within the two homes and evaluated using CIRO model. Participant self-evaluation forms were used to collect data after the session regarding satisfaction and usefulness of the session, and pre and post levels of self-reported knowledge across six facets of hydration care. Training facilitators captured qualitative data in the form of field notes. Observations of hydration care explored the impact of training on practice. RESULTS: Eighteen training sessions were delivered. A total of 161 participant evaluation forms were returned. There was a significant increase in self-reported knowledge across all six facets of hydration care (p = 0.000). The majority of participants found the training enjoyable and useful, and expressed an expected change in their practice. Participants enjoyed the interactive components of the training. A lack of reflective practice skills meant participants were unable to reflect realistically about the hydration care provided in the home. CONCLUSION: Focused training on hydration in the care home environment benefits from being interactive and experiential. Although such training can be effective in increasing staff knowledge, inclusion of skills in reflective practice is required if this knowledge is to be translated into practice.

Effects of endogenous flour lipids on the quality of semisweet biscuits.

Fractionation and reconstitution techniques were used to study the contribution of endogenous flour lipids to the quality of semisweet (Rich Tea-type) biscuits. Biscuit flour was defatted with chloroform and baked with bakery fat but without endogenous lipid addition. Semisweet biscuits baked from defatted flour were flatter, denser, and harder and showed collapse of gas cells during baking when compared with control biscuits. Defatted flour semisweet doughs exhibited a different rheological behavior from the control samples showing higher storage and loss moduli (G' and G' ' values), that is, high viscoelasticity. Functionality was restored when total nonstarch flour lipids were added back to defatted flour. Both the polar and nonpolar lipid fractions had positive effects in restoring flour quality, but the polar lipid fraction was of greatest benefit. Both fractions were needed for complete restoration of both biscuit quality and dough rheological characteristics.

The use of complementary and alternative medicine by individuals with features of metabolic syndrome.

OBJECTIVE: To compare the use of complementary and alternative medicine (CAM), including dietary supplements, by individuals with and without features of metabolic syndrome (FeMS). METHODS: Using a cross sectional study design, information was obtained by self-administered questionnaires from 300 university individuals. FeMS was defined as any individuals self-reporting at least one of the clinical diagnoses of diabetes, hypertension, hyperlipidemia, or obesity. Finally, two categories were created for cross tabulation, and individuals with and without FeMS were compared. RESULTS: Of the 192 individuals completing the study, 39% (n=76) were currently using or had used CAM therapies in the past 12 months. Individuals with FeMS (n=54, 28%) were more likely (P<0.05) to use different types of CAM therapies, in particular dietary and herbal supplements, aromatherapy and massage therapy compared to individuals without FeMS (n=138, 72%). CONCLUSION: Individuals with FeMS were more likely to use CAM, particularly supplements. Doctors need to properly inquire about and understand their patients' supplement use, especially if CAM therapies are used in conjunction with conventional medications.

Effect of short-term administration of cinnamon on blood pressure in patients with prediabetes and type 2 diabetes.

OBJECTIVE: The aim of this study was to systematically review and evaluate the effect of short-term administration of cinnamon on blood pressure regulation in patients with prediabetes and type 2 diabetes by performing a meta-analysis of randomized, placebo-controlled clinical trials. METHODS: Medical literature for randomized controlled trials (RCTs) of the effect of cinnamon on blood pressure was systematically searched; three original articles published between January 2000 and September 2012 were identified from the MEDLINE database and a hand search of the reference lists of the articles obtained through MEDLINE. The search terms included cinnamon or blood pressure or systolic blood pressure (SBP) or diastolic blood pressure (DBP) or diabetes. A random effects model was used to calculate weighted mean difference and 95% confidence intervals (CI). RESULTS: The pooled estimate of the effect of cinnamon intake on SBP and DBP demonstrated that the use of cinnamon significantly decreased SBP and DBP by 5.39 mm Hg (95% CI, -6.89 to -3.89) and 2.6 mm Hg (95% CI, -4.53 to -0.66) respectively. CONCLUSION: Consumption of cinnamon (short term) is associated with a notable reduction in SBP and DBP. Although cinnamon shows hopeful effects on BP-lowering potential, it would be premature to recommend cinnamon for BP control because of the limited number of studies available. Thus, undoubtedly a long-term, adequately powered RCT involving a larger number of patients is needed to appraise the clinical potential of cinnamon on BP control among patients with type 2 diabetes mellitus.

Cinnamon in glycaemic control: Systematic review and meta analysis.

BACKGROUND & AIMS: Cinnamon seems to be highly bioactive, appearing to mimic the effect of insulin through increased glucose uptake in adipocytes and skeletal muscles. This systematic review and Meta analysis examined the effect of cinnamon on glycaemic control in patients with Type 2 Diabetes mellitus. METHODS: A systematic literature search was conducted from the earliest possible date through to 01 August 2011. Search terms included free text terms, MeSH and Medline medical index terms such as: "cinnamon", "cinnamomum", "cinnamomum cassia", "cinnamomum zeylanicum", "type 2 diabetes mellitus". Each was crossed with the term "diabetes mellitus". In addition, references of key articles were hand searched. RESULTS: A total of 6 clinical trials met the strict inclusion criteria and considered a total of 435 patients; follow up between 40 days-4 months, doses ranging from 1 g to 6 g per day. Meta-analysis of RCTs showed a significant decrease in mean HbA1c [0.09%; 95% CI was 0.04-0.14] and mean FPG [0.84 mmol/l; 95% CI was 0.66-1.02]. CONCLUSIONS: Use of cinnamon showed a beneficial effect on glycaemic control (both HbA1c and FPG) and the short term (<4 months) effects of the use of cinnamon on glycaemic control looks promising.