Skin cancer multiplicity in lung transplant recipients: a prospective population-based study.

BACKGROUND: Lung transplant recipients are at high risk of skin cancer, but precise annual incidence rates of treated skin cancers per patient are unknown. OBJECTIVES: To perform a prospective assessment of the total burden of histologically confirmed squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) and associated factors in lung transplant recipients. METHODS: A population-based cohort of 125 Queensland lung transplant recipients aged 18 years and over, recruited between 2013 and 2015, were followed to the end of 2016. All underwent dermatological skin examinations at baseline and annually thereafter and patients self-reported all interim treated skin cancers, which were verified against pathology databases. Standard skin cancer risk factors were obtained via questionnaire, and details of medications were acquired from hospital records. RESULTS: During a median follow-up time of 1·7 years, 29 (23%) and 30 (24%) lung transplant recipients with a median duration of immunosuppression of 3·3 years developed SCC and BCC, respectively. The general population age-standardized incidence rates of SCC and BCC were 201 and 171 per 1000 person-years, respectively (based on first primary SCC or BCC during follow-up); however, on accounting for multiple primary tumours, corresponding incidence rates were 447 and 281 per 1000 person-years. Risk of multiple SCCs increased around sixfold in those aged ≥ 60 years and in those with previous skin cancer, and increased around threefold in those treated with the antifungal medication voriconazole. Multiple BCC risk rose threefold from age 60 years and tenfold for patients with previous skin cancer. CONCLUSIONS: Lung transplant recipients have very high incidence of multiple primary skin cancers. Close surveillance and assiduous prevention measures are essential. Linked Comment: Proby and Harwood. Br J Dermatol 2020; 183:416-417.

Minimally invasive wireless motility capsule to study canine gastrointestinal motility and pH.

The aim of this study was to describe the feasibility of using a gastrointestinal tract wireless motility capsule (WMC) that measured intraluminal pressure, pH and transit time through the gastrointestinal tract, in dogs in their home environment. Forty-four adult healthy dogs, eating a standard diet, were prospectively enrolled. The WMC was well tolerated by all dogs and provided data from the different sections of the gastrointestinal tract. Median gastric emptying time was 20h (range, 6.3-119h), demonstrating a large range. The gastric pressure pattern and pH depended on the phase of food consumption. The small bowel transit time was 3.1h (range, 1.6-5.4h) with average contraction pressures of 6.5mmHg (range, 1.1-21.4mmHg) and pH 7.8 (range, 7-8.9). The large bowel transit time was 21h (range, 1-69h) with average contractions pressures of 0.9mmHg (range, 0.3-2.7mmHg) and pH 6.4 (range, 5.3-8.2). There was considerable individual variation in motility patterns and transit times between dogs. No difference was observed between the sexes. No relationships between any transit time, bowel pH or pressure pattern and bodyweights were identified. The WMC likely represents movement of a large non-digestible particle rather than normal ingesta. Due to its large size, the WMC should not be use in smaller dogs. The WMC is a promising minimally invasive tool to assess GIT solid phase transit times, pressures and pH. However, further studies are necessary due to the current limitations observed.

Purification and Characterization of Two Proteins from Culture Filtrates of Mycobacterium tuberculosis H(37)Ra Strain.

Two proteins have been purified from culture filtrates of Mycobacterium tuberculosis, H(37)Ra strain by a procedure combining gel filtration, diethylaminoethyl (DEAE)-cellulose chromatography, and zone electrophoresis. The two proteins are similar in molecular weight but differ slightly in charge. The faster migrating protein, designated a(1), is not antigenic. The slower migrating protein, designated a(2), is antigenic both with respect to antisera and as a skin-testing antigen.

An ELISA for the serodiagnosis of tuberculosis using a 30,000-Da native antigen of Mycobacterium tuberculosis.

An ELISA was established for the measurement of IgG antibody in human serum to the 30,000-Da native antigen of Mycobacterium tuberculosis and evaluated for its utility in the diagnosis of tuberculosis at the Instituto Nacional de Enfermedades Respiratorias in Mexico City. The test had a sensitivity of 70% in patients with sputum-positive active pulmonary tuberculosis and a specificity in control subjects of 100%. The accuracy of positive prediction was 100% and of negative prediction 93% for patients with pulmonary tuberculosis at this institute. Less favorable test characteristics were obtained for patients with miliary and pleural tuberculosis, in which the test had sensitivities of 22% and 14%. These results offer the promise of an accurate serodiagnostic test for pulmonary tuberculosis using readily obtained reagents.

Microplate and dot immunoassays for the serodiagnosis of tuberculosis.

A simple dot enzyme immunoassay based on the recognition of serum IgG antibody to a 30,000 dalton native antigen purified from culture filtrates of Mycobacterium tuberculosis was developed and compared with a standard plate enzyme-linked immunosorbent assay in the serodiagnosis of tuberculosis. The previously described favorable test characteristics of plate enzyme-linked immunoassay were confirmed; although the dot enzyme immunoassay was promising, it was less satisfactory. Dot enzyme immunoassay may have its most promising use as a screening test for situations of limited technical facilities. Both plate enzyme-linked immunoassay and dot enzyme immunoassay had markedly reduced sensitivities in persons with human immunodeficiency virus infection.

Incidence of bacterial enteropathogens in foods from Mexico.

We examined food consumption patterns of U.S. students temporarily living in Guadalajara, Mexico. Consumption of foods prepared in Mexican homes was associated with an increased risk of acquisition of diarrhea. Foods from commercial sources and private Mexican homes in Guadalajara were subsequently examined for contamination with coliforms, fecal coliforms, and bacterial enteropathogens. For comparison, selected restaurant foods were obtained in Houston, Tex. Food obtained from Mexican homes showed generally higher counts of coliforms and fecal coliforms than those obtained from commercial sources in Mexico and Houston. The foods in Mexico, both from homes and commercial sources, commonly contained Escherichia coli and occasionally enterotoxigenic E. coli. Foods in Houston were not contaminated with E. coli or enterotoxigenic E. coli. Salmonella (17 isolates), Shigella (4 isolates), and Aeromonas hydrophila (1 isolate) were found only in the foods obtained from Mexican homes. Enterotoxigenic non-E. coli Enterobacteriaceae was recovered with approximately equal frequency from all food sources.

Reduced sensitivity of tuberculosis serodiagnosis in patients with AIDS in Uganda.

SETTING: The diagnostic utility of serodiagnosis of tuberculosis in HIV-infected persons was studied in Kampala, Uganda. OBJECTIVE: This study was undertaken to evaluate the utility of a recently described serologic assay for the diagnosis of tuberculosis in HIV-infected patients. DESIGN: The study was undertaken as a cross-sectional survey of 349 subjects, including human immunodeficiency virus-infected and uninfected patients with tuberculosis and control subjects. Serum from each subject was assayed by enzyme-linked immunosorbent assay (ELISA) for IgG antibody to the 30,000 dalton antigen of Mycobacterium tuberculosis. RESULTS: Test sensitivity dropped from 0.62 in non HIV-infected tuberculous patients to 0.28 in HIV-infected patients. CONCLUSIONS: ELISA serodiagnosis of tuberculosis may have a markedly decreased utility in populations where HIV infection is prevalent.