Toxin Type Research Articles

Botulinum Injections for Idiopathic Cervical Dystonia: a Longitudinal Study.

Botulinum toxin (BT) injections into the cervical muscles are an effective and commonly practiced treatment approach for cervical dystonia. In this retrospective longitudinal study, we collected data from the Sheba electronic medical records on consecutive patients with idiopathic cervical dystonia (ICD), treated regularly with periodic BT injections between the years 2008-2020. All treatment visits were analyzed regarding type of toxin, dose injected, and clinical outcomes. The vast majority of patients were treated with abobotulinum toxin A. Sixty-four ICD patients (51 (79.7%) females, onset at age 45.8 ± 13.7years) were treated over 17.1 ± 13.9 (range 3 to 49) visits per patient; BT treatment efficacy increased gradually from initial treatment sessions to visit 13, when it achieved a steady state. While the subjective report of percentage improvement and its duration were around 78.9 ± 17.1% for 2.8 ± 1.0months, respectively, the dose of BT increased significantly over the years (p = 0.006). Side effects (SE) were not rare, and commonly recurred after subsequent sessions and were usually mild and short-lasting, with dysphagia being the most common (~17.5%), followed by neck/arm weakness (11.9%) and cervical pain (8.9%). Repeated injections of BT for ICD remain beneficial for patients over several years of therapy, and despite mild SE, patients tend to adhere to a 3-4months interval schedule.

A preliminary study on changes in heat shock protein 70 levels induced by Fusarium mycotoxins in rats: in vivo study

The heat shock protein (Hsp70) level was assessed after 14 days of oral gavage-exposure to fumonisin B1 (FB1: 150 µg/animal/day), deoxynivalenol (DON: 30 µg/animal/day) and zearalenone (ZEN: 150 µg/animal/day), alone or in combinations (in additive manner: FD = FB1 + DON, FZ = FB1 + ZEN, DZ = DON + ZEN and FDZ = FB1 + DON + ZEN) in the liver, kidneys and lung of 24 adult male Wistar rats (n = 3/group). The liver was the most responsive tissue, as compared with kidney and lung. Except of DZ-treatment, mycotoxins elevated the Hsp70 levels in livers. The highest Hsp70-levels (≈ twofold) were in the DON, FD, FZ and FDZ treatments (additive effects). In the kidney, alterations (↑ ≈ twofold) were detected in ZEN, FD, FZ and DZ treatments. The least responsive organ was the lung (↑ only in FDZ, antagonistic effect). DON and ZEA exposures have altered the reduced glutathione concentration (↓) and glutathione peroxidase activity (↓) in the blood serum. The serum malondialdehyde level increased only after exposure to FD (synergistic effect), as compared with the DZ group (antagonistic effect). When the blood clinical chemistry was assessed, significant alterations were in alanine aminotransferase (80% increase in FDZ, antagonistic effect) and total protein (↓ ZEN). Results varied according to the organ, toxin type and interactions. Furthermore, oxidative stress was not the only key player behind the Hsp70 increase, in which another mechanism is suggested.

Influence of Storage Condition and Period Time on Fungal Contamination and Mycotoxin in Ruminant Feed

Contamination of animal feeds with mycotoxins in livestock farms is a severe matter. This study aimed to evaluate mycotoxigenic fungi, type of toxins, and toxin concentrations and contamination levels of Aflatoxin, Ochratoxin, and T2-toxin in ruminant feed collected from three different sites (a department laboratory, field 1, and field 2) and two periods of time (January and March). Also, four different genera were isolated and diagnosed from the animal feed based on the macroscopic morphology as well as on microscopic characteristics. The genera were Aspergillus spp., Penicillium spp., Fusarium spp., and Rhizopus spp. The result shows significant differences in fungal count among location storages, and among period times, too. Significant differences (P<0.05) also has found for mycotoxin concentration while storage in different locations. Additionally, animal feed collected from different sites and different periods contained lower limits of mycotoxins than the standard limits.

A multicentre analysis of Clostridium difficile in persons with Cystic Fibrosis demonstrates that carriage may be transient and highly variable with respect to strain and level

PurposeClostridium difficile has been reported to occur in the gastrointestinal tract of 50% of Cystic Fibrosis (CF) subjects, however, clinical C. difficile infection (CDI) is a rare occurrence in this cohort despite the presence of toxigenic and hypervirulent ribotypes. Here, we present the first longitudinal, multicentre analysis of C. difficile prevalence among adult CF subjects. MethodologyFaecal samples were collected from adults with CF (selected based on confirmed Pseudomonas aeruginosa pulmonary colonisation) from Ireland, UK and Belgium as part of the CFMATTERS clinical research trial (grant No. 603038) and from non-CF controls. Faecal samples were collected on enrolment, at three monthly intervals, during pulmonary exacerbation and three months post exacerbation. C. difficile was isolated from faecal samples by ethanol shocking followed by culturing on cycloserine cefoxitin egg yolk agar. Isolates were characterised in terms of ribotype, toxin type and antibiotic susceptibility to antibiotics routinely used in the treatment of CDI (metronidazole and vancomycin) and those implicated in induction of CDI (ciprofloxacin and moxifloxacin). ResultsPrevalence of C. difficile among CF subjects in the three sites was similar ranging from 47% to 50% at baseline, while the healthy control cohort had a carriage rate of 7.1%. Including subjects who were positive for C. difficile at any time point there was a higher carriage rate of 71.4%, 66.7% and 63.2% in Ireland, UK, and Belgium, respectively. Ribotyping of 80 isolates from 45 CF persons, over multiple time points revealed 23 distinct ribotypes with two ribotypes (046 and 078) shared by all centres. The proportion of toxigenic isolates varied across the sites, ranging from 66.7% in Ireland to 52.9% in Belgium and 100% in the UK. Antibiotic susceptibility rates to vancomycin, metronidazole, ciprofloxacin and moxifloxacin was 100%, 97.5%, 1.3% and 63.8%, respectively. ConclusionsThis study demonstrates the highest carriage rate of C. difficile to date in a CF cohort. Longitudinal data show that C. difficile can be a transient inhabitant of the CF gut, changing both in terms of strain and excretion rates.

Clinical implications of differential procoagulant toxicity of the palearctic viperid genus Macrovipera, and the relative neutralization efficacy of antivenoms and enzyme inhibitors

Species within the viperid genus Macrovipera are some of the most dangerous snakes in the Eurasian region, injecting copious amounts of potent venom. Despite their medical importance, the pathophysiological actions of their venoms have been neglected. Particularly poorly known are the coagulotoxic effects and thus the underlying mechanisms of lethal coagulopathy. In order to fill this knowledge gap, we ascertained the effects of venom upon human plasma for Macrovipera lebetina cernovi, M. l. lebetina, M. l. obtusa, M. l. turanica, and M. schweizeri using diverse coagulation analysing protocols. All five were extremely potent in their ability to promote clotting but varied in their relative activation of Factor X, being equipotent in this study to the venom of the better studied, and lethal, species Daboia russelii. The Insoserp European viper antivenom was shown to be highly effective against all the Macrovipera venoms, but performed poorly against the D. russelii venom. Reciprocally, while Daboia antivenoms performed well against D. russelii venom, they failed against Macrovipera venom. Thus despite the two genera sharing a venom phenotype (Factor X activation) driven by the same toxin type (P-IIId snake venom metalloproteases), the surface biochemistries of the toxins differed significantly enough to impede antivenom cross- neutralization. The differences in venom biochemistry were reflected in coagulation co-factor dependence. While both genera were absolutely dependent upon calcium for the activation of Factor X, dependence upon phospholipid varied. The Macrovipera venoms had low levels of dependence upon phospholipid while the Daboia venom was three times more dependent upon phospholipid for the activation of Factor X. This suggests that the sites on the molecular surface responsible for phospholipid dependence, are the same differential sites that prevent inter-genera antivenom cross- neutralization. Due to cold-chain requirements, antivenoms may not be stocked in rural settings where the need is at the greatest. Thus we tested the efficacy of enzyme inhibitor Prinomastat as a field-deployable treatment to stabilise patients while being transported to antivenom stocks, and showed that it was extremely effective in blocking the Factor X activating pathophysiological actions. Marimastat however was less effective. These results thus not only shed light on the coagulopathic mechanisms of Macrovipera venoms, but also provide data critical for evidence-based design of snakebite management strategies.

A Global Approach to Estimating the Abundance and Duplication of Polyketide Synthase Domains in Dinoflagellates.

Many dinoflagellate species make toxins in a myriad of different molecular configurations but the underlying chemistry in all cases is presumably via modular synthases, primarily polyketide synthases. In many organisms modular synthases occur as discrete synthetic genes or domains within a gene that act in coordination thus forming a module that produces a particular fragment of a natural product. The modules usually occur in tandem as gene clusters with a syntenic arrangement that is often predictive of the resultant structure. Dinoflagellate genomes however are notoriously complex with individual genes present in many tandem repeats and very few synthetic modules occurring as gene clusters, unlike what has been seen in bacteria and fungi. However, modular synthesis in all organisms requires a free thiol group that acts as a carrier for sequential synthesis called a thiolation domain. We scanned 47 dinoflagellate transcriptomes for 23 modular synthase domain models and compared their abundance among 10 orders of dinoflagellates as well as their co-occurrence with thiolation domains. The total count of domain types was quite large with over thirty-thousand identified, 29 000 of which were in the core dinoflagellates. Although there were no specific trends in domain abundance associated with types of toxins, there were readily observable lineage specific differences. The Gymnodiniales, makers of long polyketide toxins such as brevetoxin and karlotoxin had a high relative abundance of thiolation domains as well as multiple thiolation domains within a single transcript. Orders such as the Gonyaulacales, makers of small polyketides such as spirolides, had fewer thiolation domains but a relative increase in the number of acyl transferases. Unique to the core dinoflagellates, however, were thiolation domains occurring alongside tetratricopeptide repeats that facilitate protein-protein interactions, especially hexa and hepta-repeats, that may explain the scaffolding required for synthetic complexes capable of making large toxins. Clustering analysis for each type of domain was also used to discern possible origins of duplication for the multitude of single domain transcripts. Single domain transcripts frequently clustered with synonymous domains from multi-domain transcripts such as the BurA and ZmaK like genes as well as the multi-ketosynthase genes, sometimes with a large degree of apparent gene duplication, while fatty acid synthesis genes formed distinct clusters. Surprisingly the acyl-transferases and ketoreductases involved in fatty acid synthesis (FabD and FabG, respectively) were found in very large clusters indicating an unprecedented degree of gene duplication for these genes. These results demonstrate a complex evolutionary history of core dinoflagellate modular synthases with domain specific duplications throughout the lineage as well as clues to how large protein complexes can be assembled to synthesize the largest natural products known.

A cluster of Shiga Toxin-producing Escherichia coli O157:H7 highlights raw pet food as an emerging potential source of infection in humans.

In August 2017, a cluster of four persons infected with genetically related strains of Shiga toxin-producing Escherichia coli (STEC) O157:H7 was identified. These strains possessed the Shiga toxin (stx) subtype stx2a, a toxin type known to be associated with severe clinical outcome. One person died after developing haemolytic uraemic syndrome. Interviews with cases revealed that three of the cases had been exposed to dogs fed on a raw meat-based diet (RMBD), specifically tripe. In two cases, the tripe had been purchased from the same supplier. Sampling and microbiological screening of raw pet food was undertaken and indicated the presence of STEC in the products. STEC was isolated from one sample of raw tripe but was different from the strain causing illness in humans. Nevertheless, the detection of STEC in the tripe provided evidence that raw pet food was a potential source of human STEC infection during this outbreak. This adds to the evidence of raw pet food as a risk factor for zoonotic transmission of gastrointestinal pathogens, which is widely accepted for Salmonella, Listeria and Campylobacter spp. Feeding RMBD to companion animals has recently increased in popularity due to the belief that they provide health benefits to animals. Although still rare, an increase in STEC cases reporting exposure to RMBDs was detected in 2017. There has also been an increased frequency of raw pet food incidents in 2017, suggesting an increasing trend in potential risk to humans from raw pet food. Recommendations to reduce the risk of infection included improved awareness of risk and promotion of good hygiene practices among the public when handling raw pet food.

Botulinum Toxin (Type A) as a Minimally Invasive Treatment for Gengival Smile: Case Report

Botulinum Toxin (Type A) as a Minimally Invasive Treatment for Gengival Smile: Case Report

Inductive and synergistic interactions between plant allelochemical flavone and Bt toxin Cry1Ac in Helicoverpa armigera

Genetically engineered crops simultaneously produce defensive allelochemicals and Bacillus thuringiensis (Bt) toxin proteins to kill some of the world's most devastating insect pests. How the two types of toxins, when ingested sequentially or simultaneously, interact at both lethal and sublethal doses in these pests remains underexplored. Here, we examined the toxicological interactions between the Bt toxin Cry1Ac and the flavonoid allelochemical flavone in Helicoverpa armigera. Simultaneous exposure of H. armigera neonates to lethal doses (LC25 ) of Cry1Ac and flavone caused a mortality significantly higher than that of either toxin alone and their expected additive mortality. Preexposure for 24 h to a sublethal dose (LC10 ) of Cry1Ac followed by 6-d simultaneous exposure to the same dose of Cry1Ac plus a lethal dose (1.6 mg/g diets, LC50 ) of flavone resulted in a mortality significantly higher than that of the LC50 dose of flavone alone and the expected additive mortality of the LC50 dose of flavone plus the LC10 dose of Cry1Ac. One-day preexposure to the sublethal dose (LC10 ) of flavone followed by 6-d simultaneous exposure to the LC50 dose (6 ng/cm2 ) of Cry1Ac plus the LC10 dose of flavone yielded a mortality significantly higher than that of the LC50 dose of Cry1Ac but similar to the expected additive mortality of the LC50 dose of Cry1Ac plus the LC10 dose of flavone. The results suggest that Cry1Ac induces and synergizes the toxicity of flavone against H. armigera larvae.

Classification of the mechanism of toxicity as applied to human cell line ECV304

The objective of this study was to identify the pattern of cytotoxicity testing of the human cell line ECV304 using three techniques of an ensemble learning algorithm (bagging, boosting and stacking). The study of cell morphology of ECV304 cell line was conducted using impedimetric measurement. Three types of toxins were applied to the ECV304 cell line namely 1 mM hydrogen peroxide (H2O2), 5% dimethyl sulfoxide and 10 μg Saponin. The measurement was conducted using electrodes and lock-in amplifier to detect impedance changes during cytotoxicity testing within a frequency range 200 and 830 kHz. The results were analysed, processed and extracted using detrended fluctuation analysis to obtain characteristics and features of the cells when exposed to the each of the toxins. Three ensemble algorithms applied showed slightly different results on the performance for classifying the data set from the feature extraction that was performed. However, the results show that the cell reaction to the toxins could be classified.

Prevalence of enterotoxigenic Staphylococcus aureus with characterization of enterotoxins for subsequent detection

In this work 68 S. aureus isolated frommastitic cows (n=48), camel milk (n=5) and human samples (urine n = 4, abscesses aspiration n = 3, sputum n = 2, nasal swabs n = 2, vaginal swabs n = 1 and wound swabs n = 3) were investigated using phenotypic and molecular identification to detect the occurrence of enterotoxins. Eighteen out of 48 S. aureus isolated from mastitic cows and 5 out of 15 S. aureus isolated from human samples were enterotoxin producers. All toxigenic S. aureus isolated from clinical mastitic cows (13) were toxin type D producer while seb and sed were detected from subclinical mastitic cows. Among human isolates, 2 isolates produced mixed toxins A and E, 2 isolates produced mixed toxins C and D and one isolate produced type C toxin. No toxin was detected from camel isolates. All toxigenic S. aureus isolated from cows (13) were toxin type D producer. Among human isolates 2 isolates produced mixed toxins A and E, 2 isolates produced mixed toxins C & D and one isolate produced type C toxin. Five S. aureuscrude enterotoxin type D were investigated by protein SDS-PAGE. It was clear that all isolates had from 9 to 7 bands. All the isolates had a band at 148-159 kDa, 35-42 kDa, 28-30 kDa, 23-26 kDa, 20-22 kDa and 18-19 kDa. 4 isolates had a band at 48-55 kDa, 3 isolates had a band at 39-42 kDa, 3 isolates had a band at 31-34 kDa and one isolate had a band at 17 kDa.

Efficacy of different interventions for the treatment of postherpetic neuralgia: a Bayesian network meta-analysis

ObjectiveWe aimed to perform a network meta-analysis that combined both direct and indirect evidence to compare the relative efficacy of interventional therapies to treat patients with postherpetic neuralgia (PHN) and to determine the treatments’ superiority and validity.MethodA conventional paired meta-analysis was performed. This was followed by a network meta-analysis using the Bayesian framework.ResultsBotulinum toxin type A and pulsed radiofrequency (PRF) were the two most effective individual interventions. For combination therapy, PRF + nerve block (NB) was the best choice, followed by subcutaneous injection or local infiltration (SC) + NB + ozone (O3). However, the combination of PRF + NB + SC showed reduced the efficacy compared with each treatment and was highly invasive for patients. After a long-term follow-up, PRF was shown to be the most effective therapy for treating patients with PHN.ConclusionsRegular anti-neuropathic drug administration that was accompanied by interventional therapies at an early stage is the best choice to treat patients with PHN. Appropriate combinations of different interventions show improved pain relief. Clinicians should manage therapeutic regimens on the basis of the patients specific condition and existing measures and strive to achieve personalized treatment.

High volume on line hemodiafiltration in dialysis pregnant patients: predilutional or postdilutional?

Although the frequency of pregnancy in women on chronic dialysis is extremely low, it is associated with severe maternal and perinatal morbidity and mortality. This situation represents a challenge for the therapeutic team, which requires multidisciplinary management, as well as measures to adequate dialysis treatment. Such efforts include increasing the time and frequency of dialysis session, maintaining low uremia levels and ensuring hemodynamic stability by avoiding intra-treatment arterial hypotension and hydro electrolytic fluctuations. Regarding the dialysis modality, literature makes references to hemodialysis or peritoneal dialysis in pregnancy women, but little is known about the of high volume online hemodiafiltration (HVHDF) as well as the appropriate type of replacement fluid (pre-dilution or post-dilution). We present two cases of patients who were pregnant while being treated with HVHDF modality and had a favorable evolution, where the decision to continue with this dialysis modality was motivated by a best hemodynamic stability and the highest clearance of all types of uremic toxins offered by HVHDF.

Research Article: Organophosphorus pesticides (diazinon, malathion and azinfos methyl) accumulation in three fish species, in south coasts of the Caspian Sea, Iran

In this study the distribution and accumulation of diazinon, malathion and azinfos methyl in mullet Liza aurata,Caspian white fish Rutilus kutum and common carp Cyprinus carpio from five estuaries along the Caspian Sea have been investigated. Also, the effects of pesticides concentrations on the acetylcholinesterase enzyme (AChE) in fish species were studies. Pesticides concentration varied with fish species, sampling station and toxins types. The results indicate that the pesticides concentrations varied from 0.01 to 0.16 mg kg-1 for diazinon, 0.01 to 0.15 mg kg-1 for malathion and 0.05 to 0.36 mg kg-1 for azinfos methyl in three fish species. There was significant difference between different toxins concentrations in fish species, (p diazinon>malathion. There was significant difference in toxins concentrations between three fish species, and the highest toxins concentrations were absorbed in detritivores fish (L. aurata), followed by herbivorous fish (C. carpio) and carnivore fish (R. kutum). The results confirmed that toxins bioaccumulation in fish species is strongly controlled by habitat and feeding habits.

Mass Spectrometry-Based Characterization of New Spirolides from Alexandrium ostenfeldii (Dinophyceae).

Spirolides belong to a group of marine phycotoxins produced by the marine planktonic dinophyte Alexandrium ostenfeldii. Composed of an imine moiety and a spiroketal ring system within a macrocylcle, spirolides are highly diverse with toxin types that vary among different strains. This study aims to characterize the spirolides from clonal A. ostenfeldii strains collected from The Netherlands, Greenland and Norway by mass spectral techniques. The structural characterization of unknown spirolides as inferred from high-resolution mass spectrometry (HR-MS) and collision induced dissociation (CID) spectra revealed the presence of nine novel spirolides that have the pseudo-molecular ions m/z 670 (1), m/z 666 (2), m/z 696 (3), m/z 678 (4), m/z 694 (5), m/z 708 (6), m/z 720 (7), m/z 722 (8) and m/z 738 (9). Of the nine new spirolides proposed in this study, compound 1 was suggested to have a truncated side chain in lieu of the commonly observed butenolide ring in spirolides. Moreover, there is indication that compound 5 might belong to new spirolide subclasses with a trispiroketal ring configuration having a 6:5:6 trispiroketal ring system. On the other hand, the other compounds were proposed as C- and G-type SPX, respectively. Compound 7 is proposed as the first G-type SPX with a 10-hydroxylation as usually observed in C-type SPX. This mass spectrometry-based study thus demonstrates that structural variability of spirolides is larger than previously known and does not only include the presence or absence of certain functional groups but also involves the triketal ring system.

Occurrence of domoic acid and cyclic imines in marine biota from Lebanon-Eastern Mediterranean Sea

Marine biotoxins are naturally existing chemicals produced by toxic algae and can accumulate in marine biota. When consumed with seafood, these phycotoxins can cause human intoxication with symptoms varying from barely-noticed illness to death depending on the type of toxin and its concentration. Recently, the occurrence of marine biotoxins has been given special attention in the Mediterranean as it increased in frequency and severity due to anthropogenic pressures and climate change. Up to our knowledge, no previous study reported the presence of lipophilic toxins (LTs) and cyclic imines (CIs) in marine biota in Lebanon. Hence, this study reports LTs and CIs in marine organisms: one gastropod (Phorcus turbinatus), two bivalves (Spondylus spinosus and Patella rustica complex) and one fish species (Siganus rivulatus), collected from various Lebanese coastal areas. The results show values below the limit of detection (LOD) for okadaic acid, dinophysistoxin-1 and 2, pectenotoxin-1 and 2, yessotoxins, azaspiracids and saxitoxins. The spiny oyster (S. spinosus) showed the highest levels of domoic acid (DA; 3.88 mg kg−1), gymnodimine (GYM-B) and spirolide (SPX) (102.9 and 15.07 μg kg−1, respectively) in congruence with the occurrence of high abundance of Pseudo-nitzchia spp., Gymnodinium spp., and Alexandrium spp. DA levels were below the European Union (EU) regulatory limit, but higher than the Lowest Observed Adverse Effect Level (0.9 μg g−1) for neurotoxicity in humans and lower than the Acute Reference Dose (30 μg kg−1 bw) both set by the European Food Safety Authority (EFSA, 2009). Based on these findings, it is unlikely that a health risk exists due to the exposure to these toxins through seafood consumption in Lebanon. Despite this fact, the chronic toxicity of DA, GYMs and SPXs remains unclear and the effect of the repetitive consumption of contaminated seafood needs to be more investigated.

Determination of C. botulinum presence in pollen samples collected from different regions of Turkey by Real-Time PCR

Beekeeping industry is developing day by day in the world and accordingly, there is an increase in the variety of beekeeping products. One of these products is pollen which is the main source of proteins necessary for bees to complete their growth and development and also an excellent functional food ingredient for humans. In this study, it is aimed to determine the presence of Clostridium botulinum and its toxin types in the pollen samples obtained from seven different regions of Turkey. A total of 200 pollen samples collected from Black Sea Region (n:51), Mediterranean Region (n: 32), Central Anatolia (n: 38), Aegean Region (n: 14), Eastern Anatolia (n: 41), Southeastern Anatolia (n:8) and Marmara Region (n:16) were used as material. The conventional method determined by the Food and Drug Administration was used for isolation. Real Time PCR technique was used for identification and determination of toxin types. As a result, C. botulinum was detected only in one (0.5%) of the analyzed samples (supplied from the Black Sea region) and the toxin type was determined as Type A.

Optimum conditions of killer toxins produced by Torulaspora delbrueckii and Wickerhamomyces anomalus and their action as antifungal agents

BackgroundThis study was conducted to estimate the antifungal activity and efficiency of purified killer toxins (TK and WK) produced by Torulaspora delbrueckii and Wickerhamomyces anomalus as alternative drugs of resistant strains against several pathogenic fungi (Candida albicans, Aspergillus niger, and Aspergillus flavus). A specific focus was on the antifungal activity of such purified proteins by using a simple and economical tools under controlled conditions of fermentations.ResultsThe results showed that the optimum conditions of these experiments were detected at 30 °C, 150 rpm, pH 4.5, 3 days incubation period and by using one culture medium (yeast malt extract broth with 2% SDS). The extracted crude toxin had an excellent effect on Candida albicans, Aspergillus niger, and Aspergillus flavus. The inhibition zone values were 35 and 30 mm for WK and TK, respectively, against Candida albicans. While the lowest values of inhibition zone were recorded at 25 mm for WK and 18 mm for TK against Aspergillus flavus. The WK killer toxins were in general more active against the three clinical strains compared to the TK that had the lowest inhibitory effect.ConclusionThis study is conducted for the first time in Iraq to determine the optimum conditions for producing two types of killer toxins and testing their antifungal activity. The optimal killer activity was obtained at low pH and mesophilic temperature. The two yeast strains had a good role in the reduction of radial growth of tested pathogenic fungi

Novel PCR primers for specific detection of C1, C2 and C3 enterotoxin genes in Staphylococcus aureus

Staphylococcus aureus is the major pathogen that causes clinical infection as well as food poisoning. Enterotoxin produced by Staphylococcus aureus strains are, among others, staphylococcal enterotoxin (SE) A, SEB, SEC, SED, SEE, SEG, SEH, SEI, SEJ, SEK, SEL and SEM. For SEC, there are three major antigentically distinct SEC subtypes, i.e. SEC1, SEC2 and SEC3, in addition to other molecular variants. The nucleotide sequence homology between SEC1, SEC2, and SEC3 genes is higher than 97%; however, we were able to develop a second set of PCR primers that allowed us to differentiate the three SECs, i.e., SEC1, SEC2 and SEC3, S. aureus strains. These PCR primers and their combinations were C12F/C1BR, C12F/C23R and C3BF/C23R, for specific detection of the SEC1, SEC2 and SEC3 genes of S. aureus strains, respectively. Using these primers, we examined 39 SEC S. aureus isolates, which were obtained from foods that were likely the source of food-borne outbreaks between 1995 and 1997 in central Taiwan, and from the patients of the outbreaks. The results were consistent with those obtained from the first set of primers reported earlier, indicating that the present primers could be used for specific detection of these three toxin types.

Efficacy of Botulinum Toxin in Treating Lateral Epicondylitis-Does Injection Location Matter?: A Systematic Review.

Clinical trials assessing the efficacy of botulinum toxin in treating recalcitrant lateral epicondylitis have demonstrated varied results and differed greatly in methodology. The objective of this systematic review was to demonstrate injection location as a significant contributor to outcome heterogeneity. Two reviewers independently conducted a systematic review using Scopus, Embase, and PubMed for randomized controlled trials assessing botulinum toxin in the treatment of lateral epicondylitis. After applying inclusion/exclusion criteria to abstracts and reviewing the full-text articles, seven studies were found representing six separate injection locations. Reduction in visual analog scale pain and change in grip strength were the principal outcomes of interest. The largest reduction in pain was seen in injection at 1/3 of the length of the forearm from the lateral epicondyle at 16-wk follow-up, whereas the smallest reduction was seen at 12-wk follow-up after injection at the 0-cm mark. Differences were also identified in grip strength, although all studies reported return to baseline strength by weeks 12-18. This study demonstrates injection location as a potential source of heterogeneity. This clinical question warrants further evaluation with direct comparison of outcomes at different injection locations while controlling for dosage, toxin type, and ultrasound/electromyographic guidance.