While sensitive laboratory tests such as culture and those based on genetic probes or antigen detection are available, many laboratories still use a relatively insensitive microscopic examination of an unstained wet preparation to diagnosis this infection. Cultured
T vaginalis expresses chitin on its cell surface that fluoresces when stained with calcofluor white (CFW). This MI-503 study investigated whether CFW improves the sensitivity of microscopic detection of trichomonads.
Methods: Uvitex 2B and 7 different commercial preparations of CFW were tested with 23 urine and 20 vaginal specimens positive by microscopy for trichomonads. In addition to adding the fluorescence brighteners (FBs) to wet preparations, air-dried smears were stained with
the FBs using a variety of fixation methods, FB concentrations, and staining duration. Ten recently isolated strains of T vaginalis in cultures were also examined.
Results: In 40 clinical specimens, no fluorescence was seen with any Selleckchem PD98059 of the FB staining procedures used, either in wet preparations or smears; 3 vaginal specimens produced only minimal fluorescence. Some of the cultured trichomonads produced fluorescence, depending upon the age of the culture and fixation method.
Conclusion: For laboratories using microscopy to detect T vaginalis in vaginal smears and urine specimens, FBs do not appear to improve sensitivity compared with unstained wet preparations.”
“Purpose of review
Intestinal R406 purchase transplantation is a treatment for patients with short bowel syndrome and associated severe complications. The intestine
has long been seen as a ‘forbidden’ organ to transplant. This fact is because the first attempts at intestinal transplantation were rapidly defeated by rejection and sepsis.
Recent findings
Several factors have contributed to improve the results: tacrolimus-based immunosuppression, induction therapy (independent of the type), introduction of ganciclovir and rituximab and subsequent better control of cytomegalovirus and posttransplant lymphoma, better differential diagnosis between rejection versus infection and ischemia (avoiding unnecessary overimmunosuppression), better patient follow-up. Center experience is more important than a particular immunosuppressive protocol. M-TOR inhibitors, infliximab have been used. Mycophenolate mofetil is less frequently used because of its potential gastrointestinal toxicity. Of note, no significant improvement in short-term and long-term (> 1 year) survival was observed since 2000 and 1985, respectively.
Summary
Intestinal transplantation remains a formidable clinical/immunological challenge. With newer immunosuppression and accumulated experience, intestinal transplantation results have improved and the procedure represents a life-saving option in patients with short bowel syndrome-related complications.