Recurrent or refractory Clostridium difficile infection (CDI) has become an increasing problem in the past decade. Fecal microbiota transplant (FMT) is a highly efficacious treatment for recurrent CDI; however, a number of technical, logistical, and regulatory issues have hampered the development of an FMT capability at many hospitals. The development of a frozen stool bank of screened donor stool is an important step in the standardization of the procedure. This gives clinicians rapid access to thoroughly screened donor stool when needed, without the ethical and logistical problems associated with patient-selected donors. We describe the practicalities of establishing such a service using a stool bank of prescreened donor stool including detail regarding donor recruitment and screening, stool preparation, and delivery of the FMT.
Objective. To document the histology of Ross River virus (RRV) arthritis and to examine inflamed synovium for viral RNA. Methods. Biopsy tissue from the inflamed knees of 12 patients with RRV infection was studied using conventional and immunostaining techniques. Reverse transcriptase-polymerase chain reaction technology was used to probe for the presence of viral RNA in the synovial biopsy samples and in serum. Results. Hyperplasia of the synovial lining layer, vascular proliferation, and mononuclear cell infiltration were the main histologic changes. RRV RNA was found in knee biopsy tissue that was obtained from 2 patients at 5 weeks after the onset of symptoms. Conclusion. RRV RNA was identified in inflamed synovium more than a month after symptoms began. Inflammation was apparent in the absence of detectable virus in the majority of patients.
The ability of Helicobacter pylori to activate neutrophils is associated with peptic ulcer disease (PUD). One of the H. pylori factors previously suggested to stimulate neutrophil activation is the H. pylori neutrophil-activating protein (HpNAP). The primary aims of this study were to investigate the relationships between H. pylori neutrophil activation and reported variations in HpNAP expression and the napA gene sequence. The association between neutrophil activation and vacuolating cytotoxin activity was also investigated. The ability to activate neutrophils was found here to be associated with the development of PUD and was a characteristic more frequently identified in H. pylori isolates with vacuolating cytotoxin activity. However, no relationship was found between neutrophil activation and the expression of HpNAP or differences in the napA sequence. In conclusion, the ability to activate neutrophils contributes to the ulcerative potential of individual H. pylori isolates, but this activity is not mediated by differences in HpNAP.
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