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STUDY OBJECTIVE: The aim of this study was to review the efficacy of different medical modalities for menstrual suppression in the cohort of patients with disabilities who presented to the Queensland Paediatric and Adolescent Gynaecology (PAG) Service between January 2005 and December 2015. Menstrual suppression in adolescents with disabilities is an important aspect of care to support the patient and their carers in managing the complexities of menstrual hygiene, pain, and other discomfort associated with menses. It is important for general practitioners, pediatricians, and gynecologists to establish the right modality of suppression for each individual adolescent. DESIGN, SETTINGS, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: The study was a retrospective case notes review of 68 adolescents who presented to the Queensland PAG Service, Brisbane, Australia with a request for menstrual suppression. The medical interventions included treatment with either combined oral hormonal contraceptive, oral medroxyprogesterone, depot medroxyprogesterone, or the levonorgestrel intrauterine system (Mirena, Bayer). The primary outcome measure was success of menstrual suppression from commencement of medical intervention to achievement of complete amenorrhea or very light bleeding described as spotting, for each medical modality. Secondary outcomes were length of time from first treatment to first observed menstrual suppression, and the number of outpatient appointments taken to achieve menstrual suppression. RESULTS: Of the 68 adolescents, 59/68 (86.8%) successfully achieved menstrual suppression, with 9/68 (13.2%) having ongoing treatment or loss to follow-up at the time of conclusion of the study; 39/68 (57.4%) were menstrually suppressed with their chosen medical modality after their initial appointment. CONCLUSION: Medical modalities are highly effective in achieving menstrual suppression and no young women at this institution required a hysterectomy. Depot medroxyprogesterone was the most successful modality used to achieve menstrual suppression followed by the levonorgestrel intrauterine system. The combined oral hormonal contraceptive was the least successful medical treatment in achieving menstrual suppression.

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AIMS: To analyse the expression of EF-Tu in Lactobacillus strains with response to mucin exposure and its role in interfering with adhesion of enteropathogens to mucin. METHODS AND RESULTS: The Lactobacillus strains were analysed for their ability to adhere to immobilized mucin in microtiter plates. Lactobacillus delbrueckii M and Lactobacillus plantarum CS24.2 showed statistically significant adhesion to mucin, which was similar to Lactobacillus rhamnosus GG, the best binding probiotic strain. Lactobacillus rhamnosus GG, Lact. delbrueckii M, Lact. plantarum CS23 and Lact. plantarum CS24.2 were able to effectively antagonize the adhesion of Escherichia coli and Salmonella enterica serovar Typhi to mucin. In the presence of Lactobacillus adhesin - EF-Tu, the adhesion of Lact. delbrueckii M and the strains of Lact. plantarum to mucin was significantly inhibited. Similarly, EF-Tu also reduced the adhesion of enteropathogens to mucin. Furthermore, the relative fold change in gene expression analysis showed significant up-regulation of EF-Tu gene in the strains of Lact. plantarum and Lact. delbrueckii M when exposed to mucin for 3 h. CONCLUSIONS: The study shows the significant role of EF-Tu in lactobacilli adhesion and enteropathogens inhibition. SIGNIFICANCE AND IMPACT OF THE STUDY: The study suggests EF-Tu as an important factor linked to the Lactobacillus adhesion as well as enteropathogen inhibition. Lactobacillus plantarum CS23 and Lact. plantarum CS24.2 can be used as potential probiotic strains.

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Tolerance is achieved by mechanisms occurring in both the thymus and periphery. Several reports have shown that presence of an antigen in the peripheral circulation results in tolerance induction. These reports imply that absence of a self-antigen can lead to induction of autoimmunity. Here, we show that tyrosinase-related protein 2 (TRP-2) transcript is not detected in the peripheral blood mononuclear cells (PBMC) of vitiligo patients but is detected in healthy controls. Our result indicates that probably due to lack of expression in the PBMC, TRP-2 is not available for induction and maintenance of peripheral tolerance in vitiligo patients. It is also reported by others that co-stimulatory molecules are required for the initiation of autoimmune diseases in experimental models. We therefore analysed the transcript levels of these costimulatory molecules in vitiligo patients and healthy controls. We observed that the transcripts of B7.2 and CD40 molecules are more or less similar in both patients and controls. We could not detect B7.1 in any of the human subjects. Thus, we conclude that the antigen presenting cells (APC) are not in an activated state and that constitutively activated APC are possibly not required for the progression of the disease once it has been initiated.

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Vitiligo is a depigmenting disorder resulting from the loss of melanocytes in the skin and affects 1-4% of the world population. Incidence of vitiligo is found to be 0.5-2.5% in India with a high prevalence of 8.8% in Gujarat and Rajasthan states. The cellular and molecular mechanisms that lead to melanocyte destruction in this disorder are not yet been fully elucidated. Genetic factors, neural factors, toxic ROS metabolites, autoantibodies and autoreactive T lymphocytes may be the causative agents for the selective destruction of melanocytes. Three major hypotheses of pathogenesis of vitiligo are neural, autoimmune and oxidative stress hypotheses, however none of them explains the pathogenesis of vitiligo in toto. Genetics of vitiligo is characterized by incomplete penetrance, multiple susceptibility loci and genetic heterogeneity. Recent advances in this field are linkage and association of candidate gene studies. The linkage and association studies provide a strong evidence for the presence of multiple vitiligo susceptibility genes on different chromosomes. Several candidate genes for vitiligo are identified from different populations. In this review, we have provide an overview of different hypotheses of vitiligo pathogenesis, and discuss the recent advances in this field with special reference to linkage, association and candidate gene approach.

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Fetuses of goats in their last trimester of pregnancy were experimentally infected with Brucella abortus strain RB51, a stable rough mutant deficient in the perosamine O-chain content of its lipopolysaccharide. RB51 maintained its rough phenotype in vivo and did not induce abortion. Infection with RB51 resulted in the production of significant levels of IgG type antibodies specific for B abortus cellular antigens distinct from the perosamine O-chain. These findings suggest that strain RB51 will be useful in the pregnant goat for studying the role of brucella antigens other than the lipopolysaccharide O-chain in the immune response to brucellosis.

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A rifampin-resistant mutant of Brucella abortus, designated RB51, was derived by repeated passage of strain 2308 on Trypticase soy supplemented with 1.5% agar and varying concentrations rifampin or penicillin. The RB51 colonies absorbed crystal violet and RB51 cell suspensions autoagglutinated, indicating a rough type colonial morphology for this strain. No O-chain component was detected in lipopolysaccharide (LPS) extracted from RB51 on SDS-PAGE gels stained with silver. Western blot analysis with the monoclonal antibody BRU 38, which is specific for the perosamine homopolymer O-chain of smooth Brucella LPS, indicated that the LPS of RB51 is highly deficient in O-chain when compared with the parenteral smooth strain 2308 or rough strain 45/20. Biochemically, RB51 resembles parental strain 2308 in its ability to utilize erythritol. Intraperitoneal inoculation of RB51 into mice results in a splenic colonization which is cleared within four weeks post infection. RB51 does not revert to smooth colony morphology upon passage in vivo (mice) or in vitro. Mice infected with RB51 produce antibodies against B. abortus antigens including class 2 and 3 outer membrane proteins but not against the O-chain. Furthermore, rabbits, goats and cattle hyperimmunized with sonicates of RB51 develop antibodies to B. abortus cellular antigens but do not develop antibodies specific for the O-chain. Immunization of mice with 1 x 10(8) viable RB51 organisms confers significant protection against challenge with virulent B. abortus strain 2308.

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A colony blot enzyme-linked immunosorbent assay was developed for the rapid identification of smooth Brucella species, i.e., Brucella abortus, B. melitensis, and B. suis. Bacterial colonies from plates were blotted onto nitrocellulose disks, lysed by immersion in chloroform, and reacted with BRU 38, a rat monoclonal antibody with specificity for the O side chain of B. abortus. Reaction with anti-rat immunoglobulin G conjugated to horseradish peroxidase and development in 4-chloro-1-naphthol resulted in colonies of naturally occurring smooth Brucella species staining purple. Results could be obtained within 4 h after colonies were visible on plates and individual colonies could be detected. Yersinia enterocolitica serovar O:9 strains were the only other organisms tested which showed cross-reaction by using this procedure. Because of its speed, sensitivity, and specificity, this technique should be very useful for identifying smooth Brucella strains in diagnostic laboratories.

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The importance of the cytoskeleton in protein synthesis was studied in differentiating L6 rat myoblasts. Soluble and cytoskeletal fractions obtained after gentle, non-ionic detergent lysis of myoblasts and myotubes were analysed for the presence of ribosomes and mRNPs. Polysomal mRNPs were predominantly associated with the cytoskeletal framework and free mRNPs were present in both soluble and cytoskeletal fractions. An examination of the distribution of specific mRNAs in the polysomal and free mRNP populations of both cytoplasmic fractions revealed differences in the pattern of their distribution. It is further demonstrated that in the L6 rat myoblast system, ribosomes and mRNA (or mRNP) are not associated with the microfilaments, unlike in other systems studied.

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