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Copyright of African Journal of Clinical & Experimental Microbiology is the property of African Journals Online (AJOL) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective The National Institutes of Health Toolbox-Cognition Battery (NIHTB-CB) is an efficient computerized neuropsychological battery. This study investigated its psychometric properties in terms of sociodemographic characteristics and technology use in adults aged 57–87 (with an average age of 70). Methods Community-based participatory research procedures were used to enhance enrollment of adults with lower education and income backgrounds. Study procedures replicated work that compared the NIHTB-CB Crystallized and Fluid composites to analogous gold-standard (GS) measures and extended it by investigation of socioeconomic status and technology use-related differences in performance. Results The high correlations among the NIHTB-CB and GS analogous Crystallized and Fluid composites suggested good convergent validity. There was no evidence of significant education- or economic-related group differences in these associations. However, caution is needed as Cronbach's alpha that indicated the NIHTB-CB Fluid composite had questionable internal item consistency. The NIHTB-CB and GS measures demonstrated poor discriminant validity in the high school but not college-educated groups. Regression analyses found that comfort with technology use, income, education, and age predicted better cognitive test performance on the computerized and paper-pencil measures. Conclusions There is an urgent need to improve the understanding of socioeconomic disparities influence on test scores and brain health. Lack of discriminant validity in the cognitive tests indicates that these measures could result in diagnostic errors within noncollege-educated older adults. These findings reduce confidence in the use of the NIHTB-CB Fluid composite in older adults and support that there is a significant socioeconomic-related digital divide in comfort with technology use. [ABSTRACT FROM AUTHOR]

Aims Echinocandins are recommended for the treatment of candidaemia in moderately severe to severely ill patients. Step-down or de-escalation from echinocandin to fluconazole is advised in patients who are clinically stable but data in relation to step-down therapy are sparse. Using our hospital intravenous to oral switch therapy ( IVOST) policy to guide antifungal de-escalation in patients with candidaemia, we aimed to determine what proportion of patients are de-escalated to fluconazole, the timescale to step-down, associated reduction in consumption of echinocandins and antifungal cost savings. Methodology Patients with candidaemia were followed from April 2011 to March 2013. Results A total of 37 episodes of candidaemia were documented during the study period. Twenty-seven patients were commenced on an echinocandin or voriconazole and 19 (70.3%) were de-escalated to fluconazole based on the IVOST policy. The mean and median number of days to de-escalation of therapy was 4.6 and 5 days, respectively. One patient whose therapy was de-escalated relapsed. The overall 30 day crude mortality was 37.1%. The step-down approach led to significant saving in antifungal drug cost of £1133.88 per candidaemic episode and £2208.08 per de-escalation. Conclusion Implementation of IVOST policy led to streamlining of antifungal therapy. [ABSTRACT FROM AUTHOR]

The California mastitis test (CMT) is used on farms to identify subclinical mastitis by an indirect estimation of the somatic cell count (SCC) in milk. Four commercially available detergents were compared with a bespoke CMT fluid for their ability to detect milk samples with a SCC above 200,000 cells/ml; differences between the interpretation of the results of the tests by eight operators were also investigated. The sensitivity and specificity of the test were affected by the type of detergent, and by the operators' interpretations. When used by the most sensitive operator, suitably diluted Fairy Liquid performed almost identically to CMT fluid in identifying milk samples with more than 200,000 cells/ml. The average sensitivities achieved by the eight operators for detecting this threshold were 82 per cent for Fairy Liquid and 84 per cent for CMT fluid, and the specificities were 93 and 91 per cent respectively. The other detergents contained less anionic surfactants and were less sensitive but similarly specific. [ABSTRACT FROM AUTHOR]

An earlier study, based on interviews with a socially stratified sample showed a difference in the use of adverbs, with the middle–class speakers using derived adverbs in –ly more than twice as frequently as the working–class speakers. An examination of interactions in peer–group same–sex dyads shows a similar socially stratified pattern in both adults and adolescents. There are similar differences in the use of some other adverbs and certain adjectives. The consistency of the results suggests that there is a stable difference in speech styles between the two social classes and that this difference reflects a different attitude on the part of the speakers to their audience. [ABSTRACT FROM AUTHOR]

A case of von Recklinghausen's disease with multiple neurofibromatosis is described in which death was caused by intracerebral haemorrhage due to metastatic angiosarcoma. The primary site was a peripheral nerve tumour which, on microscopic examination, showed both angiosarcoma and neurofibrosarcoma with transitional zones between the two. This is interpreted as another example of divergent differentiation in malignant nerve sheath tumours, and the case is compared with the two similar examples found in the literature. [ABSTRACT FROM AUTHOR]

Cell suspensions from six anaplastic thyroid tumours were studied for expression of lymphocyte and macrophage surface markers, and results were correlated with electron microscopy, clinical extent of disease, and response to radiotherapy. The clinical presentation of the disease was similar in all six patients. In five cases, many of the cells showed surface immunoglobulin. Electron microscopy was available on three of these and showed appearances in keeping with malignant lymphoma. The single case whose cells did not show surface immunoglobulin had an entirely different ultrastructure and was probably a carcinoma. This case was the only one that did not achieve complete remission with radiotherapy and the patient died from extensive local recurrence. It is concluded that receptor techniques are of value in distinguishing between malignant lymphoma and other anaplastic tumours of the thyroid, particularly when the results are correlated with histology. [ABSTRACT FROM PUBLISHER]

A case is described of a patient who presented with severe oedema due to protein-losing enteropathy caused by amyloidosis secondary to bronchiectasis. [ABSTRACT FROM PUBLISHER]

A letter to the editor is presented in response to the article about two cases of central nervous system graft-versus-host disease, which was published online on May 14, 2007.