interesting medical information

MEDICAL ADVANCE

Medically significant fungi

and superficial mycoses

Fungi are eukaryotic microorganisms. Only about 15 genera and 100 species of the thousands of species are involved in human disease. Most of the medically important fungi are ubiquitous in nature.

Superficial mycoses involve the keratin-containing structures of the body (epidermis, hair, nails). The infections generally are considered cosmetic problems and are not life threatening. The disease processes very rarely spread to other tissues and, then, only in extremely immunocompromised individuals. Children are more susceptible than adults, and infections are more common in warm, moist climates.

The major causes of superficial mycoses are Trichophyton species, Microsporum species, and a single species of Epidermophyton, which collectively are referred to as dermatophytes. Other fungi involved in superficial mycoses include Pityrosporum species and Candida species.

Clinical manifestations may include scaling of skin, hair loss, pruritus, and erythema or other discoloration. The symptomatology is characteristic, but it is not diagnostic, so an accurate diagnosis relies on laboratory tests. (Photos have reprinted from the book U. Spyrakou: Basic Medical Mycology, 2nd ed., Athens, 2000.)

UMMA : A superior assay for the detection of vitamin B₁₂ deficiency

Vitamin B₁₂ is important in DNA synthesis, erythropoiesis, and development and maintenance of the myelin sheath of nerves. Deficiency of the vitamin B₁₂ can cause pernicious anaemia, neurological damage, e.g. spinal cord degeneration and mental changes. If left untreated, it is estimated that 80 - 90% of deficient individuals will develop disorders of the nervous system such as fatigue, muscle aches, decreased visual acuity, depression, confusion, loss of memory or dementia similar to Alzheimer’s disease and leg paralysis. Similarly, recent research indicates that B₁₂ deficiency can be a cause of heart attack or stroke.

Different laboratory methods have been used to screen selected individuals such as serum vitamin B₁₂ measurement, Schilling test and plasma homocysteine, but all these tests often give falsely positive and falsely negative values.

Elevated urinary methylmalonic acid (UMMA) levels indicate tissue/cellular B₁₂ deficiency since they are directly related to a B₁₂ dependent pathway:

Coenzyme B₁₂

Methylmalonic acid ———————→Succinic acid

Vitamin B₁₂ deficiency impedes this pathway causing urine excretion of methylmalonic acid to increase.

Normal UMMA is less than 3,8 μg / mg creatinine.

Many researchers have showed that UMMA assay is much more reliable than all other tests in early diagnosis of vitamin B₁₂ deficiency as well as in monitoring improvement after therapy.

IAST® : A valuable test for respiratory allergy

Two out of ten are allergic. Allergy often presents with an unclear, confusing picture, making the correct diagnosis difficult. Allergy is therefore to a large extent an underdiagnosed condition.

A recent solution to this situation is IAST® (Inhalation Allergy Screen Test). IAST is a simple blood test, which confirms or excludes atopic allergy in patients with symptoms of the eyes, ears and the upper and lower respiratory tract.

IAST® is a laboratory test based on the allergosorbent principle. It utilizes two discs, which carry balanced mixtures of relevant allergens causing common inhalant allergy. A blood sample of 0.50 ml is sufficient to perform the assay. The results are reported in AU/L (Allergy Units). Normal value is 0-35 AU/L. Recent clinical studies in IDEA Medical Labs show over 95% agreement with the more complex and expensive conventional diagnostic methods (skin tests and RAST).