Molecular epidemiology of an outbreak caused by methicillin-resistant Staphylococcus aureus in a health care ward and associated nursing home

Our point-prevalence survey followed an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in a long-term care facility and identified five MRSA strains, of which two possessed an outbreak genotype not encountered previously and three had another profile. All of them possessed SCCmec type V. Six methicillin-sensitive S. aureus strains were genotypically related to the epidemic strains.     

Spinal stenosis due to posterior syndesmophytes in a patient with seronegative spondyloarthropathy

Summary Spinal involvement in spondyloarthropathy is characterized by inflammation concentrated at the site of bony insertion of ligaments and bones. These inflammatory sites show a peculiar tendency towards prominent fibrosis, ossification and new bone formation (syndesmophytes). The syndesmophytes arise either at the margins of intervertebral disc and these are called marginal syndesmophytes as in ankylosing spondylitis, or from the vertebral bodies beyond their corners and are called nonmarginal syndesmophytes as in psoriatic arthritis and Reiter's syndrome (1,2). In some references and in the European literature, the term syndesmophyte is usually reserved for the vertical ossification that bridges two adjacent vertebrae in ankylosing spondylitis (3) Syndesmophytes predominate on the anterior and lateral aspect of the spine (1–3). We report a patient with undifferentiated spondyloarthropathy with posterior syndesmophytes resulting in symptomatic spinal stenosis.     

Association of vascular endothelial growth factor -634G/C and receptor for advanced glycation end products G82S gene polymorphisms with diabetic retinopathy

AIM: To investigate the association of receptor for advanced glycation end products (RAGE) G82S and vascular endothelial growth factor (VEGF) -634 G/C gene polymorphisms with diabetic retinopathy (DR). METHODS: Our cross-sectional study included 61 diabetic patients, 12 of them had proliferative diabetic retinopathy (PDR), 15 had non proliferative diabetic retinopathy (NPDR), 34 had no diabetic retinopathy (NDR) and 61 healthy controls. Participants were tested for RAGE G82S and VEGF -634 G/C polymorphisms by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: We found a significant association between VEGF -634 G/C polymorphism and PDR as PDR patients had increased incidence of VEGF -634 CC genotype compared to NDR patients [odds ratio for CC vs (GC+GG)=6.5, 95% CI=1.5-27.8, P=0.021]. Also VEGF -634 CC genotype and C allele were significantly higher in the PDR than in NPDR patients, which is a novel finding in our study (P=0.024, 0.009 respectively). The mean triglycerides level was significantly higher in diabetic patients with CC genotype (P=0.01) as compared to patients with other genotypes. All cases and control subjects were of the same heterozygous RAGE 82G/S genotype. CONCLUSION: Patients carrying VEGF -634 C polymorphism have a higher risk of PDR development, so VEGF -634 G/C polymorphism could be used as a predictive marker for PDR in diabetic patients. We could not find a significant association between RAGE G82S polymorphism and DR.     

Nationwide trends in molecular epidemiology of methicillin-resistant <Emphasis Type="Italic">Staphylococcus aureus</Emphasis>, Finland, 1997–2004

Background  

In Finland, the annual number of MRSA notifications to the National Infectious Disease Register (NIDR) has constantly increased since 1995, and molecular typing has revealed numerous outbreak isolates of MRSA. We analyzed the data on MRSA notifications of the NIDR, and MRSA isolates were identified mainly by pulsed-field gel electrophoresis (PFGE) at the National Reference Laboratory (NRL) in Finland during 1997–2004. One isolate representative of each major PFGE type was further characterized by multilocus sequence (MLST)-, staphylococcal cassette chromosome mec (SCCmec)-, and Panton-Valentine leukocidin (PVL)-typing.     

Results of ACDF using Alexandria Modular Cage-Plate Construct in cervical canal stenosis

Background

The purpose of this study was to assess prospectively operative results and complications of treatment of cervical spinal canal stenosis (CCS) by anterior cervical discectomy and fusion (ACDF) using a newly introduced Alexandria Modular Cage-Plate Construct (AMCPC).

Methods

Fifteen patients (eight males, seven females) with symptomatic CCS were treated by ACDF, with a mean age of 51.2 years. Post-operative assessment depended upon clinical and radiological results.

Results

Total number of operated levels was 25 levels, with a mean 1.67 levels/patient. Mean operative time was 69.6 min/level and 116 min/patient. Average blood loss was 78 mL/level and 130 mL/patient. Mean hospital stay was 2.8 days. Post-operative dysphagia/dysphonia persisted in one patient for 1 year. One patient developed C5 radiculopathy with grade 2 deltoid weakness that recovered after 3 months. According to Odom’s criteria, results were excellent in 13 patients (86.67 %), good in 1 (6.67 %), and fair in 1 patient. In 13 patients (23 cage-plates, 92 %), the implant showed to be completely contained until the end of follow-up (24 months). One patient had a broken screw and one had screw backing-out, both did not necessitate revision. The achieved sagittal profile was maintained without sinking-in of any cage.

Conclusion

AMCPC can be used safely for a variety of disorders requiring instrumentation and fusion. It is advantageous to stand-alone cage and to rigid cage-plates when intraoperative flexibility is needed. It overcomes the disadvantages of stand-alone cage, sinking-in, cage dislodgement and post-operative rekyphosis. In addition, it obviates the need for wearing post-operative neck collar.     

Off-axis microsphere photolithography patterned nanohole array and other structures on an optical fiber tip for glucose sensing

Microsphere photolithography (MPL) using off-axis UV exposure is a technique that uses a layer of self-assembled microspheres as an optical mask to project different periodic nanopatterns. This paper introduces MPL as an alternative fabrication technique to pattern complex metasurfaces on an optical single mode fiber tip as a sensor for measuring refractive index. Based on the hexagonal close packing microsphere array, complicated metasurfaces were successfully created by changing the UV illumination angle. Using the same self-assembled microspheres monolayer, multiple UV illumination jets were projected to create multiple hole group patterns. Fiber sensors with three-hole group and four-hole group patterns were fabricated and tested with different glucose concentrations in water. The different concentration solutions have various refractive indexes, which result in the shift of the metasurface resonant wavelength, represented as sensitivity. The testing results show that the three-hole group and four-hole group have the sensitivity of 906 nm per RIU and 675 nm per RIU, respectively. Finite element analysis was used to model the fiber sensor''s surrounding with different refractive index solutions. These new pattern metasurface coated fibers'' refractive index sensitivity has increased by 40% compared to our previous work, while the technique still provides a cost-effective, flexible, high-throughput fabrication of the fiber sensor.

Off-axis microsphere photolithography (MPL) was used as a method to create a plasmonic fiber-based sensor for glucose sensing. Sensitivity of 906 nm per RIU has been achieved. And multiple nanostructures have been successfully created on a fiber tip.     

Exercise‐induced thoracic outlet syndrome and concomitant osteomyelitis in cervical rib with a possible familial origin: A case report

Cervical ribs are rare and usually asymptomatic. Occasionally, they can cause nerve impingements and compressive symptoms. In cervical ribs, osteomyelitis secondary to trauma is unheard of. We report such a case made more interesting by the familial presence of bilateral cervical ribs in two generations, indicating a familial origin.