Extracranial carotid aneurysm in Behçet disease: Report of two new cases

Extracranial carotid aneurysm due to Beh?et disease is extremely rare. To our knowledge, this complication has been previously reported in only 12 cases. We report two new cases of extracranial carotid aneurysm in Beh?et disease and discuss the clinical features, therapeutic modalities, and postoperative complications of these uncommon lesions.     

Seidel and India ink tests assessment of different clear cornea side-port incision configurations

Background

Post-cataract endophthalmitis has increased after introduction of clear cornea incisions (CCI). Laboratory models suggested that these incisions might not be competent at certain changes in intraocular pressure (IOP). Considering that side-port incisions (SPI) might behave similarly, the purpose of the present study was to determine the most stable side-port incision configuration.

Methods

Using four cadaveric human eyes, four different side-port incisions (SPI) were created in each cornea: 1.5 mm and 2.5 mm squared tunnel, 1.5 mm and 2.5 mm stab tunnel. Fluorescein was placed on the eye, and the IOP varied from 10 to 80 mmHg. IOP at which each SPI started leaking was recorded. In the second part of the study, India ink was applied to the corneal surface at normal IOP, and then rinsed with balanced salt solution (BSS). The ink influx was recorded by planimetry. IOP was elevated to 80 mmHg, ink was reapplied, and IOP was dropped to 0 mmHg. Ink influx was measured again. Histological examination was used to visualize ink inflow into each incision.

Results

There was no statistically significant difference in the IOP levels at which the different incisions leaked (p?=?0.52). A significant increase in the length of India ink ingress in all incision types was measured after IOP variation (p?<?0.05). The 2.5 mm squared incision showed the least increase in ink inflow in this test.

Conclusion

All incision types of SPIs tested exhibited similar resistance to leakage after IOP variation. Good resistance to wound leakage may not predict adequate resistance to the inflow of bacterial-sized particles into the wound.     

Cardiac hydatidosis with dissemination to the pulmonary parenchyma and the pulmonary artery

Multiple thoracic hydatic disease involving a cardiac and pulmonary localization is exceptional and prognosis is poor. We report a case in a 21-year-old male who presented repeated episodes of hemoptysis. The chest x-ray showed multiple opacities. The thoracic computed tomography and echocardiography visualized cystic formations in the heart and the pulmonary arteries. Hydatic serology was strongly positive. Medical treatment with albendazole was given but the patient died from massive hemoptysis before the cardiac and pulmonary artery cysts could be removed surgically (a procedure which requires extracorporeal circulation). A hydatic cyst of the pulmonary artery is usually secondary to a cardiac localization. The risk is dissemination into the pulmonary and eventually systemic circulation. An arterial localization must be carefully ruled out in all patients with multiple or cardiac hydatidosis. Treatment is surgical to avoid dissemination.     

Elicitation of broadly neutralizing influenza antibodies in animals with previous influenza exposure

The immune system responds to influenza infection by producing neutralizing antibodies to the viral surface protein, hemagglutinin (HA), which regularly changes its antigenic structure. Antibodies that target the highly conserved stem region of HA neutralize diverse influenza viruses and can be elicited through vaccination in animals and humans. Efforts to develop universal influenza vaccines have focused on strategies to elicit such antibodies; however, the concern has been raised that previous influenza immunity may abrogate the induction of such broadly protective antibodies. We show here that prime-boost immunization can induce broadly neutralizing antibody responses in influenza-immune mice and ferrets that were previously infected or vaccinated. HA stem-directed antibodies were elicited in mice primed with a DNA vaccine and boosted with inactivated vaccine from H1N1 A/New Caledonia/20/1999 (1999 NC) HA regardless of preexposure. Similarly, gene-based vaccination with replication-defective adenovirus 28 (rAd28) and 5 (rAd5) vectors encoding 1999 NC HA elicited stem-directed neutralizing antibodies and conferred protection against unmatched 1934 and 2007 H1N1 virus challenge in influenza-immune ferrets. Indeed, previous exposure to certain strains could enhance immunogenicity: The strongest HA stem-directed immune response was observed in ferrets previously infected with a divergent 1934 H1N1 virus. These findings suggest that broadly neutralizing antibodies against the conserved stem region of HA can be elicited through vaccination despite previous influenza exposure, which supports the feasibility of developing stem-directed universal influenza vaccines for humans.     

Ceftobiprole Efficacy In Vitro against Panton-Valentine Leukocidin Production and In Vivo against Community-Associated Methicillin-Resistant Staphylococcus aureus Osteomyelitis in Rabbits

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) can cause osteomyelitis with severe sepsis and/or local complications in which a Panton-Valentine leukocidin (PVL) role is suspected. In vitro sub-MIC antibiotic effects on growth and PVL production by 11 PVL⁺ MRSA strains, including the major CA-MRSA clones (USA300, including the LAC strain; USA400; and USA1000), and 11 PVL⁺ methicillin-susceptible S. aureus (MSSA) strains were tested in microplate culture. Time-kill analyses with ceftobiprole at its MIC were also run with LAC. Efficacies of ceftobiprole (40 mg/kg of body weight subcutaneously [s.c.] four times a day [q.i.d.]) or vancomycin (60 mg/kg intramuscularly [i.m.] twice a day [b.i.d.]) alone or combined with rifampin (10 mg/kg b.i.d.) against rabbit CA-MRSA osteomyelitis, induced by tibial injection of 3.4 × 10⁷ CFU of LAC, were compared. Treatment, started 14 days postinoculation, lasted 14 days. In vitro, 6/11 strains cultured with sub-MICs of ceftobiprole produced 1.6- to 4.8-fold more PVL than did the controls, with no link to specific clones. Rifampin decreased PVL production by all tested strains. In time-kill analyses at the LAC MIC (0.75 mg/liter), PVL production rose transiently at 6 and 8 h and then declined 2-fold at 16 h, concomitant with a 2-log₁₀-CFU-count decrease. In vivo, the mean log₁₀ CFU/g of bone for ceftobiprole (1.44 ± 0.40) was significantly lower than that for vancomycin (2.37 ± 1.22) (P = 0.034), with 7/10 versus 5/11 bones sterilized, respectively. Combination with rifampin enhanced ceftobiprole (1.16 ± 0.04 CFU/g of bone [P = 0.056], 11/11 sterile bones) and vancomycin (1.23 ± 0.06 CFU/g [P = 0.011], 11/11 sterile bones) efficacies. Ceftobiprole bactericidal activity and the rifampin anti-PVL effect could play a role in these findings, which should be of interest for treating CA-MRSA osteomyelitis.     

Artemisia campestris leaf extract alleviates early diabetic nephropathy in rats by inhibiting protein oxidation and nitric oxide end products

Chronic hyperglycemia in diabetes leads to free radicals overproduction, which contributes to the development of diabetic nephropathy. The present study investigated the effects of Artemisia campestris (Ac), a plant of the Asteraceae family, on renal impairment and oxidative stress in alloxan-induced diabetic rats. Diabetes was induced by a single subcutaneous injection of alloxan (120 mg kg(-1)) in rats. Ac (200 mg kg(-1)) was administered to diabetic rats for 3 weeks. Diabetic renal injury was associated with hyperglycemia, increased serum creatinine, urea and uric acid levels. This nephropathophysiology was associated with a surproduction of nitric oxide (NO), malondialdehyde (MDA) and advanced oxidation protein products (AOPP) levels and a decrease in glutathione (GSH) levels. In addition, hyperglycemia increased the activities of antioxidant enzymes, such as catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx), in the kidney of diabetic rats. Treatment with Ac effectively ameliorated diabetic renal dysfunction by reducing oxidative and nitrosative stress. Histological studies also supported the experimental findings. The results suggested that Ac might act as a beneficial agent against renal dysfunctions developed in alloxan-induced diabetes.