Chromosomally and Extrachromosomally Mediated High-Level Gentamicin Resistance in Streptococcus agalactiae

Streptococcus agalactiae (group B Streptococcus [GBS]) is a leading cause of sepsis in neonates. The rate of invasive GBS disease in nonpregnant adults also continues to climb. Aminoglycosides alone have little or no effect on GBS, but synergistic killing with penicillin has been shown in vitro. High-level gentamicin resistance (HLGR) in GBS isolates, however, leads to the loss of a synergistic effect. We therefore performed a multicenter study to determine the frequency of HLGR GBS isolates and to elucidate the molecular mechanisms leading to gentamicin resistance. From eight centers in four countries, 1,128 invasive and colonizing GBS isolates were pooled and investigated for the presence of HLGR. We identified two strains that displayed HLGR (BSU1203 and BSU452), both of which carried the aacA-aphD gene, typically conferring HLGR. However, only one strain (BSU1203) also carried the previously described chromosomal gentamicin resistance transposon designated Tn3706. For the other strain (BSU452), plasmid purification and subsequent DNA sequencing resulted in the detection of plasmid pIP501 carrying a remnant of a Tn3 family transposon. Its ability to confer HLGR was proven by transfer into an Enterococcus faecalis isolate. Conversely, loss of HLGR was documented after curing both GBS BSU452 and the transformed E. faecalis strain from the plasmid. This is the first report showing plasmid-mediated HLGR in GBS. Thus, in our clinical GBS isolates, HLGR is mediated both chromosomally and extrachromosomally.     

Intracorneal ring segments for keratoconus correction: long-term follow-up

PURPOSE: To evaluate long-term results and stability of intracorneal ring segment (Intacs) implantation for keratoconus correction. SETTING: Vissum, Instituto Oftalmológico de Alicante and University of Miguel Hernandez, Alicante, Spain. METHODS: This retrospective study comprised 13 eyes operated on between April 2000 and December 2001 that had Intacs implantation for keratoconus correction. The outcomes were evaluated at 6, 12, 24, and 36 months in all eyes and at 48 months (6 eyes). RESULTS: Mean best spectacle-corrected visual acuity (BSCVA) increased from 0.46 (20/50) preoperatively to 0.66 (20/30) postoperatively (P< or =.001). Mean decrease of inferior-superior (I-S) asymmetry was 2.81 diopters (D) (P< or =.02), and the average K-value was 3.13 D (P< or =.001). Mean difference between 6 and 36 months (stability) showed no significant difference regarding BSCVA (P< or =.5) and I-S asymmetry (P< or =.6). Although a significant increase was noticed in the average K by 1.67 D (P< or =.002), at 36 months it did not reach the initial preoperative values. CONCLUSION: Intacs increased the BSCVA and decreased I-S asymmetry with stability up to 36 months. In spite of the decrease of the K-values at 6 months, a further significant increase was detected 36 months after surgery.     

Diagnostic Evaluation of Urinary Angiogenin (ANG) and Clusterin (CLU) as Biomarker for Bladder Cancer

Bladder carcinoma is an important worldwide health problem. Both cystoscopy and urine cytology used in detecting bladder cancer suffer from drawbacks where cystoscopy is an invasive method and urine cytology shows low sensitivity in low grade tumors. This study validates easier and less time-consuming techniques to evaluate the value of combined use of angiogenin and clusterin in comparison and combination with voided urine cytology in the detection of bladder cancer patients. This study includes malignant (bladder cancer patients, n?=?50), benign (n?=?20) and healthy (n?=?20) groups. The studied groups were subjected to cystoscopic examination, detection of bilharzial antibodies, urine cytology, and estimation of urinary angiogenin and clusterin by ELISA. The overall sensitivity and specificity were 66 and 75 % for angiogenin, 70 and 82.5 % for clusterin and 46 and 80 % for voided urine cytology. Combined sensitivity of voided urine cytology with the two studied biomarkers was 88 % which is higher than the combined sensitivity of both markers alone (82 %) and that of the cytology with each marker (76 and 80 %) for angiogenin and clusterin respectively. In conclusion, combined use of the cytology with the studied biomarkers can improve the sensitivity for detecting bladder cancer, and may be very useful in monitoring the effectiveness of antiangiogenic and apoptotic therapies in bladder cancer.     

MicroRNAs 182 and 375 Sera Expression as Prognostic Biochemical Markers in Breast Cancer

Introduction

Breast cancer (BC) is the most common malignancy among women; supporting the need for identification of novel prognostic biomarkers, circulating microRNAs (miRNAs) could serve as such in various cancers. The aim of this study was to explore the association between miRNAs 182 and 375 with BC stages and its receptors, based on their expression using real time PCR.

Biofilm elimination from infected root canals using four different single files

Background

This study aims at identifying the microbiota in traumatized immature permanent teeth with periapical lesions using Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).

Methods

The study included 16 immature maxillary central incisors with periapical lesions in 13 patients. Field decontamination and negative control samples were performed before and after access cavity preparation. Root canal samples were taken using sterile stainless-steel hand files following field decontamination. In-office inoculation and pure sub-cultures were performed. Bacterial isolates were prepared for MALDI-TOF MS (Bruker, Billerica, MA USA) analysis using the formic acid extraction method. A comparison of the prevalence of isolated microorganisms was done using a one-sample chi-square test. Comparisons between identified microbial species with the, cone beam computed tomography periapical index (CBCT PAI) scores and lesion volume were also conducted. The Chi-square test was applied to investigate the association between the categorical variables .

Results

Out of the forty isolates recovered from the 16 traumatized teeth included in the present study with the mean patients’ age of 10.93 ± 1.77, 37 isolates were reliably identified by MALDI-TOF MS. Twelve teeth (62.5%) were polymicrobial. The recovered bacteria belonged to five phyla, 15 genera and 25 species. Firmicutes were the predominant phylum (P < 0.001) over Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria. Gram positive bacteria were significantly more prevalent than Gram negative (p = 0.03). Facultative anaerobes were the most prevalent (P < 0.001) compared to the obligate anaerobes and the obligate aerobes. The latter were the least prevalent. Statistically, significant differences existed in the comparison between CBCT PAI scores according to bacterial gram staining.

Conclusion

Traumatized immature permanent teeth with periapical lesions showed a significant predominance of Gram-positive facultative anaerobes. MALDI-TOF MS provided accurate identification of numerous viable endodontic microbes.

     

Assessment of lnc RNA GAS5, lnc RNA HEIH,lnc RNA BISPR and its m RNA BST2 as serum innovative non-invasive biomarkers: Recent insights into Egyptian patients with hepatitis C virus type 4

BACKGROUND Hepatitis C virus(HCV)infection and its consequent complications are undeniably a public health burden worldwide,particularly in Egypt.Emerging evidence suggests that many lncRNAs have relevant roles in viral infections and antiviral responses.AIM To investigate the expression profiles of circulating lncRNAGAS5,lncRNAHEIH,lncRNABISPR and mRNABST2 in naïve,treated and relapsed HCV Egyptian patients,to elucidate relation to HCV infection and their efficacy as innovative biomarkers for the diagnosis and prognosis of HCV GT4.METHODS One hundred and thirty HCV-infected Egyptian patients and 20 healthy controls were included in this study.Serum lncRNAs and mRNABST2 were measured using quantitative real-time polymerase chain reaction(qRT-PCR).RESULTS Our results indicated that serum lncRNAGAS5 and LncRNABISPR were upregulated,whereas mRNA BST2 and LncRNA HEIH were downregulated in naïve patients.In contrast,HCV patients treated with sofosbuvir and simeprevir;with sofosbuvir and daclatasvir;or with sofosbuvir,daclatasvir and ribavirin exhibited lower levels of lncRNAGAS5 and lncRNABISPR with higher mRNABST2 compared to naïve patients.Notably,patients relapsed from sofosbuvir and simeprevir showed higher levels of these lncRNAs with lower mRNABST2 compared to treated patients.LncRNAGAS5 and lncRNABISPR were positively correlated with viral load and ALT at P<0.001,whereas mRNABST2 was negatively correlated with viral load at P<0.001 and ALT at P<0.05.Interestingly,a significant positive correlation between lncRNA HEIH and AFP was observed at P<0.001.CONCLUSION Differential expression of these RNAs suggests their involvement in HCV pathogenesis or antiviral response and highlights their promising roles in diagnosis and prognosis of HCV.     

Assessment of the nutritional status of children with special needs in Alexandria. Part II: Anthropometric measures

The present study was undertaken to evaluate the nutritional status of children with special needs in Alexandria city, on the basis of anthropometric measures. The following variables were determined in a sample of 278 disabled children (171 males, 107 females) aged 6 to 24 years, recruited from five specialized day care centers for retarded children in Alexandria: birth order, type of disability, socioeconomic status, body weight, height, body mass index (BMI) and hemoglobin level. Mentally retarded children represent the highest proportion of subjects followed by Down's syndrome and autism. There is an increase in the mean body weight of males with the increase in age among the three type of disability except at age from 14 to 18 years, while there is a fluctuation in the mean body weight between ages and disability among females. Down syndrome groups at all ages are shorter than the other groups, while disabled males are taller than females at all ages. Based on BMI for age, the incidence of obesity was higher among Down's syndrome and mentally retarded females and among autistic males (19.8%, 16.1% of males versus 15.8%, 6.7% of females with mental retardation and autism were underweight). Majority of subjects have mild degree anemia. Hemoglobin levels below the cut-off levels issued by WHO were found higher among autistic and mentally retarded females. The levels were comparable among males with autism and mental retardation and among Down's syndrome males and females. The results also revealed that underweight, overweight and obesity were more common in subjects who showed an evidence of anemia.     

Intracorneal asymmetrical rings for keratoconus: where should the thicker segment be implanted?

PURPOSE: To report a 20-year-old man who presented with monocular diplopia in the right eye with uncorrected visual acuity (UCVA) of 0.3 and best spectacle-corrected visual acuity (BSCVA) of 1.0 with -0.50 -3.00 x 45 degrees. METHODS: Clinical examination and corneal topography revealed grade I keratoconus in the right eye. Intracorneal ring segments (INTACS; Addition Technology, Des Plaines, III) were implanted in May 2004 without surgical complications at 415 microm (70% of the corneal thickness), with the 450-microm segment implanted superiorly and the 250-microm segment inferiorly. RESULTS: For 2 months postoperatively, BSCVA remained at 0.4 with +1.50 -4.50 x 25 degrees. The segments were reversed, implanting the 450-microm (thick) segment inferiorly and the 250-microm (thin) segment superiorly. One week later, UCVA was 1.0 and remained stable for 3 months after reimplantation. CONCLUSIONS: This report shows that implanting the thicker segment inferiorly provides better visual results.     

Corneal biomechanical properties in normal, post-laser in situ keratomileusis, and keratoconic eyes

PURPOSE: To compare the biomechanical properties of normal, post-laser in situ keratomileusis (LASIK), and keratoconic corneas evaluated by corneal hysteresis and the corneal resistance factor measured with the Reichert Ocular Response Analyzer (ORA). SETTINGS: Instituto Oftalmológico de Alicante, Vissum, Alicante, Spain. METHODS: Two hundred fifty eyes were divided into 3 groups: normal (control group), post-LASIK, and keratoconus. The corneal biomechanical properties were measured with the ORA, which uses a dynamic bidirectional applanation process. The main outcome measures were intraocular pressure, corneal hysteresis, and the corneal resistance factor. RESULTS: The control group had 165 eyes; the LASIK group, 65 eyes; and the keratoconus group, 21 eyes. In the control group, the mean corneal hysteresis value was 10.8 mm Hg +/- 1.5 (SD) and the mean corneal resistance factor, 11.0 +/- 1.6 mm Hg. The corneal hysteresis value was lower in older eyes, and the difference between the youngest age group (9 to 14 years) and oldest age group (60 to 80 years) was statistically significant (P = .01, t test). One month after LASIK, corneal hysteresis and the corneal resistance factor decreased significantly, from 10.44 to 9.3 mm Hg and from 10.07 to 8.13 mm Hg, respectively. In the keratoconus group, the mean corneal hysteresis was 7.5 +/- 1.2 mm Hg and the mean corneal resistance factor, 6.2 +/- 1.9 mm Hg. There were statistically significant differences in both biomechanical parameters between keratoconic eyes and post-LASIK eyes (P<.001, t test). CONCLUSIONS: The corneal hysteresis and corneal resistance factor values were significantly lower in keratoconic eyes than in post-LASIK eyes. Future work is needed to determine whether these differences are useful in detecting keratoconus when other diagnostic tests are equivocal.