The role of pneumolysin in pneumococcal pneumonia and meningitis

Diseases caused by Streptococcus pneumoniae include pneumonia, septicaemia and meningitis. All these are associated with high morbidity and mortality. The pneumococcus can colonize the nasopharynx, and this can be a prelude to bronchopneumonia and invasion of the vasculature space. Proliferation in the blood can result in a breach of the blood-brain barrier and entry into the cerebrospinal fluid (CSF) where the bacteria cause inflammation of the meningeal membranes resulting in meningitis. The infected host may develop septicaemia and/or meningitis secondary to bronchopneumonia. Also septicaemia is a common precursor of meningitis. The mechanisms surrounding the sequence of infection are unknown, but will be dependent on the properties of both the host and bacterium. Treatment of these diseases with antibiotics leads to clearance of the bacteria from the infected tissues, but the bacteriolytic nature of antibiotics leads to an acute release of bacterial toxins and thus after antibiotic therapy the patients can be left with organ-specific deficits. One of the main toxins released from pneumococci is the membrane pore forming toxin pneumolysin. Here we review the extensive studies on the role of pneumolysin in the pathogenesis of pneumococcal diseases.     

Role of inflammatory mediators in resistance and susceptibility to pneumococcal infection

Variations in the host response during pneumonia caused by Streptococcus pneumoniae in susceptible (CBA/Ca) and resistant (BALB/c) inbred mouse strains were investigated. Significant differences were detected in survival time, core body temperature, lung-associated and systemic bacterial loads, mast cell numbers, magnitude and location of cytokine production, lung disruption, and ability of isolated lung cells to release the cytokine tumor necrosis factor (TNF) alpha in vitro. Overall, the results indicate that the reduced capacity of CBA/Ca mice to induce rapid TNF activity within the airways following infection with S. pneumoniae may be a factor in their elevated susceptibility to pneumococcal pneumonia.     

Acromegaly is associated with a distinct oral and gut microbiota

Pituitary - Our aim was to investigate the changes in the composition of oral and gut microbiota in patients with newly diagnosed acromegaly and their relationship with IGF-1 levels. Oral and fecal...     

Discrimination between non-functioning pituitary adenomas and hypophysitis using machine learning methods based on magnetic resonance imaging‑derived texture features

Purpose

Hypophysitis is a heterogeneous condition that includes inflammation of the pituitary gland and infundibulum, and it can cause symptoms related to mass effects and hormonal deficiencies. We aimed to evaluate the potential role of machine learning methods in differentiating hypophysitis from non-functioning pituitary adenomas.

Methods

The radiomic parameters obtained from T1A-C images were used. Among the radiomic parameters, parameters capable of distinguishing between hypophysitis and non-functioning pituitary adenomas were selected. In order to avoid the effects of confounding factors and to improve the performance of the classifiers, parameters with high correlation with each other were eliminated. Machine learning algorithms were performed with the combination of gray-level run-length matrix-low gray level run emphasis, gray-level co-occurrence matrix-correlation, and gray-level co-occurrence entropy.

Results

A total of 34 patients were included, 17 of whom had hypophysitis and 17 had non-functioning pituitary adenomas. Among the 38 radiomics parameters obtained from post-contrast T1-weighted images, 10 tissue features that could differentiate the lesions were selected. Machine learning algorithms were performed using three selected parameters; gray level run length matrix-low gray level run emphasis, gray-level co-occurrence matrix-correlation, and gray level co-occurrence entropy. Error matrices were calculated by using the machine learning algorithm and it was seen that support vector machines showed the best performance in distinguishing the two lesion types.

Conclusions

Our analysis reported that support vector machines showed the best performance in distinguishing hypophysitis from non-functioning pituitary adenomas, emphasizing the importance of machine learning in differentiating the two lesions.

     

The High Diversity of MRSA Clones Detected in a University Hospital in Istanbul

Background: To characterize the methicillin-resistant Staphylococcus aureus (MRSA) clones present in Istanbul, 102 MRSA isolates collected during a 5-year period at the Istanbul Medical Faculty Hospital were characterized using microarray analysis and phenotypic resistance profiles.Methods: Resistance to methicillin was detected with a cefoxitin disk diffusion assay and confirmed with a MRSA-agar and MRSA detection kit. Antimicrobial susceptibility testing was performed by a disk diffusion assay and interpreted according to the 2012 guidelines of the Antibiogram Committee of the French Society for Microbiology. Decreased susceptibility to glycopeptides was confirmed using the population analysis profile-area under the curve (PAP-AUC) method. The presence of the mecA gene was detected by polymerase chain reaction. Bacterial DNA was extracted according to the manufacturer''s recommended protocol using commercial extraction kits. Strains were extensively characterized using the DNA microarray.Results: Isolates were grouped into six clonal complexes. The most frequently detected clone was the Vienna/Hungarian/Brazilian clone (ST239-MRSA-III), which accounted for 53.9% of the isolates. These isolates were resistant to multiple antibiotics, particularly penicillin, tetracycline, rifampicin, kanamycin, tobramycin, gentamicin, levofloxacin, erythromycin, lincomycin and fosfomycin. Furthermore, three isolates were detected by population analysis profile as heterogeneous vancomycin-intermediate S. aureus (hVISA). The UK-EMRSA-15 clone (ST22-MRSA-IV PVL negative) was detected in 9.8% of the isolates and was mainly susceptible to all anti-staphylococcal antibiotics. Seven isolates (6.9%) were positive for PVL genes and were assigned to the CC80-MRSA-IV clone (European CA-MRSA clone, three isolates), ST8-MRSA-IV clone (USA300 clone, two isolates, one ACME-positive) or ST22-MRSA-IV clone (“Regensburg EMRSA” clone, two isolates). All other clones were detected in one to six isolates and corresponded to well-known clones (e.g., Pediatric clone, Dublin EMRSA clone, WA MRSA-54/63, WA MRSA-1/57).Conclusions: This work highlighted both the high prevalence of ST239-MRSA-III clone and the large diversity of the other MRSA clones detected in a university hospital in Istanbul.     

Flexural properties of rectangular nickel-titanium orthodontic wires when used as ribbon archwires

Objective:To compare the flexural properties of rectangular nickel-titanium (Ni-Ti) orthodontic wires in occlusoapical and faciolingual orientations using a standardized test method.Materials and Methods:Twenty-two rectangular Ni-Ti wire groups were tested in occlusoapical (ribbon) orientation: eight conventional Ni-Ti products, five superelastic Ni-Ti products, and nine thermal Ni-Ti products (n = 10 per group). Six products of thermal Ni-Ti wire were tested in faciolingual (edgewise) orientation. A three-point bending test was performed to measure deactivation force at 3.0-, 2.0-, 1.0-, and 0.5-mm deflections of each rectangular wire at 37.0 ± 0.5°C. Analysis of variance and post hoc Student-Newman-Keuls tests were used to compare the mean values of the different groups (α = .05).Results:The ranges of deactivation forces varied greatly with different kinds, sizes, products, and deflections of Ni-Ti wires. One product of conventional and superelastic Ni-Ti wires had steeper force-deflection curves. Four products had similarly shaped flat force-deflection curves, whereas the sixth product had a moderately steep force-deflection curve. Thermal Ni-Ti wires had smaller deactivation forces ranging from 0.773 N (78.8 g) to 2.475 N (252.4 g) between deflections of 1.0 and 0.5 mm, whereas wider ranges of force from 3.371 N (343.7 g) to 9.343 N (952.7 g) were predominantly found among conventional Ni-Ti wires between deflections of 3.0 and 2.0 mm.Conclusions:Clinicians should critically select archwires for use in the occlusoapical orientation not only based on Ni-Ti wire type, size (0.022 × 0.016-in or 0.025 × 0.017-in), and product but also with deactivation deflections from 0.5 and 1.0 mm to obtain light forces in the occlusoapical orientation.     

Effects of paracetamol and etodolac on plasma adrenaline levels of rats

Adrenaline, which is released from the adrenal medulla, is an important compound in the reaction of sympathetic nerve system. This hormone can increase the body’s normal metabolic rate up to 100 %, and thus improves the effectiveness of the whole body. It has been considered to be involved in the control of inflammation. Therefore, we investigated whether there are effects of paracetamol and etodolac on adrenaline levels of rats after oral administration. The rats were divided into three subgroups while analysing the effects of adrenaline on paracetamol and etodolac. The first group was the control, second group was composed of rats given paracetamol, and third group was composed of rats given etodolac. In order to measure adrenaline plasma concentration, we have used the high-performance liquid chromatography coupled with fluorescence detection. According to the result of the analysis, there are statistically important differences at adrenaline levels between control group and rats-applied drugs. Obtained results showed that although adrenaline level in the paracetamol-applied group decreased, adrenaline level in the etodolac-applied group increased. It is concluded that different effects of etodolac and paracetamol on circulating adrenaline levels can be related to their different effects on inflammation, COX enzymes, prostaglandins, etc. Also we can suggest usage of paracetamol instead of etodolac in patients with cardiovascular system diseases.     

Factor V Q 506 mutation in children with thrombosis

The factor V Leiden mutation in 12 children with thrombosis and in 20 controls was investigated. Five heterozygous individuals and 1 homozygous individual among the cases with thrombosis and 1 heterozygous individual among controls were found. Central nervous system thromboses were increased in children with the factor V mutation, associated with protein S deficiency. © 1996 Wiley-Liss, Inc.