Molecular methods and techniques used in diagnosis and epidemiology of infections caused by pathogenic fungi

In this paper we reviewed the latest literature on molecular techniques used in diagnosis and epidemiology of infections caused by pathogenic fungi. Traditional methods used for the identification and typing of medically relevant fungi include morphological and biochemical analysis. These methods are time-consuming and base on phenotypic features what makes them unreliable. We described the usefulness in mycological studies of fast and very sensitive molecular methods which rely on PCR and hybridization techniques.     

Recent advances in antileishmanial drug development

Leishmania are protozoan parasites responsible for a spectrum of diseases collectively known as leishmaniasis. The disease is a significant health problem in many regions of the world and emerges as a serious co-infection in HIV-positive individuals. Current treatment of the disease is based on a limited number of chemotherapeutic agents which are rapidly becoming ineffective, and are characterized by high toxicity and cost. This review focuses on recent advances in antileishmanial drug development and improvements to current treatment options. Novel approaches currently used to identify leishmanicidal compounds as diverse as antimicrobial peptides and natural plant extracts are described in this review.     

Sphenoid sinus surgery

Sphenoid sinus surgery due to specific localization is placed in otolaryngologists and neurosurgeons field of interest. Surgery of this area, from one side, causes number of problems, which usually arise due to close neighbourhood of important structures, but on the other, serves as alternative approach, eliminating necessity of extended operations with craniotomies. The article summarizes results of sphenoid sinus surgery at ENT Department, University of Medical Sciences in Poznan between 1990 and 2003, as well as points out characteristic features of the surgery in this specific localization.     

The MCID of the transition dyspnea index is a total score of one unit

The Baseline (BDI) and Transition (TDI) Dyspnea Indexes provide interview-based measurements of breathlessness related to activities of daily living. The BDI is a discriminative instrument that includes specific criteria for each of three components at a single point in time. The TDI is an evaluative instrument that includes specific criteria for each of three components to measure changes from a baseline state. Observational studies have shown that patients with COPD generally experience a gradual progression of breathing difficulty as measured by the TDI over time. Randomized controlled trials have demonstrated excellent measurement characteristics of the TDI; these include responsiveness (ability to detect change) and construct validity (a change in the TDI correlates with changes in other variables). Supporting evidence for one unit as the minimal clinically important difference (MCID) of the TDI is based on: expert preference; use of the physician's global evaluation score as an anchor; and distribution estimates (standard error of measurement and 0.5 of the standard deviation). As an alternative to the interview process, self-administered computerized (SAC) versions of the BDI/TDI have been developed to provide direct patient-reported ratings of dyspnea. To further establish the MCID of the interview-administered and/or the SAC TDI, we recommend that a patient's report of global ratings of change by used as an independent standard or anchor.     

Cavernous carotid artery calcification and white matter ischemia

BACKGROUND AND PURPOSE: The relevance of cavernous carotid artery calcification on unenhanced CT scans of the brain has recently been investigated against the backdrop of the widespread implementation of coronary artery calcification scoring. We sought to determine whether the degree of cavernous carotid artery calcification correlated with scores of white matter hyperintensity seen on MR images. In so doing, we sought to establish a relative risk for future stroke on the grade of carotid calcification. METHODS: Neuroradiologic findings in 187 patients who underwent CT and MR imaging examinations within 1 month of each other were retrospectively reviewed. The degree of circumferential calcification and thickness of calcification were graded for the cavernous carotid arteries on the basis of CT findings. Using the scale developed by the Cardiovascular Health Study, the white matter was graded for degree of disease on the basis of MR findings. Correlation tests and regression analyses were performed to determine the impact of age, race, and sex on results. RESULTS: Although the cavernous carotid calcification scores and the MR imaging white matter scores showed good correlation (P <.001), the effect was mediated by age. With age factored in as a covariant, no correlation was shown between CT calcification scores and MR imaging white matter scores. Sex had no effect, but African American study participants had worse MR imaging white matter scores than did white participants. CONCLUSION: After adjusting for age, cavernous carotid calcification grades and MR imaging white matter scores do not show a significant correlation. The relative risk for future stroke cannot be predicted from cavernous carotid calcifications.     

Novel estrogen receptor: a chance for more specific and safe endocrinological treatment?

In 1996 Kuiper et al. have cloned a novel member of the nuclear receptor superfamily. The cDNA of clone 29 was isolated from a rat prostate cDNA library. The new receptor was highly homologus to the rat estrogen receptor protein, particularly in the DNA-binding domain. New protein consists of 485 amino acid residues and its molecular weight is 54.2 kDa. Like other steroid receptors, ER beta has six regions, A-F. A novel receptor is expressed in the secretory epithelial cells of the prostate and also in the granulosa cells of the ovary. Differences in the ligand-binding properties and transactivation function on target genes may exist. The tissue distribution and relative level of ER alpha and beta expression seems to be quite different, i.e. moderate to high expression in uterus, testis, pituitary, ovary, kidney, and adrenal for ER alpha and prostate, ovary, lung, bladder, brain, uterus and testis for ER beta. The differences between the receptors subtypes in relative ligand binding affinity and tissue distribution could contribute to the selective action of ER aginists and antagonists in different tissues. These new findings bring up many questions. The most intriguing is how has this second ER eluded investigators for so many years? Perhaps a limited number of estrogen target tissues were screened. The biological significance of the existence of two different ERs is at this moment unclear. Perhaps the existence of two ERs subtypes provides an explanation for the selective actions of estrogens in different target tissues.