Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae in Austria

OBJECTIVES: To determine the prevalence of antibiotic resistance and the distribution of serotypes among Streptococcus pneumoniae isolated in Austria. MATERIALS AND METHODS: A total of 2367 strains of S. pneumoniae were collected in an Austrian-wide surveillance system between 1996 and 2002. Isolates were tested for their susceptibility to penicillin and clarithromycin and were serotyped by the capsular swelling method. RESULTS: An overall rise in penicillin resistance was observed from 4.9% in 1996 to 10.0% in 2002 (including both intermediate-resistant and resistant strains). A rise in clarithromycin resistance was also recorded in this period. The overall distribution of serogroups/types remained relatively stable, with 23, 19, 6 and 14 being the most frequent ones. Whereas in 1996 penicillin resistance was predominantly associated with serotype 23F, in 1998 and 2002, resistance was most frequently found in isolates of serogroup 9 and serotype 14, respectively. Coverage rates for currently available vaccines ranged from 57.4% (7-valent) to 72.4% (23-valent) of all serotyped strains. CONCLUSIONS: This rise in pneumococcal resistance to penicillin and clarithromycin, and the change in distribution of serotypes in these resistant strains, indicates that ongoing surveillance programmes are warranted, in order to be able to formulate both effective vaccination strategies and optimal antibiotic therapies.     

Low back pain in physical education teachers

The purpose of this study was to investigate the factors related to occupational low back pain (LBP) occurring in male physical education teachers (PET). The location was set in Athens and we used questionnaires to collect information. Analysis revealed that the prevalence of LBP during the survey was 63%. The correlation of personal factors and LBP showed that the prevalence of LBP was significantly higher in those PET (odds ratio, 2.5) who answered yes to the item "no personal training" than in the PET who did not. Moreover, many occupational factors are related to LBP. These were the items "lifting gym instruments" (odds ratio, 2.6) and "helping students into flexing posture" (odds ratio, 3.0). From the working conditions it was confirmed that the PET (odds ratio, 2.5) who "spent more than 35 hours per week in teaching physical education" were correlated with LBP. Our results suggest that PET, under the current working condition, are vulnerable to low back pain. An improvement of these conditions must be taken into account in order to prevent LBP.     

Functional organization of parietal neuronal responses to optic-flow stimuli

We analyzed the dissimilarity matrix of neuronal responses to moving visual stimuli using tree clustering and multidimensional scaling (MDS). Single-cell activity was recorded in area 7a while random dots moving coherently in eight different kinds of motion (right-, left-, up-, and downward, clockwise, counterclockwise, expansion, contraction) were presented to behaving monkeys with eyes fixated. Tree clustering analyses showed that the [rightward, leftward], [upward, downward], and [clockwise, counterclockwise]] motions were clustered in three separate branches (i.e., horizontal, vertical, and rotatory motion, respectively). In contrast, expansion was in a lone branch, whereas contraction was also separate but within a larger cluster. The distances among these clusters were then subjected to an MDS analysis to identify the dimensions underlying the tree clustering observed. This analysis revealed two major factors in operation. The first factor separated expansion from all other stimulus motions, which seems to reflect the prominence of expansion during the common activity of locomotion. In contrast, the second factor separated planar motions from motion in depth, which suggests that the latter may hold a special place in visual motion processing.     

Prenatal diagnosis of common aneuploidies using quantitative fluorescent PCR

OBJECTIVE: Quantitative fluorescence-polymerase chain reaction (QF-PCR) has recently been used for the detection of common chromosomal aneuploidies in prenatal diagnosis. Here we describe our experience in prenatal diagnosis of 1100 samples. METHODS: Extraction of DNA was performed from amniotic fluid, chorionic villus samples (CVS), fetal blood and fetal tissue samples, using a simple, rapid protocol. Fluorescent multiplex PCR products of single tandem repeats (STRs) located on chromosomes 13, 18, 21, X and Y were then analyzed on an automated laser fluorescent sequencer. All samples were analyzed with at least two polymorphic markers for chromosomes 13, 18 and 21 and one for the X chromosome. The amelogenin locus was used for sexing. Analysis was performed twice on affected samples. When miscellaneous results were obtained extra markers were used. RESULTS: We evaluated the usefulness of different markers in the Greek population. In a total of 1100 samples, 25 chromosome aberrations were identified, including trisomy 13, 18 and 21, XYY, triploidies 69,XXX and 69,XXY and one Turner mosaic. All results but three were consistent with conventional cytogenetic analysis. One mosaic was missed. Most bloodstained samples were successfully analyzed. CONCLUSION: Successful analysis of a large number of prenatal samples proves QF-PCR to be an efficient adjunct in routine prenatal diagnosis.     

Unipolar late-onset depression: A comprehensive review

Background

The older population increases all over the world and so also does the number of older psychiatric patients, which manifest certain specific and unique characteristics. The aim of this article is to provide a comprehensive review of the international literature on unipolar depression with onset at old age.

Methods

The authors reviewed several pages and books relevent to the subject but did not search the entire literature because of it's overwhelming size. They chose to review those considered most significant.

Results

The prevalence of major depression is estimated to be 2% in the general population over 65 years of age. The clinical picture of geriatric depression differs in many aspects from depression in younger patients. It is not yet clear whether it also varies across cultures and different socio-economic backgrounds. Biological data suggest that it is associated with an increased severity of subcortical vascular disease and greater impairment of cognitive performance. Many authors consider the existence of a somatic disorder to be related to the presence of depression in late life, even constituting a negative prognostic factor for the outcome of depression. Most studies support the opinion that geriatric depression carries a poorer prognosis than depression in younger patients. The therapeutic intervention includes pharmacotherapy, mainly with antidepressants, which is of established value and psychotherapy which is not equally validated.

Conclusion

A significant number of questions regarding the assessment and treatment of geriatric depression remain unanswered, empirical data are limited, and further research is necessary.

     

The role of Hemochromatosis C282Y and H63D mutations in the development of type 2 diabetes mellitus in Greece

Several authors have suggested a positive association between diabetes type 2 (DM2) and the C282Y and H63D mutations of the hereditary hemochromatosis gene but others have disputed it. There are also papers reporting an increased iron load in diabetes type 2 and a possible association with the pathogenesis of the disease. We therefore performed a study in 100 type 2 diabetics and 100 age and sex matched controls to assess the possibility that C282Y and H63D mutations constitute a risk factor for DM2 in Greece. We also evaluated the iron load in 500 diabetes type 2 patients and 423 age and sex matched controls. We did not find any differences in the allele frequencies of the above mutations between patients with diabetes type 2 and controls. The allele frequencies were estimated to be 0.0075 for the C282Y and 0.115 for the H63D mutation. Subjects with even one mutation (C282Y or H63D) had higher transferrin saturation compared to those with no such mutations. This seems to apply to both diabetics (49+/- 8,6 vs 44,5+/- 5,4, p<0,01) and controls (49,3+/- 7,3 vs 42,6+/- 3,3 p<0,01). Patients with DM2 had higher transferrin saturation compared to the general population. These differences were found among men (n=250, mean+/- SD 31,8+11 vs n=73, mean+/- SD 29,5+8, p=0,05) as well as among women (n=250, mean+/- SD 28.5+10 vs n=350, mean+/- SD 25.5+9.6, p=0.001). The DM2 patients had higher ferritin levels compared to controls. In conclusion, DM2 patients have increased iron load. The C282Y and H63D mutations contribute to increased iron load in both DM2 and controls. There was no difference in the frequency of C282Y and H63D alleles between DM2 and controls in the Hellenic population.     

Functional electrical stimulation of lower limbs in patients with chronic heart failure

Physical training is an important component of therapy for patients with chronic heart failure (CHF) and is considered complementary to their pharmacological treatment. The majority of conventional rehabilitation programs include aerobic training, which has been demonstrated to induce significant beneficial effects on the neurohumoral, immunoreactive and functional status of patients with moderate CHF. Functional electrical stimulation (FES) of skeletal muscles constitutes an alternative training mode with beneficial effects comparable to classical aerobic exercise, suitable for patients with CHF who cannot participate in traditional training programs due to either advanced grades of CHF or the presence of comorbidities. We present a review of the numerous studies evaluating the effects of FES in CHF, focusing on its main effects on skeletal myopathy reversal, exercise tolerance improvement and quality of life modification.