Early diagnosis of endemic nephropathy

Urinary alpha(1)-microglobulin as a tubular marker and albumin as a glomerular marker were measured in 373 subjects living in a typical endemic village of Kaniza, Croatia, previously classified as diseased, suspect, 'at risk' and others according to the criteria used for the diagnosis of endemic nephropathy. Based on the excretion pattern of alpha(1)-microglobulin and albumin and its extent, significant tubular with significant glomerular proteinuria was found in seven diseased subjects. Significant tubular proteinuria with slight glomerular proteinuria was found in one diseased subject, while another diseased subject had slight tubular with significant glomerular proteinuria. Significant tubular with significant glomerular proteinuria was found in only one suspect subject. Also, significant tubular proteinuria was established in one other subject.     

Microcalorimetry: a novel method for detection of microbial contamination in platelet products

BACKGROUND: Measuring heat from replicating microorganisms in culture may be a rapid, accurate, and simple screening method for platelets (PLTs). Microcalorimetry for detection of microorganisms in in vitro contaminated PLT products was evaluated. STUDY DESIGN AND METHODS: Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus sanguinis, Escherichia coli, Propionibacterium acnes, and Candida albicans were inoculated in single-donor apheresis PLTs to achieve target concentrations of 10(5), 10(3), 10, or 1 colony-forming units (CFU) per mL of PLTs. Contaminated PLTs in growth medium were incubated at 37 degrees C for 5 days in a calorimeter. Positivity was defined as heat flow of at least 10 microW above the lowest value of the power-time curve. RESULTS: With microcalorimetry, inocula of 10 CFUs per mL PLTs could be detected with the following detection times: S. epidermidis (31.65 hr), S. aureus (24.24 hr), S. sanguinis (7.82 hr), E. coli (7.53 hr), P. acnes (73.57 hr), and C. albicans (43.77 hr). The detection time was less than 4 hr at 10(5) CFUs per mL PLTs for S. aureus, S. sanguinis, and E. coli. Noncontaminated PLTs remained negative. The total heat ranged from 2.8 (S. sanguinis) to 8.3 J (E. coli).The shape of the power-time curve was species-specific and independent from the initial concentration of microorganisms. CONCLUSION: The detection limit of microcalorimetry was 1 to 10 CFUs per mL PLTs. Microcalorimetry is a promising novel method for detection of contaminated PLTs. Applying this method to all PLT products could reduce the frequency of transfusion-related sepsis and prolong the shelf life of PLTs.     

Pharmacokinetics and pharmacodynamics of gatifloxacin against Streptococcus pneumoniae and Staphylococcus aureus in a granulocyte-rich exudate

The pharmacokinetics of gatifloxacin were assessed in serum and in skin blister fluid (SBF), as was the pharmacodynamic activity in SBF. Five hours after a single dose of gatifloxacin, SBF killed 2.5 logs of Streptococcus pneumoniae and 1.5 log of Staphylococcus aureus during a 2-h incubation ex vivo.     

Evaluation of the ventricular system in children using transcranial ultrasound: reference values for routine diagnostics

In children, evaluation of the size of the ventricular system is important. Transcranial Doppler sonography (TCD), a broadly available and easily applicable method that is not hampered by side effects, such as radiation, is a valuable tool for routine examinations. However, standard TCD values of the ventricular system are lacking. In this study, we performed TCD through the temporal acoustic bone window in a large cohort of 1693 healthy children. Of these, 157 had to be excluded because of insufficient bone windows. In the remaining children, a mean width of 1.4 +/- 0.8 mm for the third ventricle, 14.4 +/- 0.8 mm for the right and 14.6 +/- 0.7 mm for the left cella media, and 1.6 +/- 0.7 mm for the right and 1.9 +/- 0.8 mm for the left temporal horn were measured. Side differences are indicated and values are given in relation to age and gender. Inter-rater reproducibility obtained in 25 children was adequate, with no significant difference between the two measurements in any of the parts of the ventricular system measured, rendering these values suitable for reference.     

Demographic features, clinical characteristics and laboratory findings in children with multiple erythema migrans in Slovenia

OBJECTIVE: To identify demographic, clinical and laboratory characteristics of children with multiple erythema migrans (EM) in Slovenia. METHODS: We prospectively studied patients aged 15 years and less, examined at our department for multiple EM in 1996 and 1997. Demographic and clinical data were collected by means of a questionnaire. In addition, basic haematological and biochemical investigations, serologic testing, and Borrelia cerebrospinal fluid and blood cultures were performed. RESULTS: Ninety-five children (44 girls, 55 boys) aged 1 to 13.5 (median, 4.5) years fulfilled the inclusion criteria. A tick bite was recalled by 23%. The incubation period was 10.5 (range, 1 to 150) days, the duration of skin lesions before the initial examination 4 (range, 1 to 54) days, and the median number of skin lesions, 4.5 (range, 2 to 35). The initial disease was mild in 81% of patients. Local and systemic symptoms were reported by 11% and 30% of children, respectively. Clinical signs accompanying EM lesions were found in 42%. Cerebrospinal pleocytosis (predominantly lymphocytic) was seen in 18% of patients; none of them had frank clinical evidence of central nervous system involvement. Serum IgM and IgG antibodies were detected in 28% and 22% of children, respectively. In 3/79 (4%) patients, Borreliae were isolated from the blood and in 2/83 (2%) from the cerebrospinal fluid. In 2/81 (2%) children, borrelial IgG intrathecal antibody production was demonstrated. CONCLUSIONS: Multiple EM in Slovene children is a mild disease. However, some patients had an associated, usually asymptomatic, infection of the central nervous system.     

Influence of pigments and pH of urine on the determination of N-acetyl-beta-D-glucosaminidase activity with 2-methoxy-4-(2'-nitrovinyl)-phenyl-N-acetyl-beta-D-glucosaminide

The influence of urinary pigments and urine pH on the spectrophotometric determination of N-acetyl-beta-D-glucosaminidase (NAG; EC 3.2.1.30) activity with 2-methoxy-4-(2'-nitrovinyl)-phenyl-N-acetyl-beta-D-glucosaminide as a substrate was studied. The investigation was performed with human and rabbit urine samples. It was found that alkaline urine pH values influenced NAG activity in two ways: 1) NAG activity decreased due to enzyme instability with pH increase, and 2) NAG activity increased because of the contribution of urinary pigments to absorbance of 2-methoxy-4-(2'-nitrovinyl)-phenol (MNP) at 505 nm. It was shown that besides the maximum (I) in the range of 350-360 nm of the absorption spectra of alkaline urine, there was a maximum (II) in the range of 380-460 nm. With the increase of pH, maximum II was shifted toward higher wavelengths and contributed to MNP absorption (5-90%). On the other hand, the maximum of MNP absorption was shifted toward lower wavelengths (495-400 nm) with increasing pH. Two procedures to eliminate the influence of urinary pigments are presented. The justification of applying a correction to the values of NAG activity in human and rabbit urine (a model system for studying the toxic effects of cadmium) was discussed.     

The role of the nasal region in craniofacial growth: An investigation using path analysis

This study focuses on the role of the nasal region and its interactions with adjacent facial elements during early ontogeny. A series of linear measurements, areas and volumes were extracted from a collection of 227 medical CT-scans of children from 0 to 6 years of age. These measurements describe aspects of the form of the orbit, maxilla, peri-alveolar (subnasal) region, nasal area, eye, oral region, masseter, and temporal muscles. Hypothesized interactions were then examined using path analysis. Two paths were designed: the first to investigate potential interactions in, and relative contributions of the nasal derivatives and adjacent regions to overall facial growth and development; the second path sees the addition of facial soft tissue measurements and aims to assess their effects on skeletal components, and on overall facial growth and development. The results of the first path indicate a large contribution of the nasal and subnasal regions to facial development. This indicates that the nasal septum and the developing dentition provide an important but variable contribution to facial ontogeny during early years. This result is confirmed in the second path, where the soft tissue elements were added to the diagram. Results of the second path indicate that the soft tissues contribute only locally to the development of some skeletal elements of the face. This indicates that the contribution of skeletal components has a more direct effect on facial height than soft tissue matrices, however there are complex interactions between soft tissues and skeletal elements throughout ontogeny.     

Croatian population data for the C677T polymorphism in methylenetetrahydrofolate reductase: frequencies in healthy and atherosclerotic study groups

BACKGROUND: The aim of this study was to investigate the frequency of C677T methylenetetrahydrofolate reductase (MTHFR) mutation in healthy Croatian volunteers and in patients with atherosclerosis. METHODS: The C677T MTHFR gene mutation was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 640 subjects, residents of the Zagreb city or Zagreb surroundings. Control group (n=298) was healthy blood donors. Patients (n=342) were divided into two groups of those with coronary heart disease, CAD (n=247) and those with >60% carotid stenosis, CS (n=95). RESULTS: CC genotype was recorded in 45% of healthy volunteers and 46% of patients (46.3% with CS and 46.2% with CAD). TC genotype was found in 49% of healthy volunteers and 45% of patients (46.3% with CS and 44.9% with CAD). There was no significant difference (p>0.05) from the control group in the genotype or allele frequency either for the overall group of patients with atherosclerosis or for the patient subgroups. CONCLUSION: The preliminary study of MTHFR polymorphism in control subjects and cardiovascular disease/carotid stenosis patients revealed that in Croats there was a low frequency of TT genotype (6% in controls vs. 9% in patients) and T allele (31% for cases and controls). Additionally, our results did not show significantly higher frequency of MTHFR mutation in CAD and CS studied groups.