Analysis of clones from a human cartilage cDNA library provides insight into chondrocyte gene expression and identifies novel candidate genes for the osteochondrodysplasias

To begin to define the gene expression pattern in fetal cartilage and to identify uncharacterized candidate genes for the osteochondrodysplasias, we analyzed clones from a fetal cartilage cDNA library. Sequence analysis of 420 cDNA clones identified 210 clones derived from established genes but, for many of them, expression in cartilage had not been previously reported. Among the established genes were 14 genes known to produce skeletal abnormalities in either humans or mice when mutated. Thirty-two uncharacterized genes and their respective chromosomal positions were also identified. To further understand the expression profile of these genes in fetal cartilage, we constructed a cDNA microarray utilizing the clones. The microarray was used to determine which genes had higher expression in cartilage as compared with dedifferentiated, cultured chondrocytes. Many of the established genes, as well as five of the uncharacterized genes, had increased expression in cartilage, suggesting an important role for these genes in the differentiated state of chondrocytes. These data provide new candidate genes for the osteochondrodysplasias and demonstrate the usefulness of cartilage cDNA microarrays in expanding our understanding of the complexity of fetal cartilage gene expression.     

Epidemiological characteristics of fatal traffic accidents in Fars province,Iran: a community-based survey

Objectives

To determine the epidemiological characteristics of fatal traffic accidents in Fars province, Iran.

Study design

This cross-sectional study included 3642 traffic accident deaths in Fars province, Iran between November 2009 and November 2011. The data source was the Fars Forensic Medicine Registry, which covers the entire province. According to Iranian law, all deaths resulting from injuries or accidents must be investigated to determine the exact cause of death by autopsy. All such deaths are referred to forensic medicine centres in each city, and all data are sent to the main centre in Shiraz, the capital city of Fars province.

Results

Males accounted for 78.3% of the decedents (sex ratio of almost 3.6:1), and the mean ± standard deviation age of all decedents was 32.2 ± 20.3 years. Autopsy reports indicated that head trauma was the most common cause of death. Most collisions were vehicle–vehicle crashes (52.3%), with cars and motorcycles being the most prevalent modes of transport (39.6% and 24.6%, respectively). Fatal accidents were most common during the summer. Most fatal injuries (61.4%) occurred on outer-city roads and 27.4% occurred on inner-city roads. Significant associations were found between decedent's status (car driver, motorcycle driver or passenger, pedestrian or passenger) and interval between injury and death, light conditions at the scene of the accident, place of death, site of injury and cause of death.

Conclusion

Although the clinical management of trauma patients has improved in Iran, coordination between trauma system organizations is required to decrease the burden of injuries.     

A 4-year prospective study of septicemia in pediatric surgical patients at a tertiary care teaching hospital in Kuwait

Background

Critically ill children are at high risk for developing nosocomial infections that contributes to death in 4% of all pediatric intensive care unit admissions. This prospective study was undertaken to determine the prevalence of septicemia in the pediatric surgery department of a large tertiary care teaching hospital in Kuwait and to evaluate the risk factors, the microbial etiology, and the antimicrobial susceptibility pattern of the isolated microorganisms.

Methods

All patients admitted to the pediatric surgery department from January 2001 until December 2004 with the diagnosis of septicemia were included in the study, and the microbiologically proven cases were then analyzed. The patients' demographics and risk factors for sepsis were recorded. All positive blood cultures were subjected to identification and antimicrobial susceptibility testing by VITEK 2(bioMerieux, Marcy l'Etoile, France).

Results

Of 3408 patients suspected to have septicemia, 78 (2.3%) patients developed microbiologically documented septicemias, 26% of those were low-birth weight patients, and 82% were patients with congenital anomalies; 87% of those needed surgical intervention. More than 50% were admitted to the intensive care unit, and 80.5% needed ventilatory support. Fifty-seven percent had early onset septicemia. Gram-positive and gram-negative bacteria accounted for 54% and 39% of the septicemia cases, respectively, whereas Candida spp was responsible for 7%. More than 50% of the staphylococci were resistant to cloxacillin, and all gram-positives were uniformly susceptible to glycopeptides and linezolid. Gram-negative bacteria showed variable resistance to cephalosporins (65%), piperacillin/tazobactam (29%), and carbapenems (11%). The attributable mortality rate for these septic episodes was 19% mainly because of gram-negative bacteria and Candida.

Conclusion

The main etiologic agents of neonatal septicemia were coagulase-negative Staphylococcus, Pseudomonas aeruginosa, and members of the family Enterobacteriaceae. Empirical therapy with piperacillin/tazobactam or carbapenems for gram-negative septicemia and glycopeptides for gram-positive septicemia was effective.     

Pattern of Scleritis in an Egyptian Cohort

Purpose: To report the clinical experience with scleritis at four Egyptian tertiary care eye centers.

Methods: Multicenter retrospective chart review of all patients with scleritis visiting four ocular inflammation referral clinics in Egypt between January 2013 and October 2017.

Results: A total of 303 scleritis patients were enrolled. These included 76 male and 227 female patients. The most frequent subtype of scleritis was nodular anterior scleritis (44.9%). Rheumatoid arthritis and Wegener granulomatosis were the 2 most common systemic associations among our cohort. Eyes with necrotizing scleritis with inflammation had the lowest mean initial and final BCVA.

Conclusion: The visual prognosis of an eye with scleritis varies with the subtype of scleral inflammation. In our cohort, it was found to be poorer in eyes with necrotizing scleritis with inflammation compared to other subtypes.