Successful management of nosocomial ventriculitis and meningitis caused by extensively drug-resistant Acinetobacter baumannii in Austria

Nosocomial infections caused by the Gram-negative coccobacillus Acinetobacter baumannii have substantially increased over recent years. Because Acinetobacter is a genus with a tendency to quickly develop resistance to multiple antimicrobial agents, therapy is often complicated, requiring the return to previously used drugs. The authors report a case of meningitis due to extensively drug-resistant A baumannii in an Austrian patient who had undergone neurosurgery in northern Italy. The case illustrates the limits of therapeutic options in central nervous system infections caused by extensively drug-resistant pathogens.     

ACE2, angiotensin-(1-7) and Mas receptor axis in inflammation and fibrosis

Recent advances have improved our understanding of the renin-angiotensin system (RAS). These have included the recognition that angiotensin (Ang)-(1-7) is a biologically active product of the RAS cascade. The identification of the ACE homologue ACE2, which forms Ang-(1-7) from Ang II, and the GPCR Mas as an Ang-(1-7) receptor have provided the necessary biochemical and molecular background and tools to study the biological significance of Ang-(1-7). Most available evidence supports a counter-regulatory role for Ang-(1-7) by opposing many actions of Ang II on AT₁ receptors, especially vasoconstriction and proliferation. Many studies have now shown that Ang-(1-7) by acting via Mas receptor exerts inhibitory effects on inflammation and on vascular and cellular growth mechanisms. Ang-(1-7) has also been shown to reduce key signalling pathways and molecules thought to be relevant for fibrogenesis. Here, we review recent findings related to the function of the ACE2/Ang-(1-7)/Mas axis and focus on the role of this axis in modifying processes associated with acute and chronic inflammation, including leukocyte influx, fibrogenesis and proliferation of certain cell types. More attention will be given to the involvement of the ACE2/Ang-(1-7)/Mas axis in the context of renal disease because of the known relevance of the RAS for the function of this organ and for the regulation of kidney inflammation and fibrosis. Taken together, this knowledge may help in paving the way for the development of novel treatments for chronic inflammatory and renal diseases.     

A comparative study of oral health knowledge,attitude and behaviour of non‐medical,para‐medical and medical students in Udaipur city,Rajasthan, India

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2009.00393.x
Sharda AJ, Shetty S. A comparative study of oral health knowledge, attitude and behaviour of non‐medical, para‐medical and medical students in Udaipur city, Rajasthan, India. Abstract: Aim: The aim of the study was to assess and compare the Oral health knowledge, attitude and behaviour of the non‐medical, para‐medical and medical students. Material and methods: In a cross‐sectional study, a total of 825 students (males – 577, females – 248) of six different professions belonging to non‐medical, para‐medical and medical categories were surveyed using a self‐administered, structured questionnaire pretested through a pilot survey. The mean percentage scores, standard deviation and frequency distribution were calculated. The Student’s t‐test, anova test, Scheffe’s test and chi‐squared test were used as test of significance. The linear regression analysis was used to assess the relation of behaviour with knowledge and attitude. Results: The knowledge scores were significantly higher for the medical students compared with those of non‐medical students. The attitude scores were significantly lower for the non‐medical category compared with the other two categories and the scores were the highest among the para‐medical students. The behaviour scores were significantly lower for the non‐medical students than for the para‐medical and the medical categories. All the scores were significantly higher for females than for the males. Regression analysis showed a linear relationship of behaviour with the attitude, but no significant linear relation with the knowledge. Conclusion: All the students showed low level of knowledge and the preventive behaviour among the students could still be improved. The results indicate that the knowledge was not enough to influence the oral health behaviour, but behaviour showed linear relationship with attitude of the students.     

The bactericidal effect of a Genius® Nd:YAG laser

Abstract:  Purpose: To evaluate the 'in vitro' bactericidal effect of the Nd:YAG laser (Genius, MØlsgaard Dental, Copenhagen, Denmark) on six periodontal pathogens. Methods:  Suspensions of six different periodontal pathogens ( Aggregatibacter actinomycetemcomitans , Porphyromonas gingivalis , Prevotella intermedia , Tannerella forsythia , Fusobacterium nucleatum and Parvimonas micra ) were prepared in small Eppendorff tubes, and exposed to a Nd:YAG laser for five different periods of time. Laser settings used: Power 6 Watt (on a scale of 1–12 W), Frequency 50 Hz, Pulse duration 250 μs. After exposure to the laser, aliquots of the suspensions were spread on blood agar plates for bacterial counting. Results:  After 5 s of laser exposure, there was a decrease in total colony forming units for all six selected microorganisms. After 15, 30 and 45 s, no viable bacterial cells could be retrieved. Conclusion:  In this 'in vitro' model, 15 s of Nd:YAG laser use was found to be effective for total killing of the six tested periodontal pathogens.     

L929 fibroblast and Saos-2 osteoblast response to hydroxyapatite-betaTCP/agarose biomaterial

Biphasic calcium phosphate, a mixture of hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP), has been successfully used as an excellent bone graft substitute because of the HA capacity for direct interaction with bone and the beta-TCP resorption properties. Agarose has been recently mixtured with ceramics as natural biodegradable binder to increase the biomaterial flexibility facilitating its placement into the bone defect. In this study, the behavior of L929 fibroblasts and Saos-2 osteoblasts cultured on hydroxyapatite-betaTCP/agarose disks has been evaluated. Both cell types adhere and proliferate on the biomaterial surface maintaining their characteristic morphology. Transitory changes on cell cycle, size, and complexity are observed. The biomaterial induces apoptosis in Saos-2 osteoblasts but not in fibroblasts. A transitory stimulation of fibroblast mitochondrial activity is observed. This effect remains in osteoblasts after 9 days of culture showing a higher sensitivity of this cell type. However, the intracellular reactive oxygen species content and the lactate dehydrogenase release of Saos-2 osteoblasts indicate that hydroxyapatite-betaTCP/agarose does not induce oxidative stress in this cell type and confirm the integrity of the osteoblast plasma membrane. These results underline the good biocompatibility of hydroxyapatite-betaTCP/agarose disks and its potential utility for bone substitution and repair.     

Left coronary arterial blood flow: noninvasive detection by Doppler US

Continuous wave (CW) and pulsed Doppler ultrasound studies with spectral analysis were used to detect the left coronary arterial blood flow in patients who were undergoing routine echocardiography. The pulmonary artery is a stable ultrasonic landmark from which detection of the blood flow can be effected. The left coronary artery can be distinguished by its blood flow toward the cardiac apex and by specific, functional flow features. Flow patterns vary among the left main, circumflex, and anterior descending arteries; patterns also vary with respiration cycles. In the present study, coronary arterial blood flow was detected in 58 of 70 patients (83%). Findings were validated by selectively injecting an agitated saline contrast medium into the left coronary artery and, in another study, by comparing human Doppler phasic flow waveforms with electromagnetic flowmeter recordings obtained in dogs.     

Intraluminal thrombus of the internal carotid arteries: angiographic demonstration of resolution with anticoagulant therapy alone

Fourteen patients with angiographically demonstrated thrombus in the cerebral vessels were treated immediately with anticoagulant or antiplatelet medication. Follow-up angiograms, obtained in eight cases, showed resolution of the thrombus in seven. In no patient did the thrombus progress to occlude the vessel completely, and no new distal emboli were identified on the follow-up angiograms. There were no new permanent neurologic events in these 14 patients while they were undergoing medical therapy. Six patients subsequently underwent delayed endarterectomy to treat underlying stenoses. Our experience indicates that the presence of intraluminal thrombus may not be a surgical emergency.     

Fixed spinal cord: diagnosis with MR imaging

Pulsatile motion of the spinal cord was examined with phase imaging techniques. Sagittal images of the spinal cord were obtained at different times of the cardiac cycle in healthy volunteers, as well as in patients in whom the spinal cord either was tethered, was compressed, or contained an intramedullary lesion. Pulsatile velocity changes of the spinal cord, observed on the phase images, were most marked at the cervical-upper thoracic level. Cord motion was found to be significantly decreased in cases in which the cord was either tethered or compressed. Cord enlargement due to an intramedullary lesion generally did not lead to decreased cord motion. Imaging of pulsatile cord motion may be clinically useful in evaluating diseases restricting cord motion or changing the status of parenchymal compliance.