Viruses and bacteria in sputum samples of children with community-acquired pneumonia

Few comprehensive studies have searched for viruses and bacteria in children with community-acquired pneumonia (CAP). We identified 76 children hospitalized for pneumonia. Induced sputum samples were analysed for 18 viruses by antigen detection and PCR, and for six bacteria by culture and PCR. Viruses were found in 72% of samples, bacteria in 91%, and both in 66%. Rhinovirus (30%), human bocavirus (18%) and human metapneumovirus (14%) were the most commonly detected viruses. Two viruses were found in 22% of samples and three in 8%. The most common bacteria found were Streptococcus pneumoniae (50%), Haemophilus influenzae (38%), and Moraxella catarrhalis (28%). Rhinovirus–S. pneumoniae was the most commonly found combination of virus and bacterium (16%). All six children with treatment failure had both viruses and bacteria detected in the sputum. Otherwise, we found no special clinical characteristics in those with mixed viral–bacterial detections. With modern molecular diagnostic techniques, there are high rates of both viral and bacterial identification in childhood CAP. The clinical significance of mixed viral–bacterial infections remains unclear, although we found a potential association between them and treatment failure.     

The Effect of Tilted Disc Syndrome on Ocular Hemodynamic Measurements

Background: The purpose of this study was to assess ocular hemodynamics in patients with unilateral tilted disc syndrome (TDS) using color Doppler ultrasonography (CDUS). Methods: Fifteen consecutive patients with unilateral TDS and normal-appearing contralateral optic nerves were enrolled. Both eyes of all participants underwent detailed ophthalmological examination including automated visual field testing. CDUS was performed in the eyes with tilted discs and fellow unaffected eyes. Peak systolic velocities, end diastolic velocities, and vessel resistance were measured in the ophthalmic artery (OA), central retinal artery (CRA), nasal posterior ciliary artery (NPCA), and temporal posterior ciliary artery (TPCA). The minimum and maximum blood flow velocities were also measured in the central retinal vein (CRV). Results: No statistically significant differences were found between eyes with tilted discs and fellow normal eyes in terms of OA, CRA, NPCA, or TPCA mean peak systolic or end diastolic velocities, resistivity indices, and the mean maximal and minimal CRV blood flow velocities. Conclusion: Ocular hemodynamic measurements determined by CDUS do not appear to be altered in tilted disc syndrome.     

Angiotensinogen t235 and angiotensin-converting enzyme insertion/deletion polymorphisms associated with the development of posttransplantation diabetes mellitus in renal allograft recipients

Background

Genetic polymorphisms of the renin-angiotensin system (RAS) have been reported to play an important role in the pathogenesis of diabetes mellitus and hypertension. In addition, a close association has been reported between RAS and the progression of both diabetes and hypertension. But the role of RAS on the development of posttransplantation diabetes mellitus (PTDM) is not known. For this purpose we investigated the association of polymorphisms in the genes for angiotensin-converting enzyme (ACE) and angiotensinogen (AGT) with the development of PTDM.

Methods

Genotyping for ACE insertion/deletion (I/D) and AGT M235T polymorphisms was performed in 50 patients who underwent renal transplantation during a 5-year period. Group 1 consisted of 23 recipients who developed PTDM and group 2 consisted of 27 recipients that did not have PTDM.

Results

Of 50 patients, 13 (26%) showed the ACE DD, 21 (42%) the ACE ID, and 16 the ACE II genotype. The frequencies of AGT MM, AGT MT, and AGT TT were 0, 54%, and 46%, respectively. Compared with group 2, there were high frequencies of the AGT TT genotype in group 1 recipients (P < .001). In addition the ACE DD genotype was found significantly higher in group 1 patients compared with group 2 patients (P = .001).

Conclusion

The high frequencies of the AGT TT genotype and ACE DD genotype in recipients may contribute to the high prevalence of PTDM. Our data suggest a synergistic effect between the ACE and AGT polymorphism in the risk of PTDM, but to support this theory a larger patient group must be studied.     

Rapamycin prevents interstitial fibrosis in renal allografts through decreasing angiogenesis and inflammation

Rapamycin (RPM) has antiangiogenic and antiproliferative effects on cells. The aim of this study was to evaluate the mechanism of RPM as a novel antifibrotic agent by assessing its effect on interstitial fibrosis (IF). Among 60 renal transplant recipients, group 1 patients (n = 20) were treated with RPM and group 2 (n = 40), with cyclosporine. The proportions of infiltrating macrophages and lymphocytes in the interstitium were evaluated in 1-year biopsies. The microvessels were highlightened with CD34. After an initial biopsy, the development of diffuse IF over 18 months was evaluated by follow-up biopsies. The mean microvessel density (MVD) was significantly lower among group 1 (69.3 ± 16) versus group 2 (96.5 ± 30; P < .001). The proportions of macrophages and lymphocytes were lower in group 1 compared to group 2 biopsies (P < .001 for both). Fourteen (35%) group 2 and only 2 (10%) group 1 cases developed IF over 18 months (P < .05). The mean MVD in the initial biopsy was 75.6 ± 18 in cases that did not versus 120 ± 28 among those who did develop IF (P < .001). The amount of interstitial inflammation was greater among patients who did compared with cases who did not develop IF (P < .01). The overall 1-, 3-, and 5-year graft survival rates for group 1 were 95%, 95%, and 89% versus 95%, 65%, and 45% for group 2 patients, respectively (P < .001). RPM-treated patients showed a lower incidence of diffuse IF, which can be explained by antiproliferative and antiangiogenic effects of RPM. In conclusion, RPM therapy displayed an independently positive impact on long-term graft survival.     

Insomnia and cardiorespiratory fitness in a middle-aged population: the SCAPIS pilot study

Sleep and Breathing - The relationship between insomnia and cardiorespiratory fitness (CRF), a well-established risk factor for cardiovascular disease, has not been extensively studied. We aimed to...     

An in vitro comparison of diagnostic abilities of conventional radiography, storage phosphor, and cone beam computed tomography to determine occlusal and approximal caries

Aim

The aim of this study was to compare conventional radiography, storage phosphor plate, and cone beam computed tomography for in vitro determination of occlusal and approximal caries.

Methods

A total of 72 extracted human premolar and molar teeth were selected. Teeth were radiographed with conventional intraoral radiography, a storage phosphor plate system, and cone beam computed tomography and evaluated by two observers. The teeth were then separated and examined with a stereomicroscope and a scanner at approximately 8× magnification.

Results

CBCT was statistically superior to conventional radiography and phosphor plate for determining occlusal caries. No significant difference from CBCT, conventional radiography and the phosphor plate system for determining approximal caries was found.

Conclusion

The CBCT system may be used as an auxiliary method for the detection of caries.     

Elongated styloid process associated with nevoid basal cell carcinoma syndrome

This article presents a case with nevoid basal cell carcinoma syndrome (NBCCS) and an elongated styloid process. Basal cell carcinoma syndrome, also known as Gorlin-Goltz syndrome, is an autosomal dominant inherited syndrome manifested by multiple defects involving the skin, nervous system, eyes, endocrine system, and bones. Elongated styloid process or calcified stylohyoid ligament cause craniofacial or cervical pain. The actual cause of elongation of the styloid process or the calcification of the stylohyoid ligament is unclear. The cause of elongation of styloid process in this case may be the calcification induced by NBCCS. This report is the first case presentation of NBCCS with elongated styloid process. Elongated styloid process might be described as an anomaly of an NBCCS.