"Nanobacterium sanguineum"--is it a new life-form in search of human ailment or commensal: overview of its transmissibility and chemical means of intervention

Morphological, cultural, and immuno-histochemical characteristics of "Nanobacterium sanguineum" (NB) described in the literature are reviewed. NB is reported to be a motile, Gram negative organism that divides by binary fission within a calcium-coated slimy shell; this yeast-like shell replicates by budding. It measures between 20 and 200 nm with a unique structure containing 16S ribosomal RNA. NB has been observed by electron microscopy in coronary artery plaques (CAD) and in kidney stones (KS) found in renal diseases. On the basis of supportive literature, we suggest that NB is not only present in the human body but also has auxiliary association with human ailments without a specific etiological role; anti-NB antibody has been detected in subjects with calcified lesions and inflammation in diverse ailments including choriodecidual inflammation in pregnancy, ovarian cancers, arthritis and even Alzheimer's disease. More recent report on the detection and vertical transmission of NB antigen and anti-NB antibody in HIV-infected mothers supports the view that NB might be an important opportunistic infective agent contributing to HIV pathology; we note that the presence of viable and transmitting NB was not studied and suggest further studies to establish vertical transmission of NB in HIV-infected persons. On the basis of the foregoing we suggest that NB possibly exacerbates human ailments and raise the question: Is NB a new life-form in search of human ailment or a commensal organism? Recognizing the presence of NB in the human body, we discuss clinical trials, reported in the literature relevant to its eradication, with a rectal suppository containing very high amounts of disodium EDTA and tetracycline. We suggest that tetracycline in this formulation acted in combination with EDTA, more as a chelating agent than an antibiotic; oxytetracycline- a non-chelating form of tetracycline-does not inhibit or kill NB. Evaluation of anti-NB effect of orally administrable and potentially safer as well as therapeutically more acceptable chelating agent -ascorbic acid, acting alone or in combination with antibiotics-that eradicates another slime forming bacterium - Pseudomonas aeruginosa - in children with cystic fibrosis, is suggested.     

Vascular evaluation for balloon pumping.

The effectiveness of intraaortic balloon counterpulsation is reduced frequently by arterial insufficiency following balloon insertion and occasionally by inability to pass the balloon centrally from a peripheral site. From a series of patients undergoing cardiac catheterization, a subgroup with increased likelihood of needing balloon counterpulsation can be selected. Patients so chosen have received one aortoiliac injection of contrast material at the time of cardiac catheterization. Impressive degrees of vessel irregularity and stenosis on an atherosclerotic basis and of tortuosity of normal lumen size have been noted. Such information, gathered at little additional risk or irradiation, is considered to be important in the subsequent choice of sides for transfemoral insertion and may rule out attempted passage of the balloon by this route, directing the surgeon to a deliberate, prompt, transabdominal or thoracic aortic insertion if necessary.     

Minimum size and positioning of imaging field for CBCT scans of impacted maxillary canines

Clinical Oral Investigations - In children and adolescents, cone-beam computed tomography (CBCT) is frequently used for localization of unerupted or impacted teeth in the anterior maxilla. CBCT...     

An assessment of the Irish population for large-scale genetic mapping studies involving epilepsy and other complex diseases

The recent completion of the International HapMap Project has rapidly advanced our understanding of linkage disequilibrium (LD) in the human genome. Today, tagging SNPs (tSNPs) can be quickly and easily selected and consequently HapMap data are regularly applied to both small- and large-scale genetic mapping studies. However, to correctly interpret the application of HapMap-derived tSNPs in a genetic mapping study, an understanding of how well HapMap data represents LD in the study population is critical. The Irish population had not previously been characterised in this way. Here, we do so using a set of 4424 SNPs selected from 279 candidate genes for epilepsy genotyped across 1118 healthy individuals from the Irish, British, Finnish and Australian populations. By considering the Irish population alongside surrounding European populations, our results confirm that the HapMap European-derived population accurately estimates patterning of LD in European descent populations. The Irish population appears notably well matched to the European HapMap population, and is markedly similar to the neighbouring British population. Although we were unable to detect significant substructure within the Irish population (a favourable result for genetic mapping), methods for controlling stratification should always be incorporated. This analysis therefore confirms that the genetic architecture of the Irish population is well suited to the study of complex traits and that tSNPs selected using the HapMap data can be confidently applied to the Irish population.     

Metabolomics of Synovial Fluid and Infrapatellar Fat Pad in Patients with Osteoarthritis or Rheumatoid Arthritis

Inflammation - Osteoarthritis (OA) and autoimmune-driven rheumatoid arthritis (RA) are inflammatory joint diseases with complex and insufficiently understood pathogeneses. Our objective was to...     

CPAP interface: satisfaction and side effects

Purpose

This study aimed to evaluate the care receiver's satisfaction with the continuous positive airway pressure (CPAP) interfaces.

Methods

A questionnaire with visual analog scales was sent to all our CPAP patients (0?=?absolutely unsatisfied, 100?=?very satisfied). From the ResMed ResScan program, we obtained the CPAP daily use and air leak values.

Results

We received 730 answers (70 % of participants); females comprised 22 %. A total of 391 patients had ResMed interfaces, 227 had Respironics, 87 had Fisher & Paykel (F&P), and 25 patients had other interfaces. Interfaces were nasal for 79 %, nasal pillows for 9 %, oronasal for 9 %, and unidentified for 3 % of cases. The mean?±?SD satisfaction rate was 68?±?25. No statistically significant differences were found regarding the type or brand of interface, previous interface experience, or the age or gender of the patient. Users of ResMed interfaces had significantly (p?<?0.01) fewer cases of disturbing leaks than did users of Respironics or F&P interfaces (60 vs. 70 and 72 %, respectively). The ResMed Ultra Mirage interface had the fewest cases of disturbing leaks. Values for the measured median leaks were a mean of 5.9?±?7.2 l/min, and those for the maximum leaks were 39.3?±?22.2 l/min with no differences between brands. The users of F&P interfaces experienced significantly (p?<?0.01) more comfort and used the CPAP device significantly (p?<?0.007) more than did users of ResMed or Respironics interfaces (88 % of cases vs. 65 and 57 % and 6.2?±?2.6 vs. 5.3?±?2.8 or 5.8?±?2.8 h/day, respectively).

Conclusions

The majority of patients consider the use of the CPAP interface disturbing even though the satisfaction rate is good with no differences between brands.     

Protocol for motor and language mapping by navigated TMS in patients and healthy volunteers; workshop report

Acta Neurochirurgica - Navigated transcranial magnetic stimulation (nTMS) is increasingly used for preoperative mapping of motor function, and clinical evidence for its benefit for brain tumor...     

Routine Ultrasound Quality Assurance in a Multi-Unit Radiology Department: A Retrospective Evaluation of Transducer Failures

The importance of quality assurance (QA) in medical ultrasound (US) has been widely recognized and recommendations concerning technical QA have been published over the years. However, the demonstrated impact of a properly working QA protocol on clinical routine has been scarce. We investigated the transducer write-off causes for a 5-y period in a multi-unit radiology department with an annual average of 230 transducers in demanding diagnostic use. The transducer faults and the initial observers of the faults leading to transducer write-offs were traced and categorized. The most common cause of transducer write-off was an image uniformity problem or element failure. Mechanical faults or excessive leakage current and defects in the lens constituted smaller yet substantial shares. Our results suggest that a properly working routine QA program can detect majority of the faults before they are reported by users.     

Repellent efficacy of four commercial DEET lotions against Amblyomma hebraeum (Acari: Ixodidae), the principal vector of Rickettsia africae in southern Africa

African tick bite fever, caused by Rickettsia africae, is an emerging zoonotic infection in rural sub-Saharan Africa and the French West Indies. We tested the repellent efficacy of four commercial diethyl-3-methylbenzamide (DEET) lotions against Amblyomma hebraeum Koch, the principal vector of R. africae in southern Africa, by using a human bioassay in which repellent-treated fingers were presented to questing tick nymphs hourly for 4h. Three lotions with 19.5, 31.6 and 80% DEET concentrations, respectively, had a repellent efficacy of > or =90% at 1h post-application, of > or =77% at 2h post-application and of <70% during the rest of the experiment. By contrast, a lotion with 2% DEET plus 1% citronella oil provided only a 59% repellency at 1h post-application, with a drop to <22% during the following hours. Hourly negative control trials repelled <5% of tick attacks. Our results suggest that commercial repellents containing > or =19.5% DEET provide a significant but short-lasting protection against questing A. hebraeum ticks.