Screening for visual disorders in pre-primary school

Children's vision develops very early on in life and constitutes their first connection with their surroundings. Recommendations emphasise the importance of early screening to improve learning at school. The pre-primary school period, between the ages of 3 and 6 is the ideal time for this. Child care nurses thereby have an important role to play in terms of health education and orientation.     

MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging

Objectives

To evaluate the performance of diffusion-weighted imaging (DWI) against the reference standard of gadolinium-enhanced T1-weighted imaging (Gd-T1-WI) in children.

Methods

Thirty-nine consecutive patients (mean age 5.7 years) with suspected acute pyelonephritis underwent magnetic resonance imaging (MRI) including DWI and (the reference standard) Gd-T1-WI. Each study was read in double-blinded fashion by two radiologists. Each kidney was graded as normal or abnormal. Sensitivity and specificity of DWI were computed. Agreement between sequences and interobserver reproducibility were calculated (Cohen κ statistic and the McNemar tests).

Results

Thirty-two kidneys (41 %) had hypo-enhancing areas on Gd-T1-W images. The sensitivity and specificity of DWI were 100 % (32/32) and 93.5 % (43/46). DWI demonstrated excellent agreement (κ?=?0.92,) with Gd-T1-W, with no significant difference (P?=?0.25) in detection of abnormal lesions. Interobserver reproducibility was excellent with DWI (κ?=?0.79).

Conclusion

DWI enabled similar detection of abnormal areas to Gd-T1-WI and may provide an injection-free means of evaluation of acute pyelonephritis.

Key points

? Diffusion weighted magnetic resonance imaging (DWI) can confirm acute pyelonepritis. ? DWI provided comparable results to gadolinium enhanced T1-W MRI in acute pyelonepritis. ? Contrast medium injection could be avoided for diagnosing acute pyelonephritis by MRI. ? MRI with T2-WI and DWI provide a fast and comprehensive diagnostic tool.     

The surface protein HvgA mediates group B streptococcus hypervirulence and meningeal tropism in neonates

Streptococcus agalactiae (group B streptococcus; GBS) is a normal constituent of the intestinal microflora and the major cause of human neonatal meningitis. A single clone, GBS ST-17, is strongly associated with a deadly form of the infection called late-onset disease (LOD), which is characterized by meningitis in infants after the first week of life. The pathophysiology of LOD remains poorly understood, but our epidemiological and histopathological results point to an oral route of infection. Here, we identify a novel ST-17-specific surface-anchored protein that we call hypervirulent GBS adhesin (HvgA), and demonstrate that its expression is required for GBS hypervirulence. GBS strains that express HvgA adhered more efficiently to intestinal epithelial cells, choroid plexus epithelial cells, and microvascular endothelial cells that constitute the blood-brain barrier (BBB), than did strains that do not express HvgA. Heterologous expression of HvgA in nonadhesive bacteria conferred the ability to adhere to intestinal barrier and BBB-constituting cells. In orally inoculated mice, HvgA was required for intestinal colonization and translocation across the intestinal barrier and the BBB, leading to meningitis. In conclusion, HvgA is a critical virulence trait of GBS in the neonatal context and stands as a promising target for the development of novel diagnostic and antibacterial strategies.     

Pernicious anemia associated with autoimmune hemolytic anemia and alopecia areata

We report a 16-year-old male with a combination of pernicious anemia, auto-immune hemolytic anemia and alopecia areata. Autoimmune hemolytic anemia coexisted with pernicious anemia but was diagnosed only when the anemia failed to respond to cobalamin therapy. Alopecia areata occurred 9 years later.     

Molecular epidemiology of invasive and non-invasive group B Streptococcus circulating in Serbia

Streptococcus agalactiae (group B Streptococcus, GBS) remains the leading cause of invasive diseases in neonates and an important cause of infections in the elderly. The aim of this study was to access the prevalence of GBS genito-rectal colonisation of pregnant women and to evaluate the genetic characteristics of invasive and non-invasive GBS isolates recovered throughout Serbia.A total of 432 GBS isolates were tested for antimicrobial susceptibility, capsular polysaccharide (CPS) types and the presence of the hvgA gene. One hundred one randomly selected isolates were further characterized by clustered regularly interspaced short palindromic repeats (CRISPRs) analysis and/or multilocus sequence typing (MLST).The prevalence of GBS colonization in pregnant women was 15%. Overall, six capsular types (Ia, Ib, II to V) were identified, the most common being III (32.2%) and V (25.2%). The hiper-virulent clone type III/ST17 was present in 43.1% and 6.3% (p?<?0.05) of paediatric and adults isolates, respectively. Comparative sequence analysis of the CRISPR1 spacers content indicated that a few clones comprised the vast majority of the tested GBS isolates. Thus, it was estimated that dominant clones recovered from infants were CPS III/ST17 in late-onset infections (19/23; 82.6%), and Ia/ST23 in early-onset disease (44.4%). Conversely, genotype CPS V/ST1 was the most prevalent in adults (4/9; 25.4%). All isolates were susceptible to penicillin. Macrolide resistance (23.1%) was strongly associated with the ermB gene and constitutive resistance to clindamycin (63.9%). The majority of strains was resistant to tetracycline (86.6%), mostly mediated by the tetM gene (87.7%). GBS isolates of CPS V/ST1 and CPS III/ST23 were significantly associated with macrolide and tetracycline resistance, respectively.In conclusion, hyper-virulent CPS III/ST17 and V/ST1 were recognized as dominant GBS clones in this study.     

Effect of swimming exercise on premenstrual syndrome

Objective

To study the effectiveness of performing swimming on the severity of symptoms of premenstrual syndrome (PMS).

Materials and methods

A randomized controlled trial that was conducted on 70 women diagnosed with PMS divided randomly into two equal groups: Group I included women who engaged into exercise and group II controls. Daily Symptoms Report was filled at the start and at end of the study.

Results

At the posttreatment evaluation, there was a highly significant difference between the study and control groups regarding anxiety (0 vs. 5), depression (3 vs. 12), tension (3 vs. 12), mood changes (0 vs. 7), feeling out of control (0 vs. 7), weak coordination (0 vs. 10), confusion (2 vs. 9), headache (3 vs. 15), tiredness (4 vs. 12), pains (5 vs. 11), tenderness of the breast (2 vs. 8), and cramps (6 vs. 17) (P < 0.001), but no such difference was found regarding irritability, insomnia, crying, swelling, or food craving. Regarding the percentage of symptoms changes, there was a highly significant difference between the study and control groups regarding anxiety (? 33.3 vs. 0), depression (? 79.29 vs. 15.56), tension (? 81.18 vs. ? 6.79), mood changes (? 33.33 vs. 0), feeling out of control (? 91.67 vs. 0), weak coordination (? 100 vs. ? 9.55), sleeplessness (? 71.43 vs. 0), confusion (? 84.17 vs. ? 9.55), headache (? 77.78 vs. ? 6.94), fatigue (? 65.69 vs. 0), pains (? 65.83 vs. ? 8.93), breast tenderness (? 87.87 vs. 4.55), cramps (? 60.77 vs. 4.55), and swellings (? 55.05 vs. ? 8.33), but no such difference was found regarding irritability, crying, or food craving.

Conclusions

There is beneficial effect of swimming on most of the physical and psychological symptoms of PMS.

Clinical trial registry no.

NCT03264612.

     

Capacitive performance of vertically aligned reduced titania nanotubes coated with Mn2O3 by reverse pulse electrodeposition

In this study, a composite material, manganese oxide/reduced titania nanotubes (Mn₂O₃/R-TNTs), was synthesized through incorporation of Mn₂O₃ onto R-TNTs via the reverse pulse electrodeposition technique. The influence of pulse reverse duty cycles on the morphological, structural and electrochemical performance of the surface was studied by varying the applied duty cycle from 10% to 90% for 5 min total on-time at an alternate potential of −0.90 V (E_on) and 0.00 V (E_off). FESEM analysis revealed the uniform deposition of Mn₂O₃ on the circumference of the nanotubes. The amount of Mn₂O₃ loaded onto the R-TNTs increased as a higher duty cycle was applied. Cyclic voltammetry and galvanostatic charge–discharge tests were employed to elucidate the electrochemical properties of all the synthesized samples in 1 M KCl. The specific capacitance per unit area was greatly enhanced upon the incorporation of Mn₂O₃ onto R-TNTs, but showed a decrease as a high duty cycle was applied. This proved that low amounts of Mn₂O₃ loading enhanced the facilitation of the active ions for charge storage purposes. The optimized sample, Mn₂O₃/R-TNTs synthesized at 10% duty cycle, exhibited high specific capacitance of 18.32 mF cm⁻² at a current density of 0.1 mA cm⁻² obtained from constant current charge–discharge measurements. This revealed that the specific capacitance possessed by Mn₂O₃/R-TNTs synthesized at 10% duty cycle was 6 times higher than bare R-TNTs.

Mn₂O₃ was coated onto reduced titania nanotubes by reverse pulse electrodeposition, showing smooth and homogenous deposits without covering the opening of the nanotubes.