Pneumococcus-specific immunoglobulin E in cigarette smokers

A relationship between elevated serum immunoglobulin E levels and smoking has been demonstrated in epidemiological studies. Allergy skin test data suggest that the excess immunoglobulin E of smokers is not specific for aeroallergens. It is possible that the excess immunoglobulin E is specific for microorganisms that often infect the lower respiratory tract of smokers. To investigate this possibility we utilized a radioallergosorbent test assay for detecting serum immunoglobulin E specific for Streptococcus pneumoniae, an organism commonly isolated from the respiratory tract of smokers with chronic bronchitis. We assayed sera of thirty smokers and thirty nonsmokers for immunoglobulin E specific for Streptococcus pneumoniae. Individual sera were considered positive for pneumococcus-specific immunoglobulin E if the binding was at least twice the non-specific binding at the total immunoglobulin E concentration of the particular serum. Eleven of the thirty sera of smokers and two of the thirty nonsmokers were positive for pneumococcus-specific immunoglobulin E. By chi-square analysis of these data, the prevalence of pneumococcus-specific immunoglobulin E was significantly greater in the smoking group compared with the non-smoking group (P less than 0.02). These results suggest that the excess immunoglobulin E of smokers is, at least in part, specific for microorganisms that infect the airways.     

La nécrosectomie transgastrique

La nécrosectomie transgastrique semble être une alternative présentant peu de risques de traitement pour les patients gravement atteints. Cependant, il manque à ce jour, une analyse des risques du procédé sur un nombre suffisant de patients; il est urgent de procéder à des collectes de données multicentriques. Il s’agit de procédés endoscopiques complexes, qui nécessitent une grande expérience, et le traitement de chaque patient devrait être planifié de fa?on interdisciplinaire en collaboration avec le chirurgien. Ce procédé devrait par conséquent rester limité aux centres spécialisés.     

A follow-up EEG study in diabetic children

498 electroencephalograms (EEGs) were recorded from 195 diabetic children during a follow-up study. The children were divided into stable and labile groups according to diabetes control. The labile group was further subdivided into hypoglycaemic, ketoacidotic and mixed groups. In general it was found that the labile children had significantly more abnormal findings in their EEGs than the stable children, as expected. This applied particularly to generalized discharges with spikes and sharp waves or focal findings, but not to cases with only a diffuse-slowing. Nonstatistical differences in EEG abnormality were seen between the hypoglycaemic and ketoacidotic group--an unexpected finding. During the follow-up the labile group more often had an increasing EEG abnormality than the stable group. For those children who had an EEG abnormality but without an increasing tendency, there was no difference in the EEGs between the labile and stable children. It was concluded tht some of the EEG abnormalities are acquired, and apparently produced by a metabolic disturbance caused by diabetes. However, other causes may be of genetic or perinatal origin, or perhaps a combination of different causes. Because of the multifactorial aetiology of the abnormalities, EEG cannot at present be recommended for routine testing of the effects of metabolic disturbance in diabetics.     

Reliability of the evaluation of multidetector computed tomography images from the scanner's console in high-energy blunt-trauma patients

Purpose: To evaluate the reliability of a structured 5-min evaluation of multidetector computed tomography (MDCT) images from the scanner's console in high-energy trauma patients.

Material and Methods: Forty patients were scanned with four-slice MDCT using a standardized trauma protocol. Image evaluation covered the thorax, abdomen, and pelvis. The radiologist scrolled axial images on the scanner's console using three different window settings (lung, soft tissue, and bone) and performed a prospective structured evaluation of the traumatic lesions. The findings were compared to the final radiological diagnosis of the MDCT data made on a PACS workstation, the operative findings, and the clinical follow-up.

Results: Evaluation from the scanner's console enabled the diagnosis of all potential life-threatening injuries, the sensitivity for all injuries being 60% and specificity 98%.

Conclusion: A PACS workstation is needed for the final diagnosis of all injuries, but this rapid screening method can reliably detect all injuries that require instant care.     

A new model of chronic temporal lobe epilepsy induced by electrical stimulation of the amygdala in rat

Spontaneous seizures are the hallmark of human epilepsy but they do not occur in most of the epilepsy models that are used to investigate the mechanisms of epilepsy or to test new antiepileptic compounds. This study was designed to develop a new focal epilepsy model that mimics different aspects of human temporal lobe epilepsy (TLE), including the occurrence of spontaneous seizures. Self-sustained status epilepticus (SSSE) lasting for 6-20 h was induced by a 20-30 min stimulation of the lateral nucleus of the amygdala (100 ms train of 1 ms, 60 Hz bipolar pulses, 400 microA, every 0.5 s). Stimulated rats (n = 16) were monitored with a video-EEG recording system every other day (24 h/day) for 6 months, and every other video-EEG recording was analyzed. Spontaneous epileptic seizures (total number 3698) were detected in 13 of the 15 animals (88%) after a latency period of 6 to 85 days (median 33 days). Four animals (31%) had frequent (697-1317) seizures and 9 animals (69%) had occasional seizures (1-107) during the 6-months follow-up period. Fifty-seven percent of the seizures occurred during daytime (lights on 07:00-19:00 h). At the end of the follow-up period, epileptic animals demonstrated impaired spatial memory in the Morris water-maze. Histologic analysis indicated neuronal loss in the amygdala, hippocampus, and surrounding cortical areas, and mossy fiber sprouting in the dentate gyrus. The present data indicate that focal stimulation of the amygdala initiates a cascade of events that lead to the development of spontaneous seizures in rats. This model provides a new tool to better mimic different aspects of human TLE for investigation of the pathogenesis of TLE or the effects of new antiepileptic compounds on status epilepticus, epileptogenesis, and spontaneous seizures.     

Insulin resistance and lipid levels in adolescents with familial risk for psychosis

Objective: Type 2 diabetes and dyslipidemias co‐occur frequently with schizophrenia. It is not known how common they are in adolescents with a familial risk for psychosis. Method: The Northern Finland 1986 Birth Cohort consists of 9432 children born alive in the two Northernmost provinces in Finland. At the age of 15/16 they participated in clinical examination including measurements of glucose, lipids and IR, and a questionnaire including items about their diet and physical activity. The Finnish Hospital Discharge Register was used to find out non‐organic psychoses in parents during 1972–2000. This familial risk was found out in 54 boys and 68 girls. Their results were compared with other cohort members. Results: No differences were observed in the cardiometabolic risk factors between the study groups. Conclusion: Our results suggest that familial risk for psychosis is not directly associated with disturbances of glucose and lipid metabolism among adolescents.     

Aetiology of community-acquired pneumonia in children treated in hospital

Viral and bacterial antigen and antibody assays were prospectively applied to study the microbial actiology of community-acquired pneumonia in 195 hospitalised children during a surveillance period of 12 months. A viral infection alone was indicated in 37 (19%), a bacterial infection alone in 30 (15%) and a mixed viral-bacterial infection in 32 (16%) patients. Thus, 46% of the 69 patients with viral infection and 52% of the 62 patients with bacterial infection had a mixed viral and bacterial aetiology. Respiratory syncytial virus (RSV) was identified in 52 patients andStreptococcus pneumoniae in 41 patients. The next common agents in order were non-classifiedHaemophilus influenzae (17 cases), adenoviruses (10 cases) andChlamydia species (8 cases). The diagnosis of an RSV infection was based on detecting viral antigen in nasopharyngeal secretions in 79% of the cases. Pneumococcal infections were in most cases identified by antibody assays; in 39% they were indicated by demonstrating pneumococcal antigen in acute phase serum. An alveolar infiltrate was present in 53 (27%) and an interstitial infiltrate in 108 (55%) of the 195 patients. The remaining 34 patients had probable pneumonia. C-reactive protein (CRP), erythrocyte sedimentation rate and total white blood cell count were elevated in 25%, 40% and 36% of the patients, respectively, CRP was more often elevated in patients with bacterial infection alone than in those with viral or mixed viral-bacterial infections. No other correlation was seen between the radiological or laboratory findings and serologically identified viral, bacterial or mixed viralbacterial infections. By using a comprehensive serological panel, the causative agent could be found in over 50% of patients with pneumonia. We conclude that RSV and pneumococcus are the two most common organisms causing pneumonia in children. Our results suggest that mixed viral-bacterial aetiology is common in lower respiratory tract infections affecting children.     

The C/C-13910 genotype of adult-type hypolactasia is associated with an increased risk of colorectal cancer in the Finnish population

BACKGROUND AND AIMS: The role of nutrition in the pathogenesis of colorectal cancer is not fully understood. Milk products are an essential part of human nutrition in Western countries. Absorption of lactose, the main sugar of milk, is regulated by the activity of the lactase enzyme in the gut wall. The activity of lactase is genetically determined and is associated with a C/T single nucleotide polymorphism residing 13910 bp upstream of the lactase coding sequence. Here we have studied the relationship between the C/T(-13910) polymorphism and colorectal cancer in Finnish, British, and Spanish populations. PATIENTS AND METHODS: A total of 2766 subjects, including 963 Finnish, 283 British, and 163 Spanish subjects with colorectal cancer, and 773 Finnish, 363 British, and 221 Spanish control subjects, were genotyped for the C/T(-13910) variant by polymerase chain reaction minisequencing. RESULTS: The C/C(-13910) genotype, which is a robust molecular marker of low lactase activity (lactase non-persistence), was found to significantly associate with the risk of colorectal cancer (p = 0.015) in the Finnish subjects, with an odds ratio of 1.40 (95% confidence interval 1.07-1.85). No association was found with site, histology, or stage of the tumour. No significant risk was detected in the British or Spanish populations. CONCLUSION: Low lactase enzyme activity, defined by genotyping of the C/T(-13910) variant, may increase the risk of colorectal cancer. Further studies are warranted to investigate the role of milk and other dairy products in the pathogenesis of colon cancer in different populations.