Mycobacterial infection and atopy in childhood: A systematic review

The epidemiological relation between mycobacterial infection and the prevalence of atopic disease in humans is still unclear. This is in contrast to studies in murine models in which a clear suppression of atopic symptoms was observed after exposure to mycobacteria or mycobacterial products. We therefore wanted to provide a systematic overview of the published literature on the relationship between mycobacterial infection and atopic disease and to evaluate the causal relationship in a meta-analysis. The EMBASE and MEDLINE databases were searched systematically for papers published in the English literature (1966-2005) on the relation between mycobacterial infection and atopic disease. Original observational or interventional studies involving the paediatric population were included. Two authors independently reviewed articles for data on mycobacterial exposure and atopic disease outcome. Any differences were resolved by discussion. Of a total of 1201 hits, 23 studies (19 cross-sectionals, three case-controls and one prospective cohort) met the inclusion criteria. Only a minority of studies (40%) observed an association between mycobacterial infection and the prevalence of atopic disease outcome. In the meta-analysis, only studies containing data on mycobacterial exposure and atopic disease outcome variables were included. Only cross-sectional studies, in which the relation between a positive tuberculin skin test and allergic symptoms was studied, observed statistically significant negative correlation (odds ratio 0.63; 95% confidence interval: 0.51-0.79). The results of this review show that the evidence of the relationship of mycobacterial infection and atopic disease is based on observations of cross-sectional studies. In a meta-analysis, calculations showed a high level of heterogeneity (I(2)) within studies with similar design making it difficult to pool effects. This may partly be explained by differences in the type and definition of mycobacterial infection and lack of uniformity in the definition of atopy. The results show that only a minority of studies in the literature shows any evidence of inverse relationship between mycobacterial exposure and atopic disease outcome. The fact that the present epidemiological evidence on the relationship between mycobacterial infection and the development of atopic disease is based mainly on cross-sectional observational studies indicates the need for population-based prospective studies to address this issue. This issue needs to be addressed in view of recent suggestions to developing mycobacterial-based vaccines against atopic disease in the future.     

The correlation of ureaplasma urealyticum infection with infertility

Summary. A prevalence study of Ureaplasma urealyticum (UU) infection of the male genital tract was carried out in Shanghai between March 1992 and June 1995. Significantly higher frequency of UU infection was found among infertile males (549/1416) as compared to fertile controls (34/375). Examination of 8 specimens each from infertile men and fertile subjects by electron microscopy, immunogold and immunofluorescence techniques, demonstrated adhesion of Ureaplasma urealyticum to the membrane of spermatozoa and exfoliated germ cells. In addition, gold particles on Ureaplasma urealyticum were found to be adhered to the sperm surface in 4 of the 8 samples. Strong specific anti-UU fluorescence was detected in 6 of 8 samples, mainly on the midpieces and post-acrosomal regions of the spermatozoa.
To further study the effects of Ureaplasma urealyticum on fertility, 47 male Sprague-Dawley (SD) rats were infected artificially with Ureaplasma urealyticum serotype 8 (T960). Morphological changes in the seminiferous tubules were observed 3–5 weeks after inoculation in the sacrificed animals. Dramatic impairment of spermatogenesis of both testes was found in 11 rats. Mating experiment confirmed infertility in 12 of 40 rats. Offsprings of the infected rats were significantly smaller than those of controls in terms of prenatal weights and birthweights.     

Epidemiology and clinical manifestation of HIV infection in Northern Zaire

1275 patients were evaluated for HIV-1+2 seroprevalence and its association with clinical symptoms of HIV infection. Of 667 apparently healthy subjects, 8.2% had anti-HIV-1 antibodies. In 465 patients with clinical signs of AIDS, 39.4% were seropositive. 143 patients with miscellaneous symptoms had positive predictive values for HIV infection between 67% (vaginal ulcerations) and 20% (profound pyogenic abscesses). The WHO definition for AIDS had a specificity of 78.3%, a sensitivity of 72.2% and a predictive value of 61.6%.     

轮状病毒中枢神经及肺部感染

研究背景 轮状病毒性胃肠炎是婴幼儿期最常见腹泻疾病之一。国内外对轮状病毒中枢神经及肺部感染告道甚少。 研究方法 用电镜、免疫电镜、酶联免疫吸附与阻断试验确诊轮状病毒中枢神经及肺部感染。 研究结果 200例轮状病毒性胃肠炎患儿中,并发轮状病毒性脑膜炎一例,轮状病毒性肺炎2例,其中1例同时合并胸膜炎、胸腔积液。 结论 轮状病毒中枢神经及肺部感染预后良好。     

消化内镜病毒污染的现状及对策

从乙型肝炎病毒、丙型肝炎病毒和人类免疫缺陷病毒污染情况综述了消化内镜病毒污染的现状，分析了污染的原因以及消化内镜消毒现状。     

60例急性病毒性脑炎的临床分析

目的　评价急性病毒性脑炎的诊断与治疗。方法　收集 1993～ 2 0 0 1年 6月的住院病案 60份 ,就临床症状、神经体征、周围血白细胞计数和分类、脑脊液、脑电图、脑CT检查 ,以及单用激素组和激素 +抗病毒毒药组之间的疗效关系进行分析。结果　本组病毒性脑炎可分为六种临床类型 :精神异常 ;持续性剧烈头痛伴呕吐 ;强直 -阵挛性抽搐 ;持续性意识障碍 ;脑神经损害、失语、偏瘫 ;小脑性共济失调。前三型最为常见 ,并且三型之间的临床现象有相互穿插出现的现象。经统计学处理 ,单用激素组与激素 +抗病药物组之间的疗效无显著性差异。结论　急性病毒性脑炎为一种自限性疾病 ,但在没有病毒学检查的情况下 ,尚应和急性播散性脑脊髓炎或多发性硬化作鉴别     

床边纤维支气管镜检查在可疑院内获得性肺炎诊断中的意义

目的评价床边纤维支气管镜检查在可疑院内获得性肺炎诊断中的意义。方法对25例可疑院内获得性肺炎患者进行床边纤维支气管镜检查，同时进行痰标本和支气管肺泡灌洗液标本涂片细菌检测和培养。结果1例为肺出血，2例肺不张，1例肺水肿；21例为院内获得性肺炎，其中14例(72．7％)细菌培养阳性，革兰阴性杆菌占57．1％(12／21)，以铜绿假单胞菌、不动杆菌属、嗜麦芽假单胞菌、肺炎克雷伯菌最常见，革兰阳性球菌2例(9．5％)，主要是耐甲氧西林金黄色葡萄球菌。痰涂片和支气管肺泡灌洗液涂片阳性者分别为3例和10例。支气管肺泡灌洗液细菌涂片阳性率和细菌培养阳性率均高于痰标本(P=0．02和P=0．005)。结论床边纤维支气管镜检查有助除外疑似院内获得性肺炎的非感染性疾病。支气管肺泡灌洗液标本病原学检测优于痰标本。     

腰椎间盘术后椎间盘炎的诊治

目的：探讨腰椎间盘术后椎间盘炎的病因。早期诊断和治疗问题。方法：分析10例术后腰椎间盘炎的临床表现、血象、血流变化、血和病灶细菌培养、腰椎X线平片、CT、MRI所见在发病后的敏感程度，比较3例非手术与7例经前路腹膜后（2例联合后入路）病灶清除，一期椎间植骨融合本治疗的效果。结果：不同程度的发热、痉挛性腰痛、血流增快是本病的特点。MRI、CF、X线片三者的诊断敏感性存在时间差，分别约为发病后1、3、5周。仅2例血和病灶细菌培养均阳性。前路减压植骨融合术减少全身性抗生素和镇痛剂的使用量，明显缩短病程。结论：ESR、MRI对早期确诊、引导手术价值较高。高热、痉挛性腰痛、血沉增快三者具一持续2周得不到控制，可考虑及早手术。手术疗法近期效果更为确切。