Occurrence of HLA Types in H. Influenzae Type B Disease

We have studied 50 Caucasoid children under 7 years of age with Haemophilus influenzae b disease. Half of the patients (Group A) had invasive disease shown by positive blood and/or spinal fluid culture. The other half (Group B) had noninvasive disease characterized by fever, nasopharyngitis, negative blood culture, and positive throat culture. Age, number of other siblings under 12 years old in the family, immune response, antibody production and genetic markers were compared in the two groups. Significant difference between the two groups was only seen in their genetic markers. HLA-B12 was present in 52% of Group A patients as opposed to 16% in Group B patients (P less than .01). HLA-Bw40 was present in 24% of group B patients and absent in all Group A patients (P less than .01). These findings would suggest that susceptibility and resistance towards developing invasive type b disease may be genetically determined.     

Rapid Polymyxin NP test for the detection of polymyxin resistance mediated by the mcr-1/mcr-2 genes

The Rapid Polymyxin NP test has been recently developed to rapidly detect polymyxin resistance in Enterobacteriaceae. Here we evaluated this test for detecting MCR-1/MCR-2-producing Enterobacteriaceae using a collection of 70 non-redundant strains either recovered from the environment, animals, or humans. Sensitivity and specificity were found to be 100%.     

Postoperative outcome in awake, on-pump, cardiac surgery patients

Purpose  

Thoracic epidural anesthesia (TEA) alone or combined with general anesthesia (TEA-GA) has been assumed to improve early postoperative outcome in cardiac surgery. The aim of our study was to investigate data of early and late postoperative outcome results of awake TEA patients undergoing cardiac surgery with comparison to patients under combined and general anesthesia (GA).     

An investigation of the Venetian blind effect

When a rectangular wave grating is binocularly viewed with a neutral density filter over one eye, an illusory rotation resembling that of a partially opened Venetian blind is perceived (Cibis and Haber, 1951). Using a binary classification task, in the first experiment, the probability of perceiving a rotation in a given direction was measured as a function of a factorial combination of inter-ocular contrast (see Note 1) and luminance ratios. The probability of a rotation in a given direction decreased monotonically with the luminance of the brighter bars when the grating contains a less than unity contrast. This result is inconsistent with (i) the model of the Venetian blind effect proposed by Cibis and Haber (1951), (ii) a mechanism based on irradiation with a compressive non-linearity (von Helmholtz, 1911/1924, pp. 186-193) and (iii) contemporary stereo-energy/cross-correlation models of stereopsis. In the second and third experiments, we tested the prediction that irradiation combined with an early compressive non-linearity in response implies a positive relationship between both the threshold contrast or average luminance disparity to perceive rotation and the magnitude of perceived rotation, and the blur width at the bar's edge. No support was found for the prediction. We propose an intensity difference model of the probability of perceiving a rotation in a given direction as a function of the interocular difference in luminance or contrast.     

Diagnostic value of serum galactomannan, (1,3)‐β‐d‐glucan,and Aspergillus fumigatus‐specific IgA and IgG assays for invasive pulmonary aspergillosis in non‐neutropenic patients

Detection of serum galactomannan (GM) and (1,3)‐β‐d ‐glucan (BG) is considered useful for non‐culture diagnosis of invasive pulmonary aspergillosis (IPA) in neutropenic patients. Only few studies evaluated these seromarkers in non‐neutropenic patients suspected of having IPA. The aim of this study was to evaluate both tests together with the Aspergillus fumigatus‐specific serum IgG and IgA (IgAG) test for serological IPA diagnosis in non‐neutropenic patients. Sera from 87 patients suspected of having IPA were retrospectively analysed. Patients were categorised into groups of proven IPA (n = 10), putative IPA (n = 31) and non‐IPA colonisation (n = 46). When the GM, BG and IgAG assays were used for patients included in the study, the sensitivity/specificity/positive predictive value (PPV)/negative predictive value (NPV) were 48.8%/91.3%/83.3%/66.7%, 82.9%/73.9%/73.9%/82.9% and 75.6%/95.7%/93.9%/81.5%, respectively. Thus, the highest specificity and PPV were confirmed for the IgAG assay. Improvements in the sensitivity and NPV were achieved by “at least one positive” analysis with the GM and BG assays, with the sensitivity/specificity/PPV/NPV values being 85.0%/69.6%/71.4%/84.2%. Nevertheless, the highest sensitivity and NPV were achieved by the “at least one positive” analysis combining the GM, BG and IgAG tests (97.6% and 96.8%, respectively). The involvement of the IgAG assay could improve IPA diagnosis in non‐neutropenic patients by increasing the sensitivity and NPV when combined with the GM or BG assays. Furthermore, improvement was achieved by combining the GM, BG and IgAG assays using the “at least one positive test” strategy, especially if doubt exists.     

Effects of ionized waterfall aerosol on pediatric allergic asthma

Objective. Ionized water aerosols have been suggested to exert beneficial health effects on pediatric allergic asthma. Their effect was evaluated in a randomized controlled clinical trial as part of a summer asthma camp. Methods. Asthmatic allergic children (n = 54) spent 3 weeks in an alpine asthma camp; half of the group was exposed to water aerosol of an alpine waterfall for 1 hour per day, whereas the other half spent the same time at a "control site". Immunological analysis, lung function testing, and fractional exhaled nitric oxide (FeNO) testing were performed during the stay, and sustaining effects were evaluated 2 months later. Symptom score testing was done over a period of 140 days. Results. The water aerosol group showed a significant improvement in all lung function parameters, whereas only the peak expiratory flow improved in the control group. All patients showed a significant improvement in symptom score and a significant decrease in FeNO after the camp. Only the water aerosol group exhibited a long-lasting effect on asthma symptoms, lung function, and inflammation in the follow-up examination. Induction of interleukin (IL)-10 and regulatory T (Treg) cells was measured in both groups, with a pronounced increase in the water aerosol group. IL-13 was significantly decreased in both groups, whereas IL-5 and eosinophil cationic protein were decreased only in the water aerosol group. Conclusions. Our findings confirm the induction of Treg cells and reduction in inflammation by climate therapy. They indicate a synergistic effect of water aerosols resulting in a long-lasting beneficial effect on asthma symptoms, lung function, and airway inflammation. Martin Gaisberger and Renata ?anovi? as well as Markus Ritter and Arnulf Hartl contributed equally to this work.     

Intrafamily spread of Haemophilus type b infections.

Meningitis and epiglottitis are the clinical manifestations of severe Haemophilus influenzae serotype b infection. Compared with meningitis, epiglottitis occurs in older children. When secondary cases occur within the family, the type of clinical manifestation produced by this serotype is generally similar in siblings. This report concerns the unusual occurrence of meningitis developing in older child and epiglottitis developing in the younger one. We discuss the possible explanations for this unusual pattern. We also survey the spread of H influenzae both within and outside the family unit and review the present status of histocompatibility antigens and Haemophilus disease.