Accuracy of CD64 expression on neutrophils and monocytes in bacterial infection diagnosis at pediatric intensive care admission

Abstract

The CD64 receptor has been described as an interesting bacterial infection biomarker. Its expression has not been studied in previously healthy children admitted to pediatric critical care unit (PICU). Our objective was firstly to describe the CD64 expression and secondly study its diagnostic accuracy to discriminate bacterial versus viral infection in this children. We made a prospective double-blind observational study (March 2016–February 2018). A flow cytometry (FC) was done from peripheral blood at PICU admission. We studied the percentage of CD64+ neutrophils and the CD64 mean fluorescence intensity (MFI) on neutrophils (nCD64) and monocytes (mCD64). Statistical analyses were performed with non-parametric tests (p < 0.05). Twenty children in the bacterial infection group (BIG) and 25 in the viral infection group (VIG). Children in BIG showed higher values of CD64+ neutrophils (p = 0.000), nCD64 (p = 0.001), and mCD64 (p = 0.003). In addition, CD64+ neutrophils and nCD64 expression have positive correlation with procalcitonin and C reactive protein. The nCD64 area under the curve (AUC) was 0.83 (p = 0.000). The %CD64+ neutrophils showed an AUC of 0.828 (p = 0.000). The mCD64 AUC was 0.83 (p = 0.003). The nCD64 and %CD64+ neutrophils also showed higher combined values of sensitivity (74%) and specificity (90%) than all classical biomarkers.In our series CD64 expression allows to discriminate between bacterial and viral infection at PICU admission. Future studies should confirm this and be focused in the study of CD64 correlation with clinical data and its utility as an evolution biomarker in critical care children.

http://bit.ly/2GhSdKS

Detection of Enterobius vermicularis in greater Berlin, 2007–2017: seasonality and increased frequency of detection

Abstract

The pinworm (Enterobius vermicularis) causes mostly mild infections characterised by nocturnal anal pruritus, mainly in children. Still, the infection is stigmatising and sleep disturbances may lead to lack of concentration. For Germany, no epidemiological data are available. Laboratory data of all patients for whom detection of E. vermicularis by cellulose tape test had been requested between 2007 and November 2017 were analysed retrospectively. E. vermicularis was detected in 971/5578 (17.4%) samples collected from 3991 patients. The detection rate increased significantly within the period of investigation. It was higher in male than in female patients (20.0 vs. 15.4%). Children 4 to 10 years old and, if also examined, their relatives were most frequently affected. Control investigations at an interval of at least 1 month, which could indicate insufficient therapy or re-infection, were performed in 90/714 patients (12.6%). While parasite detection in children < 6 years was evenly distributed throughout the year, in older patients, it peaked between October and December. In conclusion, in the area of investigation, the frequency of E. vermicularis is higher in males than in females and is subject to a hitherto undescribed seasonality. The causes of the increased frequency of parasite detection warrant further investigations.

http://bit.ly/2Ghl1D6

Direct antimicrobial susceptibility testing from the blood culture pellet obtained for MALDI-TOF identification of Enterobacterales and Pseudomonas aeruginosa

Abstract

To standardize the methodology for conducting direct antimicrobial susceptibility testing (AST) of Enterobacterales and Pseudomonas aeruginosa causing bacteremia from positive blood culture pellets. Two methods for processing positive blood cultures with Enterobacterales and P. aeruginosa were compared: a conventional method for identification and AST versus a direct method obtaining a pellet for both matrix-assisted laser desorption/ionization–time of flight (MALDI-TOF) identification and direct AST. A total of 157 (145 Enterobacterales, 12 P. aeruginosa) positive blood cultures were included. Microorganism identification showed 100% concordance between both methods at species and genus level. Definitive AST results were obtained 24 h earlier with the rapid method than the conventional one (p < 0.001). Of the 2814 MICs generated, there were discrepancies with respect to the conventional method in 47 (1.7%), 0.3% being very major (VME) and 1.3% major (ME) errors. Better results for AST were obtained when colony counts with the pellet were ≥ 10⁵ cfu/ml. The essential agreement (EA) for antibiotics tested in Enterobacterales was at least 97%, except for ampicillin (95%). Regardless of colony count, the greatest discrepancies were observed for first/s-generation cephalosporins and aminoglycosides. In P. aeruginosa, EA was at least 92%, except for piperacillin-tazobactam (84%) and cefepime (76%). No VME occurred except for ceftazidime (8%). ME occurred in piperacillin/tazobactam (16%), ticarcillin, ceftazidime, tobramycin, amikacin, and colistin (8% each). Direct use of the blood culture pellet permits fast AST in bacteremia of Enterobacterales, enabling the clinicians to perform an early treatment adjustment. However, for Pseudomonas aeruginosa, the data needs expanding to improve the reliability of this technique.

http://bit.ly/2SfGraj

Relationship between the anatomic structures and mandibular posterior teeth for endodontic surgery in a Turkish population: a cone-beam computed tomographic analysis

Abstract

Objective

The purpose of this study is to evaluate the relationship between anatomic structures and mandibular posterior region using cone-beam computed tomography (CBCT) in terms of endodontic surgery.

Methods

A total of 150 CBCT images were used to investigate the proximity of the anatomical structures and the mandibular posterior teeth. The buccal and lingual bone thickness overlying each root, buccolingual, and mesiodistal dimension of the roots were measured at the level of 3 mm apical resection, and the mental foramen (MF) distance to the premolar teeth and the distance of the mandibular canal (MC) to all the posterior teeth were measured.

Results

The thinnest part of the buccal cortical bone was measured in the first premolar teeth (1.70 mm) and in the mesial root of the first molar (2.25 mm) while the thickest region was measured in the distal root of the second molar tooth (6.95 mm). The maximum amount of substance to be removed was measured at the distal root of the second molar tooth (11.26 mm), and at least the first premolar tooth (5.52 mm) was measured for buccal resection. The distal root of the second molar tooth was found to be the closest tooth root to the MC with a mean of 2.75 mm, and the closest distance was measured as 0 mm.

Conclusions

It is important to evaluate the parameters such as mandibular buccal and lingual bone thickness, location of the MC and the MF, and root size for atraumatic endodontic surgical approach. Evaluation of these data before endodontic surgery provides guidance to the clinician in the planning of endodontic surgery.

Clinical relevance

The mandibular posterior region, which is difficult to reach with traditional surgical approach, is now easily reached using an operation microscope. For this reason, endodontic surgical procedures have become popular in mandibular posterior teeth. Therefore, the relationship between the mandibular posterior teeth and anatomical structures that are important in the planning of surgical access line is examined in this study.

http://bit.ly/2Bh6p38

Incidence and severity of sexual dysfunction among women with breast cancer: a meta-analysis based on female sexual function index

Abstract

Purpose

Previous meta-analyses have examined the prevalence of sexual dysfunction among women with cancer, but there is no breast cancer (BC)-specific study. We therefore conducted a meta-analysis to examine the prevalence and severity of female sexual dysfunction (FSD) in women with BC.

Methods

We searched PubMed, Embase, Cochrane Library, CNKI, WanFang Data, and VIP for relevant studies published between April 2000 and January 2017. Data were extracted from studies which assessed FSD prevalence and sexual function in women with BC using the female sexual function index (FSFI). Meta-analyses were performed by pooling the prevalence rates of FSD and total FSFI scores. Meta regression was performed to explore the sources of heterogeneity.

Results

We selected 19 published studies involving a total of 2684 women with BC. In this study population, overall FSD prevalence was 73.4% (95% confidence interval (CI) 64.0%, 82.8%), and the total FSFI score was 19.28 (95% CI 17.39, 21.16). Among Asian, American, and European women with BC, there were significant differences in FSD prevalence (P < 0.001), and there was marginally significant difference (P = 0.07) in sexual function between these groups. There was also a marginally significant difference between individuals from mainland China and from other countries in FSD prevalence (P = 0.06) and FSFI score (P = 0.07).

Conclusions

Overall, women with BC have high FSD prevalence and low sexual function. American women with BC have a higher average FSD prevalence and lower average sexual function than Asian women with BC. The FSD prevalence in women with BC in mainland China was slightly higher than in other countries.

http://bit.ly/2DSFVXB

Determinants of Severe Maternal Morbidity and Its Racial/Ethnic Disparities in New York City, 2008–2012

Abstract

Objectives Severe maternal morbidity (SMM) is an important indicator for identifying and monitoring efforts to improve maternal health. Studies have identified independent risk factors, including race/ethnicity; however, there has been limited investigation of the modifying effect of socioeconomic factors. Study aims were to quantify SMM risk factors and to determine if socioeconomic status modifies the effect of race/ethnicity on SMM risk. Methods We used 2008–2012 NYC birth certificates matched with hospital discharge records for maternal deliveries. SMM was defined using an algorithm developed by the Centers for Disease Control and Prevention. Mixed-effects logistic regression models estimated SMM risk by demographic, socioeconomic, and health characteristics. The final model was stratified by Medicaid status (as a proxy for income), education, and neighborhood poverty. Results Of 588,232 matched hospital deliveries, 13,505 (229.6 per 10,000) had SMM. SMM rates varied by maternal age, birthplace, education, income, pre-existing chronic conditions, pre-pregnancy weight status, trimester of prenatal care entry, plurality, and parity. Race/ethnicity was consistently and significantly associated with SMM. While racial differences in SMM risk persisted across all socioeconomic groupings, the risk was exacerbated among Latinas and Asian-Pacific Islanders with lower income when compared to white non-Latinas. Similarly, living in the poorest neighborhoods exacerbated SMM risk among both black non-Latinas and Latinas. Conclusions for Practice SMM determinants in NYC mirror national trends, including racial/ethnic disparities. However, these disparities persisted even in the highest income and educational groups suggesting other pathways are needed to explain racial/ethnic differences.

http://bit.ly/2UyX3aj

Chromium Speciation in Water Samples by Loading a New Sulfide-Containing Biodegradable Polymer Adsorbent in Tip of the Syringe System

Abstract

A new adsorbent poly-3-hydroxybutyrate-2-(dodecylthiocarbonothioylthio)-2-methylpropionate triester (PH-DTT-MPT) was first time loaded in a micropipette tip for speciation of chromium in different water samples. Total chromium (Cr), trivalent chromium (Cr^III), and hexavalent chromium (Cr^VI) in different natural water samples were determined by electrothermal atomic absorption spectrometry. Known concentration of Cr^III and Cr^VI was passed through a biodegradable polymer for investigation of the behavior of the newly used adsorbent. The newly used copolymer absorbed the Cr^III on surface of the PH-DTT-MPT at pH 7.0, while Cr^VI was not adsorbed in desired pH value. After passing the real and standard solutions through the micropipette, then 2.0 mol L⁻¹ HCl was used for elution of Cr^III from the biodegradable polymer. Total Cr was calculated after reducing Cr^VI into Cr^III by specific concentration of hydroxy ammonium chloride (HONH₂·HCl). The concentration of Cr^VI in different natural water samples was estimated after back calculation of Cr^III from total chromium. Effect of analytical parameters like adsorbent, pH, eluent, sample volume, flow rates, and interfering ions was also studied. The LOD, LOQ, RSD, and EF of the developed method were calculated as 6.1 ng L⁻¹, 20 ng L⁻¹, 1.17%, and 90, respectively. Validation of developed method was checked by certified reference materials and spiking addition method. The developed method was successfully applied for determination of total Cr, Cr^III, and Cr^VI in various natural water ecosystems.

http://bit.ly/2Gfo0Mt