Campylobacter jejuni infection and IgE sensitization in up to 2-year-old infants

© 2015, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. The “hygiene hypothesis” addresses the correlation between the occurrence of atopy and the frequency of infections in the earliest age, explaining an increase in the incidence of atopic diseases by living in good, infection-free, hygienic conditions. The aim of our study was to determine the conection between atopy and Campylobacter infection, and to analyze the association between serum concentrations of total IgE and Campylobacter infection in relation to atopy in children up to two years. Methods. A case control study was conducted with the sample of 98 infants of the average age of 8 months. Total serum IgE and Phadiatop infant multi-test were determined on Immunocap-100 (Phadia AB, Uppsala, Sweden). The presence of atopy was determined by detection of serumspecific IgE ≥ 0.35 kUA/L (Phadiatop infant positive) and serum IgM, IgA, IgG levels against C. jejuni were determined by a quantitative immuno-enzyme test-SERION ELISA classic. Results. Total IgE cut-off values ≥ 15 kU/L point to atopy in infants, and tIgE cut-off values ≥ 8.1 kU/L pointed to a C. jejuni infection in infants. Within the group of atopic children, tIgE levels ≥ 29.8 kU/L point to C. jejuni infection, and within the group of non-atopic children, tIgE levels ≥ 5.9 kU/L point to infection. Enteritis is not a predictor of C. jejuni infection, because of a high frequency of asymptomatic cases of infection. The risk factors for C. jejuni infection are age and tIgE, and the protective factors are breastfeeding and atopy. Conclusion. C. jejuni infection increases the total serum IgE level, which is predictive of infection, regardless of the presence of atopy. The presence of symptomatic C. jejuni infection reduces the risk of atopy in a child of the age of 5–24 months by the factor of 10

Predictors of unfavourable outcome in aneurysmal subarachnoid haemorrhage

Background. Mortality rates following aneurysmal subarachnoid haemorrhage (aSAH) have decreased due to improvements in diagnoses and the management of complications, as well as early obliteration of the aneurysms. Neurogenic pulmonary oedema (NPO) is a clinical syndrome associated with an acute increase in intracranial pressure and a release of catecholamines into the circulation. This study investigated independent predictors of unfavourable outcomes (Glasgow Outcome Scores 1, 2 or 3) in patients with aSAH. Materials and methods. A total of 262 patients with aSAH (162 females) were included in this prospective study. Clinical characteristics were assessed, and electrocardiographic, serum cardiac and inflammatory biomarker measurements were recorded on admission. Outcomes were assessed three months after admission. Univariate and multivariate analyses of these data were used to predict unfavourable outcomes. Results. A total of 156 patients (59.54%) had unfavourable outcomes. Compared to those who had favourable outcomes, patients with unfavourable outcomes were significantly older (54.37 ± 10.56 vs. 49.13 ± 10.77 years; p < 0.001) and had more severe aSAHs (Hunt and Hess grades ≥ 3: 82.7% vs. 39.6%; p < 0.001). Patients with unfavourable outcomes were more likely to have NPO (10.3% vs. 2.8%; p = 0.023), hydrocephalus (34.0% vs. 20.8%; p = 0.02), and aneurysm reruptures (28.2% vs. 3.8%; p < 0.001).Independent predictors of an unfavourable outcome included Hunt and Hess grades ≥ 3 (odds ratio [OR], 4.291; 95% confidence interval [CI], 2.168–8.491; p < 0.001), increased systolic blood pressure on admission (OR, 1.020; 95% CI, 1.002–1.038; p = 0.03), increased heart rate (HR) on admission (OR, 1.024; 95% CI, 1.001–1.048; p = 0.04), and aneurysm rerupture (OR, 4.961; 95% CI, 1.461–16.845; p = 0.01).Conclusions. These findings suggest that aneurysm reruptures, as well as increased blood pressure and HR, are associated with unfavourable outcomes in patients with aSAH

Women in leadership positions in european neurosurgery: have we broken the glass ceiling?

Introduction: The proportion of male neurosurgeons has historically been higher than of women, although at least equal numbers of women have been entering European medical schools. The Diversity Committee (DC) of the European Association of Neurosurgical Societies (EANS) was founded recently to address this phenomenon. Research question: In this cross-sectional study, we aimed to characterize the status quo of female leadership by assessing the proportion of women heading European neurosurgical departments. Material and methods: European neurosurgical departments were retrieved from the EANS repository. The gender of all department chairs was determined via departmental websites or by personal contact. The proportion of females was stratified by region and by type of hospital (university versus non-university). Results: A total of 41 (4.3%) female department chairs were identified in 961 neurosurgery departments in 41 European countries. Two thirds (68.3%) of European countries do not have a female neurosurgery chair. The highest proportion of female chairs was found in Northern Europe (11.1%), owing to four female chairs in a relatively small number of departments (n = 36). The proportions were considerably smaller in Western Europe (n = 17/312 (5.5%)), Southern Europe (n = 14/353 (4.0%)) and Central and Eastern Europe (n = 6/260 (2.3%)) (p = 0.06). The distribution of female chairs in university (n = 19 (46.3%)) versus non-university departments (n = 22 (53.7%)) was even. Discussion and Conclusion: There is a significant gender imbalance with 4% of all European neurosurgery departments headed by women. The DC intends to develop strategies to support equal chances and normalize the presence of female leaders in European neurosurgery.</p

Parenthood and neurosurgery in Europe a white paper from the European Association of Neurosurgical Societies’ Diversity in Neurosurgery Committee Part I: family planning and practice during pregnancy

Introduction: Family and work have immensely changed and become intertwined over the past half century for both men and women. Additionally, alongside to traditional family structures prevalent, other forms of families such as single parents, LGBTQ + parents, and bonus families are becoming more common. Previous studies have shown that surgical trainees regularly leave residency when considering becoming a parent due to the negative stigma associated with pregnancy during training, dissatisfaction with parental leave options, inadequate lactation and childcare support, and desire for greater mentorship on work-life integration. Indeed, parenthood is one of the factors contributing to attrition in surgical specialities, neurosurgery not being an exception.Research question: The Diversity in Neurosurgery Committee (DC) of the European Association of Neurosurgical Societies (EANS) recognizes the challenges individuals face in parenthood with neurosurgery and wishes to address them in this white paper.Materials and methods: In the following sections, the authors will focus on the issues pertaining to family planning and neurosurgical practice during pregnancy in itemized fashion based on an exhaustive literature search and will make recommendations to address the matters raised.Results: Potential solutions would be to further improve the work-family time ration as well as improving working conditions in the hospital.Discussion and conclusion: While many obstacles have been quoted in the literature pertaining to parenthood in medicine, and in neurosurgery specifically, initiatives can and should be undertaken to ensure not only retention of colleagues, but also to increase productivity and job satisfaction of those seeking to combine neurosurgery and a family life, regardless of their sexual identity and orientation.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Untypical Amlodipine-Induced Gingival Hyperplasia

Amlodipine is a third generation dihydropyridine calcium channel blocker that is frequently used in therapy of hypertension. Among many side effects, amlodipine has been found associated with gingival overgrowth (GO) which usually occurs within the first three months of starting therapy at a dose of 10 mg/day. However, there are very few reports on amlodipine-induced gingival overgrowth (AIGO) at a lower dose (5 mg/day) and only after short term administration. A 64-year-old male patient with hypertension, who received amlodipine (5 mg/day) for four years, sought medical attention at the Department of Periodontology and Oral Medicine, Institute of Dentistry, Banja Luka, Bosnia and Herzegovina. The patient complained of masticatory problems due to extensive maxillary GO along with pain, bleeding, and foul odor. The clinical and the histological evidences were consistent with AIGO. The first line treatment consisted of the amlodipine substitution (amlodipine was replaced with enalapril, 5 mg/day) and the scaling and root planning/SRP. At one-month follow-up, drug replacement and SRP resulted in some reduction of the inflammation and significant reduction of symptoms. Further, gingivectomy/gingivoplasty helped overcome the effect of these drugs. The possibility of AIGO should be considered for a lower dose, as well as a late presentation

Reducing sheet resistance of self-assembled transparent graphene films by defect patching and doping with UV/ozone treatment

Liquid phase exfoliation followed by Langmuir-Blodgett self-assembly (LBSA) is a promising method for scalable production of thin graphene films for transparent conductor applications. However, monolayer assembly into thin films often induces a high density of defects, resulting in a large sheet resistance that hinders practical use. We introduce UV/ozone as a novel photochemical treatment that reduces sheet resistance of LBSA graphene threefold, while preserving the high optical transparency. The effect of such treatment on our films is opposite to the effect it has on mechanically exfoliated or CVD films, where UV/ozone creates additional defects in the graphene plane, increasing sheet resistance. Raman scattering shows that exposure to UV/ozone reduces the defect density in LBSA graphene, where edges are the dominant defect type. FTIR spectroscopy indicates binding of oxygen to the graphene lattice during exposure to ozone. In addition, work function measurements reveal that the treatment dopes the LBSA film, making it more conductive. Such defect patching paired with doping leads to an accessible way of improving the transparent conductor performance of LBSA graphene, making solutionprocessed thin films a candidate for industrial use

Campylobacter jejuni infection and IgE sensitization in up to 2-year-old infants

© 2015, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. The “hygiene hypothesis” addresses the correlation between the occurrence of atopy and the frequency of infections in the earliest age, explaining an increase in the incidence of atopic diseases by living in good, infection-free, hygienic conditions. The aim of our study was to determine the conection between atopy and Campylobacter infection, and to analyze the association between serum concentrations of total IgE and Campylobacter infection in relation to atopy in children up to two years. Methods. A case control study was conducted with the sample of 98 infants of the average age of 8 months. Total serum IgE and Phadiatop infant multi-test were determined on Immunocap-100 (Phadia AB, Uppsala, Sweden). The presence of atopy was determined by detection of serumspecific IgE ≥ 0.35 kUA/L (Phadiatop infant positive) and serum IgM, IgA, IgG levels against C. jejuni were determined by a quantitative immuno-enzyme test-SERION ELISA classic. Results. Total IgE cut-off values ≥ 15 kU/L point to atopy in infants, and tIgE cut-off values ≥ 8.1 kU/L pointed to a C. jejuni infection in infants. Within the group of atopic children, tIgE levels ≥ 29.8 kU/L point to C. jejuni infection, and within the group of non-atopic children, tIgE levels ≥ 5.9 kU/L point to infection. Enteritis is not a predictor of C. jejuni infection, because of a high frequency of asymptomatic cases of infection. The risk factors for C. jejuni infection are age and tIgE, and the protective factors are breastfeeding and atopy. Conclusion. C. jejuni infection increases the total serum IgE level, which is predictive of infection, regardless of the presence of atopy. The presence of symptomatic C. jejuni infection reduces the risk of atopy in a child of the age of 5–24 months by the factor of 10

Association between functional capacity and heart rate variability in patients with uncomplicated type 2 diabetes

Objective: We sought to investigate functional capacity, heart rate variability (HRV), as well as their relationship in the patients with uncomplicated type 2 diabetes. Methods: This cross-sectional observational study included 62 controls and 53 uncomplicated diabetic patients. Included subjects underwent laboratory analysis, 24-h ECG Holter monitoring and cardiopulmonary exercise testing. Results: All parameters of time and frequency domain of HRV were decreased in the diabetic patients. Oxygen uptake at ventilatory threshold (18.3 ± 3.9 vs. 14.6 ± 3.6 mL/kg/min, p < .001), peak oxygen uptake (peak VO2) (27.8 ± 4.1 vs. 19.5 ± 4.3, mL/kg/min, p < .001) and oxygen pulse were significantly lower in the diabetic group, whereas ventilation/carbon dioxide ratio and ventilation/carbon dioxide slope (25.4 ± 2.5 vs. 28.6 ± 3.9, p < .001) were significantly higher in this group. Furthermore, heart rate recovery in the first minute was significantly lower in the diabetic group (26 ± 5 vs. 23 ± 5 beats/min, p = .003). In the whole study population HbA1c and SDNN were independently of other clinical and HRV parameters associated with peak VO2, ventilation/carbon dioxide slope and heart rate recovery in the first minute. Conclusions: Our investigation showed that both functional capacity and HRV were significantly impaired in uncomplicated diabetic patients. HbA1c, an important parameter of glucose regulation, was independently associated with HRV parameters and functional capacity in the whole study population. This reveals a potentially important role of determination of functional capacity and cardiac autonomic function as important markers of preclinical damage in diabetic population