Susceptibility testing of Haemophilus influenzae— an international collaborative study in quality assessment

In order to compare the prevalence of antibiotic resistance in different geographical areas, it is necessary to ensure that agreement is achieved between laboratories on the assignment of strains to ‘susceptible' and ‘resistant' categories. An international quality assessment study, involving 15 laboratories in eight countries, was performed to investigate the standard of performance of the susceptibility testing of Haemophilus influenzae. One hundred and fifty strains of H. influenzae were distributed from the London Hospital Medical College (LHMC) to all laboratories who were asked to test the susceptibility of the strains to ampicillin, chloramphenicol, tetracycline, trimethoprim, cephalosporins and ciprofloxacin. Laboratories were also asked to provide the details of methodology to test the susceptibility. Significant discrepancy between the LHMC and the participating laboratories appeared in the detection of resistance to ampicillin (especially β-lactamase-negative strains resistant to ampicillin) as well as the assignment of susceptibility and resistance to chloramphenicol, tetracycline and trimethoprim. Often these reflected the use of inappropriate breakpoints which led to erroneous assignment of susceptibility. Other variations including disc content, medium and supplement, inoculum as well as failure to measure zone sizes properly also led to some repeating anomalie

Recent advances in molecular diagnosis of thyroid cancer

Recent molecular studies have described a number of abnormalities associated with the progression and dedifferentiation of thyroid carcinoma. These distinct molecular events are often associated with specific stages of tumor development. In particular, remarkable advances have occurred in several major biological areas of thyroid cancer, including the molecular alterations for the loss of radioiodine avidity of thyroid cancer, the pathogenic role of the MAP kinase and PI3K/Akt pathways and their related genetic alterations, and the aberrant methylation of functionally important genes in thyroid tumorigenesis and pathogenesis. Recognition of these features is crucial to the management of patients with thyroid cancer. Novel treatments are being designed based on our enhanced understanding of this disease process. © 2011 I. Legakis and K. Syrigos

Epidemiology of community-acquired Pseudomonas aeruginosa infections in children

The epidemiology of community-acquired Pseudomonas aeruginosa infections in children during a one-year period (January through December 1993) was evaluated, A total of 6,859 clinical samples, each one representing a separate individual with suspected infection, were cultured. Pseudomonas aeruginosa was isolated from 218 children with various infections occurring in the following order of frequency: chronic suppurative otitis media, 76.3%; appendicitis/peritonitis, 10.3%; osteomyelitis, 8.9%; skin or soft tissue infection, 6.3%; acute conjunctivitis, 3.0%; and urinary tract infection, 0.1%. A variety of O serogroups were identified: O1 (15.2%), O6 (14.7%), O11 (12.4%), O10 (11.5%), O3 (10.6%), O5 (5.1%), and O9 (4.6%), Other serogroups and nontypable strains were recovered at a frequency of 11.2% and 14.7%, respectively, Nontypable strains predominated in chronic otitis media (18.9%), while serogroups O1 (18.3%), O6 (17.5%), and O11 (17.5%) were recovered most frequently among the typable isolates, Susceptibility of Pseudomonas aeruginosa to antipseudomonadal agents was extremely high. The rate of susceptibility to ceftazidime was 99.6%, to azlocillin 98.6%, to piperacillin 98.2%, to aztreonam 97.3%, to gentamicin and netilmicin 97.7%, and to ciprofloxacin 99.1%, All isolates were susceptible to tobramycin, imipenem, and amikacin. The results might suggest that community-acquired Pseudomonas aeruginosa infections in children can be treated successfully with any antipseudomonadal antibiotic

The avian collection of the Zoological Museum of the University of Athens (ZMUA)

Background The Zoological Museum of the University of Athens (ZMUA) was established in 1858. It is the oldest natural history museum of Greece. The museum began its operation with the acquisition of a core collection and has been expanding ever since. One of the most substantial parts of the museum's collection consists of the avian exhibits, originating from around the world. New information Today, the avian collection consists of 2,948 specimens, preserved mostly through taxidermy, along with a significant number of eggs. The birds have been collected from around the world. A substantial part of the collection consists of individuals originating from Greece, Brazil, Canada and Australia. Having this valuable source of biogeographic information and a potential reserve of historical genetic diversity, ZMUA presents here the contents of the avian collection

Divergent Patterns of Thyrotropin and Other Thyroidal Parameters in Relationship with the Sex of Healthy Neonates and Infants Less than Two Years Old: A Longitudinal Study

Background: A longitudinal study was conducted in full-term healthy infants who were born between 2015 and 2017 in Athens, Greece, to elucidate the evolution of thyrotropin (TSH) and other thyroidal parameters according to sex, from their day of birth until two years old. Other thyroidal parameters that were taken into account include antithyroid peroxidase antibody (TPO-Ab) and antithyroglobulin antibody (TG-Ab), total triiodothyronine (T3), and free triiodothyronine (fT3), along with total thyroxine (T4) and free thyroxine (fT4). Methods: Blood samples were taken at 5-day intervals from the day of birth until the 31st day of life, and then every 5th month until 2 years of age. All thyroid parameters were measured by electrochemiluminescence immunoassays. The study took place at the Iaso General, Maternity and Gynecological Clinic in Athens, Greece. Results: The sample consisted of 2916 full-term healthy neonates/infants: 1507 (51.7%) boys and 1409 (48.3%) girls. There were no significant differences in TSH levels between boys and girls in all time periods from birth up to 2 years except between 11 and 15 months of age (p = 0.038). Mean TSH levels for boys exhibited much more fluctuation and variability than for girls. In boys we found a significant association between TSH levels and fT4 (p < 0.001), while we found a significant association between TSH levels and T3 in girls (p = 0.045). Furthermore, we found that mean TPO-Ab and TG-Ab levels for boys exhibited larger variability than those for girls. Conclusions: In this study, we were able to plot the development of TSH and other thyroidal parameters by sex from birth up to two years of age. In terms of clinical practice, our findings suggest the need for a re-evaluation of the reference ranges of the studied parameters according to sex, especially in the first months of life and until the first year. Furthermore, our results suggest new optimal ranges for thyroid hormone replacement for that specific period. © Copyright 2019, Mary Ann Liebert, Inc., publishers 2019

Computer-based nodule malignancy risk assessment in thyroid ultrasound imageS

This paper presents a computer-based approach for detection, delineation, and malignancy risk assessment of thyroid nodules in ultrasound (US) images. The proposed approach is automatic and integrates processes for: the thyroid gland boundaries detection, the detection of nodular lesions within the thyroid gland, the delineation of the detected nodules, and the classification of thyroid nodules according to malignancy risk. These processes embed textural and shape feature vectors derived from the US images, as well as state of-the-art medical image analysis and pattern recognition tools. The obtained classification performance, which is associated with automatic malignancy risk assessment, was evaluated by means of the receiver operating characteristic (ROC), demonstrating an area under curve (AUC) equal to 0.93. The quantification of the results shows that the proposed approach: (1) contributes to the objectification of the diagnostic process by the utilization of explicit image features, whereas it can provide the diagnosticians with a second opinion, (2) is applicable in clinical practice and could contribute to the reduction of false medical decisions

Active contours guided by echogenicity and texture for delineation of thyroid nodules in ultrasound images

Thyroid nodules are solid or cystic lumps formed in the thyroid gland and may be caused by a variety of thyroid disorders. This paper presents a novel active contour model for precise delineation of thyroid nodules of various shapes according to their echogenicity and texture, as displayed in ultrasound (US) images. The proposed model, named joint echogenicity-texture (JET), is based on a modified Mumford-Shah functional that, in addition to regional image intensity, incorporates statistical texture information encoded by feature distributions. The distributions are aggregated within the functional through new log-likelihood goodness-of-fit terms. The JET model requires only a rough region of interest within the thyroid gland as input and automatically proceeds with precise delineation of the nodules, revealing their shape and size. The performance of the JET model was validated on a range of US images displaying hypoechoic and isoechoic nodules of various shapes. The quantification of the results shows that the JET model: 1) provides precise delineations of thyroid nodules as compared to "ground truth" delineations obtained by experts and 2) copes with the limitations of the previous thyroid US delineation approaches as it is capable of delineating thyroid nodules regardless of their echogenicity or shape. © 2009 IEEE

Dissociation of ACTH, beta-endorphin and cortisol in graded sepsis

The function of the hypothalamic-pituitary-adrenal axis as related to the degree of severity of a septic process was assessed by measuring plasma levels of beta-endorphin, ACTH and cortisol. Sixty-one cases of postoperative patients treated at the intensive care unit were classified into four groups according to the severity of infection: Group 1 (control) included patients who did not show any sign of infection, group 2 patients with sepsis, group 3 patients with septic syndrome and group 4 patients with septic shock. Compared to G1 patients’ ACTH values (4.16+/-2.6 pg/ml), a statistically significant increase in ACTH values in various stages of septicemia (p < 0.005) with a noticeable difference also between G3 (7.11 +/- 3.7 pg/ml) and G4 (11.5 +/- 6.6 pg/ml) (p<0.05) was found. Differences were also observed in beta-endorphin (with a level of significance between the several groups of p=0.0001). Also, beta-endorphin values in G4 (40.6 +/- 30.3 pg/ml) differed significantly from each of G1 (17.5 +/- 6.6 pg/ml), G2 (21.1 +/- 11.3 pg/ml) and G3 (23.5 +/- 12 pg/ mi) (p<0.05). A progressive hypercortisolemia was obvious, with values of G4 (37.2 +/- 15.6 mu g/dl) differing significantly from those of G1 (18 +/- 4.6 mu g/dl) and G2 (24 +/- 8.4 mu g/dl) (p<0.05) and of G3 (28.5 +/- 12.3 mu g/dl) from that of G1 (p < 0.05). Interestingly, a dissociation of ACTH, beta-endorphin and cortisol was observed, in that the increased values of beta-endorphin and cortisol, detected in the G3 were not associated with a parallel increase in ACTH. These findings might be interpreted in the sense of an impairment of the stress stimulation of the hypothalamic pituitary adrenal axis. Provided that such a situation can be lethal, our results further confirm the idea that a low-dose, steroid replacement might be beneficial to critical illness