Viral-bacterial co-infection in Australian Indigenous children with acute otitis media

Background: Acute otitis media with perforation (AOMwiP) affects 40% of remote Indigenous children during the first 18 months of life. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are the primary bacterial pathogens of otitis media and their loads predict clinical ear state. Our hypothesis is that antecedent respiratory viral infection increases bacterial density and progression to perforation

The anti-apoptotic protein survivin can improve the prognostication of meningioma patients

Background The 2016 WHO histopathological grading includes a substantial within-variation in recurrence risk, and is thus insufficient to predict prognosis after initial surgery of patients suffering from meningiomas. The aim of this study was to compare the prognostic value of the histopathological grading and the conventional biomarker MIB-1 with expression of the anti-apoptotic protein survivin to see if this biomarker could complement recurrence prediction. Methods Using immunohistochemistry, the expression of MIB-1 and survivin were determined as labeling indices (LIs) in tissue micro arrays from 160 human meningiomas. The accuracy of prognostication was assessed with receiver operator characteristics analyses and standard survival analyses. Results The expression of survivin was significantly associated with both histopathological grade (P = 0.022) and recurrence status (P = 0.035). A survivin LI of 1% was identified as the optimal cutoff value to predict recurrence (P = 0.003), and was proven as more reliable than the histopathological grading (P = 0.497) and MIB-1 expression (P = 0.091). This result was further strengthened in multivariate analyses where survivin expression was revealed as an independent predictor of recurrence-free survival, while the histopathological grading and MIB-1 expression did not reach significance (P ≥ 0.156). Conclusions These findings suggest that incorporation of survivin in the clinical practice might be useful as complement for the histopathological grading and should further be evaluated in independent prospective studies

DNA topoisomerase IIα and mitosin expression predict meningioma recurrence better than histopathological grade and MIB-1 after initial surgery.

BACKGROUND:The 2016 WHO histopathological grade or conventional biomarker MIB-1 is insufficient for predicting meningioma recurrence after initial treatment and alternative strategies are required. In this study, we investigated whether DNA topoisomerase IIα and/or mitosin expression can predict tumor recurrence with greater accuracy than conventional methods. METHODS:The expression of MIB-1, topoisomerase IIα, and mitosin were determined as proliferation indices in tissue microarrays using immunohistochemistry. The accuracy of prognostication was assessed with receiver operating characteristic (ROC) analyses and standard survival analyses. RESULTS:Expression of topoisomerase IIα and mitosin was significantly higher in recurrent meningioma than in non-recurrent meningioma (P ≤ 0.031), but no difference in MIB-1 expression was observed (P = 0.854). ROC analysis found topoisomerase IIα and mitosin expression to be the most reliable predictors of recurrence compared to WHO histopathological grade and MIB-1 expression. This result was supported by the multivariate survival analysis, in which mitosin expression was a significant predictor of recurrence-free survival (P < 0.001) and no association was found with histopathological grade or MIB-1 expression (P ≥ 0.158). CONCLUSIONS:The results suggest that topoisomerase IIα and mitosin improve prognostication of patients resected for meningioma. Tumors with higher topoisomerase IIα and/or mitosin expression have a higher risk of recurrence after initial treatment, and these patients may benefit from adjuvant treatment and closer radiological follow-up

Kaplan-Meier curves and recurrence-free survival (RFS).

<p>Meningioma patients were stratified by optimal cutoff values revealed by receiver operator characteristics (ROC). Histopathological grade (A), MIB-1 PI (B), topoisomerase IIα (C), and mitosin (D). Topoisomerase IIα and mitosin expression were demonstrated to be predictors of RFS, but no association was found with histopathological grade or MIB-1.</p

Receiver operator characteristics (ROC) analyses of cutoff values.

<p>Receiver operator characteristics (ROC) analyses of cutoff values.</p

Differences in proliferation indices (PIs) between WHO grades and recurrent/non-recurrent meningioma.

<p>Differences in proliferation indices (PIs) between WHO grades and recurrent/non-recurrent meningioma.</p

Comparisons of labelling indices.

<p>Comparisons of labelling indices.</p

Kaplan-Meier plot of survivin labeling index (LI) < 1% vs. > 1%.

<p>Patients with survivin LI > 1% had significant shorter recurrence-free survival compared to patients with survivin LI < 1%.</p

Clinical data according to 2016 WHO histopathological grade.

<p>Clinical data according to 2016 WHO histopathological grade.</p

Cox hazard univariate and multivariate survival analyses of proliferation assessment methods for recurrence-free survival.

<p>Cox hazard univariate and multivariate survival analyses of proliferation assessment methods for recurrence-free survival.</p