Salmonella enteritidis Phlegmon in an Elderly Female: A Case Report.

Salmonella enteritidis is an individual serotype of S. enterica which can cause gastroenteritis in humans. In the case of a mild primary infection, bacteremia and phlegmon, as well as other types of extraintestinal Salmonella infection, may go undiagnosed. A 64-year-old female presents with a one-week history of fatigue, fever, and low back pain. She recently noticed a progressively growing mass in her lower back, along with swelling and redness of the surrounding skin. The patient is a nursing home resident who has been immobilized since a fall one month before the presentation. The bacterial culture of discharge from the infected area was found to be positive for S. enteritidis, and the diagnosis of the torso phlegmon was made. The patient underwent surgical removal of the phlegmon and clinically improved after post-operative treatment. After evaluating geographic location, time of the year, and host factors such as relative immobility, extremes of age, and immunosuppressive conditions, S. enteritidis should be considered in a differential diagnosis of torso phlegmon.

The Role of Urinary Nitrite in Predicting Bacterial Resistance in Urine Culture Analysis Among Patients With Uncomplicated Urinary Tract Infection.

Objective This study aims to determine the relationship between the presence of urinary nitrite and bacterial resistance to antimicrobial therapy in patients with uncomplicated urinary tract infections. Methods During a six-month time period (April-October, 2020), we reviewed the urine samples of 59 adult outpatients from the Urology Department of Tbilisi State Medical University the First University Clinic with the diagnosis of urinary tract infection. The infecting microorganisms and the presence of urine nitrite were recorded. Resistance rates to the antibiotics were compared between the positive and negative nitrite groups. Chi-squared test was used to perform the statistical analysis using Prism software version 9.3.1 (GraphPad Software, Inc., San Diego, California). Results We examined the correlation between the nitrite-positive and -negative groups with the resistance pattern to ceftriaxone, trimethoprim/sulfamethoxazole (TMP-SMX), ampicillin-sulbactam, fosfomycin, amikacin, doxycycline, cefuroxime, cefotaxime, ceftazidime, and nitrofurantoin. A total of 59 outpatients with a mean age of 37 years met the inclusion criteria between April and October 2020. In the positive and negative nitrite groups, there were 23 and 36 patients, respectively. Three (17.6%) of the 17 gram-positive organisms and 20 (62.5%) of the 42 gram-negative organisms yielded positive nitrite results. In nitrite-positive group, resistance rates to ceftriaxone, TMP-SMX, ampicillin-sulbactam, fosfomycin, amikacin, doxycycline, cefuroxime, cefotaxime, ceftazidime, and nitrofurantoin were 52.2%, 70.8%, 63.5%, 67.7%, 25.8%, 31.9%, 29.6%, 32.5%, 22.5% and 83.8%, respectively. These values in the nitrite-negative group were 6.5%, 41.3%, 60.7%, 72.9%, 49%, 3%, 2.3%, 3.3%, 4.3% and 81.9%, respectively. Highest relative resistance rate was recorded against cefuroxime (12.9), followed by doxycycline (10.6), cefotaxime (9.8), ceftriaxone (8.03), ceftazidime (5.2), TMP-SMX (1.71), ampicillin-sulbactam (1.05), nitrofurantoin (1.02), fosfomycin (0.93), and amikacin (0.53). The most commonly isolated pathogen was Escherichia coli, which was detected in 35 (71%) isolates. Other bacteria commonly found were Proteus spp in five (12%) isolates, Klebsiella spp in two (5%) isolates, and Enterococcus in five (12%) isolates. Conclusion The findings revealed that out of 10 antibiotics, nitrite-positive groups demonstrated higher resistance only against ceftriaxone, cefuroxime, cefotaxime, and doxycycline. Other antibiotics showed no statistically significant differences in resistance. Furthermore, the highest relative resistance rate was recorded against cefuroxime, whereas amikacin revealed the lowest. Therefore, we suggest physicians to not adjust antibiotic therapy for urinary tract infections (UTIs) based on the presence of nitrite. Urine bacteriology should be ordered.

Electron microscopy demonstrating noise exposure alters synaptic vesicle size in the inferior colliculus of cat.

CONTEXT: White noise is known to have detrimental effects on different brain regions, especially auditory regions, including inferior colliculus. Although the basis for such alterations has been hypothesized to result from abnormalities in neurotransmitter release, the mechanism is unclear. The final step in neurotransmission is the docking and transient fusion of synaptic vesicles at the base of cup-shaped lipoprotein structures called porosomes at the presynaptic membrane and the consequent release of neurotransmitters. Earlier studies in cat brain document altered morphology of the secretory portal the porosome at nerve terminals in the inferior colliculus following white noise exposure. The current study was performed to test the hypothesis of possible changes to synaptic vesicle size in the colliculus, following white noise exposure. MATERIAL AND METHODS: Electron microscopic morphometry of synaptic vesicles size in axo-dendritic synapses at the colliculus region of the cat brain was performed. RESULTS: We report, for first time, decreased size of both docked and undocked vesicles in high-intensity white noise-exposed animals. In both control and experimental animals, docked vesicles are demonstrated to be smaller than undocked vesicles, suggesting fractional discharge of vesicular contents via porosome-mediated kiss-and-run mechanism. CONCLUSION: These studies advance our understanding of neurotransmitter release and the impact of white noise on brain function.

Gender differences in anxiety response to high intensity white noise in rats.

Prolong exposure to high intensity white noise (HIWN), defined as a heterogeneous mixture of sound waves extending over a wide frequency range, has detrimental peripheral and central consequences including cardiovascular and emotional effects. Anxiety is a common manifestation of HIWN. Although gender-dependent differences in manifestation of anxiety and/or response to treatment of this condition has been amply documented, potential differences in response to HIWN, a common exposure in combat, construction and rave disco, has not been adequately investigated. In this study, both male and female Wistar rats were subjected to HIWN for 10 consecutive days, 1 h/day. On day 11, a day after the last exposure, the performance of the rats in open field (OF) and elevated plus maze (EPM) was evaluated. Male rats showed a higher anxiety-like response to HIWN as evidenced by: lower number of entries into the open arm of the EPM, lower number of entries into central zone of OF, excess grooming in OF and more boluses in closed arm of EPM. These results indicate that gender-related differences in anxiety in general, and in response to HIWN, in particular, has to be taken into consideration when investigating the neurobiological components and/or treatment modalities.

Immunoreactivity of p27(Kip1), cyclin D3, and Ki67 in conventional renal cell carcinoma.

The goal of the study was to evaluate expression of the cell-cycle regulatory proteins (p27(Kip1) and cyclin D3) and proliferation marker Ki67 in normal human kidneys and renal cell carcinoma (RCC) tissues. Intensity of the markers' expression was prospectively studied and compared between normal and RCC tissue samples. Association was analyzed with cancer clinical parameters. p27(Kip1) was significantly upregulated in normal compared with in RCC samples. Immunoreactivity of the protein negatively correlated with tumor size and was associated with pathological stage and grade. Patients with symptomatic disease had significantly less marker expression than those with incidentally discovered tumors. Intensity of Ki67 staining positively correlated with primary tumor size and associated with disease stage and grade. Cyclin D3 immunoreactivity positively correlated with tumor size. Loss of p27(Kip1) expression, pathological stage, grade, and tumor size were risk factors for disease recurrence (P = 0.0072, 0.0011, and 0.0467, and P < 0.0001, respectively) and patient death (P = 0.0021, 0.0106, 0.0151, and 0.0021, respectively). With Cox multivariate analysis loss of p27(Kip1) expression (hazard ratio 9.3, P = 0.002) and tumor size (hazard ratio 5.9, P = 0.015) were the predictors of cancer-specific survival. In conclusion, intensity of the markers' expression in RCC is associated with tumour clinical parameters (size, stage, grade, and disease presentation type). Loss of p27(Kip1) expression is a risk factor for the disease recurrence and cancer-related patient death.

Expression of p27((Kip1)), cyclin D3 and Ki67 in BPH, prostate cancer and hormone-treated prostate cancer cells.

p27((Kip1)), cyclin D3 and Ki67 are the markers of DNA damage and cell proliferation. The goal of the current study was to analyze expression of the markers in benign and malignant prostate cancer tissues. Activity of p27((Kip1)), cyclin D3 and Ki67 was immunohistochemically evaluated in different cells of BPH, prostate cancer (PCa) and hormonally treated prostate cancer (HTPCa) tissues. The tissue samples were derived by means of TURP or radical prostatectomy. Intensity of the expression was compared between the groups, and association was sought with clinical parameters. Total expression of p27((Kip1)) was significantly higher in BPH as compared with PCa. Epithelial marker expression was higher in HTPCa than in PCa. Intensity of the expression in epithelial, vascular and ductal cells was negatively associated with the tumor stage and Gleason grades. Total Ki67 activity was positively correlated with patient age and serum PSA level. There was significantly higher expression in PCa and hormone-escaped PCa (HEPCa) as compared with BPH. Epithelial and vascular marker expression was positively associated with tumor stage and Gleason grades. There was a positive correlation between cyclin D3 and serum PSA level. With the increase of Gleason grades, cyclin D3 expression increased significantly. Expression of p27((Kip1)) negatively correlated with Ki67 and cyclin D3, while the latter two markers correlated positively. p27((Kip1)) is down-regulated, whereas Ki67 and cyclin D3 are up-regulated in PCa. Intensity of the markers' expression is associated with tumor stage and grades. Hormonotherapy of PCa causes activation of p27((Kip1)). HEPCa is characterized by increased Ki67 expression.

Loss of p27(Kip1) CDKI is a predictor of poor recurrence-free and cancer-specific survival in patients with renal cancer.

The importance of cyclin-dependent kinase inhibitors (CDKI) in benign and malignant urological diseases is a subject of intense ongoing investigation. The goal of the current study was to analyze the expression of p27((Kip1))CDKI in benign and malignant renal cells and assess their possible association with different clinical parameters. Expression of p27((Kip1)) was evaluated and compared in 24 normal human kidneys and in 52 renal cell carcinoma (RCC) tissue samples. Intensity of the expression was compared between the groups and association was analyzed with cancer clinical parameters. The expression of the marker was significantly higher in normal than in RCC samples (P = 0.0045). Intensity of p27((Kip1)) expression in RCC was negatively correlated with tumor size (Rho = -0.438, P = 0.0051) and associated with pathological stage and grade (P = 0.0488 and < 0.0001, respectively). The patients with symptomatic disease had significantly less marker expression than incidentally discovered tumors (P = 0.0301). Loss of p27((Kip1)) expression, pathological stage, grade and tumor size were the risk-factors for disease recurrence (P = 0.0072, 0.0011, 0.0467 and < 0.0001, respectively) and patient survival (P = 0.0021, 0.0106, 0.0151 and 0.0021, respectively). With Cox multivariate analysis loss of p27((Kip1)) expression (hazard ratio 9.3, P = 0.002) and tumor size (hazard ratio 5.9, P = 0.015) were the predictors of cancer-specific survival. Expression of p27((Kip1)) is significantly decreased in RCC as compared with normal kidney tissue. Intensity of the expression is associated with clinical parameters: tumor size, stage, grade and disease presentation. Loss of p27((Kip1)) expression is a risk-factor for disease recurrence and the strongest predictor of cancer-specific survival.