Pseudomonas aeruginosa resistance phenotypes and phenotypic highlighting methods.

Pseudomonas aeruginosa genus bacteria are well known for their increased drug resistance (phenotypic ang genotypic resistance). The most important resistance mechanisms are: enzyme production, reduction of pore expression, reduction of the external membrane proteins expression, efflux systems, topoisomerase mutations. These mechanisms often accumulate and lead to multidrug ressitance strains emergence. The most frequent acquired resistance mechanisms are betalactamase-type enzyme production (ESBLs, AmpC, carbapenemases), which determine variable phenotypes of betalactamines resistance, phenotypes which are associated with aminoglycosides and quinolones resistance. The nonenzymatic drug resistance mechanisms are caused by efflux systems, pore reduction and penicillin-binding proteins (PBP) modification, which are often associated to other resistance mechanisms. Phenotypic methods used for testing these mechanisms are based on highlighting these phenotypes using Kirby Bauer antibiogram, clinical breakpoints, and "cut off" values recommended by EUCAST 2013 standard, version 3.1.

Angiogenesis in the pathogenesis of pterygium.

Pterygium represents an epithelial hyperplasia associated with fibro-vascular growth. It is an active process, associate with cellular proliferation, remodeling of the connective tissue, angiogenesis and inflammation. The aim of this study consists of emphasizing angiogenesis involvement in the pterygium pathogeny. The material used for this study consisted of 21 pterygion fragments surgically removed in the Ophthalmology Clinic of the Emergency County Hospital, Craiova. Nine patients were men, 22 were women, and they were aged between 58 and 81 years. Ten fragments of epibulbar conjunctiva from the vicinity of the sclero-corneal limbus were used as control tissue. They were initially histological processed by paraffin inclusion. The immunohistochemical processing was made in the Histological, Histopathological and Immunohistochemical Techniques Laboratory of the University of Medicine and Pharmacy of Craiova. The working technique used was ABC÷HRP (Avidin complexed with biotinylated peroxidase). Angiogenesis in the pterygion was investigated with CD31 marker that allows the identification of the vascular endothelium and the establishment of the vascular microdensity and with VEGF, which allowed the identification of the main source of proangiogenic factors in pterygium. Our study emphasized the existence of a much richer vascularization at the level of the pterygium, compared with the one of the normal conjunctiva. The respective blood vessels were best represented in the subepithelial conjunctive, due to the increased necessities of the proliferating pterygium epithelium. The morphology of the blood vessels is specific for the neoformation vessels, which have a small caliber, are branched and have a rarely visible lumen. The investigation of the vascular microdensity has shown the existence of an intense angiogenesis process at the level of the pterygium and the overexpression of the VEGF, mainly in the proliferating structures of the pterygium, plead for the pathogenic involvement of this growth factor in the development of the pterygium.

[Laser trabeculoplasty--a prospective study]. / Trabeculoplastia laser--un studiu prospectiv (rezultate de etapa).

PURPOSE AND METHOD: Prospective study on 22 glaucoma patients (31 eyes)--pseudoexfoliation glaucoma and POAG--who underwent nonselective laser trabeculoplasty during 2007. The follow-up time is intended to be 5 years, with a preliminary report at 2 years. Our study wants to evaluate the efficiency and safety of the laser procedure. RESULTS AND DISCUSSIONS: The initial success rate was 100%; the mean IOP lowering was 11 mmHg (38%) for the pseudoexfoliation glaucoma and 5 mmHg (20%) for POAG. At 2 year interval, the success rate of trabeculoplasty was 79% for pseudoexfoliation glaucoma and still 100% for POAG. CONCLUSIONS: The preliminary results provided by our study are better than those described in the literature; we find an explanation in the fact that our group was not randomized.

[Assessment of systane in severe dry eye]. / Evaluarea eficacitatii systane in formele severe de ochi uscat.

The study proposes the evaluation of the Systane effect on people that have severe dry eye sensation, with cornea or conjunctive complications. In order to do this, a study protocol has been adopted which meant comparing the values of lacrimal film break-up time, before and after Systane treatment, comparing cornea and conjunctive staining, comparing the crystallization test before and after treatment, comparing the conjunctival impression before and after treatment, and the general acceptability of Systane. The study results have shown that in severe dry eye cases, Systane increases lacrimal film break-up time by 2-3 seconds than the initial value, as well as considerable reduction in cornea/conjunctival staining and in conjunctival hyperemia in Sicca keratoconjunctivitis. After treatment, conjunctival impression have shown the proliferation of conjunctival and goblet cells, with normal morphologic aspect of the new-formed cells. In every case, the regenerating effect on epithelia of Systane was obvious, which is determined by the direct action of the HP-guar, forming a protective layer with lubrication effect, helpful to the initiation of tissue repairing processes.

[Anterior uveitis in a juvenile chronic arthritis, oligoarticular form]. / Uveita anterioara la un adolescent cu artrita cronica juvenila, forma oligoarticulara.

We present the case of a 16-year-old male teen-ager admitted in the Ophthalmology Clinic Craiova, diagnosed with Anterior neglected acute uveitis in the left eye. Before and simultaneous with the ocular manifestations, the patient complained of pain on the hips joints. The pediatric examination, based on the clinical features and the laboratory findings, diagnosed him with Juvenile chronic arthritis, oligoarthritis type. The evolution was good under the corticosteroid therapy.

[Takayasu disease--case report]. / Boala Takayasu--consideratii asupra unui caz clinic.

Chronic vasculitis which determines the thickness of the affected arteries, Takayasu disease is an uncommon finding. It is characterized by narrowing of the big arteries beginning from the aortic arch. The result is arterial hypotension, cerebral and retinal ischemic signs, the absence of pulse at the upper limbs. Manifestations includes: vascular narrowing, microaneurysms, hemorrhages, cotton wool spots, vascular occlusions. The authors present the case of a 20-years old female patient with retinal vascular signs, admitted for ocular pain, upper limbs and mastication pains. The clinical examination revealed pulseless radial and brachial arteries, arterial pressure undetermined at both upper limbs.

[Doyne retinal dystrophy--case report]. / Distrofia retiniana "în fagure de miere" Doyne--prezentare de caz.

We present the case of a female patient, 16-years old, whose the fundus examination revealed the presence, in the macular region, of drusen type lesions; the clinical aspect completed with AFG, perimetry, dark adaptation, ERG resulted in the diagnosis of Doyne's honeycomb retinal dystrophy. The disorder, included in the Familial drusen, is due to an inborn error of metabolism localized the RPE. It seems that the defect is in an intercellular matrix protein which leads to the development of abnormal basement membranes.

[Ophthalmic manifestation in icterus--hemorrhagic leptospirosis]. / Leptospiroza ictero-hemoragicâ--manifestari oculare.

We present the case of a 19-year-old male, admitted in the Ophthalmology Clinic for Macular Chorioretinitis, hemorrhagic form. Laboratory findings shown high titres of icterus-hemorrhages leptospirosis.

[Corneal neurotrophic ulcers--clinical and etiopathogenic aspects]. / Ulcere corneene trofice--aspecte clinice si etiopatogenice.

PURPOSE: The aim of this paper is to observe the corneal neurotrophic ulcers in patients with ophthalmic and systemic diseases associated with impairment of the sensory innervation of the cornea. METHODS: We have performed a retrospective study using a lot of patients with corneal neurotrophic ulcers, admitted in Ophthalmology Clinic in 2003-2006. We have analyzed the etiopathogenic factors that have determined the corneal trophic ulcers, the treatment and the complications occurred. RESULTS: The study spot-lighted two main causes responsible for the corneal trophic ulcers: ocular and systemic disorders. For many patients the etiopathogenic factor is multiple. CONCLUSIONS: 1. Corneal neurotrophic ulcer is a severe complication of an ophthalmic or a systemic disorder. 2. The moderate outcome of ophthalmic complications require early treatment, adjusted for each patient. 3. Prevention of the corneal neurotrophic ulcers is the best method of treatment.

[Changes of the conjunctival nervous fillets in diabetic patients]. / Modificari ale filetelor nervoase in conjunctiva bolnavilor cu diabet zaharat.

PURPOSE: Our study suggested to reveal nervous fillets changes from conjunctiva structure in patients with diabetes. MATERIAL AND METHOD: We removed bulbar conjunctiva during cataract surgery on diabetic and non-diabetic patients from the same age group. The conjunctiva fragments were fixed in Lillie's solution, then studied by using optical microscopy with usual and histochemical stainings. RESULTS: Nervous fillets just like perinervium are better represented in younger diabetic patients without diabetic retinopathy or with early diabetic retinopathy and non-diabetic patients, too. In older patients and old diabetes, nervous fillets are much less in number with poor represented perinervium. CONCLUSIONS: Significant changes of the conjunctiva nervous fillets were found in patients with long-term diabetes.

[Neuroprotective effect of Betoptic S-considerations after 18 months of treatment]. / Efectul neuroprotector al tratamentului cu Betoptic S-consideratii dupa 18 luni.

BACKGROUND: The aim of our study was the analysis of the hypotensor and neuroprotector effect induced by Betoptic S given to patients diagnosed with open-angled glaucoma. MATERIALS AND METHODS: A set of patients with open-angled glaucoma at different stages of evolution, during a period of 18 months were available for our examination. We took in to account parametres such as: ocular pressure values, fundus examination, kinetic and automatic perimetry. RESULTS: Betoptic S treatment in patients with open-angled glaucoma in early stages was efficient; therefore ocular pressure values continued in normal limits and visual capacity at automatic perimetry was improved. A number of patients in which Betoptic S didn't cause an ocular pressure compensation were given Xalatan. This association was a beneficial one. In those patients with open-angled glaucoma in terminal stage Betoptic S and Xalatan association was inefficient. In those patients which were not treated at all, visual capacity decreased to zero. CONCLUSIONS: 1. Betoptic S neuroprotector effect is obvious in early glaucoma patients; visual capacity was improved in all cases. 2. In advanced and terminal stages of the disease visual capacity goes on decreasing in spite of the associated treatment.