Biofilms in chronic rhinosinusitis: systematic review and suggestions for future research.

BACKGROUND: A biofilm is a community of micro-organisms encased within a self-produced, extracellular, polymeric substance. The role of biofilms as a major pathological aetiology in chronic rhinosinusitis would help explain the clinical manifestation of the disease. OBJECTIVES: To examine the current evidence, and to discuss possible future research directions, in relation to biofilms and chronic rhinosinusitis. STUDY DESIGN: Systematic literature review. EVALUATION METHOD: Two assessors independently undertook critical appraisal of the studies identified by the literature search. Significant findings were incorporated into this review. The primary outcome assessed was the presence of biofilm in human mucosal biopsy samples taken from patients with chronic rhinosinusitis, and from healthy controls. RESULTS: We identified 11 studies examining biofilm formation in human mucosal biopsy samples taken from patients with chronic rhinosinusitis. CONCLUSION: It is unlikely that biofilms occur in every case of chronic rhinosinusitis; consequently, the significance of 'biofilm detection' in some series should be considered carefully. Several authors have argued strongly for the use of confocal scanning laser microscopy with fluorescent in situ hybridisation probes as the 'gold standard' for biofilm imaging. This imaging modality should be combined with further investigation of the microbiology of chronic rhinosinusitis, and of the efficacy of traditional culture techniques used for pathogen identification.

Baseline differences between vascular cognitive impairment no dementia reverters and non-reverters.

BACKGROUND: The underlying factors of reversion from cognitive impairment to normal cognitive functioning in stroke are not well understood. We compare demographic, cognitive and imaging factors in Vascular Cognitive Impairment, No Dementia (Vascular CIND) patients who revert to normal cognitive functioning to Vascular CIND patients who do not revert. METHODS: Thirty-one ischaemic stroke patients, who met classification criteria for Vascular CIND, were >49.5 years old, met NINDS stroke criteria, and were free from additional neurological illness, completed baseline and 1-year examinations. Forty-five per cent of the Vascular CIND participants reverted to no cognitive impairment at 1-year follow-up examination. RESULTS: There was greater cognitive impairment in non-reverters on a summary score spanning several neuropsychological domains and on psychomotor and working memory summary scores. There were no differences on demographic factors or in stroke severity between reverters and non-reverters. Structural MRI analyses revealed no baseline differences in number of strokes, stroke volume or stroke location. However, there was greater frontal white matter hyperintensity load in the non-reverter group. CONCLUSIONS: These results suggest that Vascular CIND reversion may be a function of a combination of baseline neuropsychological function and location of cerebrovascular disease.

Developmental changes in face processing: results from multidimensional scaling.

Multidimensional scaling procedures were used to investigate developmental changes in the ability to process previously unfamiliar faces. Eighty male subjects, aged 7, 9, 12, or adult, rated the similarity of pairs of faces. The faces were presented to subjects in either the upright or the inverted orientation. Multidimensional scaling analyses suggest that subjects of all ages use similar information in judging the similarity of faces. However, for upright faces, individual subjects under age 10 seem to use fewer features at a time. The results argue against a qualitative shift in face processing at age 10, and suggest that the improvement in face recognition ability noted at this age is due at least in part to an increased ability to consider more features simultaneously.