Chlamydia pneumoniae and helicobacter pylori serology - importance in patients with coronary heart disease

BACKGROUND

Chronic infections in CHD are due to one or both of the organisms Chlamydia pneumoniae and Helicobacter pylori.

AIM

To examine the association between serum markers of Chlamydia pneumoniae and Helicobacter pylori infection and markers of myocardial damage. in patients with acute coronary syndrome (ACS), with chronic coronary artery disease (CAD) and in-control group.

MATERIAL AND METHODS

Sera were taken from a total of 153 subjects. Subjects were divided in three groups: 64 patients with ACS; 53 patients with CAD and a group of 35 conditionally healthy individuals. Analysis of patients' sera for IgG antibodies to H. pylori and markers for myocardial damage was done on the Immulite system. The presence of specific IgG and IgA antibodies to C. pneumoniae was determined with MIF, Sero FIA (Savyon Diagnostics, Israel). Statistical analysis of data was done using the statistical program SPSS (Statistical Package for Social Sciences), version 13.

RESULTS AND DISCUSSION

There was a high significant difference in troponin levels between the three groups of subjects (p=0.0000). Levels of creatine kinase isoenzyme (CK-MB) were highest in the ACS group (500.0 ng/mL). There was a statistically significant difference between CG subjects and ACS patients due to more frequent detection of antichlamydial IgA antibodies in patients with acute coronary syndrome. Positive serum immune response for Helicobacter pylori was 17 (53.1%) and 29 (80.6%), respectively.

CONCLUSION

Increased IgA antibody titers for C. Pneumoniae, increased CRP values as well as classic markers of myocardial damage are risk factors for coronary events.

Distribution of Clostridium Difficile Ribotypes in Macedonian Patients and their Antimicrobial Susceptibility

BACKGROUND:

Clostridium difficile is a major nosocomial pathogen. In Europe, this bacterium is mostly characterised by PCR ribotyping. Most of the Clostridium difficile infections (CDI) are treated with vancomycin or metronidazole, although prolonged antibiotic use is considered as one of the main risk factors for CDI.

AIM:

This study aimed to detect the presence of various C. difficile ribotypes in hospitalised patients and to investigate their toxigenicity and antibiotic susceptibility.

MATERIAL AND METHODS:

All stool samples obtained from each patient were inoculated on Columbia blood agar and cycloserine cefoxitine fructose agar (CCFA) for isolation of C. difficile. Glutamate dehydrogenase and toxins A and B were investigated by immunochromatographic tests. Final confirmation of the isolates was performed by Vitek 2 and MALDI-TOF. A total of 21 isolates were collected for further investigation. PCR ribotyping was performed as described by Janezic and Rupnik. PCR ribotype profiles were analysed using software (Bionumerics, Applied Maths). Antibiotic susceptibility was determined by E-tests for metronidazole, vancomycin, tetracycline, clindamycin, erythromycin, imipenem, ciprofloxacin and moxifloxacin.

RESULTS:

About 48% of C. difficile isolates belonged to ribotype 001/072. So, this ribotype was the most common ribotype in this study. The remaining 52% of C. difficile isolates consisted of 10 different ribotypes: 017, SLO 160, SLO 187, SLO 120, 255/258, 014/020, 046, 002, 070 and 027. Furthermore, 20 (95.2 %) out of 21 isolates of C. difficile were toxigenic. Toxins A and B were detected simultaneously in 90.5 % of C. difficile isolates. Two isolates from the ribotype 017 were toxin B positive only. Treatments with any of the following antimicrobials: clindamycin, erythromycin, ciprofloxacin and moxifloxacin (as well as many other antibiotics), could be a risk factor for CDI due to the high resistance of the strains in this study. About 90% of the strains from the most common ribotype 001/072 have MICs for clindamycin and erythromycin > 256 µg/ml.

CONCLUSION:

All strains isolated are highly resistant to ciprofloxacin. All strains were susceptible to vancomycin (median MIC was 0.63 µg/ml) and metronidazole (median MIC was 0.084 µg/ml), so these two antimicrobials remain optimal treatment option for CDI.

Investigation of antimicrobial activity of essential oils of several Macedonian Thymus L. species (Lamiaceae)

Antimicrobial activity of twenty specimens of essential oils of eleven Thymus species, naturally occurring in the Macedonian flora, was investigated by agar diffusion and broth dilution methods. Inhibition of growth and microbicidal action was examined on three Gram positive bacteria (Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae). In spite of wide variability in essential oil composition, ranging from traces of thymol to the amount of about 50% thymol in oils, all examined samples of Thymus essential oil possessed strong antibacterial activity. Zones of inhibition of growth (for 25% dilution of oils) was from 10-54 mm in diameters. MICs ranging from 0.012-0.1% while MMCs were from 0.025-0.4% for essential oils that contained large amounts of phenols and 0.2-1.6% for those which contained traces of phenols and large amounts of geraniol, linalool and (Z + E)-citral.

Attrition in Everyday Dental Clinical Practice

INTRODUCTION

Attrition, its prevention and therapy is a complex problem, with a multifactorial etiology. The aim of this paper is to examine the treatment of attrition in everyday dental clinical practice with the help of soft inserts.

MATERIAL AND METHOD

In this study, 30 patients were included, divided into two groups of 15 patients, the study and the control group. The examined patients had first degree of attrition diagnosed according to the Bardsley index, after which the condition was noted in four intervals: the initial situation, after 2, 4 and 6 months from the first visit. The research data were processed in Statistica for Windows 7.0 and SPSS version 20, and the same were presented graphically.

RESULTS

In the study group with I degree of attrition, for p>0.05, no statistically significant difference was determined in the range of the Bardsley index between the four measurement times (Friedman Test: N=15; Chi-Square=7,200; df =3; p=0.0658). In the control group, for p<0.05, a significant difference was determined in the range of the Bardsley index between the four measured times (Friedman Test: N=15; Chi-Square=15.180; df=3; p=0.0017) with a significantly high value after 6 months.

DISCUSSION

From the results obtained when comparing the study group in patients with I degree of attrition and the control group, a negative change from the parafunction bruxism was observed in 20% of the test group and 47% of the control group. The results of our research indicated that in patients with the first degree of attrition from the study group, soft dental inserts give significantly better results than untreated patients in the control group. This correlates with the research of Khayat N. et al.

CONCLUSIONS

From the results of the subjects in the group with I degree of attrition, we can conclude that the soft inserts has great efficiency as a means of management of this parafunction and therefore its application in daily therapy is recommended.