MedWorm: Meningitis

Bexsero® shows promise for meningococcal B

Pharmacy Europe — Wed, 08 Feb 2012 09:30:00 +0100

Pivotal study confirms potential of vaccine to protect infants against meningococcal serogroup B (Source: Pharmacy Europe)

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Is a single dose of meningococcal serogroup C conjugate vaccine sufficient for protection? Experience from the Netherlands

BMC Infectious Diseases — Wed, 08 Feb 2012 05:00:00 +0100

DiscussionSince 2001, the MenC conjugate vaccine has been implemented in the Netherlands by offering a single dose to all children aged 14 months. Prior to the introduction of the vaccine into the national immunisation programme, a catch-up vaccination campaign was initiated in which a single dose of the MenC conjugate vaccine was offered to all children aged from 14 months up to and including 18 years. Since then, there has been no report of any case of MenC disease among immunocompetent vaccinees. Administration of a single dose of MenC conjugate vaccine after infancy could be beneficial considering the already complex immunisation schedules with large numbers of vaccinations in the first year of life. The present paper deals with the advantages and critical aspects of a single dose of t...

New Meningitis Vaccine Works in Infants: Study

The Doctors Lounge - Infections — Tue, 07 Feb 2012 22:00:00 +0100

If licensed, it would protect babies from a strain of bacterium that can cause serious disease (Source: The Doctors Lounge - Infections)

Meningococcal Vaccine Effective Against Serogroup B Meningococcal Vaccine Effective Against Serogroup B

Medscape Today Headlines — Tue, 07 Feb 2012 21:19:50 +0100

The 4CMenB vaccine provides broad protection against serogroup B when given in 2 different schedules, either with or separately from routine vaccinations. Medscape Medical News (Source: Medscape Today Headlines)

Novel Vaccine Protects Against Meningococcus B (CME/CE)

MedPage Today Geriatrics — Tue, 07 Feb 2012 21:10:18 +0100

(MedPage Today) -- An investigational vaccine against meningococcal B disease produced robust immune responses in infants, researchers reported. (Source: MedPage Today Geriatrics)

New Meningitis Vaccine Works in Infants

MedlinePlus Health News — Tue, 07 Feb 2012 21:00:00 +0100

If licensed, it would protect babies from a strain of bacterium that can cause serious disease Source: HealthDay Related MedlinePlus Pages: Childhood Immunization, Meningitis (Source: MedlinePlus Health News)

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Development made in breakdown of a Meningitis B vaccine component

Health Protection Agency — Tue, 07 Feb 2012 13:24:35 +0100

Scientists from the Health Protection Agency (HPA) are a step closer to ensuring the stability of a component of a vaccine that may one day be used to protect against Meningitis B. The research is published today (Tuesday) in Vaccine. (Source: Health Protection Agency)

Meningitis in Children

eMedicineHealth.com — Tue, 07 Feb 2012 07:00:00 +0100

(Source: eMedicineHealth.com)

Immunogenicity and Tolerability of Recombinant Serogroup B Meningococcal Vaccine Administered With or Without Routine Infant Vaccinations According to Different Immunization Schedules: A Randomized Controlled Trial [Original Contribution]

JAMA — Tue, 07 Feb 2012 05:00:00 +0100

Conclusion A 4CMenB vaccine is immunogenic against reference strains when administered with routine vaccines at 2, 4, and 6 or at 2, 3, and 4 months of age, producing minimal interference with the response to routine infant vaccinations. Trial Registration clinicaltrials.gov Identifier: NCT00721396 (Source: JAMA)

Inching Toward a Serogroup B Meningococcal Vaccine for Infants [Editorial]

JAMA — Tue, 07 Feb 2012 05:00:00 +0100

(Source: JAMA)

Impact of antibiotic-impregnated catheters on the timing of cerebrospinal fluid infections in non-traumatic subarachnoid hemorrhage

Acta Neurochirurgica — Mon, 06 Feb 2012 19:35:52 +0100

Conclusions In the high-risk population of non-traumatic SAH, the use of AIC delays the occurrence of infection compared with that reported with non-antibiotic-impregnated catheters. This may orient management strategies in SAH patients requiring a ventriculostomy. Content Type Journal ArticleCategory Clinical ArticlePages 1-7DOI 10.1007/s00701-012-1276-6Authors Nancy McLaughlin, Neurosurgery Division, Centre Hospitalier de l’Université de Montréal—Hôpital Notre-Dame, 1560 Sherbrooke St. East, Montreal, QC H2L 4M1, CanadaPierre St-Antoine, Department of Microbiology, Centre Hospitalier de l’Université de Montréal—Hôpital Notre-Dame, 1560 Sherbrooke St. East, Montreal, QC H2L 4M1, CanadaMichel W. Bojanowski, Neurosurgery Division, Centre Hospitalier de l...

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Basilar leptomeningitis in Vogt-Koyanagi-Harada disease

Neurology — Mon, 06 Feb 2012 05:00:00 +0100

(Source: Neurology)

Teenagers should get meningitis C booster

Nursing Times Breaking News — Mon, 06 Feb 2012 00:01:00 +0100

A significant change is likely in the routine schedule for meningitis C vaccination, following new recommendations from government advisors. (Source: Nursing Times Breaking News)

Complete deficiency of the sixth complement component (C6Q0), susceptibility to Neisseria meningitidis infections and analysis of the frequencies of C6Q0 gene defects in South Africans.

Clinical and Developmental Immunology — Sun, 05 Feb 2012 16:25:58 +0100

Authors: Orren A, Owen EP, Henderson HE, van der Merwe L, Leisegang F, Stassen C, Potter PC Abstract Complete complement component 6 deficiency (C6Q0) is a co-dominant genetic disease presenting as increased susceptibility to invasive Neisseria meningitidis infections. Affected individuals have two affected alleles which can be homozygous or compound heterozygous for the particular gene defects they carry. This disorder has been diagnosed relatively frequently in Western Cape South Africans. Affected patients are prescribed penicillin prophylaxis. In 2004 we commenced a clinical follow-up study of 46 patients. Of these, 43 had family age-matched C6 sufficient controls. Participants were classified as either (i) well, or (ii) having a serious illness (SI) or died (D). An SI was a lo...

W5: Life or death - who gets to decide?

CTV Health — Sun, 05 Feb 2012 00:02:59 +0100

Hassan Rasouli, an electrical engineer, brought his family to Toronto from Iran, in the spring of 2010. Five months later, what was supposed to be routine surgery for a benign brain tumor, left Hassan unconscious. Bacterial meningitis had infected his brain. (Source: CTV Health)

Diagnostic pitfalls: a case of neurosarcoidosis mimicking tuberculous meningitis

Journal of Neurology — Fri, 03 Feb 2012 17:12:04 +0100

Content Type Journal ArticleCategory Letter to the EditorsPages 1-4DOI 10.1007/s00415-012-6429-2Authors Franziska Scheibe, Department of Neurology, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, GermanyHolger Flick, UKIM-LKH Universitätsklinikum/Medizinische Universität Graz, Auenbruggerplatz 20, 8036 Graz, AustriaOliver Wengert, Department of Neurology, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, GermanyDaniel Wittschieber, Department of Pathology, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, GermanyGeorg Bohner, Department of Radiology, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, GermanyPeter Ruokonen, Department of Ophthalmology, Charité–Universitätsmedizin Berlin, Augustenb...

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Azathioprine/prednisone: Cryptococcal meningitis: case report

Reactions — Thu, 02 Feb 2012 18:34:27 +0100

(Source: Reactions)

Circulating concentrations, cerebral output of the CINC-1 and blood–brain barrier disruption in Wistar rats after pneumococcal meningitis induction

European Journal of Clinical Microbiology and Infectious Diseases — Thu, 02 Feb 2012 18:15:51 +0100

Abstract Pneumococcal meningitis is a severe infectious illness of the central nervous system (CNS), with high rates of lethality and morbidity, being that the microorganism and the host’s inflammatory response are responsible for cerebral complications. Moreover, the blood–brain barrier (BBB) itself secretes cytokines and, because of the bipolar nature of the BBB, these substances can be secreted into either the CNS compartment or in the blood, so patients with acute bacterial meningitis frequently develop sepsis. Therefore, the aim of this study was to evaluate the cytokine/chemokine levels in different vessels and the BBB integrity after pneumococcal meningitis induction. Wistar rats were infected with Streptococcus pneumoniae, and the BBB integrity was investigated ...

Complete deficiency of the sixth complement component (C6Q0), susceptibility to Neisseria meningitidis infections and analysis of the frequencies of C6Q0 gene defects in South Africans

Clinical and Experimental Immunology — Thu, 02 Feb 2012 11:18:35 +0100

SummaryComplete complement component 6 deficiency (C6Q0) is a co‐dominant genetic disease presenting as increased susceptibility to invasive Neisseria meningitidis infections. Affected individuals have two affected alleles which can be homozygous or compound heterozygous for the particular gene defects they carry. This disorder has been diagnosed relatively frequently in Western Cape South Africans. Affected patients are prescribed penicillin prophylaxis. In 2004 we commenced a clinical follow‐up study of 46 patients. Of these, 43 had family age‐matched C6 sufficient controls. Participants were classified as either (i) well, or (ii) having a serious illness (SI) or died (D). An SI was a long‐term illness that did not allow the performance of normal daily activities. Among 43 patien...

A network of enzymes involved in repair of oxidative DNA damage in Neisseria meningitidis

Molecular Microbiology — Thu, 02 Feb 2012 05:00:00 +0100

ABSTRACTAlthough oxidative stress is a key aspect of innate immunity, little is known about how host‐restricted pathogens successfully repair DNA damage. Base excision repair (BER) is responsible for correcting nucleobases damaged by oxidative stress, and is essential for bloodstream infection caused by the human pathogen, Neisseria meningitidis. We have characterised meningococcal BER enzymes involved in the recognition and removal of damaged nucleobases, and incision of the DNA backbone. We demonstrate that the bi‐functional glycosylase/lyases Nth and MutM share several overlapping activities and functional redundancy. However MutM and other members of the GO system, which deal with 8‐oxoG, a common lesion of oxidative damage, are not required for survival of N. meningitidis under ...

Carriage of encapsulated bacteria in Gabonese children with sickle cell anemia

Clinical Microbiology and Infection — Thu, 02 Feb 2012 05:00:00 +0100

In conclusion, carriage and resistance rates are similar in children with and without SCA. Our data provide the basis to guide empiric therapy of invasive diseases caused by S. pneumoniae, S. aureus and H. influenza in children in Gabon. (Source: Clinical Microbiology and Infection)

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Pediatricians' Group Recommends HPV Vaccine for Boys

Cancercompass News: Gynecological Cancer — Thu, 02 Feb 2012 00:00:00 +0100

Immunization schedules for meningitis, flu also updated (Source: Cancercompass News: Gynecological Cancer)

Teens 'need meningitis C booster' warns JCVI

Telegraph Health — Wed, 01 Feb 2012 18:46:52 +0100

The current immunisation programme for meningitis C could be failing to protect older children, ministers have been warned. (Source: Telegraph Health)

Pediatricians’ Group Recommends HPV Vaccine for Boys

The Doctors Lounge - Oncology — Wed, 01 Feb 2012 15:00:00 +0100

Immunization schedules for meningitis, flu also updated (Source: The Doctors Lounge - Oncology)

Pediatricians' Group Recommends HPV Vaccine for Boys

MedlinePlus Health News — Wed, 01 Feb 2012 14:00:00 +0100

Immunization schedules for meningitis, flu also updated Source: HealthDay Related MedlinePlus Pages: Childhood Immunization, HPV (Source: MedlinePlus Health News)

Intrapartum Temperature Elevation, Epidural Use, and Adverse Outcome in Term Infants

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: The proportion of infants experiencing adverse outcomes increased with the degree of epidural-related maternal temperature elevation. Epidural use without temperature elevation was not associated with any of the adverse outcomes we studied. (Source: PEDIATRICS)

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Genetic susceptibility to invasive meningococcal disease: MBL2 structural polymorphisms revisited in a large case–control study and a systematic review

International Journal of Immunogenetics — Wed, 01 Feb 2012 05:00:00 +0100

We report the largest case–control study so far to investigate the effect of these polymorphisms in meningococcal disease (296 PCR‐positive cases and 5196 population controls, all of European ancestry) and demonstrate that no change in risk is associated with the polymorphisms overall or in any age‐defined subgroup. This finding contrasts with two smaller studies that reported an increase in risk. A systematic review of all studies of MBL2 polymorphisms in people of European ancestry published since 1999, including 24 693 individuals, revealed a population frequency of the combined ‘defective’MBL2 allele of 0.230 (95% confidence limits: 0.226–0.234). The past reported associations of increased risk of meningococcal disease were because of low ‘defective’ allele frequencie...

Unusual presentations of pediatric neurobrucellosis.

The American Journal of Tropical Medicine and Hygiene — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Budnik I, Fuchs I, Shelef I, Krymko H, Greenberg D Abstract Abstract. Neurobrucellosis is an uncommon complication of pediatric brucellosis. Acute meningitis and encephalitis are the most common clinical manifestations, however symptoms may be protean and diagnosis requires a high index of suspicion in patients from endemic areas. Diagnosis is often based on neurological symptoms, serology, and suggestive brain imaging because cerebrospinal fluid culture yields are low. Two cases of pediatric neurobrucellosis with unusual clinical and radiologic findings are presented. PMID: 22302859 [PubMed - in process] (Source: The American Journal of Tropical Medicine and Hygiene)

Predictors of Acute Bacterial Meningitis in Children from a Malaria-Endemic Area of Papua New Guinea.

The American Journal of Tropical Medicine and Hygiene — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Laman M, Manning L, Greenhill AR, Mare T, Michael A, Shem S, Vince J, Lagani W, Hwaiwhanje I, Siba PM, Mueller I, Davis TM Abstract Abstract. Predictors of acute bacterial meningitis (ABM) were assessed in 554 children in Papua New Guinea 0.2-10 years of age who were hospitalized with culture-proven meningitis, probable meningitis, or non-meningitic illness investigated by lumbar puncture. Forty-seven (8.5%) had proven meningitis and 36 (6.5%) had probable meningitis. Neck stiffness, Kernig's and Brudzinski's signs and, in children < 18 months of age, a bulging fontanel had positive likelihood ratios (LRs) ≥ 4.3 for proven/probable ABM. Multiple seizures and deep coma were less predictive (LR = 1.5-2.1). Single seizures and malaria parasitemia had low LRs (≤ 0.5). I...

Vaccinate teenagers against meningitis, say DH advisers

HealthcareRepublic Pharmacist News — Tue, 31 Jan 2012 11:02:00 +0100

Millions of teenagers may be set to routinely receive a 'booster' dose of the meningitis C vaccine following recommendations from government advisers. (Source: HealthcareRepublic Pharmacist News)

Meningoencephaloradiculomyelitis after tick‐borne encephalitis virus infection: a case series

European Journal of Neurology — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions: Polyradiculopathy and/or myelopathy as verified by electrophysiological examination within 4 weeks from symptom onset were indicative of a more severe disease course and a greater likelihood of moderate to serious sequelae even after long‐term rehabilitation. Older age at symptom onset seems to be associated with a less favourable outcome. Because of frequent long‐term hospitalization with immobilization and invasive ventilation, secondary complications, such as ventilation associated pulmonary infections and decubiti, must be avoided. (Source: European Journal of Neurology)

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How Bacteria Behind Serious Childhood Disease Evolve To Evade Vaccines

Health News from Medical News Today — Mon, 30 Jan 2012 09:00:00 +0100

Genetics has provided surprising insights into why vaccines used in both the UK and US to combat serious childhood infections can eventually fail. The study, published in Nature Genetics, which investigates how bacteria change their disguise to evade the vaccines, has implications for how future vaccines can be made more effective. Pneumococcus (Streptococcus pneumoniae) causes potentially life-threatening diseases including pneumonia and meningitis... (Source: Health News from Medical News Today)

A case of primary diffuse leptomeningeal gliomatosis predominantly involving the cervical spinal cord and mimicking chronic meningitis.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

Authors: Heijink DS, Urgun K, Sav A, Seker A, Konya D Abstract Gliomas may rarely arise in the leptomeninges without any evidence of intraaxial involvement. A case of primary diffuse leptomeningeal gliomatosis (PDLG) histologically diagnosed as oligoastrocytoma is presented. A 50-year-old woman presented with nausea, vomiting and headache. Magnetic resonance imaging (MRI) of cranium and cervical region revealed dural thickening starting from the craniocervical junction to the level of C4 without any parenchymal lesions. CSF examination showed an increase in protein and decrease in glucose levels. There were neither any kind of atypical cells nor any kind of growth in bacterial cultures. The patient underwent biopsy at the level of C1 for diagnosis. The specimen wa...

Neurologic Emergencies

Neurologic Clinics — Mon, 30 Jan 2012 02:28:35 +0100

Neurologists are often called to the emergency department to evaluate various acute primary central and peripheral nervous system disorders or neurological complications of multiple systemic illnesses. In these situations, prompt diagnosis can be lifesaving. Examples abound, but basilar thrombosis, aneurysmal subarachnoid hemorrhage, bacterial meningitis, and Guillain–Barre syndrome are just some illustrations. But the job of the neurologist is no longer restricted to being the master diagnostician. During the last three decades and with introduction of modern treatments, such as tissue plasminogen activator for treatment of acute ischemic stroke and the development of vascular interventional procedures, much can be offered to patients with acute neurological diseases in the emergency de...

What's the cause of meningitis in 5-month-old girl? [ID SNAPSHOT]

AAP News — Sun, 29 Jan 2012 05:00:00 +0100

(Source: AAP News)

Student's death after meningitis

BBC News | Health | UK Edition — Sat, 28 Jan 2012 14:14:22 +0100

Health chiefs write to students at Pembrokeshire College telling them a student has died after contracting meningitis. (Source: BBC News | Health | UK Edition)

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Meningitis and infective endocarditis caused by Rhodotorula mucilaginosa in an immunocompetent patient

Revista Brasileira de Terapia Intensiva — Fri, 27 Jan 2012 15:57:11 +0100

Os autores relatam o caso de um homem imunocompetente admitido com comprometimento agudo do sistema nervoso, crise hipertensiva e insuficiência renal, vindo a receber diagnóstico de meningite e endocardite infecciosa por Rhodotorula mucilaginosa. Até onde sabemos, esta é a primeira descrição de infecção simultânea das meninges e do endotélio causada por Rhodotorula em um paciente sem comprometimento imunológico.The authors report the case of an immunocompetent man who presented with acute impairment of the neurological system, hypertensive crisis and renal failure. The patient was eventually diagnosed with Rhodotorula mucilaginosa meningitis and infective endocarditis. To the best of our knowledge, this is the first description of simultaneous infection of the meninges and endot...

Refolding, purification and crystallization of the FrpB outer membrane iron transporter from Neisseria meningitidis

Acta Crystallographica Section F — Fri, 27 Jan 2012 05:00:00 +0100

FrpB is an integral outer membrane protein from the human pathogen Neisseria meningitidis. It is a member of the TonB-dependent transporter family and promotes the uptake of iron across the outer membrane. There is also evidence that FrpB is an antigen and hence a potential component of a vaccine against meningococcal meningitis. FrpB incorporating a polyhistidine tag was overexpressed in Escherichia coli into inclusion bodies. The protein was then solubilized in urea, refolded and purified to homogeneity. Two separate antigenic variants of FrpB were crystallized by sitting-drop vapour diffusion. Crystals of the F5-1 variant diffracted to 2.4 Å resolution and belonged to space group C2, with unit-cell parameters a = 176.5, b = 79.4, c = 75.9 Å, β = 98.3°. Crystal-packing calculatio...

Molecular epidemiological investigation on the source of a fatal case of serotype 22F pneumococcal meningitis.

Journal of Medical Microbiology — Fri, 27 Jan 2012 05:00:00 +0100

Conclusion. CM-PCR proved to be useful for assessing carriage serotype distribution in a setting of high-risk pneumococcal transmission. The causal serotype appeared to be linked to the brother of the case-patient and attendees of his day-care. PMID: 22286925 [PubMed - as supplied by publisher] (Source: Journal of Medical Microbiology)

Endonasal management of sellar arachnoid cysts: simple cyst obliteration technique.

Journal of Neurosurgery — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions Sellar ACs can be effectively treated using endonasal fenestration and obliteration with fat with resultant reversal of presenting symptoms in the majority of patients. This simplified technique of AC cavity obliteration without enlarging communication to the SAS has a low risk of CSF leakage, and in most cases appears to effectively disrupt cyst progression, although longer follow-up is required to monitor for cyst recurrence. PMID: 22283187 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

Viral Meningitis Facts and Information

Disabled World — Thu, 26 Jan 2012 21:15:34 +0100

Meningitis involves an inflammation of the membranes or, "meninges," that cover a person's spinal cord and brain. Viral infections are the most common cause of meningitis, with bacterial infections being the second most common cause. Additional and more rare causes of meningitis include parasites, fungi, and causes that are non-infectious such as ones related to drugs. (Source: Disabled World)

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Purpura Fulminans Secondary to Streptococcus pneumoniae Meningitis

Clinical and Developmental Immunology — Thu, 26 Jan 2012 11:22:23 +0100

Purpura fulminans (PF) is a rare skin disorder with extensive areas of blueblack hemorrhagic necrosis. Patients manifest typical laboratory signs of disseminated intravascular coagulation (DIC). Our case describes a 37-year-old previously healthy man who presented with 3 days of generalized malaise, headache, vomiting, photophobia, and an ecchymotic skin rash. Initial laboratory workup revealed DIC without obvious infectious trigger including unremarkable cerebrospinal fluid (CSF) biochemical analysis. There was further progression of the skin ecchymosis and multiorgan damage consistent with PF. Final CSF cultures revealed Streptococcus pneumoniae. Despite normal initial CSF biochemical analysis, bacterial meningitis should always be considered in patients with otherwise unexplained DIC as...

Microbiological characteristics of clinical isolates of Cryptococcus spp. in Bahia, Brazil: molecular types and antifungal susceptibilities

European Journal of Clinical Microbiology and Infectious Diseases — Thu, 26 Jan 2012 06:56:41 +0100

This study is the first to describe the susceptibility profiles of molecular and clinical isolates of Cryptococcus in Bahia, Brazil. The high percentage of C. gattii isolates belonging to the VGII genotype and its lower susceptibility to antifungal agents highlight the importance of knowing which species are involved in cryptococcal infections in northeastern Brazil. Content Type Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-011-1488-3Authors C. S. Matos, Graduate Program in Pharmacy, Faculty of Pharmacy, UFBA, Salvador, BrazilA. de Souza Andrade, Program for Scientific Initiation, Faculty of Pharmacy, UFBA, Salvador, BrazilN. S. Oliveira, Couto Maia Specialized Hospital, Salvador, BrazilT. F. Barros, Department of Clinical and Toxicological Analysis, Faculty of Pharm...

Frontal Sinus Osteoma with Osteoblastoma-like Histology and Associated Intracranial Pneumatocele

Head and Neck Pathology — Tue, 24 Jan 2012 18:14:59 +0100

Abstract Osteomas of the cranial sinuses are rare, benign bony tumors that can be complicated by the formation of an intracranial pneumatocele. If not treated promptly, a pneumatocele can lead to abscess formation, meningitis, or ventriculitis. In the present case, an intracerebral pneumatocele was formed when an 18 cm3 osteoma breached the posterior wall of the frontal sinus creating a one-way valve through which air could enter the intracranial cavity. The patient presented after forceful sneezing with nonspecific symptoms of headache, nausea, and vomiting. CT demonstrated a frontal collection of loculated air with mass effect within the left cerebral hemisphere. A partly mineralized mass occupied the left superior nasal ethmoid sinus and left frontal sinus. Of inter...

Measurement of antibodies to pneumococcal, meningococcal and haemophilus polysaccharides, and tetanus and diphtheria toxoids using a 19-plexed assay.

Journal of Immunological Methods — Tue, 24 Jan 2012 05:00:00 +0100

Authors: Whitelegg AM, Birtwistle J, Richter A, Campbell JP, Turner JE, Ahmed TM, Giles LJ, Fellows M, Plant T, Ferraro AJ, Cobbold M, Drayson MT, Maclennan CA Abstract The measurement of antibody responses to vaccination is useful in the assessment of immune status in suspected immune deficiency. Previous reliance on enzyme-linked immunoabsorbent assays (ELISA) has been cumbersome, time-consuming and expensive. The availability of flow cytometry systems has led to the development of multiplexed assays enabling simultaneous measurement of antibodies to several antigens. We optimized a flow cytometric bead-based assay to measure IgG and IgM concentrations in serum to 19 antigens contained in groups of bacterial subunit vaccines: pneumococcal vaccines, meningococcal vaccines, Haemoph...

Infliximab: Listeria monocytogenes meningitis: case report

Reactions — Mon, 23 Jan 2012 18:35:21 +0100

(Source: Reactions)

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Study: Vaccine against bacterial meningitis shows promise

USATODAY.com Health — Sun, 22 Jan 2012 18:00:00 +0100

A new vaccine to protect against meningococcus B, a common cause of bacterial meningitis, shows promise in clinical trials. (Source: USATODAY.com Health)

Meningococcal Vaccine: A Position Statement of the Society for Adolescent Health and Medicine

Journal of Adolescent Health — Sun, 22 Jan 2012 06:56:16 +0100

Although rates of meningococcal disease have remained low in the United States since 2000, the severity of the disease, rapidity with which it strikes, and significant sequelae remain compelling reasons to employ all means possible to prevent it. Meningococcal disease has a bimodal peak distribution in the United States with its highest incidence rates in infants and adolescents aged 16 years and older. The 2005 recommendations from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention were intended to protect youth entering adolescence including individuals 16–21 years of age, the ages at which meningococcal disease rates peak for children and young adults. Administration of the quadrivalent (serogroups A, C, Y, and W-135) meningococca...

Diagnostic features of tuberculous meningitis: A cross-sectional study

BMC Research Notes — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion: In patients with chronic meningitis syndrome, only abnormal CSF was associated with the diagnosis of TBM. (Source: BMC Research Notes)

Case report: Benefits of quantitative polymerase chain reaction in the clinical management of herpes simplex virus 1 infection with prominent hepatitis and unusual secondary progression.

Herpes — Fri, 20 Jan 2012 03:31:54 +0100

Authors: Chaillon A, Schnepf N, Jonas M, Mondon K, Orain I, Lioger B, Cottier JP, Hommet C, Goudeau A Abstract Herpes simplex virus (HSV) infection is rarely considered in the differential diagnosis of severe acute hepatitis and disseminated infection in immunocompetent adults. A case of disseminated HSV-1 infection in an 82-year-old woman initially presenting with neurological problems, signs of meningitis and prominent hepatitis was investigated. Initial diagnosis, monitoring, and follow-up were based on the application of molecular methods to cerebrospinal fluid, serum, and liver tissue samples from this patient. Following an initial full recovery, the patient presented delayed intracerebral haemorrhage and diffuse arthralgia. This atypical case, with delayed secondary progressi...

Cochlear implants for post-meningitis deafness offer good outcomes

MedWire News - Infectious Diseases — Fri, 20 Jan 2012 00:00:00 +0100

Technologic advances in cochlear implants have resulted in good outcomes for patients who develop hearing loss following meningitis, say researchers. (Source: MedWire News - Infectious Diseases)

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Group B Meningococcal Disease - New Vaccine Shows Promise

Health News from Medical News Today — Thu, 19 Jan 2012 17:00:00 +0100

In a study published Online First in The Lancet, researchers have examined the efficacy of a new vaccine against serogroups of Neisseria meningitides, which unlike the four out of six existing safe and efficacious vaccines, also includes protection against serotype B. Serogroups of Neisseria meningitides cause meningococcal diseases, including meningitis. Even though serotype B is the most prevalent strain across South America, it is also common in high-income countries causing much of the remaining meningococcal disease burden... (Source: Health News from Medical News Today)

Spectrum of fungal infection in a neurology tertiary care center in India

Neurological Sciences — Thu, 19 Jan 2012 06:56:24 +0100

This study reports clinical, MRI and outcome of patients with central nervous system (CNS) fungal infections. 39 patients with CNS fungal infections treated in neurology service during the last 3 years were included and a detailed medical history and clinical examination were undertaken. Cranial MRI including paranasal sinuses were carried out and the location and nature of abnormalities were noted. Fungal infection was confirmed by CSF examination or histopathology. Death during hospital stay was noted. The median age was 37 (8–72) years and 8 were females. The clinical features included altered sensorium in 31, focal motor deficits in 13, visual loss in 12, seizures in 10, diplopia in 7, and papilledema in 9 patients. 28 patients had the following predisposing condition...

Meningitis: is a major cause of disability amongst Papua New Guinea children?

Disability and Rehabilitation — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions: A multidisciplinary approach is required to manage the child with meningitis. Adequate knowledge, resources and assistance about the condition among the health professionals, carers and teachers would enable the children to achieve the quality of life. [Box: see text]. PMID: 22256779 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)

Meningococcal Serogroup B Vaccine Is Effective in ChileMeningococcal Serogroup B Vaccine Is Effective in Chile

Medscape Today Headlines — Wed, 18 Jan 2012 22:43:31 +0100

The new vaccine includes protection against serotype B, which is not covered by currently available meningococcal vaccines. Medscape Medical News (Source: Medscape Today Headlines)

Vaccine Against Bacterial Meningitis Shows Promise

The Doctors Lounge - Infections — Wed, 18 Jan 2012 15:00:00 +0100

Disease caused by the B strain can be deadly (Source: The Doctors Lounge - Infections)

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Meningitis jab ‘protection hope’

BBC News | Health | UK Edition — Wed, 18 Jan 2012 11:49:11 +0100

A vaccine against one of the most common forms of childhood meningitis could reduce the number of deaths in the UK even further. (Source: BBC News | Health | UK Edition)

Vaccine Against Bacterial Meningitis Shows Promise

MedicineNet Cancer General — Wed, 18 Jan 2012 07:00:00 +0100

Title: Vaccine Against Bacterial Meningitis Shows PromiseCategory: Health NewsCreated: 1/18/2012 10:06:00 AMLast Editorial Review: 1/18/2012 (Source: MedicineNet Cancer General)

New vaccine against deadly meningitis B 'will be available in the spring'

the Mail online | Health — Wed, 18 Jan 2012 05:47:09 +0100

The jab could dramatically cut the toll of infants and children dying from the disease or struggling with lifelong disabilities. Data suggests it could guard against 80 per cent of 1,000 meningitis strains in Europe. (Source: the Mail online | Health)

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Two-dose vaccine for meningitis B developed

MedWire News - Infectious Diseases — Wed, 18 Jan 2012 00:00:00 +0100

Researchers have developed a vaccine against group B meningococcal disease that provides highly effective protection after two doses. (Source: MedWire News - Infectious Diseases)

Acoustic brainstem implant in a post-meningitis deafened child—Lessons learned

International Journal of Pediatric Otorhinolaryngology — Tue, 17 Jan 2012 21:16:10 +0100

We report a case of a deafened child with advanced labyrinthitis ossificans resulting from meningo-encephalitis. She received a cochlear implant in the right ear, following a drill-out procedure. Post-implant hearing outcomes were satisfactory initially, but deteriorated over time as a result of partial electrode migration. The child subsequently received a left auditory brainstem implantation with improvement of hearing outcomes. Post-operatively, a sub-dural hematoma developed not on the side of the operation but on the opposite side. Simultaneous use of the cochlear implant on one side and the acoustic brainstem on the other, aggravated the non-auditory side effects of the ABI and compromised its potential for optimal hearing results. (Source: International Journal of Pediatric Otorhino...

Auditory brainstem implant outcomes and MAP parameters: Report of experiences in adults and children

International Journal of Pediatric Otorhinolaryngology — Tue, 17 Jan 2012 21:16:09 +0100

Conclusion: We observed that ABI may be a good option for offering some hearing attention to both adults and children. In children, the results might not be enough to ensure oral language development. Programming the speech processor in children demands higher care to the audiologist. (Source: International Journal of Pediatric Otorhinolaryngology)

Antithymocyte globulin/mycophenolic acid/prednisone/tacrolimus: Cryptococcal meningitis and IRIS: case report

Reactions — Tue, 17 Jan 2012 19:08:18 +0100

(Source: Reactions)

Clarifying Meningococcal Booster Dose RecommendationsClarifying Meningococcal Booster Dose Recommendations

Medscape Today Headlines — Tue, 17 Jan 2012 14:00:00 +0100

Dr. Amanda Cohn clears up confusion about when to give the meningococcal booster vaccine and which product to use. CDC Expert Commentary (Source: Medscape Today Headlines)

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Unencumbered by facts: what upsets me most about the anti-vaccine movement

Thrive, Children's Hospital Boston — Tue, 17 Jan 2012 13:30:11 +0100

Recently I watched a clip of Andrew Wakefield being interviewed on Good Morning America, and it gave me the chills. Andrew Wakefield, if you haven’t heard of him, is the guy who pretty much singlehandedly scared thousands of parents away from the MMR vaccine with a study he published in the Lancet linking the vaccine with autism. The study has since been retracted, something journals almost never do, after it was discovered that data in it was falsified. Not only that, Wakefield lost his medical license. But is he backing down? No way. On the contrary: he is suing the British Medical Journal (from Texas) for defamation. And he is still defending his findings. It was stunning to watch. George Stephanopoulos, who was interviewing him, pointed out that his colleagues who worked with him h...

Complications of chronic suppurative otitis media: a retrospective review

European Archives of Oto-Rhino-Laryngology — Tue, 17 Jan 2012 07:18:52 +0100

In this study, we emphasize the importance of an accurate and early diagnosis, followed by adequate surgical therapy and a multidisciplinary approach. Content Type Journal ArticleCategory OtologyPages 1-8DOI 10.1007/s00405-012-1924-8Authors E. Yorgancılar, Department of Otorhinolaryngology, Dicle University School of Medicine, Diyarbakir, 21280 TurkeyM. Yıldırım, Department of Otorhinolaryngology, Dicle University School of Medicine, Diyarbakir, 21280 TurkeyR. Gun, Department of Otorhinolaryngology, Dicle University School of Medicine, Diyarbakir, 21280 TurkeyS. Bakır, Department of Otorhinolaryngology, Dicle University School of Medicine, Diyarbakir, 21280 TurkeyR. Tekın, Department of Infectious Diseases, Dicle University School of Medicine, Diyarbakir, TurkeyC. Gocmez, Dep...

Case‐control study of risk factors for spasmodic dysphonia: A comparison with other voice disorders

The Laryngoscope — Tue, 17 Jan 2012 05:00:00 +0100

Conclusions:SD is likely multifactorial and associated with several endogenous and exogenous factors. Certain viral exposures, voice use patterns, and familial neurological conditions may contribute to the onset of SD later in life. (Source: The Laryngoscope)

Risk factors of childhood epilepsy in Kerala

Annals of Indian Academy of Neurology — Tue, 17 Jan 2012 05:00:00 +0100

Conclusion: Modifiable factors such as newborn distress and significant head trauma are significant risk factors for childhood epilepsy. Newborn distress is a risk factor for early-onset (<1 year age) epilepsy. (Source: Annals of Indian Academy of Neurology)

Bacterial meningitis and meningococcal septicaemia

NHS Networks — Tue, 17 Jan 2012 05:00:00 +0100

An update from NHS Evidence providing a summary of selected new evidence relevant to NICE clinical guideline 102: ”Management of bacterial meningitis and meningococcal septicaemia in children and young people younger than 16 years in primary and secondary care (2010).” (Source: NHS Networks)

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Results in the surgical treatment of giant acoustic neuromas.

Acta Otorrinolaringologica Espanola — Tue, 17 Jan 2012 05:00:00 +0100

CONCLUSIONS: The results of the study demonstrate that the combined retrosigmoid translabyrinthine approach for giant schwannoma treatment offers increased facial nerve preservation and lower morbidity, constituting an important option in the treatment of this kind of tumours thanks to a multidisciplinary approach. PMID: 22261646 [PubMed - as supplied by publisher] (Source: Acta Otorrinolaringologica Espanola)

High detection frequency and viral loads of human rhinovirus species A to C in fecal samples; diagnostic and clinical implications

Journal of Medical Virology — Mon, 16 Jan 2012 07:19:50 +0100

AbstractHuman rhinoviruses (HRVs) can be divided into three species; HRV‐A to HRV‐C. Up to 148 different HRV (sero)types have been identified to date. Because of sequence similarity between 5′‐NCR of HRVs and enteroviruses (EVs), it is problematic to design EV‐specific RT‐PCR assays. The aims of this study were to assess the rate of false‐detection of different rhinoviruses by EV RT‐PCR, and to evaluate the diagnostic and clinical significance of such cross‐reactivity. In vitro RNA transcripts of HRV A‐C created from cDNA templates were quantified spectrophotometrically. Six hundred twenty‐one stool samples screened as part of routine diagnostic for EV, 17 EV‐positive stool samples referred for typing, 288 stool samples submitted for gastroenteritis investigations, ...

Case report: Benefits of quantitative polymerase chain reaction in the clinical management of herpes simplex virus 1 infection with prominent hepatitis and unusual secondary progression

Journal of Medical Virology — Mon, 16 Jan 2012 07:19:35 +0100

AbstractHerpes simplex virus (HSV) infection is rarely considered in the differential diagnosis of severe acute hepatitis and disseminated infection in immunocompetent adults. A case of disseminated HSV‐1 infection in an 82‐year‐old woman initially presenting with neurological problems, signs of meningitis and prominent hepatitis was investigated. Initial diagnosis, monitoring, and follow‐up were based on the application of molecular methods to cerebrospinal fluid, serum, and liver tissue samples from this patient. Following an initial full recovery, the patient presented delayed intracerebral haemorrhage and diffuse arthralgia. This atypical case, with delayed secondary progression, highlights the wide range of clinical features of HSV infection and the benefits of monitoring vira...

Activation of the NLRP3 Inflammasome by Group B Streptococci.

Journal of Immunology — Mon, 16 Jan 2012 05:00:00 +0100

Authors: Costa A, Gupta R, Signorino G, Malara A, Cardile F, Biondo C, Midiri A, Galbo R, Trieu-Cuot P, Papasergi S, Teti G, Henneke P, Mancuso G, Golenbock DT, Beninati C Abstract Group B Streptococcus (GBS) is a frequent agent of life-threatening sepsis and meningitis in neonates and adults with predisposing conditions. We tested the hypothesis that activation of the inflammasome, an inflammatory signaling complex, is involved in host defenses against this pathogen. We show in this study that murine bone marrow-derived conventional dendritic cells responded to GBS by secreting IL-1β and IL-18. IL-1β release required both pro-IL-1β transcription and caspase-1-dependent proteolytic cleavage of intracellular pro-IL-1β. Dendritic cells lacking the TLR adaptor MyD88, but not those...

50 Years Ago in The Journal of Pediatrics: The Ototoxic Effects of Kanamycin Sulfate in Infants and Children

The Journal of Pediatrics — Sat, 14 Jan 2012 17:25:12 +0100

This report was published 3 years after kanamycin became available. As noted by the authors, kanamycin had proven to be an effective drug for the treatment of serious infections. However, because of similarities in chemical structure to streptomycin and neomycin, drugs known to be ototoxic and nephrotoxic, the potential for serious side effects was acknowledged. Yow et al performed hearing testing on 30 children who received kanamycin therapy for 5 or more days. None had known risk factors for hearing loss, but all were seriously ill. Dosages of kanamycin varied widely, and 5 infants received other ototoxic drugs. Sensorineural hearing loss was diagnosed in 5 of the 30 infants (17%) treated with kanamycin. All of these infants had potential confounders that might have increased risk of he...

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Outer membrane protein A and OprF – Versatile roles in Gram‐negative bacterial infections

FEBS Journal — Thu, 12 Jan 2012 05:00:00 +0100

AbstractOuter membrane protein A (OmpA) is an abundant protein of Escherichia coli and other enterobacteria with a multitude of functions. Although the structural features and porin function of OmpA were well studied, its role in the pathogenesis of various bacterial infections has been emerging for the past decade. The four extracellular loops of OmpA interact with a variety of host tissues for adhesion, invasion and evasion of host‐defense mechanisms. This review describes how various regions present in the extracellular loops of OmpA contribute to the pathogenesis of neonatal meningitis induced by E. coli K1 and for many other functions. In addition, the function of OmpA like proteins such as OprF of Pseudomonas aeruginosa is also discussed herein. (Source: FEBS Journal)

The effect of iron availability on transcription of the Neisseria meningitidis fHbp gene varies among clonal complexes.

Microbiology — Thu, 12 Jan 2012 05:00:00 +0100

In this study iron accessibility was found to effect fHbp transcription. However, regulation differed among meningococcal clonal complexes (cc). For the majority of isolates increased iron concentrations upregulated transcription. This effect was enhanced by the presence of an 181bp insertion element upstream of fHbp, associated with isolates belonging to cc4 and cc5. Conversely, meningococci belonging to cc32 showed iron-repressed control of fHbp as regulation was dominated by cotranscription with the iron-repressed upstream gene, cbbA. These results highlight the complexity of fHbp regulation and demonstrate that control of transcription can vary among genetic lineages. PMID: 22241045 [PubMed - as supplied by publisher] (Source: Microbiology)

Phylogenetic Analysis of Cronobacter Isolates Based on the rpoA and 16S rRNA Genes.

Current Microbiology — Thu, 12 Jan 2012 05:00:00 +0100

The objective of this study was to classify Cronobacter isolates from infant formula milk, the food processing environment and fresh produce in South Africa and to evaluate the phylogenetic placement of these isolates based on the rpoA and 16S ribosomal RNA (rRNA) gene sequences. All the South African strains were identified as Cronobacter sakazakii despite the wide variety of isolation sources. No relation between the phylogenetic placement and strain origin could be determined. Strains of C. sakazakii, Cronobacter dublinensis, Cronobacter turicensis and Cronobacter muytjensii could be differentiated from each other, but it was not possible to differentiate between C. sakazakii and Cronobacter malonaticus based on the rpoA and 16S rRNA gene sequences alone. However, sequence data of these...

Immunogenicity and safety of LBVH0101, a new Haemophilus influenzae type b tetanus toxoid conjugate vaccine, compared with Hiberix™ in Korean infants and children: A randomized trial.

Vaccine — Thu, 12 Jan 2012 05:00:00 +0100

CONCLUSIONS: LBVH0101 showed a good immunogenicity and safety profile in infants and children. The two-dose infant-priming schedule with a booster dose may suffice for Hib immunization in Korean infants (Clinical trial registration numbers: NCT01019772 and NCT01251133). PMID: 22245607 [PubMed - as supplied by publisher] (Source: Vaccine)

Question 1 Do febrile convulsions cause CSF pleocytosis?

Archives of Disease in Childhood — Wed, 11 Jan 2012 05:00:00 +0100

Scenario You are asked to review a previously healthy 11-month-old boy who presented to the Accident and Emergency department following a generalised convulsion lasting 7 min. His parents tell you that he was started on oral amoxicillin by his general practitioner 2 days ago, the reason for which is unclear. Clinical examination reveals a drowsy child with a temperature of 38.8°C. In the absence of a clear focus of infection you decide to do a full septic screen, including a lumbar puncture (LP). Cerebrospinal fluid (CSF) analysis shows a white blood cell count (WCC) of 17x106/l, a protein concentration within normal limits and no bacteria on a Gram stain. You wonder if the mild CSF pleocytosis indicates partially treated meningitis or can be attributed to the convulsion alone. Structu...

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Are there febrile diseases with a risk of sudden death in children?

Archives of Disease in Childhood — Wed, 11 Jan 2012 05:00:00 +0100

Parents' knowledge about the management of fever in children has hardly changed over the past few years in spite of a host of educational interventions aimed at improving awareness of the dangers relating to high fever. Unexpected death in children's febrile diseases is considered to be relatively rare and may mostly occur due to meningitis, bronchiolitis, malaria, acute leukaemia and Kawasaki syndrome. Two rare autosomal recessively inherited diseases can present high fever bouts in the neonatal period, which might represent a serious threat due to their intrinsic risk of unpredictable sudden death: Sohar–Crisponi syndrome (SCS, OMIM 601378) and Stüve–Wiedemann syndrome (SWS, OMIM 601559). SCS is already evident at birth with paroxysmal muscular contractions, resembling n...

Severe meningo-radiculo-nevritis associated with ipilimumab

Investigational New Drugs — Tue, 10 Jan 2012 06:41:50 +0100

Conclusion The adverse event profile associated with ipilimumab was primarily immune-related. This is the first case in which such a severe event has been reported. Content Type Journal ArticleCategory SHORT REPORTPages 1-4DOI 10.1007/s10637-011-9787-1Authors Flavie Bompaire, Service de neurologie, Hôpital d’instruction des armées du Val de Grâce, Service de santé des Armées, Paris, FranceChristine Mateus, Service de dermatologie, département d’oncologie médicale, Institut Gustave Roussy, Villejuif, FranceHervé Taillia, Service de neurologie, Hôpital d’instruction des armées du Val de Grâce, Service de santé des Armées, Paris, FranceThierry De Greslan, Service de neurologie, Hôpital d’instruction des armées du Val de Grâce, Service de santé des Armées, Par...

A novel mutation W388X underlying properdin deficiency in a Finnish family

Scandinavian Journal of Immunology — Tue, 10 Jan 2012 05:00:00 +0100

AbstractProperdin deficiency is a rare immunological disorder inherited as an X‐chromosomal recessive trait. Properdin deficiency poses a significant risk for severe meningococcal infections. About 20 mutations have been reported to underlie properdin deficiency. Here we report a large Finnish family with a novel mutation in the properdin gene (CFP). Based on the total absence of properdin activity in a 14‐year‐old male patient with an infection resembling meningococcal bacteraemia the coding region and splice sites of the gene were sequenced. The mutation is located in exon 9 and changes guanine to adenine at nucleotide 1164 (c.1164G>A) that causes tryptophan to change to a premature stop‐codon (W388X). The mother of the patient was shown to be a carrier of the mutation. In tot...

Meningitis advice as student dies

BBC News | Health | UK Edition — Mon, 09 Jan 2012 07:41:54 +0100

A student at a South Yorkshire university dies of suspected meningitis. (Source: BBC News | Health | UK Edition)

Infective endocarditis with cerebrovascular complications: timing of surgical intervention

Interactive CardioVascular and Thoracic Surgery — Mon, 09 Jan 2012 05:00:00 +0100

Management of infective endocarditis (IE) with cerebrovascular complications is difficult due to absence of concrete evidence. These patients usually have multiple neurological deficits and the optimal timing for cardiac operation remains controversial. The aims of this study were to present cases and discuss the treatment options for IE with cerebrovascular complications. From 1998 to 2010, 51 patients underwent operations for IE at our institution. From a review of medical records, 10 patients (19.6%) with preoperative neurological complications were identified. Data on these 10 patients were analysed. Cerebrovascular complications included cerebral infarction (n = 4, 40.0%), mycotic aneurysm (n = 1, 10.0%), mycotic aneurysm plus cerebral infarction (n = 3, ...

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What is the optimal timing for surgery in infective endocarditis with cerebrovascular complications?

Interactive CardioVascular and Thoracic Surgery — Mon, 09 Jan 2012 05:00:00 +0100

Neurologic dysfunction complicates the course of 10–40% of left-side infective endocarditis (IE). In right-sided IE, instead, when systemic emboli occur, paradoxical embolism should be considered. The spectrum of neurologic events includes embolic cerebrovascular complication (CVC), intracranial haemorrhage, ruptured mycotic aneurysm, transient ischaemic attack (TIA), meningitis, encephalopathy and brain abscess. Cardiopulmonary bypass might exacerbate neurological deficits due to: heparinization and secondary cerebral haemorrhage; hypotension and cerebral oedema in areas of the disrupted blood brain barrier. A best evidence topic was written according to a structured protocol. The question addressed was, whether there is an optimal timing for surgery in IE with CVCs. One hundred pap...

Extracranial and intracranial complications of otitis media: 22-year clinical experience and analysis.

Acta Oto-Laryngologica — Sun, 08 Jan 2012 05:00:00 +0100

Conclusion: The morbidity of the complications has had a decreased tendency in recent decades, but the category of the complications was rather diverse. There are still many serious complications that require our attention. Surgery is still the most important treatment option. Objective: To investigate otogenic extracranial and intracranial complications in patients with acute and chronic otitis media. Methods: A retrospective study investigated 285 patients with extracranial and intracranial complications among the 2346 inpatients with acute or chronic otitis media with or without cholesteatoma admitted to the Department of Otolaryngology, AnHui Medical University Hospital between 1987 and 2008. Results: In the 285 patients with cranial complications, 253 had a single complication, 29 had...

John Brockman: the man who runs the world's smartest website

Guardian Unlimited Science — Sun, 08 Jan 2012 00:05:00 +0100

Since the mid-1960s John Brockman has been at the cutting edge of ideas. He is a passionate advocate of both science and the arts, and his website Edge is a salon for the world's finest mindsTo say that John Brockman is a literary agent is like saying that David Hockney is a photographer. For while it's true that Hockney has indeed made astonishingly creative use of photography, and Brockman is indeed a successful literary agent who represents an enviable stable of high-profile scientists and communicators, in both cases the description rather understates the reality. More accurate ways of describing Brockman would be to say that he is a "cultural impresario" or, as his friend Stewart Brand puts it, an "intellectual enzyme". (Brand goes on helpfully to explain that an enzyme is "a bio...

Prospective investigation of pituitary functions in patients with acute infectious meningitis: is acute meningitis induced pituitary dysfunction associated with autoimmunity?

Pituitary — Sat, 07 Jan 2012 16:55:14 +0100

Abstract Previous case reports and retrospective studies suggest that pituitary dysfunction may occur after acute bacterial or viral meningitis. In this prospective study we assessed the pituitary functions, lipid profile and anthropometric measures in adults with acute bacterial or viral meningitis. Moreover, in order to investigate whether autoimmune mechanisms could play a role in the pathogenesis of acute meningitis-induced hypopituitarism we also investigated the anti-pituitary antibodies (APA) and anti-hypothalamus antibodies (AHA) prospectively. Sixteen patients (10 males, 6 females; mean ± SD age 40.9 ± 15.9) with acute infectious meningitis were included and the patients were evaluated in the acute phase, and at 6 and 12 months after the ...

Recombinant outer membrane secretin PilQ(406-770) as a vaccine candidate for serogroup B Neisseria meningitidis.

Vaccine — Sat, 07 Jan 2012 05:00:00 +0100

Authors: Haghi F, Peerayeh SN, Siadat SD, Zeighami H Abstract Secretin PilQ is an antigenically conserved outer membrane protein which is present on most meningococci. This protein naturally expressed at high levels and is essential for meningococcal pilus expression at the cell surface. A 1095bp fragment of C-terminal of secretin pilQ from serogroup B Neisseria meningitidis was cloned into prokaryotic expression vector pET-28a. Recombinant protein was overexpressed with IPTG and affinity-purified by Ni-NTA agarose. BALB/c mice were immunized subcutaneously with purified rPilQ(406-770) mixed with Freund's adjuvant. Serum antibody responses to serogroups A and B N. meningitidis whole cells or purified rPilQ(406-770) and functional activity of antibodies were determined by ELISA and ...

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Is adjunctive corticosteroid beneficial in pneumococcal meningitis in a region with high rates of resistance to penicillin and ceftriaxone?

Journal of Neurology — Fri, 06 Jan 2012 06:44:39 +0100

Abstract The role of adjunctive corticosteroids remains controversial in meningitis by penicillin-resistant pneumococci. We determined the effect of adjunctive corticosteroids in adults with pneumococcal meningitis in a region with a high rate of penicillin resistance. A multicenter, retrospective cohort study was conducted between 1998 and 2008 in Korea. The mortality and neurological sequelae were evaluated. Among 93 patients with pneumococcal meningitis, adequate adjunctive corticosteroids were given in 45.2%. The penicillin resistance rate was 60.0%, and 42.1% were nonsusceptible to ceftriaxone. The 30-day mortality rates in the group receiving adequate corticosteroid therapy, the group in which corticosteroid was not given, and that inadequately given were 24.3, 31.6,...

Adverse events following immunization during mass vaccination campaigns at first introduction of a meningococcal A conjugate vaccine in Burkina Faso, 2010.

Vaccine — Fri, 06 Jan 2012 05:00:00 +0100

We report on the monitoring of adverse events following immunization (AEFI) in Burkina Faso where more than 11 million people aged 1-29years were vaccinated. Vaccine pharmacovigilance relied on stimulated passive AEFI surveillance countrywide and active surveillance for 12 clinical conditions in one sentinel district (Ziniaré) with 97,715 people eligible for vaccination. All AEFI occurring during the 10days of mass campaign or the 42 subsequent days were to be notified. Serious AEFI were submitted to a national expert committee (NEC) for causality assessment. A total of 11,466,950 people were vaccinated with 1471 vaccines reported to have experienced at least one AEFI (12.83 cases per 100,000). 1444 AEFI were minor; the most common of which were fever, headache, gastro-intestinal disorder...

The challenge of post-implementation surveillance for novel meningococcal vaccines.

Vaccine — Fri, 06 Jan 2012 05:00:00 +0100

Authors: Snape MD, Medini D, Halperin SA, Detora L, Drori J, Moxon ER Abstract Novel serogroup B meningococcal vaccines are currently in late stage development and may be used in mass immunisation campaigns over the coming years. This represents an exciting development in the prevention of childhood meningitis, however monitoring the impact of these vaccines on meningococcal disease epidemiology will provide significant challenges. Although designed to prevent serogroup B meningococcal disease the vaccine antigens are not serogroup specific, creating the potential for multiple definitions of vaccine effectiveness and vaccine failure. PMID: 22230578 [PubMed - as supplied by publisher] (Source: Vaccine)

Definition and characterization of localised meningitis epidemics in Burkina Faso: a longitudinal retrospective study

BMC Infectious Diseases — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: This definition of localised epidemics a the health centre level will be useful for risk factor and modelling studies to understand the meningitis belt phenomenon and help documenting vaccine impact against epidemic meningitis where no widespread laboratory surveillance exists for quantifying disease reduction after vaccination. (Source: BMC Infectious Diseases)

Cochlear Implant Failure Rate Generally Low

Health News from Medical News Today — Wed, 04 Jan 2012 17:00:00 +0100

A study published in the December issue of Archives of Otolaryngology - Head & Neck Surgery, one of the JAMA/Archives journals, found that among children treated at a pediatric tertiary care clinic in Canada, the overall percentage of re-implantation of cochlear implants as result of device failure seems was low. However, the risk of device failure seems to be increased among those who develop hearing loss due to bacterial meningitis before implantation... (Source: Health News from Medical News Today)

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Medicaid reimbursement and the uptake of adolescent vaccines.

Vaccine — Wed, 04 Jan 2012 05:00:00 +0100

CONCLUSIONS: Our results suggest that, contrary to what has been shown for childhood vaccines, raising Medicaid reimbursement rates may not improve adolescent vaccine utilization. Instead, other policy changes may be more effective, such as expansion of VFC programs into universal purchase programs, further implementation of school-based vaccine mandates and efforts to raise preventive care visits among adolescents. PMID: 22226859 [PubMed - as supplied by publisher] (Source: Vaccine)

Licensure of a Meningococcal Conjugate Vaccine for Children Aged 2 Through 10 Years and Updated Booster Dose Guidance for Adolescents and Other Persons at Increased Risk for Meningococcal Disease--Advisory Committee on Immunization Practices (ACIP), 2011 [From the Centers for Disease Control and Prevention]

JAMA — Tue, 03 Jan 2012 05:00:00 +0100

(Source: JAMA)

Endoscopic third ventriculostomy in tubercular meningitis with hydrocephalus

Neurology India — Mon, 02 Jan 2012 05:00:00 +0100

Conclusion: Endoscopic third ventriculostomy was safe and effective in TBM hydrocephalus. Complex hydrocephalus and associated cerebral infarcts were the major causes of failure to improve. Good results were observed in better grades. (Source: Neurology India)

Application of neuroendoscopy in the treatment of obstructive hydrocephalus secondary to hypertensive intraventricular hemorrhage

Neurology India — Mon, 02 Jan 2012 05:00:00 +0100

Conclusions: Endoscopic management of severe IVH with obstructive hydrocephalus allows effective reduction of the amount of ventricular blood and improves level of consciousness. Future refinement in instrumentation and discreet case selection may make this method more applicable and effective. (Source: Neurology India)

Infectious psychosis: Cryptococcal meningitis presenting as a neuropsychiatry disorder

Neurology India — Mon, 02 Jan 2012 05:00:00 +0100

Anil Kumar, Siby Gopinath, Kavitha R Dinesh, Shamsul KarimNeurology India 2011 59(6):909-911 (Source: Neurology India)

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Recognition of Streptococcus pneumoniae by the innate immune system

Cellular Microbiology — Sun, 01 Jan 2012 05:00:00 +0100

SummaryStreptococcus pneumoniae is both a frequent colonizer of the upper respiratory tract and a leading cause of life‐threatening infections such as pneumonia, meningitis, and sepsis. The innate immune system is critical for the control of colonization and for defence during invasive disease. Initially, pneumococci are recognized by different sensors of the innate immune system called pattern recognition receptors (PRRs), which control most if not all subsequent host defense pathways. These PRRs include the transmembrane Toll‐like receptors (TLRs) as well as the cytosolic NOD‐like receptors (NLRs) and DNA sensors. Recognition of S. pneumoniae by members of these PRR families regulates the production of inflammatory mediators that orchestrate the following immune response of infecte...

Etiology of acute, non-malaria, febrile illnesses in jayapura, northeastern papua, indonesia.

The American Journal of Tropical Medicine and Hygiene — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Punjabi NH, Taylor WR, Murphy GS, Purwaningsih S, Picarima H, Sisson J, Olson JG, Baso S, Wangsasaputra F, Lesmana M, Oyofo BA, Simanjuntak CH, Subekti D, Corwin AL, Richie TL Abstract Abstract. We conducted a prospective, inpatient fever study in malaria-endemic Papua, Indonesia to determine non-malaria fever etiologies. Investigations included malaria blood films, blood culture, paired serologic samples analysis for dengue, Japanese encephalitis, leptospirosis, scrub typhus, murine typhus, and spotted fever group rickettsia. During 1997-2000, 226 patients (127 males and 99 females) 1-80 years of age (median age = 25 years) were enrolled. Positive blood cultures (n = 34, 15%) were obtained for Salmonella Typhi (n = 13), Escherichia coli (n = 8), Streptococcus pneumoniae (...

Temperate Climate Niche for Cryptococcus gattii in Northern Europe.

Emerging Infectious Diseases — Sun, 01 Jan 2012 05:00:00 +0100

We report environmental isolation of the primary pathogenic fungus C. gattii from a forest in Berg en Dal, the Netherlands, which extends its geographic distribution to the temperate climate of northern Europe. PMID: 22261398 [PubMed - in process] (Source: Emerging Infectious Diseases)

Invasive meningococcal capsular group y disease, England and wales, 2007-2009.

Emerging Infectious Diseases — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Ladhani SN, Lucidarme J, Newbold LS, Gray SJ, Carr AD, Findlow J, Ramsay ME, Kaczmarski EB, Borrow R Abstract Enhanced national surveillance for invasive meningococcal disease in England and Wales identified an increase in laboratory-confirmed capsular group Y (MenY) disease from 34 cases in 2007 to 44 in 2008 and 65 in 2009. For cases diagnosed in 2009, patient median age at disease onset was 60 years; 39% of patients had underlying medical conditions, and 19% died. MenY isolates causing invasive disease during 2007-2009 belonged mainly to 1 of 4 clonal complexes (cc), cc23 (56% of isolates), cc174 (21%), cc167 (11%), and cc22 (8%). The 2009 increase resulted primarily from sequence type 1655 (cc23) (22 cases in 2009, compared with 4 cases each in 2007 and 2008). cc23 was...

Mumps vaccine effectiveness against orchitis.

Emerging Infectious Diseases — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Hahné S, Whelan J, van Binnendijk R, Swaan C, Fanoy E, Boot H, de Melker H Abstract TO THE EDITOR: Yung et al. reported in the April 2011 issue of Emerging Infectious Diseases on the epidemiologic characteristics of the nationwide mumps outbreak in England and Wales in 2004-2005 (1). The associated effect of disease was considerable, with >43,000 reported cases and >2,600 hospitalizations. Compared with the prevaccine era, the average age of infection was higher, with infection occurring mostly in older teenagers and young adults (2). Older age at infection is associated with a higher risk of certain complications, particularly orchitis (3). Yung et al. reported that among cases of mumps, previous mumps measles rubella (MMR) vaccination offered considerable protecti...

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Ruptured intracranial dermoid cyst.

Baylor University Medical Center Proceedings — Sun, 01 Jan 2012 05:00:00 +0100

We present a case of intracranial rupture of a dermoid cystic tumor with consequent dissemination of subarachnoid fat droplets resulting in acute aseptic chemical meningitis. Radiographic findings, operative treatment, and pathologic features are described. PMID: 22275778 [PubMed - in process] (Source: Baylor University Medical Center Proceedings)

Neuroimaging of Pediatric Intracranial Infection—Part 1: Techniques and Bacterial Infections

Journal of Neuroimaging — Sun, 01 Jan 2012 05:00:00 +0100

ABSTRACTConventional and advanced neuroimaging have become central to the diagnosis of infectious diseases of the pediatric central nervous system. Imaging modalities used by (pediatric) neuroradiologists include cranial ultrasound, computed tomography, and magnetic resonance imaging, including advanced techniques such as diffusion weighted or tensor imaging, perfusion weighted imaging, susceptibility weighted imaging, and 1H magnetic resonance spectroscopy. In this first of a two part review, imaging techniques in general and the imaging findings of bacterial infections of the intracranial compartment including epidural empyema, subdural empyema, meningitis, cerebritis, cerebral abscess, and pyogenic intraventricular empyema (ventriculitis) are discussed. J Neuroimaging 2012;XX:1–11. (S...

Neural Stem Cell Depletion and CNS Developmental Defects After Enteroviral Infection.

Am J Pathol — Sat, 31 Dec 2011 05:00:00 +0100

Authors: Ruller CM, Tabor-Godwin JM, Van Deren DA, Robinson SM, Maciejewski S, Gluhm S, Gilbert PE, An N, Gude NA, Sussman MA, Whitton JL, Feuer R Abstract Coxsackieviruses are significant human pathogens causing myocarditis, meningitis, and encephalitis. We previously demonstrated the ability of coxsackievirus B3 (CVB3) to persist within the neonatal central nervous system (CNS) and to target neural stem cells. Given that CVB3 is a cytolytic virus and may therefore damage target cells, we characterized the potential reduction in neurogenesis within the developing brain and the subsequent developmental defects that occurred after the loss of these essential neural stem cells. Neonatal mice were inoculated with a recombinant CVB3 expressing eGFP (eGFP-CVB3), and alterations in neuro...

U.S. approves Prevnar pneumonia vaccine for adults

Reuters: Health — Fri, 30 Dec 2011 22:22:40 +0100

(Reuters) - U.S. health regulators approved the expansion of Pfizer Inc's blockbuster Prevnar vaccine for use in adults 50 and older to fight pneumonia, meningitis and other diseases cause by pneumococcus bacteria. (Source: Reuters: Health)

FDA approves Pfizer's Prevnar pneumonia vaccine for adults

Reuters: Health — Fri, 30 Dec 2011 20:10:10 +0100

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Validation of a Clinical Prediction Rule to Distinguish Lyme Meningitis From Aseptic Meningitis

PEDIATRICS — Fri, 30 Dec 2011 05:00:00 +0100

Available clinical prediction rules to identify children with cerebrospinal fluid pleocytosis at low risk for Lyme meningitis include headache duration, cranial nerve palsy, and percent cerebrospinal fluid mononuclear cells. These rules require independent validation. These clinical prediction rules accurately identify patients at low risk for Lyme meningitis in our large multicenter cohort. Children at low risk may be considered for outpatient management while awaiting Lyme serology. (Read the full article) (Source: PEDIATRICS)

2011's best health news

NHS News Feed — Thu, 29 Dec 2011 12:43:00 +0100

Although Behind the Headlines often spends time explaining mistaken or misguided news reports, the joy of this service is when there are genuinely exciting medical advances to report. Over the past year there have been many important and fascinating stories, and it is a credit to the national press that so many of them have been so well understood and so well reported. Here’s our pick of some of the best stories from the many brilliant health articles and impressive studies published in 2011. Heartwarming gene therapy By far the most heartwarming breakthrough in medical science involves the story of seven-year-old Jack Crick (presumably no relation to the co-discoverer of the DNA double helix). Jack was born with severe combined immunodeficiency (SCID) – an inherited genetic mutati...

Combat pneumococcal infections: adhesins as candidates for protein-based vaccine development.

Current Drug Targets — Thu, 29 Dec 2011 05:00:00 +0100

Authors: Gámez G, Hammerschmidt S Abstract Streptococcus pneumoniae (pneumococcus) is an asymptomatic colonizer of the upper respiratory tract in humans. However, these apparently harmless bacteria have also a high virulence potential and are known as the etiologic agent of respiratory and life-threatening invasive diseases. Dissemination of pneumococci from the nasopharynx into the lungs or bloodstream leads to community-acquired pneumonia, septicaemia and meningitis. Traditionally, pneumococcal diseases are treated with antibiotics and prevented with polysaccharide-based vaccines. However, due to the dramatic increase in antibiotic resistance and limitations of the current available vaccines, the burden of diseases remains high. Thus, combating pneumococcal transmission and infe...

Clinical Characteristics and Prognosis of Acute Bacterial Meningitis in Elderly Patients Over 65: A Hospital-based Study

BMC Geriatrics — Wed, 28 Dec 2011 05:00:00 +0100

Conclusions: Elderly ABM patients accounted for 34.8% of the overall ABM cases, and this relatively high incidence rate may signify the future burden of ABM in the elderly population in Taiwan. The relative frequency of implicated pathogens of elderly ABM is similar to that of non-elderly ABM. Compared with non-elderly patients, the elderly ABM patients have a significantly lower incidence of peripheral blood leukocytosis. The mortality rate of elderly ABM remains high, and the presence of shock and seizures are important prognostic factors. (Source: BMC Geriatrics)

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SNPs in the TLR3 and CD44 genes are associated with persistence of vaccine-induced immunity to serogroup C meningococcal conjugate vaccine.

Clinical and Vaccine Immunology — Wed, 28 Dec 2011 05:00:00 +0100

Authors: Moore CE, Hennig BJ, Perrett KP, Hoe JC, Lee SJ, Fletcher H, Brocklebank D, O'Connor D, Snape MD, Hall AJ, Segal S, Hill AV, Pollard AJ Abstract The rate of decay of antibody concentration following Serogroup C meningococcal (MenC) polysaccharide-protein conjugate vaccination varies between individuals. This partly depends on vaccination age but may be influenced by human genetics. We studied 721 single nucleotide polymorphisms (SNPs) across 131 candidate genes in a first cohort of 905 Caucasians (11-21 years, mean 4.9 years after vaccination) and 30 SNPs across 17 genes in a replication study using 155 children aged (six to twelve years, mean 6.7 years after vaccination) and 196 infants (one year, mean eight months after vaccination). Individuals were classified as respon...

Group B Streptococcus surface proteins as major determinants for meningeal tropism.

Current Opinion in Microbiology — Tue, 27 Dec 2011 05:00:00 +0100

Authors: Tazi A, Bellais S, Tardieux I, Dramsi S, Trieu-Cuot P, Poyart C Abstract Streptococcus agalactiae (group B Streptococcus, GBS), a normal constituent of the intestinal microbiota is the major cause of human neonatal infections and a worldwide spread 'hypervirulent' clone, GBS ST-17, is strongly associated with neonatal meningitis. Adhesion to epithelial and endothelial cells constitutes a key step of the infectious process. Therefore GBS surface-anchored proteins are obvious potential adhesion mediators of barrier crossing and determinant of hypervirulence. This review addresses the most recent molecular insights gained from studies on GBS surface proteins proven to be involved in the crossing of the brain-blood barrier and emphasizes on the specificity of a hypervirulent c...

Escherichia coli physiology and metabolism dictates adaptation to diverse host microenvironments.

Current Opinion in Microbiology — Mon, 26 Dec 2011 05:00:00 +0100

Authors: Alteri CJ, Mobley HL Abstract Bacterial growth in the host is required for pathogenesis. To successfully grow in vivo, pathogens have adapted their metabolism to replicate in specific host microenvironments. These adaptations reflect the nutritional composition of their host niches, inter-bacterial competition for carbon and energy sources, and survival in the face of bactericidal defense mechanisms. A subgroup of Escherichia coli, which cause urinary tract infection, bacteremia, sepsis, and meningitis, have adapted to grow as a harmless commensal in the nutrient-replete, carbon-rich human intestine but rapidly transition to pathogenic lifestyle in the nutritionally poorer, nitrogen-rich urinary tract. We discuss bacterial adaptations that allow extraintestinal pathogenic ...

Hearing Devices More Apt to Fail in Children Who Had Meningitis

The Doctors Lounge - Infections — Sat, 24 Dec 2011 05:00:00 +0100

Once cochlear implants were replaced, hearing improvement returned, study finds (Source: The Doctors Lounge - Infections)

Toddler who lost hands to meningitis enjoys her first real Christmas - using special cutlery to eat a turkey dinner

the Mail online | Health — Sat, 24 Dec 2011 02:00:39 +0100

Kaiya Jackson, from Burton-on-Trent, spent last Christmas battling for her life in hospital and lost her fingers and a foot to meningitis. (Source: the Mail online | Health)

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Hearing Devices More Apt to Fail in Children Who Had Meningitis

MedicineNet Hepatitis C General — Fri, 23 Dec 2011 07:00:00 +0100

Title: Hearing Devices More Apt to Fail in Children Who Had MeningitisCategory: Health NewsCreated: 12/22/2011 6:06:00 PMLast Editorial Review: 12/23/2011 (Source: MedicineNet Hepatitis C General)

South Africa: Meningitis Patient On the Run

AllAfrica News: Health and Medicine — Thu, 22 Dec 2011 12:33:38 +0100

A 26-year-old Mamelodi man is on the run after being provisionally diagnosed with meningococcal meningitis, said the Gauteng Department of Health and Social Development. (Source: AllAfrica News: Health and Medicine)

Tuberculous Meningitis: Diagnosis and Treatment Overview

Clinical and Developmental Immunology — Wed, 21 Dec 2011 23:54:28 +0100

Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis (TB) and has very high morbidity and mortality. TBM is typically a subacute disease with symptoms that may persist for weeks before diagnosis. Characteristic cerebrospinal fluid (CSF) findings of TBM include a lymphocytic-predominant pleiocytosis, elevated protein, and low glucose. CSF acid-fast smear and culture have relatively low sensitivity but yield is increased with multiple, large volume samples. Nucleic acid amplification of the CSF by PCR is highly specific but suboptimal sensitivity precludes ruling out TBM with a negative test. Treatment for TBM should be initiated as soon as clinical suspicion is supported by initial CSF studies. Empiric treatment should include at least four first-line ...

Lyme meningitis prediction rule validated

Modern Medicine — Wed, 21 Dec 2011 05:00:00 +0100

NEW YORK (Reuters Health) - A retrospective study confirms that the "Rule of 7's" tool can accurately identify children at low risk for Lyme meningitis. (Source: Modern Medicine)

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Seroprevalence of serum bactericidal antibodies against group W135 and Y meningococci in England in 2009.

Clinical and Vaccine Immunology — Wed, 21 Dec 2011 05:00:00 +0100

Authors: Trotter CL, Findlow H, Borrow R Abstract Serological surveillance has been used in the UK to inform vaccine policy for several infections, including group C meningococci. Meningococcal conjugate vaccines, containing capsular groups A, W135 and Y in addition to C are now available but their use in the UK is restricted to at risk groups and travellers to endemic areas. The aim of this study is to establish a baseline for natural immunity for groups W135 and Y. Serum samples collected in 2009 from individuals of all ages were obtained from the Health Protection Agency Seroepidemiology Unit, which collects residual sera from participating laboratories across the country. Serum bactericidal antibody (SBA) activity against two reference strains representing group Y (strain M03 2...

MSF releases 10 stories that mattered in 2011

MSF News — Tue, 20 Dec 2011 20:31:00 +0100

A list of 10 Stories that Mattered in Access to Medicines in 2011 was released this week by Médecins Sans Frontières (MSF). The list looks at developments in 2011 that had an impact – whether positive or negative – on people’s ability to access needed drugs, diagnostics and vaccines in developing countries. “For the diseases our medical teams encounter every day in places where we work, 2011 was a year of both critical progress and dangerous backsliding,” said Tido von Schoen-Angerer, a physician and executive director of MSF’s Campaign for Access to Essential Medicines. “At a time of so much promise, it is crucial to continue pushing forward, and refuse to accept a double standard in care between rich and poor countries.” The list covers key developments regarding ...

MSF Releases 'Ten Stories That Mattered in Access to Medicines in 2011'

MSF News — Tue, 20 Dec 2011 17:14:00 +0100

Geneva/New York, December 20, 2011—A list of "Ten Stories that Mattered in Access to Medicines in 2011" was released today by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF). The list looks at developments in 2011 that had an impact—whether positive or negative—on people’s ability to access needed drugs, diagnostics, and vaccines in developing countries. Access to Essential Medicines: Ten Stories That Mattered in 2011 Download full report [1989 KB] For the diseases our medical teams encounter every day in places where we work, 2011 was a year of both critical progress and dangerous backsliding,” said Dr. Tido von Schoen-Angerer, executive director of MSF’s...

Meningococcal quadrivalent (serogroups a, C, w135, and y) conjugate vaccine (menveo®)†: profile report.

Paediatric Drugs — Tue, 20 Dec 2011 13:12:40 +0100

Authors: Deeks ED Abstract † Adapted and reproduced from the original article published in BioDrugs 2010; 24 (5): 287-97.[1]. PMID: 22149552 [PubMed - in process] (Source: Paediatric Drugs)

Acetylcholinesterase activity in the rat brain after pneumococcal meningitis

Microbiology and Immunology — Tue, 20 Dec 2011 05:00:00 +0100

In this study was to verify the acetylcholinesterase activity in the rat brain after pneumococcal meningitis. In the hippocampus, frontal cortex and cerebrospinal fluid the acetylcholinesterase activity were found increased at 6, 12, 24, 48 and 96h without antibiotic treatment, at 48 and 96h with antibiotic treatment. Our data suggest that acetylcholinesterase activity could be related to neuronal damage induced by pneumococcal meningitis. (Source: Microbiology and Immunology)

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"Rule of 7s" Shows Accuracy in Lyme Meningitis Prediction"Rule of 7s" Shows Accuracy in Lyme Meningitis Prediction

Medscape Today Headlines — Mon, 19 Dec 2011 15:58:34 +0100

The tool showed high reliability and simplicity in predicting a low risk for Lyme meningitis in children in a large multicenter cohort. Medscape Medical News (Source: Medscape Today Headlines)

Low Pediatric Cochlear Implant Failure Rate: Contributing Factors in Large-Volume Practice [Original Article]

Archives of Otolaryngology — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions A very low rate of failure occurs in children who receive CI devices, and several factors may account for this low rate. Children who develop meningitis before CI appear to be at an increased risk of device failure. (Source: Archives of Otolaryngology)

A Pilot In Vivo Model of Human Microcystic Lymphatic Malformations [Original Article]

Archives of Otolaryngology — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions This preliminary in vivo model suggests that microcystic LM can survive in the athymic nude mouse. The presence of markers for human antibodies, lymphatic endothelium, and cellular proliferation demonstrates the stability of native tissue qualities within the xenografts. (Source: Archives of Otolaryngology)

Best interest standards do not correlate with the reality of physicians' decision making in life and death choices

Evidence-Based Nursing — Mon, 19 Dec 2011 05:00:00 +0100

Implications for nursing practice and research Clinicians appear to take decisions relating to resuscitation and non-resuscitation that do not always adhere to the best interest standard used in clinical ethical guidelines. Discrepancies between best interest valuation and the respect of families' requests not to resuscitate shows that shared decision making is lacking in most cases. There is a need for a shared decision making process with all patients and surrogates. Further research is needed to explore decision making in this context. Context The best interests standard is widely used in clinical ethical guidelines to frame emergency medicine practice in the absence of guidance by patients or their family. It is at the heart of the beneficence principle1 and cited in many bioethical...

Anal Extrusion of a Ventriculoperitoneal Shunt Catheter

Journal of Pakistan Medical Students — Mon, 19 Dec 2011 05:00:00 +0100

We report a case of a two-year-old female child who presented to the emergency department when her mother noticed the shunt catheter protruding from her anus four months after shunt placement. The shunt tube was removed and the patient underwent repeat ventriculoperitoneal shunting on the left side two weeks after shunt removal. Removal of the catheter by a less invasive method is advisable in the absence of infection. Exteriorization of the proximal end is recommended as it can be useful to rule out ventriculitis and meningitis and also to assess the dependency on shunt followed by placement of new shunt after control of the infection. Key words: Bowel perforation; Ventriculoperitoneal shunt; Anal extrusion INTRODUCTION Bowel perforation and spontaneous extrusion of the l...

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Vascular colonization by Neisseria meningitidis.

Current Opinion in Microbiology — Sun, 18 Dec 2011 05:00:00 +0100

Authors: Melican K, Dumenil G Abstract Bacterial infection of human vasculature can lead to unregulated systemic activation of coagulation and innate immunity and rapidly becomes life threatening. Neisseria meningitidis is a vascular pathogen that causes fatal sepsis and meningitis. Post-mortem histological analysis of tissues from individuals infected with N. meningitidis show large bacterial aggregates in close association with the vascular wall of small vessels. The ability of this bacterium to colonize blood vessel endothelium is likely to impact its capacity to both multiply in the blood stream and reach the brain. This process will be referred to as vascular colonization. Recent work has described a number of early steps in N. meningitidis vascular colonization, from attachme...

Perception of limitations on communicative activities, temporal resolution and figure-to-ground in unilateral hearing loss

Revista da Sociedade Brasileira de Fonoaudiologia — Sat, 17 Dec 2011 22:11:29 +0100

CONCLUSION: Individuals with unilateral hearing loss present limitations on communicative activities, especially in noisy environments, associated with worse auditory processing abilities of temporal resolution and figure-to-ground. (Source: Revista da Sociedade Brasileira de Fonoaudiologia)

Petra Ecclestone talks about her suffering when she was diagnosed with meningitis

the Mail online | Health — Sat, 17 Dec 2011 21:59:31 +0100

Bernie's youngest daughter talks about the morning she developed the disease and how quickly her health deteriorated. (Source: the Mail online | Health)

Spontaneous Pneumocephalus After Commercial Air Travel Complicated by Meningitis

Aviation, Space, and Environmental Medicine — Fri, 16 Dec 2011 23:03:25 +0100

(Source: Aviation, Space, and Environmental Medicine)

Meningococcal Quadrivalent (Serogroups A, C, W135, and Y) Conjugate Vaccine (Menveo): Profile Report

Pediatric Drugs — Fri, 16 Dec 2011 18:25:18 +0100

(Source: Pediatric Drugs)

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GSK extends pneumococcal vaccine agreement with GAVI Alliance

GSK news — Fri, 16 Dec 2011 12:10:27 +0100

GSK today announced it has expanded its agreement with the GAVI Alliance in a move to help protect millions more children in the world‟s poorest countries from pneumococcal disease. Pneumococcal disease can lead to pneumonia, meningitis and sepsis and is a leading cause of death in children under the age of five in developing countries. (Source: GSK news)

Immune globulin: Aseptic meningitis in paediatric patients: 4 case reports

Reactions — Fri, 16 Dec 2011 06:55:18 +0100

(Source: Reactions)

Bactericidal Human Meningococcal LOS IgG [Microbiology]

Journal of Biological Chemistry — Fri, 16 Dec 2011 05:00:00 +0100

Antibodies that initiate complement-mediated killing of Neisseria meningitidis as they enter the bloodstream from the oropharynx protect against disseminated disease. Human IgGs that bind the neisserial L7 lipooligosaccharide (LOS) are bactericidal for L3,7 and L2,4 meningococci in the presence of human complement. These strains share a lacto-N-neotetraose (nLc4) LOS α chain. We used a set of mutants that have successive saccharide deletions from the nLc4 α chain to characterize further the binding and bactericidal activity of nLc4 LOS IgG. We found that the nLc4 α chain conforms at least four different antigens. We separately purified IgG that required the nLc4 (non-reducing) terminal galactose (Gal) for binding and IgG that bound the truncated nLc3 α chain that lacks this Gal residue...

LPS from Neisseria meningitidis is crucial for inducing monocyte- and microparticle-associated tissue factor activity but not for tissue factor expression.

Innate Immunity — Fri, 16 Dec 2011 05:00:00 +0100

Authors: Ovstebø R, Dalsbotten Aass HC, Haug KB, Siebke Trøseid AM, Gopinathan U, Kierulf P, Berg JP, Brandtzaeg P, Henriksson CE Abstract Neisseria meningitidis causes sepsis with coagulopathy. The present study evaluated the tissue factor (TF)-inducing capacity of bacterial LPS in different presentation forms, i.e. membrane-bound LPS versus purified LPS, and of non-LPS components of N. meningitidis. By using a wild-type N. meningitidis, a mutant N. meningitidis lacking LPS (LPS-deficient N. meningitidis), purified LPS from N. meningitidis and Escherichia coli, we measured TF-expression and TF-activity on human monocytes and microparticles (MPs). The effect of TF-modulators, such as phosphatidylserine (PS), tissue factor pathway inhibitor (TFPI) and recombinant IL-10 (rhIL-10) w...

Monoclonal gammopathy of undetermined significance and risk of infections: a population-based study.

Haematologica — Fri, 16 Dec 2011 05:00:00 +0100

Authors: Kristinsson SY, Tang M, Pfeiffer RM, Bjorkholm M, Goldin LR, Blimark C, Mellqvist UH, Wahlin A, Turesson I, Landgren O Abstract No comprehensive evaluation has been conducted to assess the risk of viral and bacterial infections among patients with monoclonal gammopathy of undetermined significance. Using population-based data from Sweden, we estimated risk of infections among 5,326 MGUS patients compared to 20,161 matched controls. Patients with monoclonal gammopathy of undetermined significance had a 2-fold increased risk (P<0.05) of developing any infection at 5 and 10 years of follow-up. More specifically, patients with monoclonal gammopathy of undetermined significance had an increased risk (P<0.05) of bacterial infections (pneumonia, osteomyelitis, septicemia, p...

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Vaccines: Enhancing glycan presentation increases vaccine efficacy

Nature Reviews Drug Discovery — Fri, 16 Dec 2011 05:00:00 +0100

Nature Reviews Drug Discovery 11, 21 (2012). doi:10.1038/nrd3637 Author: Monica Hoyos Flight Carrier proteins coupled to polysaccharides that are extracted from bacterial cell walls are used as vaccines to prevent many infectious diseases such as pneumonia and meningitis. These glycoconjugate vaccines elicit a T cell response that boosts the production of high-affinity antibodies against the polysaccharide by (Source: Nature Reviews Drug Discovery)

Aetiology, Clinical Presentation, and Outcome of Meningitis in Patients Coinfected with Human Immunodeficiency Virus and Tuberculosis

Clinical and Developmental Immunology — Thu, 15 Dec 2011 23:54:25 +0100

We conducted a retrospective review of confirmed HIV-TB coinfected patients previously enrolled as part of the SAPiT study in Durban, South Africa. Patients with suspected meningitis were included in this case series. From 642 individuals, 14 episodes of meningitis in 10 patients were identified. For 8 patients, this episode of meningitis was the AIDS defining illness, with cryptococcus (9/14 episodes) and tuberculosis (3/14 episodes) as the commonest aetiological agents. The combination of headache and neck stiffness (78.6%) was the most frequent clinical presentation. Relapsing cryptococcal meningitis occurred in 3/7 patients. Mortality was 70% (7/10), with 4 deaths directly due to meningitis. In an HIV TB endemic region we identified cryptococcus followed by tuberculosis as the leading ...

YgfZ contributes to secretion of cytotoxic necrotizing factor 1 into outer membrane vesicles in Escherichia coli.

Microbiology — Thu, 15 Dec 2011 05:00:00 +0100

Authors: Yu H, Kim KS Abstract Cytotoxic necrotizing factor 1 (CNF1), a Rho-GTPase activating bacterial toxin has been shown to contribute to E. coli K1 invasion of human brain microvascular endothelial cells (HBMEC), which constitute the blood-brain barrier. CNF1, however, is a cytosolic protein and it remains unclear how CNF1 secretion occurs, contributing to E. coli invasion of HBMEC. In order to investigate the genetic requirement for CNF1 secretion in E. coli K1 strain RS218, we performed mini-Tn5 in vitro mutagenesis and constructed a transposon mutant library of strain NBC, in which β-lactamase was fused to the C-terminal of CNF1 in the chromosome of strain RS218. We identified a transposon mutant (NBC-1E6) that exhibited reduced β-lactamase activity in its culture superna...

Detection of herpes simplex virus (1 and 2), varicella‐zoster virus, cytomegalovirus, human herpesvirus 6 and enterovirus in immunocompetent tunisian patients with acute neuromeningeal disorder

Journal of Medical Virology — Wed, 14 Dec 2011 19:14:09 +0100

This study aimed to investigate the incidence of herpes simplex virus types‐1 (HSV‐1) and 2 (HSV‐2), varicella‐zoster virus (VZV), cytomegalovirus (CMV), human herpesvirus 6 (HHV‐6) and human enteroviruses (EVs) in cerebrospinal fluid (CSF) samples of Tunisian immunocompetent patients with neuromeningeal disorders. The patients had been hospitalized at the Fattouma Bourguiba University Hospital (Monastir, Tunisia) between September 2007 and June 2009. At least one viral genome was detected in 58 (46%) out of 126 CSF samples collected. Enterovirus was detected in 31 of the positive samples (53.4%), CMV in 20 (34.5%), HSV‐1 in 3 (5.2%), HSV‐2 in 6 (10.3%), VZV in 4 (6.9%), HHV‐6 in 2 (3.4%). More than one viral genome was detected in seven CSF samples, including CMV DNA in si...