Oral ulcer by Sphingomonas paucimobilis: first report.

The first case of an oral infection caused by Sphingomonas paucimobilis is reported. A 73-year-old man presented with a gingival ulcer with bone exposure affecting the attached gingiva in the anterior maxillary region. He reported pain during chewing and the presence of fever. Since the first case of S. paucimobilis infection was reported in 1977, involving a leg ulcer, the number of reports related to this organism has been increasing, indicating that the bacterium should be considered an emerging pathogen. It is possible that other non-classical pathogens of the oral cavity may be responsible for infectious lesions, which represents a diagnostic and therapeutic challenge.

Association among 1267 A/G HSP70-2, -308 G/A TNF-α polymorphisms and pro-inflammatory plasma mediators in old ZincAge population.

Proinflammatory cytokines and heat shock proteins play relevant roles in the pathogenesis of inflammatory diseases. We investigated whether Hsp70 1267 A/G and TNF-α -308 G/A polymorphisms are associated with proinflammatory mediators, zinc status and laboratory parameters in 1,078 healthy elderly from ZincAge study. Hsp70 1267 A/G genotype and allele distribution were similar among various European countries, while a TNF-α genetic heterogeneity was observed between the Northern and the Southern European populations, with a major frequency of the -308 A variant in France, Germany and Poland. We used linear regression models to test additive, dominant or recessive associations of each SNP with proinflammatory mediators, laboratory parameters, metallothioneins and zinc status. Hsp70 1267 A/G SNP, but not TNF-α -308 G/A SNP, influences TNF-α and IL-6 plasma levels under additive, dominant and recessive models (for TNF-α only). An association between Hsp70 1267 A/G SNP and zinc plasma levels was observed in the dominant model. In particular, G allele carriers showed increased circulating pro-inflammatory cytokines and zinc. Moreover, both these SNPs affect creatinine levels suggesting a possible influence on renal function. In conclusion, Hsp70 1267 A/G SNP is associated with pro-inflammatory cytokine production in healthy elderly and might represent a possible determinant of individual susceptibility to inflammatory diseases.

Nutritional assessment in head injured patients through the study of rapid turnover visceral proteins.

BACKGROUND & AIMS: Nutritional monitoring of rapid turnover visceral protein is important in the recognition of malnutrition in patients admitted to the Intensive Care Unit (ICU). We studied prealbumin and retinol-binding protein in patients who received three different kinds of artificial nutrition in order to evaluate the appropriateness of artificial nutrition. METHODS: 45 consecutive head injury patients received enteral (Group A), parenteral (Group B) or both enteral and parenteral nutrition (Group C) at random. We considered these parameters: prealbumin, retinol binding protein and nitrogen balance before (T1), after 3 (T2), 7 (T3) and 11 (T4) days after the beginning of study. Statistical analysis was performed with Kruskal-Wallis test and Bonferroni's t -test. RESULTS: Plasma prealbumin and Retinol binding protein (RBP) showed an increasing of basal values during the study period in all groups (<< 0.0001) and more significantly in group A (Enteral nutrition P < 0. 001 vs Total parenteral nutrition (TPN) and Enteral P<< 0.01 vs Enteral and parenteral nutrition). CONCLUSION: Data obtained in the present study indicate that a laboratory is essential for monitoring nutritional assessment and for checking the appropriateness of nutritional therapy. We found prealbumin to be the most sensitive measure and found it to be the test of choice for early assessment and intervention.

Macroamylasaemia and selective IgA deficiency.

Macroamylasaemia and selective IgA deficiency were diagnosed in a 2 year old child who presented with persistent hyperamylasaemia. Macroamylasaemia is an isolated biochemical abnormality caused by aggregation of serum amylase activity with immunoglobulins. Early recognition of macroamylasaemia is important to avoid diagnosing pancreatic disease.