Outbreak of central nervous system infections among children in Thai Binh, Viet Nam.

From July to October 2020, 99 cases of central nervous system (CNS) infections were identified in Thai Binh Pediatric Hospital, Viet Nam, representing a five-fold increase compared to the baseline incidence during the previous five years. Clinical data were retrospectively collected. Cerebrospinal fluid specimens (CSF) were secondarily tested for pathogens using viral culture and PCR assays. Patient median age was 5 years (0-12 years); 58.6% were male. Of these children, 83.8% had CSF white blood culture (WBC) counts of ≥ 10 cells/µL, including 58 of 99 (58.6%) with a WBC count ≥ 100 cells/µL. Overall, 72 (72.7%) patients had confirmed infections with a pathogen identified in the CSF, the majority of which (66) were enterovirus. Sequencing results suggested that the rise of incidence observed in 2020 was due to Echovirus 4 (n = 45), Echovirus 30 (n = 8), and Echovirus 6 (n = 1) circulation. A confirmed CNS infection was significantly associated with older age (≥5 years, OR = 3.64, p = 0.03) and with an increased WBC count in the CSF (OR = 6.38, p-value = 0.01 for WBCs from 10 to <100 and OR = 7.90, p-value = 0.002 for WBCs ≥100). Ninety-seven (97) of 99 (98.0%) children received empiric antimicrobial treatment, and 35 (35.3%) were treated with multiple antibiotics. Eighty-four (84) patients (84.9%) were discharged home, and 11 (11.1%) were transferred to the National Hospital because their condition had worsened. No deaths were recorded. Point-of-care tests, including real-time PCR assays to identify common pathogens, should be implemented for more accurate diagnosis and more appropriate antibiotic use.

Crotamine stimulates phagocytic activity by inducing nitric oxide and TNF-α via p38 and NFκ-B signaling in RAW 264.7 macrophages.

Crotamine is a peptide toxin found in the venom of the rattlesnake Crotalus durissus terrificus and has antiproliferative, antimicrobial, and antifungal activities. Herein, we show that crotamine dose-dependently induced macrophage phagocytic and cytostatic activity by the induction of nitric oxide (NO) and tumor necrosis factor-alpha (TNF-α). Moreover, the crotamineinduced expression of iNOS and TNF-α is mediated through the phosphorylation of p38 and the NF-κB signaling cascade in macrophages. Notably, pretreatment with SB203580 (a p38-specific inhibitor) or BAY 11-7082 (an NF-κB inhibitor) inhibited crotamine-induced NO production and macrophage phagocytic and cytotoxic activity. Our results show for the first time that crotamine stimulates macrophage phagocytic and cytostatic activity by induction of NO and TNF-α via the p38 and NF-κB signaling pathways and suggest that crotamine may be a useful therapeutic agent for the treatment of inflammatory disease. [BMB Reports 2016; 49(3): 185-190].

Palatal bone thickness compared with cone-beam computed tomography in adolescents and adults for mini-implant placement.

INTRODUCTION: The purpose of this study was to compare the bone thickness of the palatal areas in early and late mixed and early permanent dentitions according to dental age. METHODS: Cone-beam computed tomography scans of 118 subjects were selected and divided into 38 early mixed (8.03 ± 0.93 years), 40 late mixed (11.51 ± 0.92 years), and 40 permanent (20.92 ± 1.17 years) dentition subjects. The measurements of palatal bone thickness were made at 49 sites by using InVivoDental5.0 software (Anatomage, San Jose, Calif). Repeated measures analysis of variance was used to analyze intragroup and intergroup differences as well as sex dimorphism. RESULTS: There was significantly lower bone thickness in the early mixed dentition group than in the 2 other groups (P <0.001). Bone thickness was higher in the anterior region than in the middle and posterior regions (P <0.001). Also, significant differences were found among the midline, medial, and lateral areas of the palate. CONCLUSIONS: Palatal bone thicknesses were significantly lower in the early mixed dentition group than in both the late mixed and permanent dentition groups. These findings might be helpful for clinicians to enhance the successful use of temporary anchorage devices in the palate.