The role of TAS2R38 genotype in surgical outcomes and culturable bacteria in chronic rhinosinusitis with or without nasal polyps.

BACKGROUND: Recent studies reported the relationship between genetic variations and TAS2R38, which is a bitter taste receptor expressed in the cilia of human sinonasal epithelial cells, among the predisposing factors playing role in immune response to upper respiratory tract bacterial infection. The present study aims to examine the relationship of TAS2R38 genotype with the active microorganism and the effect of genotype on the surgical outcomes among chronic rhinosinusitis patients. METHODOLOGY: 34 patients undergoing endoscopic sinus surgery (ESS) for chronic rhinosinusitis with or without polyps (23 CRSwNP, 11 CRSsNP) and 30 patients undergoing septoplasty surgery for isolated nasal septum deviation were included. All the patients were genotyped for TAS2R38. Scoring was made using endoscopic Modified Lund-Kennedy and radiological Lund-Mackay systems preoperatively. Sino-Nasal Outcome Test with 22 items (SNOT-22) was implemented preoperatively and postoperatively. Nasal swab culture samples were taken intraoperatively from CRS patients and the active microorganism were isolated. RESULTS: In the TAS2R38 genotyping of the study group, PAV/PAV was found in 32.4% of patients, PAV/AVI in 47.1%, and AVI/AVI in 20.6%. In the control group, PAV/PAV was found in 26.7%, PAV/AVI in 36.7%, and AVI/AVI in 36.7%. In the study group, there was no statistically significant difference between the CRS and CRS subgroups in terms of TAS2R38 genotype distributions. The changes in patients' preoperative and postoperative SNOT-22 scores were similar between the genotypes. Proliferation was detected in culture in the whole AVI-AVI group, 81.8% of PAV-PAV group, and 56.3% of PAV-AVI group but the difference was not found to be statistically significant. The proliferation level of Staphylococcus epidermidis by TAS2R38 genotype was found to be statistically significantly higher among patients, who had AVI-AVI genotype, in CRSwNP. CONCLUSIONS: We did not find a statistically significant relationship between the TAS2R38 genotype and CRS subtype, sinonasal bacterial infection risk increase and surgical success rate in CRS patients. Long-term and large-scale studies are needed, which are to be carried out by individual genotyping and sequencing to provide more information on the effects of these genetic variants.

The Temporal Memory Sequence Test (TMST) in children: Validity test performance in clinically referred children.

Validity evaluation is fundamental in neuropsychological assessment in adults, with increasing interest among pediatric neuropsychologists. Although some measures exist, given time constraints placed on clinicians, and children's limited sustained attention, development of less time-consuming measures is beneficial. We explored the use of the Temporal Memory Sequence Test (TMST), a new performance validity test, in clinically referred children. One minor adaptation included reading the instructions and labels to non-fluent readers. Participants were 68 consecutive clinically referred children and adolescents, aged 6-18 years, with neurological (n = 46) or behavioral (n = 22) difficulties. Applying the adult cutoff, 83.8% passed the TMST. Age, gender, and diagnosis did not differ between children passing the TMST cutoff and those who failed it. Classification accuracy calculated against three embedded measures of performance validity (Wechsler scale Digit Span, Coding, and Processing Speed Index) indicated specificity over 90% (Digit Span: 94%, Coding: 96%, Processing Speed Index: 92%) and sensitivity between 30 and 33%. For individuals without Intellectual Disability (ID), 90.9% passed the TMST, and intelligence did not predict success. Thus, the use of the TMST with the adult cutoff was supported in children without ID, offering an additional validity measure for clinically referred children.

Effect of topical netilmicin on the reduction of bacterial flora on the human conjunctiva.

PURPOSE: To investigate the effects of topical netilmicin on human conjunctival bacterial flora. METHODS: Fifty-six patients' eyes with cataract were treated three times a day with netilmicin 1 day before the surgery. The fellow eyes of the patients were not treated. After 1 day of netilmicin application cultures of the inferior palpebral conjunctiva were performed in both eyes. Bacterial evaluation is qualitative. McNemar test was used for statistical analyses. RESULTS: The number of eyes with positive culture for coagulase negative staphylococcus (CNS) in untreated eyes was 43 (76.8%) and in treated eyes it was 5 (8.93%) and the difference was statistically significant (p=0.000). In untreated eyes number of negative cultures with no bacterial growth was 8 (14.3%) and it was 47 (83.9%) in the treated eyes. The difference among groups was statistically significant (p=0.000). Netilmicin is found very effective for CNS as the percentage of positive cultures (n=43) in untreated eyes to positive cultures (n=4) in the treated fellow eye was 90.7%. Likewise, all patients with Staphylococcus aureus positive cultures in untreated eyes (n=5) had negative culture for this microorganism in their treated fellow eyes (100%). CONCLUSIONS: The Endophthalmitis Vitrectomy Study demonstrated that the most common causes of postoperative endophthalmitis are coagulase negative microorganisms, S aureus and Streptococcus species. As netilmicin was found effective to reduce the number of positive cultures for these bacteria, it can be used to lower the incidence of postoperative endophthalmitis before surgery.