Tumor load rather than contrast enhancement is associated with the visual function of children and adolescents with optic pathway glioma - a retrospective Magnetic Resonance Imaging study.

INTRODUCTION: Optic pathway gliomas are often asymptomatic tumors occurring in children with neurofibromatosis type 1 (NF1 + OPG) or sporadically (spOPG). Treatment is usually prompted by visual loss and/or tumor progression on MRI. The aim of this study was to investigate the relationship between visual acuity (VA), tumor growth, and contrast enhancement to provide more distinct indications for the administration of gadolinium-based contrast agents. METHODS: Tumor load was retrospectively measured and enhancement semi-quantitatively scored on 298 MRIs of 35 patients (63% NF1 + OPG). Spearman rank correlation between tumor load and enhancement was calculated and a linear mixed model used to examine the influence of tumor load and enhancement on corresponding VA tests (LogMAR). RESULTS: The optic nerve width in NF1 + OPGs was strongly associated with VA (regression coefficient 0.75; confidence interval 0.61-0.88), but weakly with enhancement (0.06; -0.04-0.15). In spOPGs, tumor volume and optic nerve width were more relevant (0.31; -0.19-0.81 and 0.39; 0.05-0.73) than enhancement (0.09; -0.09-0.27). CONCLUSIONS: Tumor load measures may be more relevant for the surveillance of optic pathway gliomas than enhancement, given that VA is the relevant outcome parameter. Regular contrast administration should therefore be questioned in these patients.

Candidiasis caused by Candida kefyr in a neonate: case report.

BACKGROUND: Systemic Candidia infections are of major concern in neonates, especially in those with risk factors such as longer use of broad spectrum antibiotics. Recent studies showed that also term babies with underlying gastrointestinal or urinary tract abnormalities are much more prone to systemic Candida infection. We report a very rare case of candidiasis caused by Candida kefyr in a term neonate. CASE PRESENTATION: Renal agenesis on the left side was diagnosed antenatally and anal atresia postnatally. Moreover, a vesico-ureteral-reflux (VUR) grade V was detected by cystography. The first surgical procedure, creating a protective colostoma, was uneventful. Afterwards our patient developed urosepsis caused by Enterococcus faecalis and was treated with piperacillin. The child improved initially, but deteriorated again. A further urine analysis revealed Candida kefyr in a significant number. As antibiotic resistance data about this non-albicans Candida species are limited, we started liposomal amphotericin B (AMB), but later changed to fluconazole after receiving the antibiogram. Candiduria persisted and abdominal imaging showed a Candida pyelonephritis. Since high grade reflux was prevalent we instilled AMB into the child's bladder as a therapeutic approach. While undergoing surgery (creating a neo-rectum) a recto-vesical fistula could be shown and subsequently was resected. The child recovered completely under systemic fluconazole therapy over 3 months. CONCLUSIONS: Candidiasis is still of major concern in neonates with accompanying risk factors. As clinicians are confronted with an increasing number of non-albicans Candida species, knowledge about these pathogens and their sensitivities is of major importance.

Detection of Salmonella in Foods Using a Reference PN-ISO Method and an Alternative Method Based on Loop-mediated Isothermal Amplification Coupled with Bioluminescence.

BACKGROUND: Salmonella, one of the primary indicators of food safety, is a common cause of food poisoning of an epidemic nature around the world. These microorganisms can colonize the gastrointestinal tract of both people and animals, and next contaminate not only eggs, milk, meat and dairy products, but also vegetables, fruit, grains and even spices. OBJECTIVES: The aim of this study was to analyze the frequency of detection of Salmonella spp. in food samples using a reference PN-ISO method and an alternative method based on loop-mediated isothermal amplification (LAMP) coupled with bioluminescence. MATERIAL AND METHODS: Food samples were obtained in cooperation with the State Sanitary-Epidemiological Station in Wroclaw. Dairy products, meat, fish, pastry and confectionery, vegetables, herbs and spices were analyzed. The food samples were examined using a standard culturing method according to PN-ISO 6579:2003 for Salmonella spp. and an alternative method based on the isothermal amplification and bioluminescence phenomenon using the 3M MDS device. RESULTS: In 399 tested food samples in 8 materials, using both the reference and the alternative LAMP-based method, the presence of salmonella was confirmed. The results obtained show the 100% sensitivity, specificity and accuracy of the presented alternative, LAMP-based technique compared to the reference PN-ISO method. CONCLUSIONS: The alternative method using isothermal amplification and bioluminescence makes it possible to detect Salmonella in foods in a much shorter time than the referential culturing method.