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This study aimed to determine the aetiology of community-acquired pneumonia (CAP) by adding polymerase chain reaction (PCR) to conventional methods and to describe the clinical and laboratory features between patients with bacterial pneumonia (BP) and viral pneumonia (VP). Adults with CAP admitted from November 2009 to October 2010 were included. Demographics, comorbidities, severity and clinical features were recorded. Conventional microbiological methods included blood and sputum cultures, acute and convalescent serologic samples, and antigen urinary detection. New methods included multiplex PCR for Mycoplasma pneumoniae, Legionella pneumophila, Chlamydophila pneumoniae, Bordetella pertussis and 15 respiratory viruses. A total of 169 patients were included. Using conventional methods, we identified a pathogen in 51 % of cases. With PCR, up to 70 % of cases had an aetiological diagnosis. Forty-five patients had BP (34 %), 22 had VP (17 %) and 25 (19 %) had co-infection (BP and VP). Pneumococci and respiratory syncytial virus (RSV) were the most frequently identified pathogens. Procalcitonin (PCT) and C-reactive protein (CRP) median values were significantly higher in BP than in VP patients. Shaking chills, higher CURB score and shock were significantly more frequent in BP. A viral infection was identified in more than one-third of patients with CAP. Clinical and laboratory features could help to differentiate between VP and BP and to guide empirical therapy.

Background Colonic mast cells have been proposed to be related to the pathophysiology of irritable bowel syndrome (IBS). Whether mast cell counts are altered in the small intestine, a less‐explored region in patients with IBS is not completely clear. Methods PubMed and EMBASE were searched for case‐control studies on mast cell count/density in the small intestine of patients with IBS vs controls through February 2019. Mast cell counts were separately analyzed in the duodenum, jejunum, and ileum. Data were pooled using the standardized mean difference (SMD) method. When zero was not within the 95% confidence interval (CI), the SMD was considered significant. Key Results Data from 344 patients with IBS and 229 healthy controls from three studies in the duodenum, six in the jejunum, and five in the ileum were pooled in this meta‐analysis. The number of mast cells was significantly higher in the ileum (SMD: 1.78 [95% CI: 0.89, 2.66]) of patients with IBS. Mast cell counts were not significantly different in the duodenum (SMD: 0.81 [‐0.06, 1.67]) or the jejunum (SMD: 0.58 [‐0.03, 1.19]) of patients with IBS vs healthy controls. Conclusions and Inferences Mast cells are increased in the small intestine of IBS vs controls, mainly in the ileum. Future studies should address whether such findings are IBS subtype or gender‐dependent. Methodological variations, single‐center bias, and the limited number of studies included in this meta‐analysis may affect the final results.

The vaquita, Phocoena sinus, is a porpoise in the family Phocoenidae that lives only in the Gulf of California. The external appearance of P. sinus was unknown until 13 fresh specimens were recently examined. The most obvious morphological feature distinguishing P. sinus from its two congeners is the proportionately higher dorsal fin. The most striking features of the pigmentation pattern are the large black eye patches and the black upper and lower lip patches. In both areas, the pigmentation contrasts sharply with the surrounding light gray coloration. The total lengths of the specimens ranged from 70.3 cm (a neonate) to 143.5 cm (an adult female).

It is known that L-tryptophan stimulates serotonin synthesis in the brain and serotonergic neuronal activity. Also, the N1/P2 component of auditory evoked potential (AEP) is a good indicator of this activity in the auditory cortex. In the present work, we examined the effect of the L-tryptophan administration on electric activity of the auditory cortex recorded as the N1/P2 component of the AEP in adult male rats. The effect of serotonergic agonists or antagonists was also tested. The results showed that indeed L-tryptophan was able to induce a drastic change in auditory cortex electric activity, reducing very significantly the amplitude of the N1/P2 component of the AEP. Quipazine maleate had a similar effect as L-tryptophan and the serotonergic antagonist spiperone induced an increase in the N1/P2 amplitude. These results show how an isolated nutrient is able to induce significant changes in brain auditory cortical function, through stimulation of serotonin synthesis. Besides, they add evidence about the important role of serotonergic neurotransmission modulating sensory cortical activity and that the N1/P2 component of AEPs represent a useful noninvasive indicator of brain serotonin tone.

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