Nontypeable Haemophilus influenzae (NTHI) are Gram-negative bacteria that colonize the human pharynx and can cause respiratory tract infections, such as acute otitis media (AOM). Since NTHI require iron from their hosts for aerobic growth, the heme acquisition genes may play a significant role in avoiding host nutritional immunity and determining virulence. Therefore, we employed a hybridization-based technique to compare the prevalence of five heme acquisition genes (hxuA, hxuB, hxuC, hemR, and hup) between 514 middle ear strains from children with AOM and 235 throat strains from healthy children. We also investigated their prevalences in 148 Haemophilus haemolyticus strains, a closely related species that colonizes the human pharynx and is considered to be nonpathogenic. Four out of five genes (hxuA, hxuB, hxuC, and hemR) were significantly more prevalent in the middle ear strains (96%, 100%, 100%, and 97%, respectively) than in throat strains (80%, 92%, 93%, and 85%, respectively) of NTHI, suggesting that strains possessing these genes have a virulence advantage over those lacking them. All five genes were dramatically more prevalent in NTHI strains than in H. haemolyticus, with 91% versus 9% hxuA, 98% versus 11% hxuB, 98% versus 11% hxuC, 93% versus 20% hemR, and 97% versus 34% hup, supporting their potential role in virulence and highlighting their possibility to serve as biomarkers to distinguish H. influenzae from H. haemolyticus. In summary, this study demonstrates that heme acquisition genes are more prevalent in disease-causing NTHI strains isolated from the middle ear than in colonizing NTHI strains and H. haemolyticus isolated from the pharynx.
Rhizobium radiobacter bacteremia is an infrequent cause of human infection. We report a rare manifestation of R. radiobacter infection in which bacteremia occurred in a newborn infant without other risk factors.
Mycobacterium avium complex (MAC) is the most frequent nontuberculous mycobacteria implicated in opportunistic infections that define acquired immunodeficiency syndrome. With highly active antiretroviral therapy, disseminated MAC (dMAC) has become a rare entity. This unique case of dMAC was diagnosed in an adolescent with newly diagnosed perinatally-acquired HIV infection whose initial CD4 cell count was severely depleted and viral load was extremely high. While maximized treatment regimen had not been able to control his dMAC, improvement was noted when granulocyte macrophage colony-stimulating factor (GM-CSF) was added. GM-CSF should be considered as an adjunctive therapy in patients with refractory dMAC.
Background: Universities’ core values need to be translated into real learning design. At the end of the preclinical phase, the curriculum turned into a more comprehensive and full of trustworthiness of knowledge and attitudes. Meanwhile, the development of attitudes requires intensive support (mentoring). The team intended to translate the core values of Atma Jaya (Christianity, Excellence, Professional, Caring, KUPP) into an instructional design. Mentoring was the selected approach to build a dialogue and work together with students. In this article we presented the implementation of mentoring on the Elective Block of Medical Education (Block IPK) for the 7th semester medical students at Atma Jaya School of Medicine (August-September 2015, 5 weeks). The Block IPK then was followed by an advanced mentoring until the end of November 2015. We intended to realise KUPP through mentorship throughout Block IPK until the end of the first semester of 2015/2016. In particular, this action research was intended to find answers to research questions: (1) What were perceived by the students throughout the mentoring in the Block IPK ?, (2) What were perceived by the students throughout the mentoring after Block IPK?, (3) What products were the students proud of after the mentoring?Method: Qualitative analysis using Delphi method were utilized to determine the main theme. Analyses were fulfilled using interpretive analysis. Data were taken from: reflective writing, FGD or interviews, email communication, and the mentors’ observation. The Delphi was performed in three rounds. Results: Findings showed positive impression on Block IPK. Students were aware of the meaning or significance of Block IPK. Field trip and working group were learning methods which considered to be important, because the methods had succeeded in generating meaningful learning for students. Approximately 40-50% of the students stated the significance of working group in Block IPK. Approximately 50-75% of students experienced personal cultivation. Approximately 67-75% of the class stated the superiority of Blok IPK and mentoring. Students appreciated the working group, which gave opportunities to have a discussion on campus with mentors. Mentoring had advantages in terms of students’ cultivation of the freedom of thought and to proceed further learning (advance learning).Conclusion: Students perceived positively to mentoring activities during and after the Block IPK. Mentoring benefited to personal cultivation, academic support, role modeling and leadership. The implication to medical education institutions was to implement a mentoring steadily.
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