Apmis

doi: 10.1111/apm.12871pmid: N/A

Miesbauerová, Markéta; Tommola, Satu; Šteiner, Petr; Baněčková, Martina; Skálová, Alena; Kholová, Ivana

doi: 10.1111/apm.12950pmid: 30942913

Secretory carcinoma (SC) of salivary glands is a newly described low‐grade malignancy characterized by the presence of ETV6 rearrangement. Only a few cases and very small series with cytomorphology were reported so far. Six cases of fine‐needle aspirations (FNAs) from afterward histologically, immunohistochemically and genetically confirmed SCs were retrieved from the archives of the authors. Ancillary immunocytochemistry (ICC) and translocation detection were performed on cell blocks (CBs). All aspirates were sufficiently cellular and cells were arranged in more or less cohesive groups with only mild nuclear polymorphism. The cytoplasm was eosinophilic, granulated and vacuolated, especially in CBs. Secretory material within the microcystic spaces was periodic acid‐Schiff (PAS) positive. Triple positivity of immunomarkers S‐100 protein, mammaglobin and vimentin was present. The proliferation index was low. Ancillary techniques suggested the possibility of SC in a few cytology cases; nevertheless, the final diagnosis was based on histomorphology, immunohistochemistry and genetics. The SC of salivary glands is detectable pre‐operatively using ICC and genetics. The presence of the diagnostic ETV6 rearrangement increases the accuracy of FNA to the maximum. According to the Milan system, cases genetically not confirmed should be categorized as Suspicious for Malignancy or Salivary Gland Neoplasm of Uncertain Malignant Potential (SUMP), both requiring surgery.

Boiko, Iryna; Golparian, Daniel; Krynytska, Inna; Bezkorovaina, Halyna; Frankenberg, Arkadii; Onuchyna, Margarita; Jacobsson, Susanne; Unemo, Magnus

doi: 10.1111/apm.12948pmid: 30903707

Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a major public health concern globally. However, recent gonococcal AMR data from Eastern Europe are extremely limited and no AMR data for strains spreading in Ukraine have ever been internationally published. We investigated the AMR of N. gonorrhoeae isolates in two regions of Ukraine (Ternopil 2013–2018, Dnipropetrovsk 2013–2014), and, where information was available, the treatment administered to the corresponding gonorrhoea patients. Determination of minimum inhibitory concentration (MIC) of eight antimicrobials was performed using Etest and resistance breakpoints from the European Committee on Antimicrobial Susceptibility Testing (EUCAST) were applied. Overall, 9.3% of the examined 150 isolates were resistant to ciprofloxacin, 6.0% to tetracycline, 2.0% to azithromycin, and 0.7% to benzylpenicillin. No isolates were resistant to ceftriaxone, cefixime, spectinomycin, or gentamicin. However, one (0.7%) isolate showed a MIC value of 0.125 mg/L for both ceftriaxone and cefixime, i.e., bordering resistance. Eighty‐eight (67.2%) of 131 patients were administered dual therapy (ceftriaxone 1 g plus doxycycline/clarithromycin/azithromycin/ofloxacin) and 22 (16.8%) ceftriaxone 1 g monotherapy. Worryingly, 21 (16.0%) patients received monotherapy with clarithromycin/doxycycline/azithromycin/ofloxacin/benzylpenicillin. In conclusion, the antimicrobial susceptibility of gonococcal strains spreading in Ternopil and Dnipropetrovsk, Ukraine during 2013–2018 was high. Low levels of resistance to ciprofloxacin, tetracycline, azithromycin, and benzylpenicillin were found, but no resistance to the internationally recommended ceftriaxone, cefixime, or spectinomycin. Ceftriaxone 1 g should remain as empiric first‐line treatment, in dual therapy with azithromycin or doxycycline or in monotherapy. Continued and expanded gonococcal AMR surveillance in Ukraine is essential to monitor the susceptibility to particularly extended‐spectrum cephalosporins, azithromycin and doxycycline.

Bakhtiari, Somaye; Hasanvand, Banafsheh; Pajavand, Hamid; Alvandi, Amirhooshang; Abiri, Ramin

doi: 10.1111/apm.12953pmid: 31009119

Loop‐mediated isothermal amplification (LAMP) is a promising nucleic acid‐based assay for quick, accurate and cost‐effective diagnosis of many infectious agents. The purpose of this study was to assess the diagnostic value of LAMP for rapid and accurate detection of Helicobacter pylori in biopsy specimens. Patients suffering from one or several gastroduodenal disorders were enrolled in the study. Specificity, sensitivity, and the positive and negative predictive values of LAMP were compared with the gold standard result, which was the assembled result of culture, rapid urease test and polymerase chain reaction. Sensitivity, specificity, and the positive and negative predictive values of LAMP in comparison with the gold standard result were 100%, 30.76%, and 87.67% and 100% respectively [%95 CI]. As the diagnostic value of LAMP is favourable, the method is an optimum technique for diagnosis the presence of H. pylori in different clinical and environmental samples.

Forsblom, Erik; Lepäntalo, Aino; Wartiovaara‐Kautto, Ulla; Ruotsalainen, Eeva; Järvinen, Asko

doi: 10.1111/apm.12955pmid: 31009118

The aim of this study was to examine the changes in hemostasis parameters in endocarditis and thromboembolic events in nonfatal methicillin‐sensitive Staphylococcus aureus bacteremia (MS‐SAB) – a topic not evaluated previously. In total, 155 patients were recruited and were categorized according to the presence of endocarditis or thromboembolic events with gender‐age adjusted controls. Patients who deceased within 90 days or patients not chosen as controls were excluded. SAB management was supervised by an infectious disease specialist. Patients with endocarditis (N = 21), compared to controls (N = 21), presented lower antithrombin III at day 4 (p < 0.05), elevated antithrombin III at day 90 (p < 0.01), prolonged activated partial thromboplastin time at days 4 and 10 (p < 0.05), and enhanced thrombin–antithrombin complex at day 4 (p < 0.01). Thromboembolic events (N = 8), compared to controls (N = 34), significantly increased thrombin–antithrombin complex at day 4 (p < 0.05). In receiver operating characteristic analysis, the changes in these hemostasis parameters at day 4 predicted endocarditis and thromboembolic events (p < 0.05). No differences in hemoglobin, thrombocyte, prothrombin fragment, thrombin time, factor VIII, D‐dimer or fibrinogen levels were observed between cases and controls. The results suggest that nonfatal MS‐SAB patients present marginal hemostasis parameter changes that, however, may have predictability for endocarditis or thromboembolic events. Larger studies are needed to further assess the connection of hemostasis to complications in SAB.

Tingstedt, Jeanette Linnea; Hove‐Skovsgaard, Malene; Gaardbo, Julie; Ullum, Henrik; Nielsen, Susanne Dam; Gelpi, Marco

doi: 10.1111/apm.12956pmid: 31017317

Chronic immune activation and inflammation are constant findings in people living with HIV (PLWH) and contribute to the risk of non‐AIDS‐related morbidities, including cardiovascular diseases (CVD). Type 2 diabetes (T2D) is also characterized by immune activation and inflammation. We aimed to investigate the impact of concurrent HIV infection and T2D on T‐cell subsets. The study included PLWH with T2D (HIV+T2D+, N = 25) and without T2D (HIV+T2D−, N = 25) and HIV‐negative controls with T2D (HIV−T2D+, N = 22) and without T2D (HIV−T2D−, N = 28). All PLWH in the study were receiving combination antiretroviral therapy. We examined T‐cell homeostasis by determining T‐cell subsets (immune maturation, immune regulation and immune activation) using flow cytometry. HIV+T2D− had lower proportion of Tc17 cells and higher proportion of apoptotic cells than HIV−T2D−. When comparing HIV+T2D+ and HIV+T2D− a lower proportion of CD4+ recent thymic emigrants (RTE) was found (p = 0.028). Furthermore, HIV+T2D+ had a higher proportion of non‐suppressive CD4+ Tregs compared to HIV+T2D− (p = 0.010). In conclusion, even in the setting of treated HIV infection, distinct immunological alterations are found. In PLWH with concomitant T2D, most alterations in T‐cell subsets were related to HIV and only few differences were found between PLWH with and without diabetes.

Winberg, Line Kjær; Rasmussen, Niclas Stefan; Nielsen, Claus Henrik; Jacobsen, Søren

doi: 10.1111/apm.12954pmid: 31009117

Microvesicles (MVs) are extracellular vesicles released by several cell types upon activation or apoptosis. MVs have the potential to activate complement, which has been suggested to mediate their clearance. However, it is not clear how complement‐opsonized MVs are prevented from activating circulating polymorphonuclear leukocytes (PMNs) with release of reactive oxygen species (ROS) and potential damage of endothelium and other bystander cells as consequence. We hypothesized that binding of opsonized MVs to erythrocytes (Es) attenuates MV‐induced PMN activation. To test this, normal PMNs were exposed to MVs in the presence and absence of Es from allogenic healthy donors. As analyzed by flow cytometry, the presence of Es restricted the PMN binding of MVs by about 85% (p = 0.002) and mediated a 60–70% inhibition of the PMN production of the ROS H2O2, induced by MVs, when lipopolysaccharide was used as a primer (p = 0.002). The competitive binding of MVs to Es was partly dependent on complement, since EDTA inhibited MV binding to Es by 75%. These data suggest that Es, through competitive binding, may restrict MV‐induced activation of circulating PMNs and thereby serve a role as a regulator of PMN activation.