Molecular epidemiology of Aspergillus collected from cystic fibrosis patients

Background - Aspergillus respiratory infection is a common complication in cystic fibrosis (CF) and is associated with loss of pulmonary function and allergic disease. Methods - Fifty-three Aspergillus isolates recovered from CF patients were identified to species by Internal Transcribed Spacer Region (ITS), β-tubulin, and calmodulin sequencing. Results - Three species complexes (Terrei, Nigri, and Fumigati) were found. Identification to species level gave a single Aspergillus terreus sensu stricto, one Aspergillus niger sensu stricto and 51 Aspergillus fumigatus sensu stricto isolates. No cryptic species were found. Conclusions - To our knowledge, this is the first prospective study of Aspergillus species in CF using molecular methods. The paucity of non-A. fumigatus and of cryptic species of A. fumigatus suggests a special association of A. fumigatus sensu stricto with CF airways, indicating it likely displays unique characteristics making it suitable for chronic residence in that milieu. These findings could refine an epidemiologic and therapeutic approach geared to this pathogen.

Type of strabismus and changes to fusion measures

Assessing the range of vergence provides information about the patient’s ability to maintain the binocular vision. Disparity vergence measurements should be used to quantify control of an underlying eye misalignment. In the presence of a manifest deviation the testing is performed by first compensating the angle of deviation to determine prognosis. Type of deviation: a) in an exophoria there is an increase in the fast fusional convergence while in an esophoric deviation there is an increase in reflex fusional divergence to attain binocular single vision; b) convergence fusion amplitudes have been found to correlate with control of the exodeviation; c) there is a greater BO range for esos and greater BI range for exos.