Curr Opin Otolaryngol Head Neck Surg, 2005 Feb, 13(1), 2 - 8 New paradigm for the roles of fungi and eosinophils in chronic rhinosinusitis; Sasama J et al.; PURPOSE OF REVIEW: Chronic rhinosinusitis represents a challenge with its poorly understood pathophysiology and limited treatment options . Potential roles of fungi and eosinophils in the etiology and pathophysiology of chronic rhinosinusitis are summarized . RECENT FINDINGS: Previously, the fungal role in chronic rhinosinusitis was limited to the rare subgroup, allergic fungal rhinosinusitis . Critical examination of earlier diagnostic criteria for allergic fungal rhinosinusitis reveals limitations . By using updated diagnostic standards and novel sensitive techniques to detect fungi, a higher number of patients can now be diagnosed with fungal rhinosinusitis . A novel non-IgE-mediated immunologic mechanism in chronic rhinosinusitis patients links the predominant eosinophilic inflammation to certain fungi . Overall, these new findings have implications for surgical and medical approaches, including anti-inflammatory and antifungal medications . SUMMARY: Several classification schemes and diagnostic criteria describe chronic rhinosinusitis and make comparisons difficult . Preselection of patient groups within the chronic rhinosinusitis population and the lack of sensitive diagnostic techniques have prevented a full understanding of the syndrome complex of chronic rhinosinusitis . New results suggest a broader role for fungi in the pathophysiology of chronic rhinosinusitis, linking the eosinophilic inflammation to the presence of certain molds in the nasal and paranasal cavities . Although fungi are commonly found in nearly everyone, only chronic rhinosinusitis patients respond to them with an eosinophilic inflammation . These findings support a shift in the etiologic understanding of chronic rhinosinusitis away from a bacteriologic infectious pathogenesis to a fungal-driven inflammatory pathophysiology . Herein, the authors review earlier studies and describe an updated view on an old paradigm. Indian J Med Res, 2004 Dec, 120(6), 523 - 6 Chromobacterium violaceum septicaemia from north India; Ray P et al.; Though Chromobacterium violaceum is a common inhabitant of soil and water in tropical and sub-tropical regions, human infections are rare but when they do occur result in high mortality . Since the first case from Malaysia in 1927, about 150 cases have been reported in world literature . Till date 6 cases have been reported from southern and eastern parts of India . We report here a case of C . violaceum septicaemia, probably the first case from north India . The patient, a 6 and a half year old boy was admitted with high fever . The patient had anaemia, neutrophilic leucocytosis and bilateral chest infiltrates . Routine and bacteriological investigations were carried out to establish the aetiological diagnosis . C . violaceum was isolated in pure culture from blood and pus . The patient was successfully treated with ciprofloxacin and amikacin . This is probably the first documented case report of C . violaceum infection from north India and the only Indian case with septicaemia which survived. Chest, 2005 Jan, 127(1), 233 - 241 Cytomegalovirus Infection in Critically Ill Patients: Associated Factors and Consequences; Jaber S et al.; OBJECTIVE: To determine the prevalence, associated findings, and consequences of cytomegalovirus (CMV) antigenemia in critically ill patients . DESIGN: A retrospective, case-control clinical study . SETTING: A 12-bed university hospital medical-surgical ICU . PATIENTS: Two hundred thirty-seven patients with fever for > 72 h, without proven evidence of bacteriologic and/or fungal origin, and whose pp65 antigenemia assays were studied . Patients with HIV infection and transplant recipients were excluded . INTERVENTIONS: None . MEASUREMENTS AND RESULTS: CMV antigenemia was diagnosed within 20 +/- 12 days (mean +/- SD) after ICU admission in 17% patients in whom the pathology was suspected . The 40 patients in the CMV group were matched with 40 other patients in the control group . CMV infection was linked to renal failure (58% vs 33%, respectively; p = 0.02) and steroid use (55% vs 33%, respectively; p = 0.04) . Patients with CMV had a significantly longer stay in the ICU (41 +/- 28 days vs 31 +/- 22 days, respectively; p = 0.04), a longer duration of mechanical ventilation (35 +/- 27 days vs 24 +/- 20 days, respectively; p = 0.03), a higher rate of nosocomial infection (75% vs 50%, respectively; p = 0.04), and a higher mortality (50% vs 28%, p = 0.02) . CONCLUSIONS: CMV antigenemia is not an uncommon diagnosis in critically ill ICU patients with unexplained prolonged fever after 10 days of hospitalization, regardless of their immune system status . Although associated with a higher morbidity and mortality, the clinical significance of CMV is unknown . Further prospective studies should evaluate the impact on ICU outcome and whether CMV is truly a pathogen or simply another indicator of immunosuppression. Int J Syst Evol Microbiol, 2005 Jan, 55(Pt 1), 1 - 2 Validation of publication of new names and new combinations previously effectively published outside the IJSEM; Lack of enteral nutrition-effects on the intestinal immune system; Section of Pediatric Surgery, C . S . Mott Children's Hospital, University of Michigan Health System, Ann Arbor, Michigan, USABACKGROUND: Total parenteral nutrition (TPN) results in a loss of mucosal immune function by alterations in both phenotype and function of intraepithelial lymphocytes (IEL) . We hypothesized that the observed changes with TPN administration are caused by the lack of enteral feeding, and not to the TPN solution itself . METHODS: Mice received oral feeding (Control), TPN alone (TPN), or TPN plus oral feeding (TPN+Food) . Mice were killed after 7 days, and bacteriological cultures from spleen, liver, and mesenteric lymph nodes obtained, with bacterial translocation (BT) being defined as a positive culture . IEL phenotype was analyzed by flow cytometry . IEL messenger RNA (mRNA) cytokine expression used reverse transcriptase polymerase chain reaction (RT-PCR) . Apoptosis was detected by terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) staining . RESULTS: BT significantly (P < 0.05, with analysis of variance {ANOVA}) increased in the TPN group (53%) compared with Control (9%) and TPN+Food (14%) groups . TPN also resulted in a significant (P < 0.01) increase in epithelial cell apoptosis: TPN 7.6 +/- 1.1% versus Control 2.9 +/- 1.1% and TPN+Food 2.1 +/- 0.3% (mean +/- SD) . Height of the villus-crypt complex was significantly decreased in TPN mice (315 +/- 16 mum) compared with Control (431 +/- 27 mum) and TPN+Food (421 +/- 26 mum) groups . IEL phenotypes significantly changed with TPN administration: CD4(+)CD8(-) as well as CD4(+)CD8(+) subpopulations were reduced compared with Control or TPN+Food mice; as were the CD8alphabeta(+) thymus-dependent, and CD8(+)CD44(+) mature IEL . IEL cytokine mRNA expression was also significantly altered with TPN: IL-2 and IL-10 expression declined, and IL-4 IL-6, interferon gamma (IFN-gamma), transforming growth factor beta-(1) (TGF-beta(1)), and tumor necrosis factor-alpha (TNF-alpha) were increased, when compared with Control or TPN+Food mice . CONCLUSIONS: This study demonstrates that the major factor responsible for TPN-induced BT and IEL-changes is the lack of enteral feeding and not the administration of the TPN solution itself. Cancer Biother Radiopharm, 2004 Oct, 19(5), 613 - 20 Efficacy of (99m)Tc-EDDA/HYNIC-TOC Scintigraphy in Differential Diagnosis of Solitary Pulmonary Nodules; Plachcinska A et al.; Fifty consecutive patients with solitary pulmonary nodules (SPN) on chest radiographs were studied scintigraphically after the administration of a somatostatin analog (99m)Tc-EDDA/HYNIC-TOC . The activity amounted to 740-925 MBq and a single photon emission computed tomography (SPECT) technique was applied . Verification of the nodule etiology was based on histology or cytology and bacteriology . As additional criterion for nodule benignity, its stable size in a chest radiograph for at least 3 years was accepted . In 31 patients, malignant etiologies of nodules were found . The diagnoses included: 11 adenocarcinomas, 6 squamous-cell carcinomas, 2 large-cell carcinomas, 6 nonsmall-cell lung cancers (NSCLC) of unspecified, more detailed morphology, 2 small-cell lung cancers (SCLC), 2 typical carcinoids, and 2 metastatic tumors: leiomyosarcoma and malignant melanoma . In 19 patients, the following benign tumors were diagnosed: 6 tuberculomas, 2 other granulomas, 4 hamartomas, 2 nonspecific inflammatory infiltrates, 1 abscess, 1 peripheral carcinoid of morphological characteristics of a benign tumor, 1 ectopic lesion of thyroid tissue, and 2 benign tumors of unspecified etiology, with stable size over 3 and 5 years . Positive scintigraphic results were obtained in 28 of 31 patients (90%) with malignant SPNs; among these there were 26 of 27 (96%) cases of primary pulmonary carcinoma . The remaining 2 false-negative cases included metastatic tumors: liposarcoma and melanoma . Among 19 benign lesions, 15 (79%) did not accumulate the radiopharmaceutical . The remaining 4 tumors visible on scintigrams included: 1 tuberculoma, 1 hamartoma, 1 abscess, and 1 case of nonestablished diagnosis (with stable size over 3 years) . In conclusion, scintigraphy with (99m)Tc-EDDA/HYNIC-TOC appears to be an effective procedure for differentiation between malignant and benign SPNs. Intern Med, 2004 Dec, 43(12), 1201 - 4 Rheumatoid arthritis complicated with acute interstitial pneumonia induced by leflunomide as an adverse reaction; Kamata Y et al.; A 49-year-old Japanese man with rheumatoid arthritis acutely developed a skin eruption and severe non-productive cough seventeen days after the administration of leflunomide . Because all bacteriology findings were negative, steroid pulse-therapy was initiated promptly due to the rapidity of chest X-ray progression and the deterioration of arterial blood oxygen pressure . Although cough was induced by methotrexate, interstitial pneumonia was not detected clinically before leflunomide administration . He finally died of respiratory failure 128 days after the onset of acute interstitial pneumonia . According to the post-market surveillance, as high as approximately 1.1% of the patients on,leflunomide have developed interstitial pneumonia in Japan . It is important to emphasize that acute interstitial pneumonia due to leflunomide is a very severe and potentially fatal side effect. Khirurgiia (Sofiia), 2003, 59(4), 3 - 7 {Mediastinitis--diagnostics and surgical treament}; SLC11A1 (NRAMP1) but not SLC11A2 (NRAMP2) polymorphisms are associated with susceptibility to tuberculosis in a high-incidence community in South Africa; Medical Biochemistry and MRC Centre for Molecular and Cellular Biology, Stellenbosch University, Tygerberg, South Africa . egvh@sun.ac.za SETTING: Stellenbosch University Faculty of Health Sciences, and metropolitan Cape Town, Western Cape, South Africa . OBJECTIVE: To investigate whether the reported association between SLC11A1 (also NRAMP1) polymorphisms and susceptibility to tuberculosis (TB) can be confirmed in a different population, and whether polymorphisms in SLC11A2 (also NRAMP2, DCT1, DMT1) are associated with TB . DESIGN: A case-control study design was used to compare the frequencies of five polymorphisms in SLC11A1 and three in SLC11A2 between a group of bacteriologically confirmed TB patients and healthy community controls . RESULTS: The 5' (GT)9 allele in the promoter of SLC1A1 was found at significantly higher frequencies among 265 controls than in 224 pulmonary TB (PTB) patients (P = 0.002; OR 0.6; 95% CI 0.43-0.83) . Homozygotes for the TGTG deletion (1729+55del4) in the 3'UTR of SLC11A1 were over-represented among PTB patients (P = 0.013; OR 5.19; 95% CI 1.42-18.94) . Stepwise logistic regression analysis indicated that the 5' and 3' polymorphisms contribute separate main effects . Tuberculous meningitis patients (n = 22) showed the same allele and genotype frequency as PTB patients . No SLC11A2 polymorphisms tested were associated with TB . CONCLUSION: The 5' (GT)n allele driving the highest rate of transcription of SLC11A1 appears to be associated with protection against TB in the majority of the populations studied. Zhonghua Yi Xue Za Zhi, 2004 Nov 17, 84(22), 1876 - 8 {Comparative study on cefdinir and cefaclor in the treatment of patients with mild to moderate bacterial community acquired pneumonia.}; Jiang XT et al.; OBJECTIVE: To evaluate the efficacy and safety of cefdinir in the treatment of patients with mild to moderate bacterial community acquired pneumonia (CAP) . METHODS: A prospective single-blind randomized controlled clinical study was performed comparing cefdinir with cefaclor in the treatment of sixty-four patients with CAP . The clinical and bacteriological efficacy and safety were compared between cefdinir and cefaclor in treating mild to moderate CAP . Thirty-three patients were treated with cefdinir 100 mg, orally, threatimes a day (cefdinir group), thirty-one patients were treated with cefaclor 500 mg, orally, threatimes a day (cefaclor group) . In both groups 7 - 14 d was a treatment course . RESULTS: The cure rate of cefdinir and cefaclor was 84.8% and 77.4% respectively and the overall efficacy rate was 93.9% and 87.1% respectively . The bacterial positive rates and bacterial eradication rates of the two groups were 81.8%, 80.7% and 96.3%, 88%, respectively . The adverse drug teaction rate were 3% in cefdinir group and 6.5% in cefaclor group . There was no statistical significant difference between the two groups for the above results (P > 0.05) . The time of given medicine of cefdinir and cefaclor was (10.8 +/- 1.6) d and (12.1 +/- 1.7) d (P < 0.01) respectively . CONCLUSION: cefdinir is safe and effective, shorten the course of treatment in the treatment of mild to moderate bacterial community acquired pneumonia. Rev Med Suisse Romande, 2004 Nov, 124(11), 693 - 5 {In Process Citation}; Sibai K et al.; Lemierre syndrome (also called post-anginal sepsis or necrobacillosis) is an uncommon complication of oropharyngeal infections for which early recognition and aggressive therapy is mandatory, since it is potentially life-threatening . Due to it's rarity, with a prevalence of 0.8 cases per million in the general population, many physicians are unfamiliar with this disorder . This is attested by the fact that diagnosis most often relies on bacteriological grounds . We report the case of a patient whose diagnosis of thrombophlebitis of the internal jugular vein was made by the emergency physicians based upon clinical presentation, allowing for prompt initiation of adequate antibiotherapy . The aim of this report is to enhance general practitioner's and emergency physicians' awareness of this uncommon disorder, which should always be suspected in case of sepsis following an oropharyngeal infection. Kekkaku, 2004 Oct, 79(10), 561 - 7 {Miss-managements in treatment failure of pulmonary tuberculosis}; Ito K et al.; PURPOSE: To investigate the risk factor of treatment failure of pulmonary tuberculosis excluding multi-drug resistant cases from the standpoint of both clinical management and tuberculosis control . OBJECT AND METHOD: Retrospective chart review of patients who admitted to Fukujuji Hospital for treatment failure of pulmonary tuberculosis excluding multi-drug resistant cases from Jan . 1993 to Dec . 2003 . RESULTS: Out of 24 treatment failure cases available for analysis, 4 cases were associated with chronic tuberculous empyema with broncho-pleural fistula, and among them, chronic empyema was considered to be the main cause of treatment failure in one case . In 6 cases, poor adherence to medication was confirmed or suspected, and 2 of these 6 cases was also associated with miss-management . In 9 cases miss-management was found without poor adherence or chronic empyema, and in 8 out of these 9 cases, miss-management was considered to be the main cause of treatment failure . In 5 cases no apparent risk factor was found, but in 2 out of these 5 cases the ignorance of the results of drug sensitivity tests (and, therefore, miss-management) was strongly suspected . Summing up, in 10 out of 24 cases (41.7%), the miss-management was considered to be the main cause of treatment failure, and it was more frequently seen than poor adherence to medication . CONCLUSION: Clinicians should be aware of these risk factors of treatment failure such as chronic empyema, weak regimen in bacteriological negative cases, rifampicin+ethambutol regimen, and miss-management of drug adverse effect . From the standpoint of tuberculosis control in Japan we considered that, in addition to DOT, strategy to secure the quality of tuberculosis treatment is by all means needed. Vet Microbiol, 2005 Jan 31, 105(2), 103 - 11 Epub 2004 Dec 16. Prevalence of Brucella pinnipediae in healthy hooded seals (Cystophora cristata) from the North Atlantic Ocean and ringed seals (Phoca hispida) from Svalbard; Tryland M et al.; Investigations for Brucella-infections were conducted in 29 hooded seals (Cystophora cristata) caught between Svalbard and Greenland (North Atlantic Ocean; Greenland Sea) autumn 2002, and from 20 ringed seals (Phoca hispida) caught in Billefjord, Svalbard, spring 2003 . All animals were apparently healthy and were caught in their natural habitat . Bacteriology on tissue samples from ringed seals was negative, whereas Brucella sp . were recovered in tissues from 11 of the 29 hooded seals (38%), with the highest tissue prevalence in spleen (9/29) and lung lymph nodes (9/24) . Anti-Brucella antibodies were detected in sera from 9 hooded seals (31%) (EDTA-modified Slow Agglutination test of Wright, Rose Bengal test, Complement Fixation Test, and Protein-A ELISA) . The bacterial isolates all belonged to the genus Brucella according to classical biotyping and PCR analysis based on Insertion Sequence IS711, and were shown to be typical marine mammal strains, based on the occurrence of an IS711 element downstream of the bp26 gene . Their dependency on CO(2) for growth, and the presence of one copy each of the omp2a and omp2b gene finally classified them as Brucella pinnipediae . Furthermore, all the hooded seal isolates showed an A+ M+ agglutination profile, which is different from the profile of reference seal strain 2/94 (harbour seal, Phoca vitulina) . Thus, these results indicate that B . pinnipediae may contain different biovars . The present results suggest that infection with B . pinnipediae is enzootic in this population . Since the hooded seal is commercially hunted and consumed in Norway, the pathological impact of such infections and their zoonotic potential should be further addressed. Med Mal Infect, 2004 Aug-Sep, 34(8-9), 364 - 70 {Clinical and bacteriological diagnosis of tuberculosis}; Efficacy and safety of pharmacokinetically enhanced amoxicillin-clavulanate at 2 et al.; University of Buffalo, 3495 Bailey Ave., Medical Research 151, Buffalo, NY 14215, USA . ssethi@buffalo.edu This randomized, controlled trial was designed to show that a short, 5-day course of pharmacokinetically enhanced amoxicillin-clavulanate at 2,000/125 mg (Augmentin XR) is as effective clinically as a longer, 7-day course of conventional amoxicillin-clavulanate at 875/125 mg (both given twice daily) in the treatment of acute exacerbations of chronic bronchitis (AECB) . Amoxicillin-clavulanate at 2,000/125 mg was designed to extend the therapeutic levels of amoxicillin in serum over the 12-h dosing interval, compared with conventional formulations, to eradicate bacterial strains for which amoxicillin MICs were < or =4 microg/ml while retaining efficacy against beta-lactamase-producing pathogens . A total of 893 patients were randomized and received study medication (amoxicillin-clavulanate at 2,000/125 mg for 443 patients and 875/125 mg for 450 patients) . Overall, 141 patients receiving amoxicillin-clavulanate at 2,000/125 mg and 135 receiving the comparator formulation had at least one pathogen identified at screening . Amoxicillin-clavulanate at 2,000/125 mg was as effective clinically in the per-protocol (PP) population at the test of cure (days 14 to 21, primary efficacy endpoint) as amoxicillin-clavulanate at 875/125 mg (clinical success rates of 93.0 and 91.2%, respectively; treatment difference, 1.8; 95% confidence interval {CI}, -2.2, 5.7) . Bacteriological success in the bacteriology PP population was high for both formulations (amoxicillin-clavulanate at 2,000/125 mg, 76.7%; amoxicillin-clavulanate at 875/125 mg, 73.0%; treatment difference, 3.8; 95% CI, -7.5, 15.0) . Both therapies were well tolerated, with a similar incidence of adverse events . Fewer than 5% of patients in each group withdrew from the study due to adverse events . The shorter, 5-day course of amoxicillin-clavulanate at 2,000/125 mg was shown to be as effective clinically as a longer, 7-day course of amoxicillin-clavulanate at 875/125 mg, with high bacteriological efficacy and no difference in tolerability. Vet Res, 2005 Jan-Feb, 36(1), 13 - 25 The effects of inoculation of Mannheimia haemolytica into the teat of lactating ewes; Mavrogianni VS et al.; The objectives of the work described in this paper were: (i) to study the outcome of challenging ewes with Mannheimia haemolytica, at different sites of their teats, (ii) to compare the effects of two different isolates of the organism and (iii) to describe the features of the resulting lesions . Thirty-two ewes were used in the study and allocated into one of two groups (A or B, n = 16); they were challenged with one of two isolates of M . haemolytica, respectively, strain ES26L of known pathogenicity or strain VSM08L from the teat duct of a healthy ewe . Each group was further divided into four equal subgroups: the ewes in the A1/B1 subgroups were intramammarily challenged; one teat of the ewes in the A2/B2 subgroups was immersed into a broth-culture of the organisms; one teat of the ewes in the A3/B3 subgroups was inoculated 2 mm-deep, whilst one teat of the ewes in the A4/B4 subgroups was inoculated 6 mm-deep . The animals were monitored clinically, bacteriologically and cytologically before and after challenge; one animal in each subgroup was euthanised 2, 4, 7 and 11 days after challenge . All ewes in the A1/B1 subgroups developed clinical mastitis, whilst of the other animals, only one ewe in each of the A4/B4 subgroups did . Neither of the two strains used was associated with more positive bacteriological or CMT results; the A2/B2 subgroups were associated with less positive results than the A3/B3 and A4/B4 subgroups . In some ewes of the A2/B2 subgroups, mild leucocytic infiltration in the teat was evident; in the ewes of the A3/B3 subgroups, leucocytic infiltration (neutrophils, lymphocytes, plasma cells) was seen, as well as a lymphoid hyperplasia at the border between the teat duct and teat cistern; in ewes of the A4/B4 subgroups, intense subepithelial leucocytic infiltration was the salient feature . No differences were found in the severity of lesions between the two strains used or the three treatments carried out . Although strain VSM08L had been isolated from the teat duct of a healthy ewe, it caused mastitis when inoculated intramammarily; although strain ES26L is of known pathogenicity for the mammary gland, it did not cause clinical mastitis when deposited 2 mm-deep into the teat . These findings point to a protective role of the teat of ewes, which appear to limit bacterial penetration from the teat duct or cistern to the mammary gland . The lymphoid tissue, at the border between the teat duct - teat cistern, may play a significant protective role. Pol Merkuriusz Lek, 2004, 17 Suppl 1, 156 - 9 {The results of treatment of acute haemorrhagic necrotizing pancreatitis in the own material}; Jablonski S et al.; AIM OF WORK: The retrospective estimation of surgical procedure and the results of treatment of haemorrhagic necrotizing pancreatitis in the own material . MATERIAL AND METHODS: The estimated group consist of 161 patients from the clinic treated for heavy grade of acute pancreatitis . Characteristics which qualified patients to the chosen group were: aggravating general condition, biochemical parameters of disease's progression, results of radiological investigations (USG, CT of abdomen) and bacteriological culture from peritoneal cavity . RESULTS: 142 patients (88.2%) were surgically treated in different duration periods of illness (from 0 to 53 day of illness) . Firstly, they were intensively treated with conservative treatment . After about 9.6 days they were operated on (from 0 to 51 day of treatment) . Clinical symptoms such as: rapid aggravating general condition of patients, septic shock, as well as infected necrosis in radiological and bacteriological investigations, were indication to surgical intervention . The methods of surgical treatments were: laparotomy and flow drainage 73 patients, closed drainage 31 patients, repeated relaparotomy 25, Bradley's method 13 . Mortality in the group of operated patients was 5.9% . The most common causes of death were: respiratory insufficiency 29.4%, multiorgan insufficiency 21.6%, circulatory insufficiency 13.8%, insufficiency of kidneys 9.8% CONCLUSIONS: The authors suggest that the most important in deciding about necessity and time of surgical intervention of haemorrhagic necrotizing acute pancreatitis are individual clinical characteristics of patients . The lowest mortality was in the group of operated patients in later period of illness and who did not required reoperation. Cell Tissue Bank, 2004, 5(4), 201 - 4 Keratocyte injury in human corneas cryopreserved under standard conditions; Villalba R et al.; This study was conducted to characterize ultrastructural damage to human corneas cryopreserved by a standard protocol . The materials used were seven human corneas that were unsuitable for transplantation due to the presence of positive bacteriological cultures; they were cryopreserved according the standard procedure . After freezing and thawing, samples were obtained for scanning and transmission electron microscopy studies . Marked damage was observed in keratocytes with signs of apoptotic cellular injury . However our observations have shown that apoptosis contribute less significantly than necrosis to cellular death in keratocytes of human corneas and although the control of apoptosis is clearly desirable, in order to improve the success of cryopreserved corneas for transplant, we need to continue our investigation to reduce the effects of the necrotic process. J Dairy Sci, 2005 Jan, 88(1), 93 - 9 Comparative efficacy of local and systemic antibiotic treatment in lactating cows with clinical mastitis; Serieys F et al.; The intramuscular administration of penethamate hydriodide over 3 consecutive days and the intramammary administration of an ampicillin/cloxacillin combination were compared in lactating cows suffering from infectious clinical mastitis in one quarter, through an open, randomized, controlled multicenter field trial . Clinical examinations were carried out on d 1 (immediately before treatment), 3, 8, 17, and 22 . Milk samples were taken from affected quarters for bacteriological analysis on d 1, 17, and 22, and from all quarters for somatic cell count (SCC) determination on d 1, 8, 17, and 22 . There was no significant difference in bacteriological and clinical cure rates between the 2 treatment groups . The systemic treatment with penethamate resulted more frequently in a reduction of the milk SCC below the threshold of 250,000 cells/mL . This also occurred in the adjacent quarters not affected by clinical mastitis but with an SCC above 250,000 cells/mL before treatment . These findings suggest that the parenteral treatment with penethamate provides collateral cure on the quarters of the cows affected by subclinical mastitis . The number of quarters per cow affected by clinical or subclinical mastitis should be considered when selecting an antibiotic treatment by the local or systemic route. Dis Aquat Organ, 2004 Oct 21, 61(1-2), 41 - 51 Isolation and characterization of mycobacteria from striped bass Morone saxatilis from the Chesapeake Bay; Rhodes MW et al.; Mycobacteriosis in striped bass Morone saxatilis of Chesapeake Bay, USA, was first diagnosed in 1997 based on the presence of granulomatous inflammation and acid-fast bacteria in skin and spleen . To confirm histopathology, bacteriological detection and identification of mycobacteria were begun using splenic tissue from fish with and without skin ulcerations . On the basis of initial studies using a variety of selective and nonselective media, decontamination, homogenization and incubation conditions, a simple and quantitative recovery method using aseptic necropsy of splenic tissue was developed . Optimal recovery was obtained by spread-plating homogenates on Middlebrook 7H10 agar with incubation for 3 mo at 23 degrees C . Mycobacteria were recovered from 76% (n = 149/196) of fish examined . Mycobacterial densities exceeded 10(4) colony forming units x g tissue(-1) in 38% of samples (n = 63/168) that were examined using a quantitative approach . The most frequently recovered mycobacterium, present in 57% (n = 109/192) of characterized samples, was the recently named new species Mycobacterium shottsii . Polyinfections of M . shottsii and other mycobacteria were observed in 25% of samples (n = 47/192) with densities of M . shottsii usually 1 or more orders of magnitude higher than co-isolate(s) . Other mycobacteria recovered included isolates that, based on phenotypic traits, resembled M . interjectum, M . marinum, M . scrofulaceum, M . szulgai and M . triplex . M . marinum, commonly associated with fish mycobacteriosis and human disease, was recovered infrequently (3%, n = 6/192) . The presence of multiple mycobacterial types occurring at high densities suggests that a variety of mycobacteria could be causative agents of mycobacteriosis in striped bass from the Chesapeake Bay . Striped bass is the major recreational fish species in the Chesapeake Bay, and the significance of the current epizootic to human health and the potential adverse effects on fish stocks are not known. Hist Philos Life Sci, 2003, 25(3), 391 - 412 From miasma to asthma: the changing fortunes of medical geography in America; Mitman G et al.; Historians of modern medicine often divide their subject into two parts, separated by the bacteriological revolution of the late nineteenth century, when medicine supposedly became 'scientific' for the first time . The history of medical geography--to say nothing of other subjects--calls this common view into question . At least in the United States, students of medical geography, arguably the pre-eminent medical science in an age dominated by miasmatic theories of disease, readily adapted to the discovery of germs . And although bacteriology quickly eclipsed medical geography in the world of medicine, place remained an important consideration in treating asthma (and allergies generally) throughout the post-bacteriological period. Chir Main, 2004 Oct, 23(5), 257 - 9 {Bone tuberculosis of the thumb unmasked by an injury}; Bellarbi S et al.; Tuberculous dactylis is uncommon, which makes it difficult to differentiate from tumorous and metabolic affections . Histological analysis constitutes a reliable and easy way to achieve a positive diagnosis, especially as the bacteriological findings can be negative . We report the case of a 43-year-old woman who consulted for a painful right thumb following an injury . Radiographs showed a fracture of the proximal phalanx through a lytic lesion . Pathology examination of a biopsy specimen revealed granulomata with caseous necrosis, specific to tuberculosis . The clinical signs and radiographs resolved after anti-tuberculosis treatment for 12 months. Eur Respir J, 2004 Dec, 24(6), 947 - 53 Levofloxacin versus clarithromycin in COPD exacerbation: focus on exacerbation-free interval; Lode H et al.; Antibiotic treatment of bacterial exacerbation of chronic obstructive pulmonary disease (COPD) shows some immediate clinical benefits and may also minimise the frequency of further recurrences . Patients (n=511) were enrolled into a randomised double-blind multicentric study comparing the exacerbation-free interval (EFI), efficacy and safety of 7-day levofloxacin versus 10-day clarithromycin in patients with COPD exacerbation . Patients were monitored over a 1-yr period . A total of 434 patients (per protocol population) received the medication for > or =5 days . The median EFI in the per protocol population was 300 days for levofloxacin and 350 days for clarithromycin . For patients with a new documented exacerbation during follow-up (n=223), the median EFI was 100.5 days in the levofloxacin group and 95 days for clarithromycin . No significant differences in EFI between groups could be observed when stratifying the study population according to microbial aetiology and severity of bronchial obstruction . Levofloxacin and clarithromycin showed similar clinical success rates . The bacteriological success rate was significantly higher in the levofloxacin group . Both antibiotics were well tolerated . In summary, levofloxacin was associated with a significantly higher bacteriological eradication rate but similar exacerbation-free interval in patients with chronic obstructive pulmonary disease exacerbation compared to clarithromycin. J Hosp Infect, 2005 Jan, 59(1), 53 - 61 Evaluation of antibiotic use in intensive care units of a tertiary care hospital in Turkey; Erbay A et al.; The object of this study was to evaluate the appropriateness of antibiotic use in relation to diagnosis and bacteriological findings in the intensive care units (ICUs) of a 1100-bed referral and tertiary care hospital with an antibiotic restriction policy in Turkey . Between June and December 2002, patients who received antibiotics in the medical and surgical ICUs were evaluated prospectively . Two infectious diseases (ID) specialists assessed the antibiotics ordered daily . Of the 368 patients admitted to the ICUs, 223 (60.6%) received 440 antibiotics . The most frequently prescribed antibiotics were first-generation cephalosporins (16.1%), third-generation cephalosporins (15.2%), aminoglycosides (12.1%), carbapenems (10.7%) and ampicillin-sulbactam (8.7%) . Antibiotic use was inappropriate in 47.3% of antibiotics . ID specialists recommended the use of 47% of all antibiotics . An antibiotic order without an ID consultation was more likely to be inappropriate {odds ratio (OR)=13.2, P<0.001, confidence intervals (CI)=4.4-39.5} . Antibiotics ordered empirically were found to be less appropriate than those ordered with evidence of culture and susceptibility results (OR=3.8, P=0.038, CI=1.1-13.1) . Inappropriate antibiotic use was significantly higher in patients who had surgical interventions (OR=3.6, P=0.025, CI=1.2-10.8) . Irrational antibiotic use was high for unrestricted antibiotics . In particular, antibiotic use was inappropriate in surgical ICUs . Additional interventions such as postgraduate training programmes and elaboration of local guidelines could be beneficial. Acta Chir Belg, 2004 Oct, 104(5), 601 - 3 Isolated hepatic tuberculous pseudometastasis co-existent with adenocarcinoma of the stomach; report of a case; Sen M et al.; A 10 x 9 mm metastasis-like lesion in segment V of the liver was detected, when a 70-year-old man was operated on for adenocarcinoma of the stomach . Since exact diagnosis of the hepatic lesion could not be made by frozen sections, the lesion was excised, considering it to be a metastasis of gastric adenocarcinoma . Bacteriologic and pathologic studies established a diagnosis of isolated tuberculosis of the liver . A good response to antituberculous drug therapy was noted. Zhonghua Yi Xue Za Zhi, 2004 Oct 17, 84(20), 1678 - 80 {The epidemic of childhood tuberculosis in China}; Li L et al.; OBJECTIVE: To analyze the epidemic situation of children Tuberculosis (TB) in China . METHODS: To sum up the data of four times national TB epidemic survey from 1979 to 2000, and analyze the epidemic situation of children whose age were between 0 and 14 . RESULTS: The TB prevalence rates in children were 8.8%, 9.6%, 7.5% and 9.0% in 1979, 1984/85, 1990, 2000 . The active pulmonary TB (PTB) prevalence rates in children were 241.7/100 000 172.1/100 000, 91.8/100 000 in 1979, 1990 and 2000, the bacteriological positive PTB prevalence rates were 12.7/100 000, 12.3/100 000 in 1990 and 2000, the smear positive PTB prevalence rates were 7.5/100 000, 7.5/100 000 and 6.7/100 000 in 1979, 1990 and 2000; It was estimated there were 26.08 million children who were infected by microbacterial TB, 266 thousands children active PTB cases, 36 thousands children bacteriological positive PTB cases and 19 thousands children smear positive PTB cases in 2000 according to the data of the national population survey . the rates were 4.5%, 5.9%, 1.8%, 1.3% when comparing them to the all patients . the ratio of children TB prevalence rates between city and country were 1.8, 1.8, 1.7 and 1.2 in the four survey . CONCLUSIONS: The TB prevalence rates in children had not obvious decrease from 1979 to 2000 were not allowed to optimize to the epidemic of children TB . The bacteriological negative PTB had a bigger . The difference of children TB prevelance between city and country reduced gradually . The quantity of sample and other factors influenced the forecast value of PPD to disease, so it would be a trend of using the routine surveillance to replace the national epidemic survey . BCG still would be the an important content in our national TB control before the emergence of the new and more efficient vaccine. J Am Vet Med Assoc, 2004 Nov 15, 225(10), 1573 - 7, 1548 Putative transmission of Mycobacterium tuberculosis infection from a human to a dog; Hackendahl NC et al.; A 3.5-year-old Yorkshire Terrier was evaluated for anorexia and vomiting; infection with Mycobacterium tuberculosis was diagnosed by use of histology, bacteriologic culture, and polymerase chain reaction (PCR) assay on various tissues . The dog was living with a human with an established M . tuberculosis infection . Findings were unique in that diagnosis of M . tuberculosis infection was obtained via PCR techniques, and isolates from the owner and dog were matched via restriction fragment length polymorphism fingerprinting . Dogs infected with M . tuberculosis from humans are most commonly infected via the respiratory tract . Clinical signs in dogs are variable and depend on the integrity of the immune system and the degree of dissemination . Diagnosis can often be obtained through histopathology and bacteriologic culture; additional diagnostic techniques are also available . Treatment of a dog with confirmed M . tuberculosis infection is controversial, and at least 6 months of multidrug treatment is required. Clin Diagn Virol, 1995 Jul, 4(1), 15 - 25 Large-scale evaluation of an alternative strategy for confirmation of HIV antibodies; Thorstensson R et al.; Objective: To retrospectively compare the accuracy of combinations of two enzyme-linked immunosorbent assays (ELISAs) with a Western blot based strategy for identification of human immunodeficiency virus type 1 (HIV-1) seropositivity . Materials and methods: 48,977 sera, sent to the National Bacteriological Laboratory, Stockholm, Sweden, for HIV antibody determinations between October 1988 and June 1993, were investigated . All samples were tested in parallel with two different ELISAs, either Abbott Recombinant HIV-1 EIA and Wellcozyme Recombinant Anti-HIV-1 EIA, or Enzygnost Anti-HIV-1/2 and Wellcozyme Recombinant Anti-HIV-1 EIA, or Enzygnost Anti-HIV-1/2 and Wellcozyme Anti-HIV-1+2 EIA . 1565 sera repeatedly reactive by one or both ELISAs were investigated by Western blot (WB) . Furthermore, a total of 2820 referred sera, screen reactive at primary laboratories but negative on our combinations of two ELISAs were analysed by WB . Results: Out of 1244 truly HIV antibody positive samples 1203 were WB positive and 41 (3.4%) were WB indeterminate . A sensitivity of 100% was obtained by all three combinations of two ELISAs on examination of these 1244 sera including repeated testing of 5 samples with initially discrepant results . Among 2820 sera from HIV-negative individuals 649 (23%) sera were WB indeterminate . The combination of Enzygnost (indirect test with synthetic peptides) and Wellcozyme (sandwich test with recombinant and synthetic peptides) Anti-HIV 1+2 EIAs was 100% specific when used for analysis of 9111 sera . One of 30,323 HIV-1 antibody negative sera tested was initially reactive on both Enzygnost Anti-HIV 1+2 and Wellcozyme Recombinant Anti-HIV-1 EIA (competitive assay) but was found to be negative by repeated testing, resulting in a specificity of 100% for that combination of ELISAs . Abbott Recombinant Anti-HIV-1 EIA (indirect assay) combined with Wellcozyme Recombinant Anti-HIV-1 EIA was initially falsely reactive with 12 of 8272 sera of which 6 were repeatedly reactive . Conclusions: This large-scale evaluation demonstrates that combinations of two ELISAs based on different test principles and antigens increase the accuracy of the HIV antibody determination and could be used as an alternative or complement to WB. Am J Vet Res, 2004 Nov, 65(11), 1483 - 9 Investigation of the transmission of Mycobacterium bovis from deer to cattle through indirect contact; Palmer MV et al.; OBJECTIVE: To investigate the infection of calves with Mycobacterium bovis through oral exposure and transmission of M . bovis from experimentally infected white-tailed deer to uninfected cattle through indirect contact . ANIMALS: 24 11-month-old, white-tailed deer and 28 6-month-old, crossbred calves . PROCEDURE: In the oral exposure experiment, doses of 4.3 x 10(6) CFUs (high dose) or 5 x 10(3) CFUs (low dose) of M . bovis were each administered orally to 4 calves; as positive controls, 2 calves received M . bovis (1.7 x 10(5) CFUs) via tonsillar instillation . Calves were euthanatized and examined 133 days after exposure . Deer-to-cattle transmission was assessed in 2 phases (involving 9 uninfected calves and 12 deer each); deer were inoculated with 4 x 10(5) CFUs (phase I) or 7 x 10(5) CFUs (phase II) of M . Bovis . Calves and deer exchanged pens (phase I; 90 days' duration) or calves received uneaten feed from deer pens (phase II; 140 days' duration) daily . At completion, animals were euthanatized and tissues were collected for bacteriologic culture and histologic examination . RESULTS: In the low- and high-dose groups, 3 of 4 calves and 1 of 4 calves developed tuberculosis, respectively . In phases I and II, 9 of 9 calves and 4 of 9 calves developed tuberculosis, respectively . CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that experimentally infected deer can transmit M . bovis to cattle through sharing of feed . In areas where tuberculosis is endemic in free-ranging white-tailed deer, management practices to prevent access of wildlife to feed intended for livestock should be implemented. Braz J Infect Dis, 2004 Aug, 8(4), 305 - 10 Epub 2004 Aug. Diagnosis of pulmonary tuberculosis by score system in children and adolescents: a trial in a reference center in Bahia, Brazil; Sant'anna CC et al.; Since 2002, the Brazilian Ministry of Health has recommended a score system for tuberculosis diagnosis of children and adolescents that does not need bacteriological positivity, because most cases in this age group have few bacteria . An observational, transversal study was carried out at the outpatient health care service of the reference medical service in Salvador, Bahia, including 164 patients with pulmonary tuberculosis, with ages ranging between 1 and 15 years of age, who were treated from 1990 to 2001 . The gold standard used to establish the diagnosis was clinical, radiological, epidemiological and based on follow-up data . The score system for diagnosis purposes was tested retrospectively . The median age and the average age of the 164 patients were 6 and 6.62 years (SD +/- 4.33), respectively . About 65% of the sample reported a history of close contact with a tuberculous adult . The BCG vaccine coverage was 70.7% (116/164) . It was found that 26% (43/164) of the patients had severe malnutrition . Out of this group, 26/43 (60.47%) were < 5mm reactive to the tuberculin test . On the other hand, out of the 91 patients with tuberculin test < 5mm, 29% (26/ 91) had severe malnutrition . The use of the score gave the following distribution: a) TB very likely in 81.7% (134/164) of the patients; b) possible TB in 15.9% (26/164) and TB unlikely in 2.4% (4/164) . Among patients who had been vaccinated more than 2 years before, there was a 9 times higher risk of finding a tuberculin test above 10 mm in individuals with probable TB in comparison with the patients with possible or unlikely TB. Eur J Dermatol, 2004 Nov-Dec, 14(6), 421 - 3 Relapsing herpes simplex-2 folliculitis in the beard area; Foti C et al.; We describe the case of a 52-year-old immunocompetent man with recurrent folliculitis on the left cheek, associated with intense pain . Bacteriological, mycological and Tzanck tests from the lesions were negative . Histopathological study showed an aspecific flogosis pattern . Virological tests carried out on swabs and paraffin-embedded tissue sections from the facial lesions by nested PCR technique (nPCR) demonstrated the presence of herpes simplex virus type 2 (HSV\2) in both samples . Skin swabs from other healthy areas of the face resulted negative for herpetic infection . A diagnosis of recurrent herpetic folliculitis by HSV\2 was made . This case report underlines that even in immunocompetent patients HSV\2 lesions can feature atypical clinical aspects . In dermatological assessment the benefits of routine PCR techniques for differential diagnosis of herpetic infection should be considered above all for the prompt initiation of antiviral therapy and appropriate patient management. Transfus Clin Biol, 2004 Oct, 11(4), 221 - 7 {The responsibility of the physician prescriber of blood products}; Hergon E et al.; Blood transfusion presents mainly virological, bacteriological, immunohaematological and volemic risks; with the latter two particularly concerning health establishment employees . This article tackles the physician's responsibility in blood transfusion . Taking into account the regulations that surround the activity, prescribing physicians must know and put into action the relative requirements in their practises in order to avoid taking on its responsibility, or that of the health establishment in which they work, as any lack of respect for the rules and regulations could result in being held liable for any side affects suffered by the patient . The article has the objective of identifying the main regulation requirements in order to control them despite a difficult environment, from the point of view of patients' rights regarding the benefits and the consequences of transfusion . These requirements focus mainly on information and patient consent, the prescription of blood products as well post transfusion information and the follow-up care . Proof of respect for these rule requirements must be available for each of these aspects. Trop Anim Health Prod, 2004 Aug, 36(6), 537 - 46 Evaluation of abattoir inspection for the diagnosis of Mycobacterium bovis infection in cattle at Addis Ababa abattoir; Asseged B et al.; Detailed postmortem examinations were conducted to evaluate the efficiency of meat inspection procedures and to determine the distribution of lesions in Mycobacterium bovis-infected cattle . The study involved routine inspection at slaughter, collection of tissues for detailed examination in the laboratory, and bacteriological examination to identify M . bovis . Additionally, a 10-year (1992--2001) meat inspection record was analysed to determine tuberculosis trends in the past decade . chi2-Test and simple regression were used to analyse the data . Out of 1350 cattle examined, 1.5% were found with tuberculous lesions . Routine abattoir inspection detected only 55% of cattle with confirmed lesions . Fifty-four per cent of tuberculous lesions were found in the lungs and thoracic lymph nodes, 23% in the lymph nodes of the head, and the remaining 23% in the mesenteric and other lymph nodes of the carcase . M . bovis was additionally isolated from an animal that had no gross lesions of tuberculosis . On average, the annual rate of whole-carcase condemnation due to generalized tuberculosis was 0.024% and it has increased annually by 0.34% over the past decade . The rate of whole-carcase condemnation indicates a high degree of TB transmission and requires immediate attention from both the economic and public health points of view . The lower sensitivity of routine abattoir inspection confirms the importance of improving necropsy procedures. Int J Syst Evol Microbiol, 2004 Nov, 54(Pt 6), 1909 - 10 Validation of publication of new names and new combinations previously effectively published outside the IJSEM; Study of the antibody response against Mycobacterium tuberculosis antigens in Warao Amerindian children in Venezuela; Catedra de Immunologia, Escuela de Medicina Jose Maria Vargas, Facultad de Medicina, Universidad Central de Venezuela, Apartado 4043, Caracas 1010A, Venezuela . zaraujo@telcel.net.ve This study was aimed at investigating alternate methods for serodiagnosis of tuberculosis (TB), which are needed because bacteriologic diagnosis of childhood TB is difficult . A selection of 80 serum and saliva samples were tested from Warao indigenous children under 15 years of age; 34 high TB suspects (28 positive and 6 negative for the tuberculin skin test, TST) and 46 healthy contact children (32 positive and 14 negative for the TST) . Several enzyme-linked immunosorbent assay (ELISA) serological tests were developed to test for Mycobacterium tuberculosis-specific antibodies, including serum IgA, IgG, IgE, and secretory IgA (sIgA) in saliva against 3 specific antigens (PPD, HSP60, 38 kDa) . Of these, 2 antigens, PPD and 38 kDa, showed significantly higher reactivity . The sensitivity and specificity of these tests for diagnosis remained limited, between 26.5% and 38.2%, and 77.4% and 97%, respectively . Of all the samples studied and combinations realized between all isotypes and antigens combined with 3 isotypes (anti-PPD IgG, IgE, and anti-38kDa sIgA) managed to detect the largest number of patients, showing an improved sensitivity level of 64.7%, although specificity levels dropped to 81.8% . These results were compared with the Omega diagnostics commercial kit results . The commercial kits showed significantly lower reactivity (sensitivity of 20% and 13.33% to Myco G and Complex Plus, respectively) and a specificity of 100% . This study shows that in indigenous populations of Venezuela, where invasive procedures cannot be used to select samples but evaluation with a chest X-ray for radiological studies is available, the combination of 3 specific isotypes may be a useful tool to increase diagnostic accuracy with pulmonary TB in this population, when used together with clinical and epidemiological criteria. Crit Care Med, 2004 Nov, 32(11 Suppl), S466 - 94 Diagnosis of infection in sepsis: an evidence-based review; Cohen J et al.; OBJECTIVE: In 2003, critical care and infectious disease experts representing 11 international organizations developed management guidelines for the diagnosis of infection in sepsis that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis Campaign, an international effort to increase awareness and improve outcome in severe sepsis . DESIGN: The process included a modified Delphi method, a consensus conference, several subsequent smaller meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee . METHODS: The modified Delphi methodology used for grading recommendations built on a 2001 publication sponsored by the International Sepsis Forum . We undertook a systematic review of the literature graded along five levels to create recommendation grades from A to E, with A being the highest grade . Pediatric considerations to contrast adult and pediatric management are in the article by Parker et al . on p . S591 . CONCLUSIONS: Obtaining a precise bacteriological diagnosis before starting antibiotic therapy is, when possible, of paramount importance for the success of therapeutic strategy during sepsis . Two to three blood cultures should be performed, preferably from a peripheral vein, without interval between samples to avoid delaying therapy . A quantitative approach is preferred in most cases when possible, in particular for catheter-related infections and ventilator-associated pneumonia . Diagnosing community-acquired pneumonia is complex, and a diagnostic algorithm is proposed . Appropriate samples are indicated during soft tissue and intraabdominal infections, but cultures obtained through the drains are discouraged. Cas Lek Cesk, 2004, 143(9), 594 - 7 {Tuberculosis in the Czech Republic in 2003}; Homolka J et al.; BACKGROUND: 1162 new cases of tuberculosis were diagnosed in the Czech Republic in 2003; pulmonary tuberculosis represented 942 cases and in 660 cases the diagnosis of tuberculosis was bacteriologically confirmed . METHODS AND RESULTS: 355 cases were smear positive tuberculosis . The increase of certain TB cases (70%) in 2003 compared to 2002 is not statistically significant (p = 0.031) . The notification rate (incidence) in 2003 was 11,4/100 000 all cases of tuberculosis, 9,2/100 000 pulmonary tuberculosis and 6,5/100 000 certain cases of tuberculosis . CONCLUSIONS: Compared to 2002 a decline of all forms of tuberculosis was observed, this decline however was not statistically significant . The increase in bacteriologically confirmed tuberculosis and smear positive tuberculosis was also not statistically significant. Int J Tuberc Lung Dis, 2004 Oct, 8(10), 1186 - 93 Non-tuberculous mycobacteria: patterns of isolation . A multi-country retrospective survey; Martin-Casabona N et al.; OBJECTIVE: To collect data on non-tuberculous mycobacteria (NTM) isolated from clinical laboratories in different countries to establish: 1) whether the isolation of NTM was increasing, 2) which species were increasing, and 3) whether there was any pattern of geographical distribution . DESIGN: In 1996, the Working Group of the Bacteriology and Immunology Section of the International Union Against Tuberculosis and Lung Disease contacted 50 laboratories in different countries for the necessary information . RESULTS: The number of patients reported with NTM was 36099 from 14 countries . Mycobacterium avium complex, M . gordonae, M . xenopi, M . kansasii and M . fortuitum were the five species most frequently isolated . There was a significant upward trend for M . avium complex and M . xenopi . Pigmented mycobacteria predominated in Belgium, the Czech Republic and the Mediterranean coast of Spain . Non-chromogenic mycobacteria were found to be predominant in the area of the Atlantic coast of Brazil and in Turkey, the United Kingdom, Finland and Denmark . CONCLUSIONS: There was an increase in the number of NTM isolated from clinical samples of patients . Isolation of the most frequent species is constantly changing in most of the geographical areas, and newer species are emerging due to better diagnostic techniques to detect and identify NTM. Schweiz Arch Tierheilkd, 2004 Oct, 146(10), 461 - 8; discussion 469 Porcine circovirus as a possible cause of postweaning wasting in pigs in Switzerland; Staebler S et al.; Postweaning wasting is a major worldwide problem in pig production, particularly with respect to the disease termed postweaning multisystemic wasting syndrome (PMWS) . In addition to wasting, PMWS symptoms include respiratory distress, diarrhoea, pallor and occasional cases of jaundice . The causative agent is porcine circovirus type 2 (PCV-2) . The objective of the present study was to determine the significance of PMWS and similar conditions in Switzerland . A total of 72 weaned piglets from 26 farms showing wasting were examined for the presence of PCV-2 by immunohistochemical and histological analysis and 57 piglets from 21 farms were examined serologically . Possible causes for wasting other than PCV-2 were investigated by macroscopic, histological and bacteriological methods . PCV-2 antigen was identified immunohistochemically in the lymphatic organs in 11 of these 72 piglets . However, only 4 animals showed histological changes typical of PMWS . PCV-2 antibodies were found in 70% of the piglets . Piglets with wasting syndrome not associated with PCV-2 infection suffered from conditions including porcine proliferative enteropathy, gastric ulcers, polyserositis and polyarthritis . The most frequent condition was chronic enteritis not associated to circovirus infection . The results from the serological analyses indicate a wide distribution of PCV-2 in the Swiss pig population . However, confirmed cases of PMWS were rare in the investigated piglets. Med Arh, 2004, 58(4), 253 - 6 {Establishment of the first medical faculty in Bosnia and Herzegovina}; Masic I; After establishment of the medical faculties in Zagreb (1917 year), Ljubljana (1919 year) and Belgrade (1921 gear), by the decision of the minister of the National education of the Independent State Croatia from 31.3.1944 . year, there were establishment the medical faculties in Sarajevo and Split the same year . The Medical faculty in Sarajevo, as the faculty of the University in Zagreb, officially began with the work 22.11.1944 . year by the opening which made the then dean of the Medical faculty in Zagreb professor (doctor) Ante Sercer . For the dean of the Medical faculty in Sarajevo was nominated professor Stanko Sielski, the renown bosnian-herzegovinian physician, the former head of the district bacteriological station in Tuzla and Banja Luka . The access lectures held professor (doctor) Mile Budak, professor (doctor) Ljudevit Thaller, professor (doctor) Ibrahim Ruzdic . The first generation of the students of the school 1944/1945 year numbered about 165 students . The teaching was organized in the complex of the building of the present residance Conac in Sarajevo, and the practical instruction was performed on the basis of the contract with the then General hospital in Sarajevo . The teachers of the faculty were the eminent professors of the Medical faculty at the University in Zagreb . From all the known person, the fact about the so called NDH (IS Croatia) to the medical faculty, for the long time were hidden from the publicity, so that about them was not spoken, till the back several years, either the momentary alive students of the generation . In this article is stated the factographia connected for the establishment and functionioning of the mentioned first medical faculty in Bosnia and Herzegovina. Presse Med, 2004 Sep 11, 33(15), 1012 - 8 {Clinical and biological manifestations of adult-onset Still's disease}; Pouchot J et al.; A TRIAD OF FEATURES: Adult onset Still's disease (ASD) is an uncommon disorder usually associating high spiking fever, evanescent skin rash constituted of small salmon pink macules, and arthritis . NUMEROUS SYSTEMIC MANIFESTATIONS: A sore throat is common and often misleading . More than 60% of the patients develop mobile and indolent lymph nodes, usually in the cervical area . Liver involvement is common and usually limited to a mild or moderate cytolysis . However, several observations of severe hepatitis have been reported justifying strict monitoring of the liver biology in these patients . Amongst the other numerous systemic manifestations that have been reported, pericarditis is common and sometimes responsible for tamponade, the pulmonary involvement may lead to an acute respiratory distress, and the rare neurological manifestations include aseptic meningitis or cranial nerve palsy . FROM A BIOLOGICAL POINT OF VIEW: The sedimentation rate is consistently elevated and there is usually a marked elevation in the polymorphonuclears . The bacteriological survey is negative as are the immunological tests . An increase in the serum level of IL-18 might be both diagnostic and prognostic . It is the increase of the serum level of ferritin and the marked decrease in its glycosylated fraction below 20% that seem to be of more potent diagnostic value. Chir Narzadow Ruchu Ortop Pol, 2004, 69(3), 179 - 84 {Revision hip arthroplasty after prosthesis removal in septic loosening}; Krol R; The author presents the therapeutic protocol in "hanging hip" after prosthesis removal in septic loosening, basing on a series of 11 patients--7 females and 4 males--age ranging from 31 to 67 years . On average the primary prosthesis was removed 2.5 years after implantation, while patients remained with a "hanging hip" for an average period of 2.2 years (limb shortening before revision arthroplasty was on average 4.5cm) . When qualifying patients for revision arthroplasty the following parameters were taken into account: sedimentation rate, CRP creactive protein levels, bacteriological blood culture results, cultures from the hip punctate, every-day life activity and post-op patient compliance with the therapy . Acetabular roof defects were managed according to Zuk's method . Clinical assessment of the patients was performed 6 weeks, 3, 6 and 12 months using Merle-d'Aubigne and Postel classification, while X-rays were used to assess proper prosthesis implantation . During follow-up proper prosthesis implantation was found in all cases, while no signs of re-infection, nor radiological and clinical signs of implant loosening were noted . Clinical assessment of the patients yielded 1 very good result, 7 good results and 3 satisfactory . The presented material indicates that good results can be obtained in prosthesis reimplantation after removal of the primary prosthesis because of its septic loosening. J Clin Neurosci, 2004 Nov, 11(8), 901 - 2 Meningitis and pneuomocephalus . A rare complication of external dacryocystorhinostomy; Usul H et al.; Meningitis due to fracture of the fovea ethmoidalis during external dacryocystorhinostomy is a rare complication . We report a case of pneumocephalus and meningitis in a 51-year-old female who underwent an external dacryocystorhinostomy (DCR) . Although extracranial complications during or after external DCR have been well-described, only one case of meningitis has been reported in the literature . Physical examination, computerised tomography, lumbar puncture, and bacteriologic cultures were used to make the diagnosis . The patient responded well to antibiotic therapy . Her symptoms resolved immediately and she was discharged on the 21st post-operative day . This complication emphasises the importance of careful surgical technique and a thorough knowledge of regional anatomy, during DCR and similar procedures. Nihon Kokyuki Gakkai Zasshi, 2004 Sep, 42(9), 810 - 4 {Pulmonary infection with Nocardia species: a report of 10 cases}; Takiguchi Y et al.; OBJECTIVE: To investigate the clinical features of pulmonary nocardiosis . PATIENTS AND METHODS: We retrospectively reviewed ten consecutive patients (5 men, 5 women; aged 25 to 80 years (average 49.3 years)) with confirmed bacteriological pulmonary nocardiosis from 1998 to 2003 . Patients were divided into two groups: infected (8 patients) and isolated (2 patients) . RESULTS: All patients had predisposing factors and/or pulmonary disease . Six were immunosuppressed by steroid therapy with or without other immunosuppressive drugs . The overall survival rate among infected patients was 75.0% (6/8), but the survival rate of patients who were diagnosed speedily by a gram-stain procedure was 85.7% (6/7) . CONCLUSIONS: Although pulmonary nocardiosis is difficult to diagnose, prompt use of the gram-staining procedure and appropriate treatment appeared to improve survival . And new diagnostic method is desirable. Gesundheitswesen, 2004 Oct, 66(10), 682 - 7 {Surface disinfection in nursing homes -- what is the actual state? Checkup study in three Duisburg nursing homes}; Martin U et al.; The effectiveness of cleaning and disinfection of environmental surfaces was evaluated in three nursing homes using bacteriological monitoring . Samples from inmates (nose, throat and wounds) and surface cleaning equipment were also taken . Cleaning solutions, disinfectants and cleaning clothes were found to be highly contaminated in two of three institutions . Referring to the surfaces in some cases disinfection didn't reduce bacterial colony counts and seeded MRSA as a potential pathogen in one nursing home . Six MRSA-positive inmates and identical strains were registered in the environment . MRSA can be used as a marker organism to demonstrate effectiveness of cleaning . To achieve further improvement bacteriological monitoring can help in focussing special cleaning and disinfection related problems. Biomedica, 2004 Jun, 24 Supp 1, 65 - 72 {Surgical treatment of multiresistant lung tuberculosis}; Tobon A et al.; Drug resistance has become a major problem in the treatment of tuberculosis . Pulmonary resection in combination with chemotherapy appears to be an effective measure for the treatment of multi-drug resistant pulmonary tuberculosis . A retrospective review was performed of the medical and laboratory findings of 28 patients with multi-drug resistant tuberculosis who underwent pulmonary resection for pulmonary tuberculosis between January 1990 and December 2000 at La Maria Hospital, Medellin . Twenty-one of them had medical therapy before surgery; 14 patients underwent upper lobectomy and 10 patients pneumonectomy) . The AFB negative sputum conversion rate was 88.9% (25/27) after surgery, during an average of 6 weeks . Bacteriological relapses were confirmed in 6 of 27, 4 of these 6 had AFB negative sputum . Twenty-eight patients had medical therapy after surgery . For selected patients, pulmonary resection in combination with chemotherapy should be considered an effective measure for treatment of multi-drug resistant pulmonary tuberculosis. Cochrane Database Syst Rev . 2004 Oct 18;(4):CD004495. Antibiotic regimens for suspected early neonatal sepsis; Mtitimila E et al.; BACKGROUND: Early acquired infection may cause severe illness or death in the neonatal period . Prompt treatment with antibiotics has shown to reduce mortality . It is not clear which antibiotic regimen is suitable for treatment of presumed early neonatal sepsis . OBJECTIVES: To compare effectiveness and adverse effects of antibiotic regimens for treatment of presumed early neonatal sepsis . SEARCH STRATEGY: The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2003), MEDLINE (1966 to August 2003), EMBASE (1980 to September 2003) and ZETOC (1993 to August 2003) databases were searched for possible studies . Pharmaceutical companies were contacted for any unpublished data . SELECTION CRITERIA: Randomised and quasi-randomised controlled studies comparing antibiotic regimens for the treatment of early neonatal sepsis (both monotherapies and combination therapies) . DATA COLLECTION AND ANALYSIS: Both reviewers screened abstracts and full reports against the inclusion criteria, appraised the quality of and extracted data from papers . For dichotomous outcomes, treatment effect was expressed as relative risk with 95% confidence interval . Meta-analysis was performed using a fixed effect model . MAIN RESULTS: Two small studies had compared monotherapy with combination therapy . There was no significant difference in mortality, treatment failure or bacteriological resistance . REVIEWERS' CONCLUSIONS: There is no evidence from randomised trials to suggest that any antibiotic regimen may be better than any other in the treatment of presumed early neonatal sepsis . More studies are needed to resolve this issue. Mikrobiyol Bul, 2004 Jul, 38(3), 253 - 6 {Case report: subdural hemorrhage in neurobrucellosis}; Tuncer Ertem G et al.; In this report, a 49-year-old female patient who were diagnosed as neurobrucellosis by the clinical, bacteriologic and serologic findings, has been presented . The case deserved presentation and discussion since it presented with subdural hemorrhage which is a rare complication of neurobrucellosis. Eur J Radiol, 2004 Nov, 52(2), 175 - 9 Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis; Chung MJ et al.; OBJECTIVES: Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk of pulmonary tuberculosis . However, detecting pulmonary tuberculosis may be difficult due to the underlying fibrosis . The aim of this report is to describe the radiological and clinical findings of pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis . MATERIALS AND METHODS: We reviewed 143 consecutive patients in whom IPF was diagnosed by either the histological or radio-clinical criteria . Among them, nine patients were histologically (n=2) or bacteriologically (n=7) confirmed to have active pulmonary tuberculosis . The location and patterns of pulmonary tuberculosis were examined on a thin section CT scan . RESULTS: The most common thin section CT findings were subpleural nodules (n=6; mean diameter, 3.2 cm) and a lobar or segmental consolidation (n=3) . The lesions were located most commonly in the right lower lobe (n=4) . The incidence of tuberculosis in patients with idiopathic pulmonary fibrosis was more than five times higher than that of the general population . CONCLUSION: The atypical manifestation of pulmonary tuberculosis is common in patients with idiopathic pulmonary fibrosis, which may mimic lung cancer or bacterial pneumonia. J Dairy Sci, 2004 Nov, 87(11), 3770 - 7 Cow-level prevalence of paratuberculosis in culled dairy cows in Atlantic Canada and Maine; McKenna SL et al.; The prevalence of Mycobacterium avium ssp . paratuberculosis (Mptb) in culled dairy cattle in Eastern Canada and Maine was determined to be 16.1% (95% confidence interval 13.8 to 18.3%) based on a systematic random sample of abattoir cattle . Mesenteric lymph nodes and ileum from 984 cows were examined by histologic and bacteriologic methods . Histological testing was far less sensitive than bacteriologic methods for detecting infected cattle . A seasonal pattern of positive cows was also detected, with the highest proportion of cows being Mptb-positive in June (42.5%) . Overall, body condition score was not associated with prevalence of Mptb isolation. Expert Rev Anti Infect Ther, 2004 Oct, 2(5), 787 - 94 Kingella kingae infections of the skeletal system in children: diagnosis and therapy; Yagupsky P; As the result of improved bacteriological techniques, Kingella kingae is emerging as an important cause of infections of the skeletal system in children younger than 2 years of age . This review details the bacteriological features and detection methods of this pathogen, as well as the epidemiology, clinical presentation, treatment and prognosis of septic arthritis, osteomyelitis and diskitis caused by the organism. Semin Pediatr Infect Dis, 2004 Jul, 15(3), 150 - 4 Tuberculosis in children: considerations for children from developing countries; Nelson LJ et al.; Although accurate data are scarce for children, tuberculosis (TB) represents one of the most common infectious causes of morbidity and mortality worldwide . TB case rates have declined among children in the United States in the last decade, but they remain high among children from low-income countries and racial or ethnic minorities . Establishing the definitive diagnosis of TB in a child remains difficult and frequently relies on a constellation of history, clinical findings, and bacteriology . Recently, updated national and international treatment recommendations have been published . Contact investigation and treatment using directly observed therapy are important components of the optimal case detection and management of TB in children. J Foot Ankle Surg, 2004 Sep-Oct, 43(5), 321 - 6 Total extrusion of the talus: a case report; Montoli C et al.; Total extrusion of the talus without recovery of the bone is a very unusual injury . The authors present a case of a 25-year-old man who sustained an open total enucleation of the talus in a motorcycle accident . The talus was not recovered at the scene of the accident . An immediate tibiocalcaneal stabilization was performed by using an external fixator . In the postoperative period, a polymicrobic infection was observed and treated with parenteral antibiotics . Nine months after injury, the patient developed an infection of both the empty space and the distal third of the tibia . A wound debridement with tibial sequestrectomy and insertion of gentamicin-impregnated polymethylmethacrylate beads was performed . Three months later, after multiple negative bacteriologic examinations, a tibiocalcaneal arthrodesis with staples and autogenous bone graft was performed . Because of a pseudoarthrosis, the patient underwent a revision of the arthrodesis by retrograde tibiocalcaneal nailing, achieving clinical and radiographic success . The definitive treatment of total enucleation of the talus is still controversial because of its rarity and the high rate of complications, such as avascular necrosis, osteomyelitis, and ankle stiffness . In this case, without recovery of the talus, retrograde nailing afforded good stability by bypassing the bone defects. Probl Tuberk Bolezn Legk, 2004, (8), 28 - 30 {A role of the biological chip test in the determination of rifampicin resistance in Mycobacteria in adolescents with active pulmonary tuberculosis}; Firsova VA et al.; Forty-nine adolescents with active pulmonary tuberculosis were followed up to assess the biological chip test for the detection of rifampicin resistance in Mycobacterium tuberculosis (MBT) . Rifampicin resistance (rpo B gene mutation) was detected in 22 (44.9%) patients . Disseminated processes were detected in a larger proportion of the patients with rifampicin resistance than in those with MBT susceptibility (63.6 and 40.7%, respectively (p < 0.05) . Comparison of the data on MBT resistance and susceptibility, which had been obtained by bacteriological studies (nutrient medium cultuvations) and the biological chip test, revealed their agreement in 50% of the cases . A response could be showed after 2-3 months in the former case and after 2-3 days in the latter case . With the biological chip test, the resistance of MBT to rifampicin was additionally established in 38.7% of the patients with negative cultivation tests on admission and during therapy . Follow-ups have demonstrated that MBT resistance to rifampicin preserves longer with the biological microchip test than that with nutrient medium cultivation. Osiris, 2004, 19, 133 - 48 Mapping a zoonotic disease: Anglo-American efforts to control bovine tuberculosis before World War I; Jones SD; Before World War I, British and American public health officials correlated tuberculosis in dairy cattle with severe infections in milk-drinking children . They traced bacteria in municipal milk supplies, mapped the locations of infected animals, and sought regulatory power to destroy them . Consumers, milk producers, municipal officials, veterinarians, and physicians all influenced the shape of antituberculosis regulations . Many condemned pasteurization as too costly and as masking tubercular contamination and poor sanitation . They saw milk-borne tuberculosis as an environmental as well as a bacteriological problem . Similar to other zoonotic diseases such as BSE, bovine tuberculosis blurred the boundaries between urban and rural, production and consumption, and human and animal bodies. Khirurgiia (Mosk), 2004, (10), 31 - 3 {Treatment of intestinal insufficiency syndrome in patients with peritonitis}; Immune response in burn patients in relation to HIV infection and sepsis; Department of Surgery, University of Zimbabwe, Harare, Zimbabwe . thomas.sjoberg@unn.no The post-burn immune dysfunction predisposes patients to sepsis and multiple organ failure leading to increased mortality . HIV infection also results in a depressed immune response . The combination of burn injury and HIV might therefore lead to an increased morbidity and mortality as compared to non-HIV infected burn patients . Twenty burn patients and 10 healthy volunteers were included in a prospective study . To evaluate their immune status, CD4+ and CD8+ T-lymphocyte counts were determined in peripheral blood . HIV serology samples were obtained on admission . Bacteriological cultures were obtained from wound surface samples and wound tissue biopsies . Six burn patients were HIV infected . Clinical signs of sepsis were observed in 10 patients . The number of CD4+ T-lymphocytes were lower in burn patients compared to healthy volunteers (P < 0.05) . HIV infected burn patients had lower CD4+ lymphocyte counts than non-HIV infected patients (P < 0.05) . Patients with clinical signs of sepsis had lower CD4+ counts compared to patients without sepsis (P < 0.05) . There was no difference in the mortality rate or the length of hospitalisation between patient groups . Burn injury, HIV infection and sepsis independently result in immunosuppression. Trop Gastroenterol, 2004 Apr-Jun, 25(2), 73 - 5 C-reactive protein in patients with gallbladder and biliary tract diseases; Vaishnavi C et al.; C-reactive protein (CRP) assay is widely used as a clinical tool for the evaluation of bacterial infections . No study has been undertaken to evaluate the presence of CRP and/or the estimation of this protein in the bile of patients with diseases of the gallbladder (GB) . In the present study, we estimated the quantity of CRP in bile (n=358) as well as serum samples (n=186) obtained from patients with GB and biliary tract diseases, using the semiquantitative Avitex CRP kit . Bacteriological study was also done on the bile samples . CRP was positive in the bile of 56 patients, (15.6%) many of who had bacteriobilia . CRP was also present in 49 of the serum samples studied (26.3%) . Control serum samples did not show any CRP within detectable limits . Hitherto, this is the first report that investigated the level of CRP in the bile of patients with GB and biliary tract diseases, along with biliary bacterial profile. Acta Otorrinolaringol Esp, 2004 May, 55(5), 240 - 3 {Primary nasal tuberculosis: a forgotten disease?}; Agulles Fornes MJ et al.; Nasal tuberculosis represents a rare manifestation of infection by Mycobacterium tuberculosis . Clinically, it appeared to resemble cancer presenting as a nasopharyngeal mass with concomitant enlarged lymph nodes . It is important to consider tuberculosis in the differential diagnosis of all nasopharyngeal lesions and take biopsy samples for histological and bacteriological studies . Antituberculosis treatment is satisfactory with standard anti-tuberculous chemotherapy . Although this is a rare finding, it should be considered when a patient presents with nasal obstruction. Reprod Nutr Dev, 2004 May-Jun, 44(3), 243 - 50 Effect of frozen semen on the uterus of mares with pathological uterine changes; Guvenc K et al.; Pregnancy rates after frozen semen inseminations (AI), particularly in older and problem mares, are lower than after fresh semen AI . Uterine contractility and the inflammatory reaction after frozen semen insemination were studied in two groups of mares: the abnormal group comprised of 6 old barren mares categorized in biopsy category IIB or III, and the control group including 6 reproductively normal young maiden mares in biopsy category I or IIA . All 12 mares were inseminated in the first cycle with 2 mL of phosphate-buffered saline (PBS) and in their second cycle with 2 mL of frozen semen containing 800 x 10(6) spermatozoa . Before and 1, 2, 4, 8, and 20 to 24 h after this treatment, all mares were examined by ultrasonography for intrauterine fluid accumulations (IUFA) . The examinations were videotaped to count the number of uterine contractions later . Uterine fluid was obtained by tampon before treatment, and by the tampon method followed by uterine lavage after the last examination . Fluids were cultured bacteriologically, and polymorphonuclear leukocytes (PMN) were counted . Trypsin-inhibitor capacity (TIC), lysozyme concentration, and beta-glucuronidase (BGase) and N-acetyl-beta-D-glucosaminidase (NAGase) activities were determined in frozen-thawed tampon and lavage fluids . Both treatments induced significant neutrophilia in the uterine lumen . Although PMN concentrations were numerically higher after frozen semen AI than after PBS-treatment, the difference was not significant . There was not any difference between the mare groups either . The amount of IUFA differed only in the normal group between frozen semen AI and PBS treatment, and between 0- and 24-h samples for frozen semen AI . Although abnormal mares showed consistently more fluid than normal mares, this difference was not significant . Uterine contractions and enzyme concentrations between groups did not differ . None of the variables showed significant differences between the normal and abnormal mares in their reaction to frozen semen AI. Mol Microbiol, 2004 Oct, 54(1), 2 - 13 A network of net-workers: report of the Euresco conference on 'Bacterial Neural Networks' held at San Feliu (Spain) from 8 to 14 May 2004; Hellingwerf KJ; In May 2004, over 100 bacteriologists from 19 different countries discussed recent progress in identification and understanding of individual signal transfer mechanisms in bacteria and in the mutual interactions between these systems to form a functional living cell . The meeting was held in San Feliu and supported by ESF and EMBO . In part through the extensive sequencing efforts of the past few years, the bulk of the bacterial signal transfer systems have been resolved and their detailed characterization is revealing such characteristics as signal specificity, signalling rate constants, molecular interaction affinities, subcellular localization, etc., which should provide a solid basis to a computational extension of this field of studies . In parallel, the new genomics techniques are providing tools to characterize the way a collection of such systems interact in an individual cell, to give rise to 'life' . Systems theory provides rational and convenient ways to bring order to the wide range of observables thus obtained . Ultimately, the performance of engineered design will have to prove whether or not we know enough about the processes involved. Chir Ital, 2004 Jul-Aug, 56(4), 563 - 5 Percutaneous drainage and surgery for splenic abscess: a case report; Ferronato M et al.; Splenic abscess is a rare clinical entity; however, thanks to the refinement of diagnostic techniques and to the increase of population at risk its presence is discovered more frequently . In our ward we evaluated a patient by ematochimical and bacteriological exams and abdomen CT . After antibiotical therapy and percutaneous drainage the patient was discharged on the fifteenth day . One month later the patient returned to our emergency room: for the presence of two intrasplenic lesions; he underwent splenectomy . Six month after the operation, the patient was healty . The two methods (surgery and radiological drainage) cannot be compared because the indications are different . Therefore a progressively invasive therapeutic approach would appear to be indicated . If this not successful, splenectomy performed whit laparoscopic or laparotomic techniques should follow. Int J Syst Evol Microbiol, 2004 Sep, 54(Pt 5), 1905 - 6 A replacement name of the specific epithet aurantiaca in Micromonospora aurantiaca Sveshnikova et al . 1969 (Approved Lists 1980) and a proposal to treat the combination Micromonospora aurantiaca Sveshnikova et al . 1969 as a rejected name . Request for an opinion; Euzeby JP et al.; According to Rules and Principles of the Bacteriological Code (1990 Revision), Micromonospora aurantiaca Sveshnikova et al . 1969 (Approved Lists 1980) is not correct because the specific epithet is illegitimate . The authors request the replacement of the specific epithet aurantiaca and they suggest sandarakina . They also request that the specific epithet aurantiaca in M . aurantiaca be rejected. Int J Syst Evol Microbiol, 2004 Sep, 54(Pt 5), 1425 - 6 Validation of publication of new names and new combinations previously effectively published outside the IJSEM; Soybean: feed quality and safety . Part 1: biologically active components . A review; Institute of Animal Breeding, Nutrition and Laboratory Animal Science, Faculty of Veterinary Science, Szent Istvan University, H-1078 Budapest, Istvan u 2, Hungary . icsaky@univet.hu A large number of soybean components have diverse biological activities . These include hormonal, immunological, bacteriological and digestive effects . The presently known allergens are listed . The divergence between chemical evaluation and biological value is highlighted . The following components are discussed: Kunitz inhibitor, Bowman-Birk inhibitor, saponins, soyacystatin, phytoestrogens (daidzein, glycitein, genistein), Maillard products, soybean hydrophobic protein, soy allergens, lecithin allergens, raffinose, stachyose, 2-pentyl pyridine . The studies describing the effects of the isolated components are reviewed. J Invest Surg, 2004 Jul-Aug, 17(4), 203 - 9 The role of antibiotic prophylaxis with sodium ceftriaxone to prevent bacterial translocation associated with hypovolemic shock: an experimental study in rats; Weber EL et al.; One of the measures adopted to reduce or prevent intestinal bacterial translocation (BT) in patients who are in hemorrhagic shock consists of prophylactic antibiotics . This study attempted to assess the effectiveness of administering systemic antibiotic to suppress BT in rats submitted to hemorrhagic shock . Sixty-eight male Wistar rats were divided into two experiments . In experiment 1 (n = 28), the animals were randomly divided into three groups: group I (n = 7), sham operation; group II (n = 11), constituted by animals that were submitted to hemorrhagic shock by removing 40% of the volemia, and were resuscitated after 40 min of sustained shock, replacing the previously removed blood; and group III (n = 10), animals that, besides hemorrhagic shock and volemic replacement, received 50 mg/kg of sodium ceftriaxone intravenous 1 min after blood readministration . Mesenteric lymph nodes (MLN) for culture tests and segments of the small bowel were removed for histopathological studies 1 day after the operation in the three groups . In experiment 2, the same procedures were performed, except the laparotomy for removing MLN and segments of jejunal and ileal bowel, but the animals were followed during 7 days, in order to evaluate the mortality rate . In the control group (group I), the bacteriological assessment of the MLN was negative in all cases . Only 40% of the animals treated with antibiotics after hypovolemic shock (group III) presented positive bacteriological exams of the MLN, and this rate was 90% in the group of animals that did not receive this substance (group II) (p < .05) . Escherichia coli was the bacteria identified most frequently in culture tests (92.8%) . The villosities atrophy and inflammatory infiltrate of the lamina propria were the most common histological changes in the bowel, although the intensity was similar in groups II and III (p > .05), but more intense that in group I (p < .05) . The mortality rates in groups I, II, and III 7 days after hypovolemic shock were 0%, 20%, and 20%, respectively . Prophylactic antibiotics significantly reduced the presence of bacteria in the MLN in situations of hypovolemic shock, in rats . This was probably related to a lower BT . However, this aspect did not modify the mortality rate of the animals . Also, the possibility that BT may not have a significant influence in this outcome should be considered. Ann Clin Microbiol Antimicrob . 2004 Sep 15;3(1):17. Incidence, risk factors and mortality of nosocomial pneumonia in Intensive Care Units: A prospective study; Alp E et al.; To determine the frequency, risk factors and mortality of nosocomial pneumonia a prospective study was conducted in the intensive care units . In the study period, 2402 patients were included . The nosocomial pneumonia was defined according to the Centers for Disease Control Criteria . Overall, 163 (6.8%) of the patients developed nosocomial pneumonia and 75.5% (n = 123) of all patients with nosocomial pneumonia were ventilator-associated pneumonia . 163 patients who were admitted to the intensive care unit during the same period but had no bacteriologic or histologic evidence of pneumonia were used as a control group . The APACHE II score, coma, hypoalbuminemia, mechanical ventilation, tracheotomy, presence of nasogastric tube were found as independent risk factors . Crude and attributable mortality were 65% and 52.6%, respectively . The mortality rate was five times greater in the cases (OR: 5.2; CI 95%: 3.2-8.3) . The mean length of stay in the intensive care unit and hospital in the cases were longer than controls (p < 0.0001) . Patients requiring mechanical ventilation have a high frequency of nosocomial pneumonia. Gesnerus, 2004, 61(1-2), 5 - 23 {The explicative models of infectious diseases in Canada in the 19th Century}; Goulet D et al.; Until the last third of the 19th Century in Canada, physicians looked for the causes of infectious diseases and adopted explicative models associated to airist theories, climatic variations and the physical environment . Rarely did they mention the social environment . Yet, the interpretation of disease plays a fundamental role in the elaboration of preventive measures . Consequently, Canadian physicians adopted a naturalist approach based on local sanitation rather than a social approach of the disease . This reinforced the concept of "predisposing causes" . By examining local conditions and, to a lesser extent, the living conditions of Quebec's population, the pre-bacteriologist theories prepared the way for the intervention of modern hygienists. Hand Surg, 2004 Jul, 9(1), 109 - 13 A case of tuberculous tenosynovitis in a patient with systemic lupus erythematosus; Fukui A et al.; A 52-year-old woman with systemic lupus erythematosus (SLE) was infected with tuberculosis (TB) on her forearm and hand, after 16 years of steroid therapy . Debridements and anti-TB therapy were performed successfully . Recently, the risk of significant morbidity from TB has been on the rise; this appears to be a complication of steroid therapy used to treat AIDS and some collagen vascular diseases . It is thought that steroid therapy causes an increased risk of TB . In this paper, we report our experience of this SLE patient who developed tuberculous tenosynovitis . We suggest that TB infection must be considered in the differential diagnosis whenever a patient presents with a chronic wrist or hand inflammation that is non-responsive to steroid treatment . Once TB infection is suspected, both histopathological and bacteriological examinations should be performed . Emergent treatment includes surgical debridement and the institution of early anti-TB therapy immediately after completing histopathological examination. Otolaryngol Head Neck Surg, 2004 Sep, 131(3), 207 - 14 Efficacy and safety of oral telithromycin once daily for 5 days versus moxifloxacin once daily for 10 days in the treatment of acute bacterial rhinosinusitis; Ferguson BJ et al.; OBJECTIVE: To compare the clinical and bacteriologic efficacy and safety of short-duration treatment with telithromycin given for 5 days with moxifloxacin given for 10 days in adults with acute bacterial rhinosinusitis (ABRS) . STUDY DESIGN: In this prospective, double-blind, parallel-group, randomized, multicenter study, adult patients (N = 349) with ABRS were randomized to oral telithromycin (800 mg once daily for 5 days) or to oral moxifloxacin (400 mg once daily for 10 days) and followed for 31 to 36 days . Clinical outcome was determined by the investigator at the posttherapy/test of cure (TOC) visit . Bacteriologic outcome was determined by comparing cultures taken at the pretreatment visit with cultures obtained at the posttherapy/TOC visit . The primary objective was to demonstrate equivalence of clinical cure rates in the per-protocol population between treatment groups at the posttherapy/TOC visit . RESULTS: Clinical success at TOC (primary endpoint) was achieved in 87.4% of patients in the telithromycin group compared with 86.9% for moxifloxacin (per-protocol patients; 0.5% difference between treatment groups; 95% confidence interval {CI}, -8.1, 9.2; P = 0.8930) . The bacteriologic success rates were 94.1% and 93.9%, respectively (0.2% difference between treatment groups; 95% CI, -14.2, 14.5; P = 0.9734) . Overall treatment-emergent adverse events for both drugs (mostly gastrointestinal) were mild to moderate in intensity . CONCLUSION AND SIGNIFICANCE: The clinical and bacteriologic efficacy of telithromycin 800 mg once daily for 5 days was equivalent to that of moxifloxacin 400 mg once daily for 10 days, establishing telithromycin as an important treatment option for ABRS. Hist Sci Med, 2004 Apr-Jun, 38(2), 177 - 89 {Bacteriological war (1916-1933): from anecdote to terror}; Regnier C; Rotten corpses were occasionally used as weapons in the Antiquity . So wells and springs were usually contaminated . In 1915-1916, just after the use of poison gas on the battlefield, bacteriological suspensions were prepared to destroy men and cattle in Europe, Russia and the United of America but the attempts of using bacteriological weapons remained inefficient . Moreover the evidences of this use during the Great War are very fragile.After the war there was a consensus about inhumanity of this weapon which yet might be used if the enemy did it . Between 1925 and 1933 the debates in the Society of Nations proved that bacteriological war was possible in spite of a compromise solution between some nations . Then English journalist Wickdam Steed disclosed the German tries of bacteriological weapons in the Paris metro and the London tube in 1933 (Was this article a manipulation?). Clin Diagn Lab Immunol, 2004 Sep, 11(5), 942 - 51 Epitope-specific antibody levels demonstrate recognition of new epitopes and changes in titer but not affinity during treatment of tuberculosis; Bothamley GH; Antibody levels rise during treatment of tuberculosis . This study examined when this rise occurred, whether there was recognition of new antigen binding sites (epitopes) on the same or different antigens, and how long specific antibody persisted . Forty patients with smear-positive pulmonary tuberculosis provided serum before and during treatment . Antibody levels were measured using a monoclonal antibody competition assay to epitopes restricted to the Mycobacterium tuberculosis complex and an enzyme-linked immunosorbent assay for lipoarabinomannan . Significant increases in antibody levels were apparent after 7 days of treatment . Five samples (12.5%) had positive titers to all epitopes at the start of treatment, and this increased to 23 (58%) during treatment . Antibody to epitopes with the poorest sensitivity (the TB23 epitope of the 19-kDa antigen and the TB78 epitope of hsp65) showed the greatest increases after treatment . Antibody to these two epitopes was also absent in some patients with relapsed tuberculosis until after treatment . Antibody titers showed a biphasic response, with a fall at 2 to 3 months of treatment . Sera from two patients showed changes in the affinity of epitope-specific antibody during treatment, whereas the majority did not . Those infected with isoniazid-resistant strains of M . tuberculosis showed a late rise in antibody . Antibody to the TB68 epitope of the 16-kDa alpha-crystallin homolog was short-lived, but it recurred with bacteriological relapse during treatment . Positive antibody titers persisted for at least 3 to 18 months after treatment . Diagnostic tests for tuberculosis should be evaluated using only pretreatment sera . Delayed antigenic recognition could be due to active suppression and/or failure to engage internal antigens of M . tuberculosis. Mol Gen Mikrobiol Virusol, 2004, (3), 11 - 20 {PCR with subsequent sequencing of the 16S gene rRNA in species identification of mycobacteria of the non-tuberculosis complex}; Maiorova AA et al.; One hundred of mycobacterium cultures were assayed by the method of PCR with subsequent sequencing of the 16S rRNA region . The below mycobacterium species were identified: M . tuberculosis complex (n = 55), M . avium (n = 17), M . intracellulare (n = 4), M . scrofaleceum (n = 2), M . kansasii - M . gastri (n = 3), M . gordonae (n = 3), M . ulcerans - M . marinum (n = 1), M . smegmatis (m = 2), M . fortuitum (n = 11), M . peregrinum (n = 1) and M . chelonae - M . abscessus (n = 1) . The method enabled the differentiation of species M . avium from M . intracellulare and M . peregrinum from M . fortuitum, which could not be differentiated by using the classic biochemical and bacteriological methods . Genetic heterogeneity of the mycobacterium strains of M . avium, M . fortuitum and M . gordonae was also established by PCR plus sequencing of the 16S rRNA region. Kekkaku, 2004 Jul, 79(7), 453 - 7 {A case of cervical and mediastinal lymph nodes tuberculosis, tuberculous pleurisy, spinal caries and cold abscess in the anterior chest wall}; Iwata Y et al.; A 61-year-old woman with schizophrenia that had been treated in a psychiatric hospital was admitted to our hospital because of subileus and back pain . Though subileus was improved, she had a sudden attack of fever 7 days later and developed right pleural effusion, a cold abscess in the anterior chest wall and swelling of a thumb-sized right cervical lymph node which broke through the skin . We made a diagnosis of cervical and mediastinal lymph nodes tuberculosis, tuberculous pleurisy, spinal caries and cold abscess in the anterior chest wall due to the biopsy findings of the specimen taken from the cervical lymph node, examination of pleural effusion, chest CT, bacteriological examination of the cold abscess and spinal MRI . We started chemotherapy with the antituberculous drugs (HRSZ) and symptoms except back pain improved . She complained of paresis of the both lower extremities, which completely paralyzed 8 months later in spite of continued chemotherapy . Thereafter her paralysis was gradually improved and she was able to walk by herself after 12 months chemotherapy. Head Neck, 2004 Sep, 26(9), 823 - 8 Efficacy of piperacillin-tazobactam in the treatment of surgical wound infection after clean-contaminated head and neck oncologic surgery; Rodrigo JP et al.; BACKGROUND: Although perioperative antibiotic prophylaxis has significantly reduced surgical wound infection rates, this complication is still a frequent complication of head and neck cancer surgery . Because these infections are typically polymicrobial, our study evaluated the safety and efficacy of piperacillin-tazobactam in the treatment of surgical wound infection after clean-contaminated head and neck oncologic surgery . METHODS: In this multicenter, prospective clinical trial, 70 patients with surgical wound infection received piperacillin-tazobactam . RESULTS: Of patients who were evaluable, 92.4% were also clinically cured or improved, and the bacteriologic eradication rate was 80.3% . Of the 70 patients enrolled in the study, six (8.5%) experienced six adverse events: two cases of moderate diarrhea, one allergic skin reaction, and three cases of phlebitis . No deaths were attributable to the study drug . CONCLUSIONS: Piperacillin-tazobactam is a good choice of treatment as monotherapy for surgical wound infection after clean-contaminated head and neck oncologic surgery . J Mater Sci Mater Med, 2001 Feb, 12(2), 107 - 10 Stability study of tetracyclines with respect to their use in slow release systems; Honnorat-Benabbou VC et al.; In the aim of optimizing implantable slow-release systems for the local delivery of antibiotics, the stability of tetracyclines was studied in water at 37 degrees C or under gamma irradiation . Four tetracyclines in their chlorhydrate form were chosen depending on their hydrophilic/hydrophobic balance . Their chemical stability was established by HPLC, and biological stability by bacteriological tests . It was shown that methacycline and doxycycline are stable in water for three days . Tetracycline and minocycline exhibit limited decomposition (less than 10%) under the same conditions . So, in vitro drug release for at most three days, appears to be possible . Besides, all four tetracyclines either in powdered form or included in a calcium phosphate matrix, kept their bacteriological activity after gamma irradiation at 32.4 kGr . Consequently, the in vivo study of these implantable slow drug release systems, can be carried out. Appl Environ Microbiol, 2004 Sep, 70(9), 5343 - 8 Comparison of fluorescence microscopy and solid-phase cytometry methods for counting bacteria in water; Lisle JT et al.; Total direct counts of bacterial abundance are central in assessing the biomass and bacteriological quality of water in ecological and industrial applications . Several factors have been identified that contribute to the variability in bacterial abundance counts when using fluorescent microscopy, the most significant of which is retaining an adequate number of cells per filter to ensure an acceptable level of statistical confidence in the resulting data . Previous studies that have assessed the components of total-direct-count methods that contribute to this variance have attempted to maintain a bacterial cell abundance value per filter of approximately 10(6) cells filter(-1) . In this study we have established the lower limit for the number of bacterial cells per filter at which the statistical reliability of the abundance estimate is no longer acceptable . Our results indicate that when the numbers of bacterial cells per filter were progressively reduced below 10(5), the microscopic methods increasingly overestimated the true bacterial abundance (range, 15.0 to 99.3%) . The solid-phase cytometer only slightly overestimated the true bacterial abundances and was more consistent over the same range of bacterial abundances per filter (range, 8.9 to 12.5%) . The solid-phase cytometer method for conducting total direct counts of bacteria was less biased and performed significantly better than any of the microscope methods . It was also found that microscopic count data from counting 5 fields on three separate filters were statistically equivalent to data from counting 20 fields on a single filter. Microbes Infect, 2004 Sep, 6(11), 972 - 6 Bacteriological follow-up of pulmonary tuberculosis treatment: a study with a simple colorimetric assay; Farnia P et al.; The viability of Mycobacterium tuberculosis (MTB) in serial sputum specimens from persistently smear positive patients was evaluated . The assay was based on oxidation-reduction of Alamar Blue and Malachite Green dyes that change their color in response to MTB growth . A total of 280 sputum specimens from 40 persistently smear positive TB patients and 40 sputa from non-tuberculosis patients were digested, decontaminated and examined microscopically . To check the MTB viability, the sediments from decontaminated samples were inoculated into three culture media: Lowenstein-Jensen (LJ) slants, Alamar Blue and Malachite Green culture tubes . We found that out of 280 smear positive specimens, the LJ culture was positive in 124 (44%) . The numbers of correctly identified S+/C+ cases by Alamar Blue and Malachite Green were 118 (95%) and 116 (93%), respectively . The mean time required for reporting the positive signal in Alamar Blue culture tubes was 9 versus 11 days by Malachite Green culture tubes . In the standard LJ culture media the average detection time was 27 days (P < 0.05) . The sensitivity of LJ was 99%, Alamar Blue 95% and Malachite Green 93% . The specificity was 100%, 92% and 93%, respectively . The oxidation-reduction method is rapid, sensitive and inexpensive in monitoring the treatment response of patients with pulmonary TB . Thus, using this method can be of paramount importance, particularly in resource-constrained areas. Tijdschr Diergeneeskd, 2004 Jul 15-Aug 1, 129(14-15), 468 - 70 {Subperitoneal cyst in a Friesian mare}; Scheffer CJ et al.; The case of a 5-year-old Friesian mare with a mass in her abdomen and a gait irregularity of the left hind limb is discussed . At rectal ultrasonogrphic examination the mass appeared to be a thin-walled, anechogenic cavity in the left abdomen . By means of laparoscopy the mass could be visualized as a smooth structure, covered by peritoneum and fat . Under laparoscopic guidance the mass was punctured and fluid was aspirated . Cytological and bacteriological findings of the fluid were indicative of a cyst . After drainage of the cyst the locomotion disorder of the left hind limb disappeared . It is concluded that this horse suffered from a subperitoneal cyst, a rare disorder in humans and never previously described in horses . The case emphasizes the value of laparoscopy in the diagnosis and treatment of (intra)abdominal masses and further clearly shows that in the differential diagnosis of locomotion disorders not only structures related to the locomotion system should be taken into account. Antibiot Khimioter, 2004, 49(3), 26 - 31 {Efficacy of moxifloxacin (Avelox) in prophylaxis of infection in patients with profound neutropenia}; Minenko SV et al.; Comparative efficacy of moxifloxacin and ciprofloxacin as prophylactics of infection in cancer patients with severe neutropenia after the chemotherapy was studied . The study included 40 patients with malignant lymphomas and solid tumore who received 52 courses of the aggressive chemotherapy . Twenty four patients (30 courses) received oral moxifloxacin in a dose of 400 mg once a day from the first day of the neutrophil count decrease below 1.0 x 10(9)/l until its recovery to > 1.0 x 10(9)/l or when the signs of infection appeared . In the control group 16 patients (22 courses) received oral ciprofloxacin in a dose of 500 mg twice a day . The patients in both the groups were compatible by the diagnosis, age and neutropenia duration . The median of the days of the febrile neutropenia duration in the patients prophylactically treated with moxifloxacin was statistically lower (2.1 vs 3.6 in the control group, p < 0.05) . The incidence of febrile neutropenia in the moxifloxacin group was significantly lower than that in the control group (73 and 100% respectively, p = 0.01) . The incidence of bacteriologically confirmed infection in the moxifloxacin group was also lower (6% vs 27.2%, p = 0.04) . Therefore, moxifloxacin proved to be a more efficient agent vs ciprofloxacin (standard prophylactic) in prevention of febrile neutropenia and neutropenic infection in cancer patients, which is likely due to its higher activity against grampositive organisms. Antibiot Khimioter, 2004, 49(3), 17 - 21 {Clinical efficacy of clarithromycin delayed release dosage form in the treatment of community-acquired pneumonia}; Iutanova NS; The efficacy of clarithromycin retarded release dosage form in the treatment of patients with community-acquired pneumonia was estimated in a open prospective comparative study . The drug was administered in a dose of 500 mg once a day (29 patients) and in a dose of 500 mg twice a day (28 patients) . The clinical efficacy in the compared regimens amounted to 90.6 and 93.3% of the patients respectively and the bacteriological efficacy was 93.3 and 84.6% respectively . The adverse reactions were observed in 15.6 and 30.0% of the cases respectively. J Am Vet Med Assoc, 2004 Aug 15, 225(4), 545 - 7, 538 Naturally occurring tularemia in a dog; Meinkoth KR et al.; A 4-year-old spayed female Irish Setter was examined because of acute onset of lethargy, anorexia, and weakness . The dog had eaten an adult rabbit 36 hours earlier . Tularemia was suspected because of the rabbit exposure; however, other common diseases characterized by fever, malaise, and lymphadenopathy of acute onset were also considered (ie, ehrlichiosis and Rocky Mountain spotted fever) . The dog was treated with doxycycline (5 mg/kg {2.3 mg/lb}, PO, q 24 h) for 14 days as well as supportive treatment with a balanced electrolyte solution (lactated Ringer's solution {200 mL, SC}) . The diagnosis was first established by results of bacteriologic cultures of fine-needle aspirates obtained from lymph nodes and confirmed by results of ELISA and a polymerase chain reaction assay Successful and timely antemortem diagnosis of tularemia in dogs can be accomplished through lymph node aspiration and bacteriologic culture. Rev Soc Bras Med Trop, 2004 Jul-Aug, 37(4), 338 - 42 Epub 2004 Aug 20. {Epidemiologic aspects of tuberculosis in the Suruí Indians, Brazilian Amazon}; Basta PC et al.; Tuberculosis persists as a serious public health problem in Brazil . Prevalence rates are alarming in certain social groups, including indigenous peoples . This article presents an epidemiological analysis of records for the Surui Indians available at the Tuberculosis Control Program in the Municipality of Cacoal, Rondonia . The study includes a descriptive statistical analysis of cases reported from 1975 to 2002 . There is evidence that the Surui have an increased risk of acquiring and dying from tuberculosis as compared to other indigenous groups in Rondonia as well as non-Indians . The average incidence coefficient for tuberculosis in the Surui was 2518.9 per 100,000 inhabitants in the period 1991-2002 . It was observed that 45% of the cases were diagnosed in children < 15 years old . Over half of the cases (63.3%) were reported in men . Only 43.2% of the cases were confirmed by sputum microscopy . The use of PPD skin tests, histopathological exams or bacteriological culture were not reported throughout the period . Attention is called to the need for prevention and control measures specifically tailored to the reality of indigenous peoples. J Dairy Sci, 2004 Aug, 87(8), 2442 - 8 Association of CXCR2 polymorphisms with subclinical and clinical mastitis in dairy cattle; Youngerman SM et al.; The ability to identify objectively cows that are more or less susceptible to mastitis has been a long-standing goal . Genetic markers associated with inflammatory responses during mastitis could aid in selection of these cattle . One potential marker is CXCR2, a chemokine receptor required for neutrophil migration to infection sites, which contains single nucleotide polymorphisms (SNP) within the gene . The objective of this experiment was to evaluate the association of CXCR2 SNP genotypes with subclinical and clinical mastitis . Thirty-seven Holstein and 42 Jersey cows that completed at least 2 full lactations were used . Quarter foremilk samples were collected for bacteriological examination quarterly and when cows exhibited clinical mastitis . Subclinical mastitis was defined as the presence of the same pathogen in the same quarter in at least 2 of 3 consecutive samples . A significant association was detected between CXCR2 SNP +777 genotype and percentages of subclinical mastitis cases in Holsteins . Holsteins expressing genotype GG had decreased percentages of subclinical mastitis, but genotype CC cows had increased percentages of subclinical mastitis . Significant differences in clinical mastitis incidence were not detected between genotypes for either breed . This approach of genetically identifying mastitis resistant cows may represent an effective means of marker-assisted selection for mastitis and other inflammatory diseases involving neutrophils. Antimicrob Agents Chemother, 2004 Sep, 48(9), 3343 - 8 Novel murine model of pneumococcal pneumonia: use of temperature as a measure of disease severity to compare the efficacies of moxifloxacin and levofloxacin; Bast DJ et al.; Surface temperature measured by an infrared temper