Am J Dent, 2003 Sep, 16 Spec No, 25A - 30A Treatment of root caries lesions with chlorhexidine-containing varnishes and dentin sealants; Wicht MJ et al.; PURPOSE: To evaluate the effects of chlorhexidine-containing varnishes and dentin sealants on the progress of demineralization, cariogenic bacteria and clinical appearance of root caries lesions . METHODS: 68 lesions in 22 adult patients, with a mean age of 51.3 +/- 13.8 years were enrolled in this study . After the removal of soft, infected dentin, all lesions were randomly sealed with (1.) Cervitec, used as control (CE), (2.) EC 40 (EC), (3.) Prime and Bond NT (PB) or (4.) Seal & Protect (SP) . Clinical appearance, laser fluorescence diagnosis (DIAGNOdent) and bacteriological status were recorded at intervals of 1 and 3 months . RESULTS: Regarding alteration of surface texture and color of the lesions, differences between the groups were not detected . Application of EC resulted in suppressed MS counts after 3 months (P < 0.05) . Initial lower MS counts were observed in the CE group (P = 0.053) . Laser fluorescence values increased in the chlorhexidine groups (CE = 27.9 +/- 17.5, EC = 28.3 +/- 26.0) but remained stable in the sealant groups (PB = 15.1 +/- 22.0, SP = 10.2 +/- 7.3), (P < 0.05). J Dairy Sci, 2003 Nov, 86(11), 3460 - 5 Relationship between udder and leg hygiene scores and subclinical mastitis; Schreiner DA et al.; The objective of this study was to determine the relationship between udder and leg hygiene scores of lactating dairy cattle and measures of subclinical mastitis . Study animals (n = 1250) consisted of lactating dairy cows from eight commercial dairy farms . Herds were enrolled during December 2000 and January 2001 and were visited bimonthly for a total of five visits per herd . Udder and leg hygiene scores were recorded by one person using a four-point scale ranging from one (very clean) to four (very dirty) . Udder and leg hygiene scores were compared to bacteriological cultures of milk samples and monthly individual SCC values . Mean hygiene scores were 2.09 and 2.33 for udders and legs, respectively . Udder hygiene scores (UHS) were significantly associated with leg hygiene scores and varied among farms . Linear somatic cell scores increased as udder hygiene score increased . Significant differences in somatic cell scores were observed for all contrasts of udder hygiene score, except between scores of 1 and 2 and of 3 and 4 . Linear somatic cell scores were associated with leg hygiene scores, but the only significant contrast was between leg hygiene scores of 2 and 4 . There was a significant association between the prevalence of intramammary contagious pathogens and udder hygiene score . The prevalence of intramammary environmental pathogens was significantly associated with udder hygiene score and was 7.7, 10.0, 10.6, and 13.5% for UHS of 1, 2, 3, and 4, respectively . The prevalence of environmental pathogens was not associated with LHS . Cows with udder hygiene scores of 3 and 4 were 1.5 times more likely to have major pathogens isolated from milk samples compared with cows with hygiene scores of 1 and 2. JAMA, 2003 Dec 10, 290(22), 2968 - 75 Trends in pertussis among infants in the United States, 1980-1999; Tanaka M et al.; CONTEXT: Reported cases of pertussis among adolescents and adults have increased since the 1980s, despite increasingly high rates of vaccination among infants and children . However, severe pertussis morbidity and mortality occur primarily among infants . OBJECTIVE: To describe the trends and characteristics of reported cases of pertussis among infants younger than 12 months in the United States from 1980 to 1999 . DESIGN, SETTING, AND PARTICIPANTS: Cases of pertussis in infants younger than 12 months in the United States reported to the National Notifiable Disease Surveillance System of the Centers for Disease Control and Prevention between 1980 and 1999, and detailed case data from the Supplementary Pertussis Surveillance System . MAIN OUTCOME MEASURES: Incidence and demographic and clinical characteristics of cases . RESULTS: The incidence of reported cases of pertussis among infants increased 49% in the 1990s compared with the incidence in the 1980s (19 798 vs 12 550 cases reported; 51.1 cases vs 34.2 cases per 100 000 infant population, respectively) . Increases in the incidence of cases and the number of deaths among infants during the 1990s primarily were among those aged 4 months or younger, contrasting with a stable incidence of cases among infants aged 5 months or older . The proportion of cases confirmed by bacterial culture was higher in the 1990s than in the 1980s (50% and 33%, respectively); the proportion of hospitalized cases was unchanged (67% vs 68%, respectively) . Receipt of fewer doses of vaccine was associated with hospitalization, when cases were stratified by age in months . CONCLUSIONS: The incidence of reported cases of pertussis among infants increased in the 1990s compared with the 1980s . The limited age group affected, the increased rate of bacteriologic confirmation, and the unchanged severity of illness suggest that an increase in infant pertussis has occurred apart from any change in reporting . Strategies are needed to prevent the morbidity and mortality from pertussis among infants too young to be fully vaccinated, according to the current recommended schedules of vaccination in the United States. Chemosphere, 2004 Feb, 54(8), 1267 - 71 Effects of ionic strength on the production of short chain volatile hydrocarbons by Dunaliella salina (Teodoresco); Munoz J et al.; The effect of ionic strength on the production of short chain volatile hydrocarbons was studied in cultures of Dunaliella salina . Axenic cultures of D . salina were grown at three different ionic strengths 0.5, 2 and 3 M of NaCl in Johnson (J/1) culture medium {Journal of Bacteriology 95 (1968) 1461} under the following laboratory growth conditions: a 12:12 h photoperiod, 300 micromolm(-2)s(-1) of photosynthetic active radiation (PAR) provided by a fluorescent lamp of 40 W combined with a 100 W incandescent lamp at 20 +/- 1 degrees C at pH 7.5 . C1 to C5 hydrocarbons were detected using a head space technique and GC-FID . Cell numbers and growth rate was greatest at 2 M NaCl 4.3 x 10(6) cellml(-1) after a 15 days period of culture . Maximum hydrocarbon production was measured in the concentration of 0.5 NaCl with lower production rates in the more concentrated solutions . The principal hydrocarbon was pentane at 0.5 M but was ethane in 2 and 3 M solutions . Production rates for individual compounds ranged between 0.13 and 22 x 10(-15) microgCcell(-1)h(-1) . It is suggested that the ability to produce and release volatile organic compounds of D . salina is related to osmotic conditions established by the ionic strength of growth solution. Klin Khir, 2003 Sep, (9), 28 - 31 {Clinical and functional characteristics of patients late after pneumonectomy with complicated course of postoperative period}; Heints VT et al.; Results of examination of 65 patients, to whom twenty years before pneumonectomy was performed for pulmonary tuberculosis and chronic nonspecific pulmonary diseases, were analyzed . Peculiarities of postoperative period course were determined in patients with early complications, including the tuberculosis reactivation . Methods of examination: clinical investigation, standard laboratory tests, bacteriologic investigation of phlegm, roentgenography, multiradial roentgenoscopy of thoracic cage, bronchography, computeric tomography, roentgenokymography, spirography, pneumotachometry . Specific and nonspecific changes in lungs, which resided, were revealed accordingly in 20 and 23.3% patients . The tuberculosis reactivation is possible twenty years after the operation . Pneumonectomy performance permits to eliminate an active tuberculosis in 70-80% patients . The tuberculosis changes in residual lung worsen the patients quality of life after pulmonectomy performance due to progress of respiratory insufficiency. Klin Khir, 2003 Sep, (9), 15 - 6 {Application of magnetic therapy in acute paraproctitis}; Kondratenko PG et al.; There were studied the possibilities and perspectives of application of the magnetically liquefied layer as an instrument for better purulent and putrefactive wounds clearance after intervention for an acute paraproctitis . Together with clinical signs the results of bacteriological investigation were controlled as well . There was established high efficacy of the method proposed and expedience of its application. Clin Nucl Med, 2003 Dec, 28(12), 971 - 4 Tc-99m exametazime-labeled leukocyte scans in the study of infections in skull neurosurgery; Liberatore M et al.; Diagnosis and follow-up of skull infections are usually performed by neurologic examination, laboratory tests and instrumental diagnostic methods such as computed tomography (CT) and magnetic resonance imaging (MRI) . These have, however, shown some limitations for specificity . The aim of the current study was to evaluate the overall contribution of Tc-99m exametazime-labeled leukocyte imaging scan Tc-99m hexamethylpropyleneamine (HMPAO) labeled white blood cells (WBC) in the diagnosis and management of infections in skull neurosurgery . Thirty-four patients were subdivided into 4 groups on the basis of the suspected pathology: intracerebral lesions on CT or MRI (group A, n = 20), suspected postsurgical infections (group B, n = 6), suspected deep infection of the surgical wound (group C, n = 4), and suspected infection of the ventriculoperitoneal shunt (group D, n = 4) . All patients underwent CT, MRI, and Tc-99m HMPAO WBC imaging . Patients in group C also underwent bacteriologic and culture examinations of wound secretions if present . In positive cases in group A, Tc-99m HMPAO WBC imaging was repeated . The scintigraphic results were compared with histologic findings in patients who underwent surgery and with the results of a 12-month clinical follow-up in the remaining patients . Tc-99m HMPAO WBC scans correctly detected the infections in all groups . Furthermore, such imaging proved to be able to document recovery from the disease in all of the assessed cerebral abscesses . This study may have an important role both in the diagnosis and in the management of infections in skull neurosurgery, which, it is hoped, will be confirmed in the future. Int J Syst Evol Microbiol, 2003 Nov, 53(Pt 6), 1701 - 2 Validation of publication of new names and new combinations previously effectively published outside the IJSEM; International Journal of Systematic and Evolutionary Microbiology; The purpose of this announcement is to effect the valid publication of the following new names and new combinations under the procedure described in the Bacteriological Code (1990 Revision) . Authors and other individuals wishing to have new names and/or combinations included in future lists should send three copies of the pertinent reprint or photocopies thereof to the IJSEM Editorial Office for confirmation that all of the other requirements for valid publication have been met . It is also a requirement of IJSEM and the ICSP that authors of new species, new subspecies and new combinations provide evidence that types are deposited in two recognized culture collections in two different countries (i.e . documents certifying deposition and availability of type strains) . It should be noted that the date of valid publication of these new names and combinations is the date of publication of this list, not the date of the original publication of the names and combinations . The authors of the new names and combinations are as given below, and these authors' names will be included in the author index of the present issue and in the volume author index . Inclusion of a name on these lists validates the name and thereby makes it available in bacteriological nomenclature . The inclusion of a name on this list is not to be construed as taxonomic acceptance of the taxon to which the name is applied . Indeed, some of these names may, in time, be shown to be synonyms, or the organisms may be transferred to another genus, thus necessitating the creation of a new combination. Pediatrics . 2003 Dec;112(6 Pt 1):e467. Value and limitations of the von Reyn, Duke, and modified Duke criteria for the diagnosis of infective endocarditis in children; Tissieres P et al.; OBJECTIVE: To compare the sensitivity of 3 different criteria-von Reyn, Duke, and modified Duke-in diagnosing infective endocarditis (IE) in children . STUDY DESIGN: Retrospective case study in a tertiary pediatric hospital . METHODS AND RESULTS: Between 1985 and 2001, 41 episodes of IE were documented in 40 children (median: 7 years old; range: 1 week to 18 years) . The diagnosis was based on echocardiographic and microbiologic or pathologic findings . The initial echocardiogram suggested IE in 95% of the cases . Main findings were vegetations in 36, perivalvular abscess in 4, and/or new valvular leaks in 6 cases . In 31 (76%) of the 41 episodes, the causative organisms were identified directly by specimen bacteriology or blood cultures (BCs) or indirectly by polymerase chain reaction or serology . Sensitivities of the von Reyn, Duke, and modified Duke criteria in diagnosing IE were 63%, 81%, and 88%, respectively . In 10 cases (22%), the diagnosis of IE was "rejected" by the von Reyn criteria but was "definite or possible" by the Duke and modified Duke criteria . In 3 cases, the diagnosis of IE was "possible" by the Duke but "definite" by the modified Duke criteria: 2 of the 3 cases had 1 major and >or=3 minor symptoms, and 1 had Q fever . Five episodes (12%) were classified as "possible" IE by the modified Duke criteria: although major findings were present on echocardiography, no organism was identified on repeat BCs . Positive BC was the only criterion that differentiated "definite" from "possible" IE . CONCLUSIONS: The modified Duke classification was more sensitive in diagnosing IE in children than the von Reyn and Duke criteria . Still, 12% failed to be classified as "definite" IE by the modified Duke criteria . This illustrates the importance of positive BCs as a major IE criterion while significant echocardiographic findings are less considered by the presently used criteria. Hist Cienc Saude Manguinhos, 2003, 10(Suppl 1), 361 - 96 Fight for survival: the life of a Hansen's disease sufferer through his correspondence with Adolpho Lutz; Benchimol JL et al.; This project presents the complete set of letters between the family of a Hansen's disease (leprosy) sufferer in the state of Maranhao, in the Northeast of Brazil, and the doctor and bacteriologist Adolpho Lutz . For more than twenty years Fabricio Caldas de Oliveira and Numa Pires de Oliveira, father and son, exchanged a steady flow of letters with the scientist in pursuit of a cure for the disease that had assailed Numa since childhood . The 24 letters compiled here paint a unique portrait of the medical and social drama confronted by this family, and the results of the use of chaulmoogra oil and other medications in their search for alternative treatments. Hepatology, 2003 Dec, 38(6), 1508 - 15 Bacterial translocation up-regulates GTP-cyclohydrolase I in mesenteric vasculature of cirrhotic rats; Wiest R et al.; In cirrhosis, arterial vasodilation and the associated hemodynamic disturbances are most prominent in the mesenteric circulation, and its severity has been linked to bacterial translocation (BT) and endotoxemia . Synthesis of nitric oxide (NO), the main vasodilator implicated, is dependent on the essential cofactor tetrahydrobiopterin (BH(4)) . The key enzyme involved in BH(4) synthesis is GTP-cyclohydrolase I (GTPCH-I), which is stimulated by endotoxin . Therefore, we investigated GTPCH-I activity and BH(4) biosynthesis in the mesenteric vasculature of cirrhotic rats with ascites, as well as their relationship with BT and endotoxemia, serum NO, and mean arterial pressure (MAP) . GTPCH-I activity and BH(4) content in mesenteric vasculature was determined by high-performance liquid chromatography . BT was assessed by standard bacteriologic culture of mesenteric lymph nodes (MLNs) . Serum endotoxin was measured by a kinetic turbidimetric limulus amebocyte lysate assay, and serum NO metabolite (NOx) concentrations were assessed by chemiluminescence . BT was associated with local lymphatic and systemic appearance of endotoxin and was accompanied by increases in serum NOx levels . GTPCH-I activity and BH(4) content in mesenteric vasculature were both increased in animals with BT and correlated significantly (r = 0.69, P <.01) . Both GTPCH-I activity and BH(4) levels significantly correlated with serum endotoxin and NOx levels (r = 0.69 and 0.54, 0.81 and 0.53, P <.05) . MAP (a marker of systemic vasodilatation) correlated with endotoxemia (r = 0.58, P <.03) and with GTPCH-I activity (r = 0.69, P <.01) . In conclusion, in cirrhotic animals BT appears to lead to endotoxemia, stimulation of GTPCH-I, increased BH(4) synthesis, and further enhancement of vascular NO production that leads to aggravation of vasodilatation. Am J Ind Med, 2003 Dec, 44(6), 600 - 10 Cancer incidence among laboratory workers in biomedical research and routine laboratories in Israel: Part I-the cohort study; Shaham J et al.; BACKGROUND: Laboratory work is associated with exposure to a mixture of carcinogens . METHODS: The cohort is comprised of 4,300 laboratory workers . Cancer incidence was followed from 1960 to 1997 . RESULTS: A total of 230 cases were included in the cohort . The overall cancer standardized incidence ratio (SIR) was 1.04 (0.91-1.18) . When a 20-year latency was introduced, SIR was increased significantly: 1.35 (1.13-1.61) . Among routine workers and researchers, SIR was elevated significantly for the total population and for women, when a 20-year latency was introduced . SIR was also elevated significantly in research, routine, bacteriology and virology, and isotope laboratories . With respect to specific sites, significantly increased SIR was observed in breast, ovary, and thyroid cancer among women; and prostate cancer, leukemia, and melanoma among men . CONCLUSIONS: We suggest that work in research and biomedical laboratories might involve an increased risk of certain types of cancer . Am . J . Ind . Med . 44:600-610, 2003 . Antibiot Khimioter, 2003, 48(7), 20 - 3 {Cefepime treatment efficacy in surgical patients}; Bogomolova NS et al.; Clinical and bacteriologial efficacies of cefepime were studied in the treatment of 20 surgical patients . Intraoperative prophylaxis is with the use of cefepime alone and postoperative prophylaxis with the use of cefepime in combination with some other drugs were applied to 10 patients . No postoperative complications in the group of the 10 patients were stated . The other 10 patients were subjected to intraoperative and postoperative combined prophylaxis with some other antibiotics . In 6 patients of the latter group postoperative complications developed . Obvious clinical advantages of cefepime were demonstrated. Zentralbl Chir, 2003 Oct, 128(10), 858 - 61 {Severe acute pancreatitis: role for laparoscopic surgery}; Pavars M et al.; Minimally invasive surgery is a new and promising treatment modality in the management of patients with severe acute pancreatitis (SAP) . Aim of our study was the evaluation of our first experiences with laparoscopic surgery in the management of patients with SAP . METHODS: A total of 65 patients complied with Atlanta recommendations for SAP and were included into this retrospective study . Indications for laparoscopic surgery were SAP presented with intraabdominal or retroperitoneal exudates and detected by ultrasound (US) and/or contrast enhanced computer tomography (CT) scan, and the presence of acute calculous cholecystitis when 3 to 5 days of conservative treatment did not show clinical improvement and surgical treatment was considered . Patients with improvement after initial therapy received conservative therapy only . Bacteriological cultures were done for abdominal exudates and necrotic tissue obtained during surgery . RESULTS: Totally, 39 patients were operated and 26 were treated conservatively only . Laparoscopic surgery was started in 31 patients and completed in 26 patients . The overall conversion rate was 16.1 % . Laparoscopic drainage of the intraabdominal exudate was done in 26 patients including drainage of the lesser sac in five of them . Laparoscopic cholecystectomy in 25 cases and laparoscopically assisted jejunostomy in 6 cases were performed as a part of the procedure . Conventional surgery was the primary procedure in 8 patients . Peripancreatic abscess formation was observed in one case one month after laparoscopic procedure and was cured with conventional surgical drainage . Bile leakage from the cystic stump was successfully treated with endoscopic papillotomy in one case . All patients survived after laparoscopic procedures . Overall complication rate was 7.7 % and mortality reached 3.1 % . CONCLUSIONS: Laparoscopic drainage of the abdominal cavity, drainage of the lesser sac and revision of the retroperitoneal compartment can be safely carried out as an alternative to the conventional surgical approach . Laparoscopic cholecystectomy and/or jejunostomy may be additionally performed if indicated. An Med Interna, 2003 Nov, 20(11), 569 - 74 {Infective endocarditis in the elderly}; Cruz JM et al.; BACKGROUND: The influence of age on the clinical presentation and on the prognosis of infective endocarditis (IE) is unclear . Our aim was to analyse the epidemiologic, clinical and bacteriological characteristics of IE in the elderly compared with younger adult patients . PATIENTS AND METHODS A retrospective study of all patients with IE non intravenous drug users diagnosed in our hospital during the period from 1990 to 2000 . We used the Duke criteria to compare the characteristics of 46 episodes of definitive IE in elderly patients (>65 years old ) and of 46 episodes in younger adult patients (20-64 years of age ) . RESULTS: No significant differences were observed among the two groups with respect to the delay in diagnosed, possible source of infection, the frequency of positive blood cultures and the type of infective organism, clinical presentation and evolution of the IE . Elderly patients more often had risk factors predisposing (degenerative valvular disease, prosthetic valve and pacemaker ), which decreased the sensitivity of transthoracic echocardiography to 46.5% compared with 64.4% in the younger patients . Transesophageal echocardiography improved the diagnostic of IE in the 37.2% in elderly patients . The patients in the both groups underwent surgical therapy with similar frequency (36.9% in the elderly and the 39.1% in the younger adult patient ) and the mortality rate not was significantly higher in the elderly (19.5%) than in the younger adult patients (10.8%) . CONCLUSIONS: The age itself is not a poor prognostic, and should not be used prejudicially in denying a early and aggressive treatment of the patients with IE. Arch Otolaryngol Head Neck Surg, 2003 Nov, 129(11), 1240 - 2 Malakoplakia of the neck; Schmerber S et al.; Malakoplakia that presents in the head and neck is very rare . We describe a 76-year-old man who presented with an inflammatory mass in the lateral aspect of the neck that clinically mimicked a tumoral expansion and was consistent with a cervical malakoplakia . To our knowledge, this is the second case reported with manifestations of this chronic inflammatory disease localized in the neck . Malakoplakia is a rare granulomatous disease that most frequently involves the genitourinary tract and occurs in an immunodeficient host . The symptoms are nonspecific and the diagnosis is based on the histologic findings . In the present case, the biopsy specimen of the cervical mass revealed a collection of numerous von Hansemann cells containing Michaelis-Gutmann bodies, which are pathognomonic of malakoplakia . Bacteriologic analysis identified Escherichia coli . The evolution was favorable after surgical excision and prolonged antibiotic therapy with fluoroquinolones. Transfus Med, 2003 Oct, 13(5), 315 - 7 False-positive result of sterility testing after a supposed adverse transfusion reaction; Strobel E; We report on the case of a woman who suffered from chills and fever when she was transfused with two units of red blood cell concentrate . Immunohaematological evaluation of the adverse reaction was inconspicuous, as well as sterility testing of one unit, but bacteriological evaluation of the second unit showed growth of Stenotrophomonas maltophilia . The sample for sterility testing of this unit had been drawn from the distal end of the transfusion device that was still connected to the blood bag . Later, two samples were drawn from the blood bag itself and were found to be sterile, whereas another sample drawn from the distal end of the transfusion device also showed growth of S . maltophilia . We conclude that reflux of the patient's blood into the transfusion device has caused a false-positive result of sterility testing of the second unit when the sample was drawn from the distal end of the device. J Vet Sci, 2000 Jun, 1(1), 33 - 7 Detection of Lawsonia intracellularis in diagnostic specimens by one-step PCR; Suh DK et al.; Lawsonia intracellularis is not culturable with a standard bacteriologic culture . One step PCR assay as a clinical diagnostic method was developed for the rapid detection of porcine proliferative enteritis (PPE) caused by L . intracellularis . Primers were designed based on the p78 DNA clone of L . intracellularis . The one step PCR resulted in the formation of a specific 210-bp DNA product derived from L . intracellularis . The nonspecific amplification product was not detected with swine genomic DNA or other bacterial strains causing similar symptoms to L . intracellularis infection . The one step PCR was as sensitive as 100 pg of L . intracellularis genomic DNA . We applied this method to field specimens diagnosed as PPE by macroscopic observation . Of 17 mucosal scraping specimens, 16 (94%) were identified as positive to PPE and 15 (88%) of 17 feces specimens . These results suggest that the one step PCR can be used as a rapid diagnostic method for L . intracellularis infection. Immunol Lett, 2003 Nov 15, 90(1), 3 - 11 Alteration of intestinal intraepithelial lymphocytes and increased bacterial translocation in a murine model of cirrhosis; Inamura T et al.; Alterations in immunological defense in the gut may lead to the bacterial infection that is frequently associated with cirrhosis of the liver . The aim of this study was to investigate the changes in distribution and function of intestinal intraepithelial lymphocytes (IELs) in relation to intestinal barrier dysfunction in experimental cirrhosis . Cirrhosis was induced in mice by treatment with carbon tetrachloride (CCl4) intraperitoneally with 5% alcohol in drinking water for 12 weeks . Bacterial translocation was assessed in mesenteric lymph nodes (MLNs) by the transport of fluorescence-labeled latex beads and by bacteriological cultures . The lymphocyte subpopulation was compared in three groups (cirrhosis, alcohol alone and controls) . IFN-gamma production from isolated IELs was determined by ELISA after stimulation with anti-CD3 or IL-12/IL-18 . The total number of IELs significantly increased in the cirrhosis and alcohol groups . There was a preferential increase in TCRgammadelta+CD8+ population in the alcohol group, but no change in cirrhosis . Bacterial translocation was negative in the control group, and a small number was noted in the alcohol group, whereas it was significantly noted in the cirrhosis group . Although the number of IEL was significantly increased in the cirrhosis group, their proliferative response was decreased, and IFN-gamma production from each IEL was markedly diminished in either stimulation by anti-CD3 or IL-12/IL-18 . These changes were more remarkable in the cirrhosis group than in the alcohol group . In conclusion, bacterial translocation due to intestinal barrier dysfunction in cirrhosis may be closely correlated with the alteration of the immune function in IELs. J Clin Pathol, 2003 Nov, 56(11), 835 - 9 The nodular form of hepatic tuberculosis: a review with five additional new cases; Huang WT et al.; BACKGROUND: Tuberculosis presenting as an isolated liver tumour, without active pulmonary or miliary tuberculosis, or other clinical evidence of tuberculosis, is distinctly rare . A greater awareness of this rare clinical entity may prevent needless surgical intervention . AIMS: To help characterise this distinctly rare presentation of tuberculosis, five new cases are presented, together with a review of the world literature . The clinical, laboratory, radiological, and pathological features of these patients are described . METHODS: Polymerase chain reaction (PCR) assay of the liver tissue was carried out in all cases to confirm an aetiological diagnosis of Mycobacterium tuberculosis infection . RESULTS: All five patients (44-71 years old; two women, three men) underwent surgery, and had a preoperative diagnosis of malignant hepatic neoplasm and a postoperative histological diagnosis of chronic granulomatous inflammation, suggestive of tuberculosis . None of them had a known previous history of tuberculosis . All of them were positive for M tuberculosis by PCR analysis of the liver tissue . CONCLUSIONS: This report illustrates the difficulty in reaching a correct preoperative diagnosis . It is usually unsuspected and confused with primary or metastatic carcinoma of the liver, especially when it coexists with other malignancies . A high index of suspicion is required for diagnosis, which can be made only by histological and bacteriological studies, and PCR analysis. Tip Tarihi Arastirmalari, 1999, 9, 229 - 35 {Evaluation of the last 50 years of the progress in immunology in our country}; Dogan H; Different methods of vaccination have been observed in the ancient civilizations, to protect themselves from diseases . Pontus King, Mitridates Eupaton (132-63 B.C.), established the basic principles of Immunology unconsciously . Since he was scared of being poisoned all the time, he looked for an antidote . He gave the poison in little amounts to the prisoners and found a way to be immune against poisons with immunization . He turned out to be the first immunologist . The essential idea of immunology was established by the idea of immunity developed by Jenner and Pasteur, against cholera and smallpox . In our country, immunology has evolved from bacteriology and virology, as well . Actually, in the ancient times, Turks used variolation in their daily lives (from human to human) . In the last 50 years, immunology progressed both in our country and in the world rapidly and played an important role in the etiopathogenesis of the diseases of different systems . Also, through a philosophical point of view, it brought the necessity of a holystic evaluation for the description of human health. Vestn Ross Akad Med Nauk, 2003, (9), 39 - 44 {Laser fluorescence in assessing the hygienic status of oral cavity}; Aleksandrov MT et al.; The issue related with an objective evaluation of a hygienic status of the oral cavity and a method to solve it by modern laser technologies are addressed in the paper . The efficiency of bacteriological and of laser-fluorescence express-diagnostics is comparatively analyzed . A hygienic index and its clinical value are substantiated. Probl Tuberk Bolezn Legk, 2003, (9), 26 - 9 {Accelerated determination of blood bacteriostatic activity in patients with tuberculosis by using the semiliquid culture medium}; Manicheva OA; Blood bacteriostatic activity (BBA) was studied in 87 patients with respiratory tuberculosis . Clinical Mycobacterium tuberculosis (MBT) strains and different culture media, such as solid (Lowenstein-Jensen and Middlebrook), liquid (modified Soton) and semiliquid (SM developed for accelerated determination of drug resistance in MBT) media were used . With isoniazid-resistance of MBT, the use of solid media yielded underestimated BBA . The SM medium based on the Soton medium added by 0.35% of culture agar and 25% equine serum was optimal, which provided evidence for BBA on day 7 (visual recording of MBT growth) . Examination of BBA by means of SM revealed a clear inverse correlation between the degree of BBA and the bacteriological parameters of sputum study . The small numbers of sputum MBT cultures (a high correlation, r = -0.88; p = 0.01) and short bacterial isolation (average correlation, r = -0.65; p = 0.01) corresponded to the high values of BBA. J Int Med Res, 2003 Sep-Oct, 31(5), 434 - 47 Moxifloxacin in the treatment of acute maxillary sinusitis after first-line treatment failure and acute sinusitis with high risk of complications; Gehanno P et al.; This multicentre, prospective study evaluated the efficacy and safety of 7-day oral moxifloxacin (400 mg/day) for treatment of acute maxillary sinusitis after first-line treatment failure (group 1), and acute sinusitis with high risk of complications (group 2) . Two hundred and fifty-eight patients with radiologically confirmed acute sinusitis were enrolled by 52 investigators; 216 patients (83.7%) qualified for per protocol efficacy analysis (group 1, n = 175; group 2, n = 41), and 92 for bacteriological analysis . Samples were collected from the middle meatus . The clinical success rate 7-10 days post-treatment was 92.6% . Bacteriological success rates were 95.7% after 3-4 days of treatment, and 97.2% and 95.2%, in group 1 and group 2, respectively, at 7-10 days post-treatment . Drug-related adverse events, including abdominal pain (2.4%), nausea (2.4%) and diarrhoea (1.2%), were reported in 12.2% of patients . Overall, moxifloxacin therapy resulted in rapid bacteriological eradication, with a high rate of clinical success. Rev Med Liege, 2003 Jul-Aug, 58(7-8), 456 - 60 {Male infertility}; Demoulin A; In 2/3 of infertility problems, the male partner is, partially or entirely, responsible . His investigation starts with a careful history and is followed by a thorough physical examination . Then, comes the spermogram . In addition to an assessment of the number, motility, and morphology of spermatozoids, this examination must involve a spermocytogram, tests of anti-spermatozoid immunity, and a bacteriological analysis . The biological study of the seminal plasma is also of considerable value . Electron microscopy of sperm is valuable in asthenospermic men . A genetic and hormonal investigation is, nowadays, almost mandatory in all cases . Testicular biopsy with cryopreservation of testicular tissue and demonstration of a possible varicocele can also, in selected cases, be of great help . The overall strategy will be decided on the basis of the whole investigation. An R Acad Nac Med (Madr), 2003, 120(1), 79 - 93 {Eugenio Espejo, the Quito physician: pioneer of bacteriology in the Americas}; Fierro Benitez R; Eugenio Espejo (1747-1795) . Mestizo . Was born in the Royal Audience of Quito . Today, the Republic of Ecuador . The 18th century was isf illustration and enlightment for the Quitenos . Espejo's extraordinary erudition is explained by the full access he had to yhe libraries created in Quito by the Jesuits . The best in the continent at that time . His work, Reflections on Smallpox, makes or Espejo outstanding in his field . Pioneer in bacteriology and of the biopathological observations in America . The first newspaper in Quito, Primicies of the culture of Quito, was his own work . Furthermore, Espejo is considered the precursor of the independence of Hispanoamerica. Vet Res, 2003 Sep-Oct, 34(5), 565 - 78 Indicators of inflammation in the diagnosis of mastitis; Pyorala S; Mastitis affects the quality of milk and is a potential health risk for the other cows . In a well managed dairy herd, in addition to clinical mastitis, subclinical mastitis should be efficiently detected . Bacteriological sampling is not feasible as a routine test to identify subclinical mastitis, and indirect tests of mastitis are more suitable for selecting cows with intramammary infections for subsequent bacteriological sampling . Mastitis affects the composition of milk, and the degree of changes depends on the infecting agent and the inflammatory response . Indicators of inflammation in the milk which can be determined using rapid, reliable and easy routine techniques, can be used for the early detection of mastitis . The measuring of the somatic cell count in milk is the standard method, but the analysis technique is problematic for routine use in herds . The most promising parameters for monitoring subclinical mastitis are milk N-acetyl-beta-D-glucosaminidase activity, lactose, and electrical conductivity along with some other indicators such as optical and milk flow measurements, preferably with an inter-quarter evaluation included in the test . Acute phase proteins, haptoglobin and serum amyloid A, are also potential candidates for mastitis monitoring . New mastitis detection systems which can be adapted into on-line use are urgently needed, since dairy units are growing bigger and automatic milking systems are being taken into use. Int J Tuberc Lung Dis, 2003 Oct, 7(10), 1010 - 2 Assessment of the Mycobacteria Growth Indicator Tube for the bacteriological diagnosis of tuberculosis; Diraa O et al.; Fast, accurate diagnosis is necessary for rapid treatment of patients and to prevent the spread of Mycobacterium tuberculosis strains . The rate of recovery, mean time to detection and contamination rates of the Mycobacteria Growth Indicator Tube (MGIT) were compared with Lowenstein-Jensen (LJ) medium for mycobacterial cultures performed on 405 clinical specimens decontaminated by the trisodium phosphate method without benzalkonium chloride . The recovery rate of M . tuberculosis using MGIT was 45/61 (73.8%) compared with the reference LJ . The mean times to detection of M . tuberculosis in smear-positive specimens were 11.9 days with MGIT and 20 days with LJ . For smear-negative samples, the mean times were respectively 18.6 and 31 days, and the contamination rates were respectively 4% and 1.2% . When the trisodium phosphate decontamination method is used, MGIT cannot be used alone for isolation of mycobacteria, but may be used in combination with LJ. J Am Vet Med Assoc, 2003 Oct 1, 223(7), 993 - 8 Assessment of plasma concentrations of doxycycline in budgerigars fed medicated seed or water; Flammer K et al.; OBJECTIVE: To determine whether plasma doxycycline concentrations considered effective for treatment of avian chlamydiosis could be safely established and maintained in budgerigars via administration of doxycycline in water or seed . DESIGN: Prospective study . ANIMALS: 68 healthy mature budgerigars . PROCEDURE: In 14-day trials, plasma doxycycline concentrations were measured in budgerigars provided with water containing 0, 50, 100, 200, or 400 mg of doxycycline hyclate/L or a hulled seed diet containing 0, 100, 200, or 400 mg of doxycycline hyclate/kg . On the basis of these results, birds were fed seed containing 300 mg of doxycycline/kg for 42 days, and a control group received unmedicated seed . Blood samples for plasma doxycycline analysis were collected either in the morning on treatment days 4, 7 14, 21, 28, 35, and 42 or in the afternoon on days 12, 26, and 40 . Birds were observed daily . On days 14, 28, and 42, physical and plasma biochemical variables, PCV, and total solids concentration were measured; cloacal specimens were obtained for bacteriologic and fungal culture . RESULTS: During a 14-day period, treatment with water containing < or = 400 mg of doxycycline/L did not maintain plasma doxycycline concentrations of > or = 1 microg/mL, but seed containing 300 mg of doxycycline hyclate/kg maintained mean plasma doxycycline concentrations > 0.98 microg/mL for 42 days without notable adverse effects . CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that hulled seed containing 300 mg of doxycycline hyclate/kg can safely establish and maintain plasma doxycycline concentrations that are considered adequate for treatment of chlamydiosis in adult nonbreeding budgerigars. Presse Med, 2003 Sep 27, 32(31), 1445 - 9 {Acute mastoiditis in children: clinical and bacteriological study of 17 cases}; Moriniere S et al.; OBJECTIVE: Acute mastoiditis (AM) represents the most frequent complication of acute otitis media (AOM) in children . In the literature, its incidence is stable but with an impressive increase in pneumococci with reduced sensitivity to penicillin (PRSP) . The aim of this study was to assess the incidence of AM in the area of Tours and the prevalence of PRSP . METHOD: This was a retrospective study of children admitted to the regional paediatric centre in the Tours area, between January 1994 and May 2001 . The coded AM files were analysed, excluding all the sub-acute forms or those complicating a cholesteatoma . The criteria studied concerned the clinical signs on admission, the imaging data and the bacteriological samples and the results of treatment . RESULTS: Seventeen children (8 boys, 9 girls) were admitted for an AM during the study period . Their mean age was of 3.2 years (range: 6 months to 13 years) . In 24% of cases, the mastoiditis existed on admission and in 59% of cases it complicated an AMO already treated with antibiotics . In 3 cases (18%), the AM was complicated on admission with peripheral facial paralysis in one case and thrombosis of the lateral sinus in 2 cases . The germ responsible was identified in 14 cases (82%) with a predominance of pneumococci (11 cases) . Eight were PRSP-type . Scan of the pars petrosa identified a subperiosteal abscess in 13 cases . Fourteen mastoidectomies were performed and the mean duration of antibiotic therapy was of 23 days . The outcome was always good . CONCLUSION: Over the past 7 years, the incidence of AM has been estimated at 1.2/100 000 children aged under 15 per year . The prevalence of PRSP is high but does not change the principles or the results of the treatment of AM. Ned Tijdschr Geneeskd, 2003 Sep 20, 147(38), 1825 - 9 {Delay in the diagnosis of tuberculosis}; van Hest NA et al.; In five patients, a 46-year-old Surinamese man, a 45-year-old Dutch barkeeper, a 41-year-old woman from Eritrea, and an 18-year-old Afghan woman and her 43-year-old mother, tuberculosis was diagnosed and treated after a considerable delay . Such a late diagnosis and subsequent treatment is not uncommon for tuberculosis as the symptoms, physical examination, laboratory tests, imaging techniques and bacteriological results are often not very specific . However under certain circumstances, tuberculosis (including the extrapulmonary manifestations) should be considered at an earlier stage, especially among certain risk groups such as the homeless, drug addicts, immigrants and asylum seekers . In the five patients discussed the causes of delay were identified as: delay caused by the asymptomatic phase of the disease, the patient's delay in presenting, a delay on the part of the physician, a delay in diagnostic confirmation and a delay in the treatment. J Clin Microbiol, 2003 Oct, 41(10), 4901 - 3 Paronychia due to Prevotella bivia that resulted in amputation: fast and correct bacteriological diagnosis is crucial; Riesbeck K; Prevotella bivia is mainly associated with endometritis . The case of a patient with paronychia in a thumb due to P . bivia resulting in osteitis and amputation is reported . The species was not acknowledged in the first bacterial culture 2 weeks before surgery. Ned Tijdschr Geneeskd, 2003 Sep 13, 147(37), 1778 - 83 {Clinical reasoning and decision making in practice . A 41-year old with periodic fever of unknown origin}; Koopmans RP et al.; A 41-year-old man presented with unexplained bleeding from the right tonsil . He subsequently developed periodic fever, cervical lymphadenopathy and hepatosplenomegaly . Despite extensive bacteriological, serological and radiographic investigations for infectious disease, rheumatic disease and malignancy no diagnosis was made . Although the fever pattern was very suggestive of Pel-Ebstein fever--commonly associated with lymphoproliferative disease--multiple biopsies of lymph nodes, bone marrow, tonsils and liver all proved negative . Empirical glucocorticoid therapy gave some temporary improvement lasting for a month . Splenectomy or splenic biopsy was not carried out because of the risk of excessive bleeding . Eventually the patient died of multi-organ failure and sepsis . At autopsy, a T-cell lymphoma with an unusual phenotype and focal involvement of bone marrow, liver and spleen was found . Clinicians are sometimes faced with the dilemma of whether to perform multiple, invasive and possibly harmful diagnostic tests or to start empirical therapy . Empirical therapy may only be started if the diagnosis has been made on strong clinical grounds and, if this is not the case, only after further diagnostic tests . The question of whether a potentially harmful diagnostic test is justified depends on the clinical course, the sensitivity and specificity of the test and the therapeutic possibilities. Pancreatology, 2003, 3(5), 383 - 8 Epub 2003 Sep 24. Is late antibiotic prophylaxis effective in the prevention of secondary pancreatic infection? Cinar E, Ateskan U, Baysan A, Mas MR, Comert B, Yasar M, Ozyurt M, Yener N, Mas N, Ozkomur E, Altinatmaz K. BACKGROUND: Secondary infection of the inflamed pancreas is the principal cause of death after severe acute pancreatitis (AP) . Although patients are not always managed early in the course of AP in clinical practice, prophylactic antibiotics that were used in experimental studies in rats were always initiated early after induction of pancreatitis . The effectiveness of antibiotics initiated later is unknown . AIM: The aim of this study was to compare the effectiveness of ciprofloxacin and meropenem initiated early versus later in the course of acute necrotizing pancreatitis (ANP) in rats . METHODS: 100 Sprague-Dawley rats were studied . ANP was induced in rats by intraductal injection of 3% taurocholate . Rats were divided randomly into five groups: group I rats received normal saline as a placebo, group II and IV rats received three times daily meropenem 60 mg/kg i.p . at 2 and 24 h, respectively and group III and V rats received twice daily ciprofloxacin 50 mg/kg i.p . at 2 and 24 h, respectively, after induction . At 96 h, all rats were killed for quantitative bacteriologic study . A point-scoring system of histological features was used to evaluate the severity of pancreatitis . RESULTS: Meropenem and ciprofloxacin initiated 2 h after induction of pancreatitis significantly reduced the prevalence of pancreatic infection (p < 0.001 and p < 0.04, respectively) as compared to controls . Neither of the antibiotics initiated later during the course of AP caused a significant decrease in pancreatic infection in rats (p > 0.05) . Although the rats treated early infected less frequently than the rats treated later, the comparison reached statistical significance only in the meropenem group (p < 0.02) . CONCLUSION: Early antibiotic treatment reduces pancreatic infection more efficiently than late antibiotic treatment in ANP in rats . Probl Tuberk Bolezn Legk, 2003, (8), 34 - 7 {Comparison of nitrate reductase and automatic BACTEC MGIT 960 AST techniques for determining the drug sensitivity of mycobacteria tuberculosis}; Golyshevskaia VI et al.; The accelerated nitrate reductase method (NRM) developed at the Central Research Institute of Tuberculosis versus the automatic assay of drug sensitivity by means of a BACTEC 960 bacteriological analyzer was assessed . NRM was carried out, by using the Lowenstein-Jensen medium for 10 days . It is based on the detection of alive Mycobacteria tuberculosis, by recording their enzymatic activity . The study showed a good agreement of the results obtained by NRM with those obtained on a BACTEC 960 analyzer . Agreements were found for 52 isolates in 47 (90.4%) cases, the results disagreed in the testing of 5 (9.6%) cultures . The results of NRM were identical to those for 21 of the 22 cultures sensitive on a BACTEC 960 device; the coincidence was 95.5% . The sensitivity of NRM ranged from 88.2% (for rifampicin) to 96.3% (for isoniazid) and the specificity did from 96% (for isoniazid) to 100% (for streptomycin, rifampicin, and ethambutol) . The positive prognostic value of NRM was 100% (for streptomycin, rifampicin, and ethambutol) and 96.3% (for isoniazid) . The negative prognostic value of NRM ranged from 94.6 to 96.8% for individual drugs . The efficiency of NRM (a ratio of the number of correct results to the total number of results) was greater than 0.96, which suggests that this method and the BACTEC MGIT 960 AST technique may be regarded as rather comparable . The testing of NRM versus the automatic BACTEC MGIT 960 AST technique has indicated that the former may be successfully used to determine the sensitivity of Mycobacteria to the critical concentrations of first-line antituberculous agents. Intern Med, 2003 Sep, 42(9), 806 - 11 A large outbreak of Legionnaires' disease due to an inadequate circulating and filtration system for bath water--epidemiologic manifestations; Nakamura H et al.; OBJECTIVE: To study the epidemiologic manifestations of a large outbreak of Legionnaires' disease due to an inadequate circulating and filtration system for bath water . PATIENTS: In June 2000 at Ishioka City, Ibaraki Prefecture, a large outbreak of Legionnaire's disease occurred, as a result of an inadequate circulating and filtration system for communal bath water . This outbreak was the worst ever experienced in Japan, involving a total of 34 patients (20 confirmed, 14 probable), 3 of whom died . MEASUREMENTS AND RESULTS: Legionella pneumophila serogroup 1 was isolated from sputum culture in two patients . Bacteriological culture of the public bath water subsequently yielded large numbers of Legionella species . Cleavage of genomic DNA showed that restriction fragment patterns coming from clinical and environmental isolates of L . pneumophila serogroup 1 were closely related, focusing the inquiry to a public bathhouse where a circulating filtration system was suspected as the source of infection . CONCLUSIONS: It was later concluded that the circulating filtration system adopted for bath water was marred by a serious design flaw that subsequently caused the mass outbreak . Specifically, a line of the bath water was being returned to the bath without undergoing heat exchange or sterilization by chlorine; and the Legionella species that had proliferated in the filter and the bright stone filtration unit were allowed to return to the bath, eventually culminating in a mass infection. Indian J Med Sci, 2003 Jan, 57(1), 12 - 5 Mycobacterial cervical lymphadenitis in childhood; Jindal N et al.; A study of 190 children of chronic cervical lymphadenitis showed tuberculous etiology on histopathological examination in 92 (48.4%) and bacteriological evidence of mycobacterial infection (smear and/or culture) in 42 (22.1%) . Of these 42, twelve (28.6%) showed histopathological diagnosis of non-specific lymphadenitis . Positive culture for mycobacteria was obtained in 40, of which 30 (75%) were typical M . tuberculosis and 10 (25%) were atypical mycobacteria . The most predominant species of typical mycobacteria was M . scrofulaceum (60%) followed by M . avium intracellulare (40%) . There was no remarkable difference in the histopathological pattern of those in which M . tuberculosis was grown and those in which bacterial growth was that of atypical mycobacteria . The diagnosis of chronic cervical lymphadenitis should therefore be taken a step beyond histopathology, up to complete bacteriological examination, especially to confirm the cases of mycobacterial lymphadenitis caused by atypical mycobacteria. Ophthalmic Surg Lasers Imaging, 2003 Sep-Oct, 34(5), 409 - 12 Tuberculous osteomyelitis and optic neuritis; Das JC et al.; This case report describes a rare instance of bilateral optic papillitis associated with histologically and bacteriologically proven tubercular osteomyelitis of the right sphenoid and temporal bone of the orbit in a 30-year-old woman . This case also highlights the usefulness of computerized axial tomography of the orbits, skull, and paranasal sinuses to evaluate optic neuritis and its pathophysiology in the event of no obvious cause or contributing systemic disease. Vet Ther, 2003 Summer, 4(2), 145 - 54 Effects of oral selenium supplementation on mastitis markers and pathogens in Estonian cows; Malbe M et al.; The effects of selenium supplementation on mastitis parameters in milk and on glutathione peroxidase (GPx) levels in blood were evaluated . Fifty-five Estonian dairy cows were allocated to selenium-supplemented (n=39) and nonsupplemented (n=16) groups . The supplemented group received 0.2 ppm organic selenium in the form of selenium yeast in their diet daily for 8 weeks . The nonsupplemented cows received their standard diet with no selenium supplementation . Mastitis parameters (i.e., bacteriologic findings and somatic cell count, N-acetyl-beta-D-glucosaminidase, and bovine serum albumin concentration) and GPx levels were monitored . The increase in the activity of GPx was significantly (P<.001) greater in selenium-supplemented cows than in nonsupplemented ones . Milk samples from each quarter were examined before and 8 weeks after initiation of the study . The proportion of quarters still pathogen-free after 8 weeks was significantly (P<.01; odds ratio {OR}=9.7) higher in selenium-supplemented cows than in nonsupplemented cows . However, when quarters milk-tested as pathogen-infected at the start of the study were reexamined after 8 weeks, there was no significant (P=.14; OR 3.6) difference in the proportion of pathogen-free quarters between selenium-supplemented cows and nonsupplemented cows . Differential positive rate (Youden's index) revealed that individual quarters were more prone to be infected by pathogens when the blood GPx activities in cows were below the cutoff value of 3.3 microkat/g hemoglobin than when GPx activity was above this value . It was concluded that selenium supplementation in cows with low GPx activity seems to support udder defense mechanisms that favor reduction of the incidence of new mastitis cases. Presse Med, 2003 Aug 9, 32(26), 1208 - 12 {Audit on antibiotic prescriptions in a department of infectious diseases}; Zahar JR et al.; OBJECTIVES: France is one of the countries that prescribe the most antibiotics . The inappropriate use of antibiotics participates in the emergence of multi-resistant bacteria . This study was aimed at assessing the adequation of antibiotic prescriptions in a hospital department of internal medicine-infectious diseases . METHODS: Over a two-month period, all the antibiotics treatments were analysed prospectively . The adequation of the treatments was analysed at first with regard to the various consensus conferences of the French-speaking Society of infectious diseases (Societe de pathologie infectieuse de langue francaise (Spilf)) and then with regard to the bacteriological results . RESULTS: One hundred and five prescriptions were analysed during the study period . Thirty-five percent of prescriptions were inadequate with regard to the criteria used . In 22 cases the prescription was excessive, in 8 cases it was unjustified and in 5 cases it was inappropriate . Moreover, in univariate analysis, 3 factors were correlated with inadequation: prescriptions drawn-up by a non-infectious disease practitioner (OR =3.45, IC 95% 1.34-9.09, p=0.008), prescriptions drawn-up by junior in the department (OR =4.10, IC 95% 1.54-11.08, p=0.003) and prescriptions pour respiratory infections (OR=2.58, IC 95% 1.03-6.48, p =0.04) . CONCLUSION: This study conducted in a department of infectious diseases reveals the persisting high rate of inappropriate prescriptions, confirming the need to develop control and retro-control strategies regarding the prescription of antibiotics in order to control the diffusion of multi-resistant bacteria. Ann Dermatol Venereol, 2003 Jun-Jul, 130(6-7), 639 - 42 {Cutaneous T-cell lymphoma bullosa: 2 cases}; Heliot I et al.; INTRODUCTION: Since the first case described by Kaposi in 1887, bullous forms of cutaneous T-cell lymphomas are extremely . CASE-REPORT: We describe an unusual case of mycosis fungoides bullosa with palmoplantar dyshidrosis-like eruption and, to our knowledge, the first case of pleomorphic cutaneous T-cell lymphoma bullosa . DISCUSSION: Cutaneous T-cell lymphoma bullosa can be very misleading, particularly when the bullous lesions are inaugural . Differential diagnosis have to be excluded (autoimmune blistering diseases or contact dermatitis during topical treatment of lymphoma or bacterial or viral cutaneous infections) by biopsy, direct immunofluorescence and bacteriological examinations . In these cutaneous lymphoma bullosa, the blisters appear to de due to excessive epidermotropism and/or toxicity of the tumoral infiltrate. Curr Med Res Opin, 2003, 19(5), 411 - 20 Short-course therapy of acute bacterial exacerbation of chronic bronchitis: a double-blind, randomized, multicenter comparison of extended-release versus immediate-release clarithromycin; Nalepa P et al.; OBJECTIVE: The objective of this study was to compare the efficacy and safety of two clarithromycin formulations given for 5 days to patients with acute bacterial exacerbation of chronic bronchitis (ABECB) . PATIENTS AND METHODS: This was a double-blind, randomized, multicenter study of ambulatory patients between 40 and 75 years of age with a medical history of chronic bronchitis, chronic obstructive pulmonary disease and a presumptive diagnosis of ABECB who met Anthonisen Type 1 criteria (increased dyspnea, increased sputum volume and increased sputum purulence) . Eligible patients received a 5-day course of clarithromycin extended-release (ER) 500 mg once daily or clarithromycin immediate-release (IR) 250 mg twice daily . Clinical cure, bacteriological cure and pathogen eradication rates were determined at the end of therapy and at a follow-up visit . RESULTS: Clinical cure rates were similar at the test-of-cure visit for evaluable patients in the clarithromycin ER group (97%, 298/307) and clarithromycin IR group (98%, 300/307) (95% CI (-3.2, 1.9)) . The bacteriological cure rate was 89% and the pathogen eradication rate was 90% in both treatment groups . Resolution or improvement in cough, sputum production, sputum volume and sputum appearance was observed in > 90% of evaluable patients in each treatment group . The incidence of study drug-related adverse events was 6.6% (23/351) in the clarithromycin ER group and 5.4% (19/352) in the clarithromycin IR group . The most frequently occurring study drug-related adverse events were abdominal pain, diarrhea and taste perversion . CONCLUSION: Clarithromycin ER 500 mg once daily for 5 days is equivalent to clarithromycin IR 250 mg twice daily for 5 days in treating adults with ABECB . Both regimens were effective in resolving clinical signs and symptoms of ABECB and eradicating the target pathogens, and were well tolerated. Vestn Otorinolaringol, 2003, (4), 42 - 4 {Halotherapy in combined non-puncture therapy of patients with acute purulent maxillary sinusitis}; Grigor'eva NV; Halotherapy was applied for non-puncture treatment of 45 patients with acute purulent maxillary sinusitis . The response was evaluated by changes in clinico-immunological, cytological, x-ray and bacteriological parameters . Halotherapy was found effective in the treatment of acute purulent maxillary sinusitis without puncture. J Radiol, 2003 Jul-Aug, 84(7-8 Pt 1), 861 - 4 {Tuberculosis of the knee: MRI findings in two pediatric cases}; Aloui N et al.; Osteo-articular tuberculosis is rare in infants . The MRI findings reported for adolescents and young adults mainly relate to spinal involvement . Two cases of osteo-articular tuberculosis of infants located at the knee are presented . Vaccination has been correctly done . Skin test and chest radiography were normal . Evolution was insidious for one case . Osseous, medullary, cartilaginous and soft tissue abnormalities revealed by MRI were suspicious for tuberculosis . Diagnosis was confirmed at histology for both cases and bacteriology for one case . The aim of this study is to report the MRI features of osteo-articular tuberculosis in pediatric patients. Oral Dis, 2003, 9 Suppl 1, 54 - 62 Diagnostic testing as a supportive measure of treatment strategy; Sixou M; The bacteriological tests in periodontology have been available to clinicians since the end of the 1980s . Despite the vast and varied information that they contribute to the literature on this topic, some controversy has arisen with regard to the use of these tests . Clinicians faced with a multitude of clinical forms of periodontal disease in their patients can count on laboratory examinations to help them in the therapeutic process . These biological examinations can offer help in five areas of application: support in diagnosis and prognosis, verification of the efficiency of the treatment, indication of the correct antibiotic therapy and choice of the most appropriate molecules . The clinician's needs determine the type of bacteriological technical analysis used: bacterial culture or genetic identification using the molecular techniques . Each technique has its advantages and disadvantages . Knowing these limits allows the most appropriate choice to be made, depending on the clinical situation . The richness of information provided by culture in the anti-microbial susceptibility test and the non-targeted aspect of this test make this technique very interesting for the diagnosis of periodontitis . However, the targeted aspect of molecular techniques (PCR), their excellent sensibility and their rapidity make them prevail, particularly in the control and maintenance phases . Furthermore, despite the constant development of bacterial identification techniques, these examinations are little used by dental surgeons as these examinations are little known . They are also difficult to interpret and generate heavy additional costs. Chest, 2003 Sep, 124(3), 893 - 901 Uptake rates of 18F-fluorodeoxyglucose and 11C-choline in lung cancer and pulmonary tuberculosis: a positron emission tomography study; Hara T et al.; STUDY OBJECTIVE: The purpose of this study was to examine the uptake rates of (18)F-fluorodeoxyglucose (FDG) and (11)C-choline in patients with lung cancer, pulmonary tuberculosis, and atypical mycobacterial infection of the lung by positron emission tomography (PET) scanning with relation to their tumor size . DESIGN: Ninety-seven patients with untreated lung cancer, 14 patients with untreated pulmonary tuberculosis, and 5 patients with untreated atypical mycobacterial infection were examined . The diagnosis of lung cancer was confirmed pathologically after biopsy and surgery . The diagnosis of tuberculosis and atypical mycobacterial infection was confirmed by bacterial culture . The uptake rates of FDG and (11)C-choline were presented quantitatively as the standardized uptake value (SUV) . SETTING: International Medical Center of Japan . RESULTS: In lung cancer patients, the SUV of FDG increased with increasing tumor size, whereas the SUV of (11)C-choline was almost constant at around 3.5 for every tumor size . In tuberculosis patients, the SUV of FDG increased with increasing tumor size, whereas the SUV of (11)C-choline was almost constant at around 2 for every tumor size . In atypical mycobacterial infection patients, the SUV of FDG and the SUV of (11)C-choline were equally low at around < or = 2 . CONCLUSION: The differences in the SUVs of FDG and (11)C-choline in patients with lung cancer, tuberculosis, and atypical mycobacterial infection for the same tumor size (tumor size, > 1.5 cm) were distinct . In lung cancer patients, the SUVs of both FDG and (11)C-choline were high . In tuberculosis patients, the SUV of FDG was high, but the SUV of (11)C-choline was low . In atypical mycobacterial infection patients, the SUVs of both FDG and (11)C-choline were low . It may be possible to apply this principle to make a presumptive diagnosis of a solitary pulmonary nodule if it is too small to make a definitive diagnosis pathologically and bacteriologically. Zh Mikrobiol Epidemiol Immunobiol, 2003 Jul-Aug, (4), 67 - 71 {Enzyme immunoassay and polymerase chain reaction for evaluation of brucella persistence}; Zheludkov MM et al.; The complex approach, including the use of traditional bacteriological and serological methods, as well as the polymerase chain (PCR) reaction and the enzyme immunoassay (EIA), was used for evaluation of Brucella (the causative agents of brucellosis) persistence in the dynamics of the infectious process in patients with the acute and chronic forms of brucellosis as well as in experimentally infected laboratory animals . Sick humans and experimental animals were found to have positive PCR and EIA reactions at different periods of the disease . The use of these methods makes it possible to evaluate indirectly the persistence of Brucella. Jpn J Thorac Cardiovasc Surg, 2003 Aug, 51(8), 384 - 6 Early valvular obliteration of cryopreserved aortic valve allograft; Saito A et al.; This report describes a 60-year-old male patient who developed early valvular obliteration of a cryopreserved aortic valve allograft with associated severe valvular leakage . The patient had previously undergone two operations for aortic valve insufficiency resulting from infective endocarditis, and prosthetic valve endocarditis: aortic valve replacement with a mechanical prosthesis was done 4 years ago, and two years later aortic root replacement with a cryopreserved allograft was performed . Perforation through the non-coronary cusp of the aortic allograft was found, and valve replacement was achieved using a mechanical prosthesis . The intraoperative findings, histological, immunological, and bacteriological studies of the resected cusps demonstrated negative for infection and rejection, therefore, the valvular perforation might have been caused by an injury or degeneration during management of the homologous graft . The patient showed neither aortic regurgitation on echocardiography nor recurrence of endocarditis 10 months after surgery. Neurosurg Rev, 2003 May, 26(2), 102 - 7 Epub 2002 Dec 10. Microsurgical management of postoperative disc space infection; Bavinzski G et al.; We analysed seventeen patients with septic postoperative spondylodiscitis (POD) who were managed by early microsurgical removal of the infected necrotic tissue, application of a closed suction-irrigation system (for a mean of 6.7 days), and early mobilisation . The POD was diagnosed clinically by elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) values and radiographically by computerised tomography scanning or magnetic resonance imaging . According to the sensitivity studies of the obtained pathogens, systemic antibiotics were given, followed by early mobilisation of all patients in a light cast corset . Immediate pain relief was noted in all patients except one, who required a third operation that was followed by rapid clinical improvement . Bacteriological diagnosis was obtained in 88% of the patients . Excellent or good clinical long-term results were achieved in 82% of the patients, whereas 18% had poor results . Elevated ESR/CRP values returned to normal ranges within 6 to 44 days (mean 15 days) after reoperation . All but one patient tolerated early mobilisation (within 2 to 4 weeks) well without any complication . Early microsurgical removal of the necrotic and infected tissue and application of a closed suction-irrigation system supported by specific antibiotic therapy should be considered an effective means to treat POD, thereby avoiding a prolonged period of unpleasant immobilisation for the patient. Pneumonol Alergol Pol, 2003, 71(1-2), 86 - 94 {Purulent lung diseases necessitating surgical treatment--case reports}; Grudny J et al.; Majority of purulent lung diseases are treated with antibiotics . But sometimes this therapy is not successful and surgical treatment is necessary . Two patients are described in this paper . 68 years old woman in whom infiltration in left lung enlarged during antibiotics therapy . CT examination did not allow to differentiate between abscessus and tumor . Results of bacteriologic and cytologic examination of transthoracic biopsy were negative . During thoracothomy abscessus was resected and diagnosis was confirmed by patomorphologic examination . The second case: 16-years old girl was addmitted to hospital because of high temperature and abnormal chest X-ray picture (infiltration and liquid level in lower right lobe) . During puncture the pus was evacuated but bacteria were not cultured . Antibiotics were not effective . Thoracothomy was done and large cysta bronchogenes was resected . In both cases surgical treatment was effective. Pneumonol Alergol Pol, 2003, 71(1-2), 12 - 6 {Surgical treatment and adjunct hyperbaric therapy to improve healing of wound infection complications after sterno-mediastinitis}; Siondalski P et al.; Although the incidence of wound complications after median sternotomy is less than 1%, it remains a serious complication in patients undergoing cardiac procedures . We suggest that the combination of hyperbaric oxygen therapy and aggressive surgical approach improves clinical outcomes in these patients . Between August 1997 and May 2002, 55 patients with postoperative sternal wound infection and/or mediastinitis were qualified for hyperbaric oxygen treatment in connection to surgical management . Surgical procedure included wound debridment and/or sternum rewiring, omental pedicle flap plasty or sternectomy . Hyperbaric oxygen therapy consisted of 20 to 40 expositions per patient and was carried before and after the surgery . RESULTS: There was no in-hospital death . The total time between the admission and discharge from the hospital varied from 2 to 24 weeks (average 8 weeks) . The infection has been cured in all patients treated for postoperative sternal wound infection . That has been confirmed by negative bacteriological tests, stabilization of the sternum and complete wound healing . CONCLUSIONS: The combination of surgical treatment and hyperbaric oxygen therapy may improve clinical outcome in patients with sterno-mediastinis and poststernotomy wound infection after cardiac surgery. Med Microbiol Immunol (Berl), 2004 Nov, 193(4), 209 - 17 Epub 2004 Nov. Prospective study on nontuberculous mycobacteria in patients with and without cystic fibrosis; Leitritz L et al.; Recent reports indicated an increase of nontuberculous mycobacteria (NTM) in cystic fibrosis (CF) patients . However, it is still a matter of discussion whether criteria for diagnosis of NTM pulmonary infection established by the American Thoracic Society (ATS) are applicable for CF patients . We determined incidence and prevalence of NTM in CF patients and non-CF patients without HIV infection, and validity of ATS criteria for CF patients . Over a period of 2 years, 1,251 respiratory samples were investigated for mycobacteria from 91 CF and 162 non-CF patients . For all patients with NTM recovery, we reviewed clinical charts and determined outcome for up to 2 years . Incidence and prevalence for repeated recovery of NTM were higher in CF patients, but not significantly . CF patients with repeated recovery of NTM met clinical and bacteriological ATS criteria, but radiographic criteria were not met . Treated CF patients showed favorable clinical outcomes, as opposed to untreated patients . We propose a modified definition for diagnosis and hence treatment of NTM pulmonary infection in CF patients. Curr Treat Options Gastroenterol, 2003 Oct, 6(5), 359 - 367 Surgical Treatment of Acute Pancreatitis; Werner J et al.; Patients with predicted severe necrotizing pancreatitis as diagnosed by C-reactive protein (>150 mg/L) and/or contrast-enhanced computed tomography should be managed in the intensive care unit . Prophylactic broad-spectrum antibiotics reduce infection rates and survival in severe necrotizing pancreatitis . Endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy is a causative therapy for gallstone pancreatitis with impacted stones, biliary sepsis, or obstructive jaundice . Fine needle aspiration for bacteriology should be performed to differentiate between sterile and infected pancreatic necrosis in patients with sepsis syndrome . Infected pancreatic necrosis in patients with clinical signs and symptoms of sepsis is an indication for surgery . Patients with sterile pancreatic necrosis should be managed conservatively . Surgery in patients with sterile necrosis may be indicated in cases of persistent necrotizing pancreatitis and in the rare cases of "fulminant acute pancreatitis." Early surgery, within 14 days after onset of the disease, is not recommended in patients with necrotizing pancreatitis . The surgical approach should be organ-preserving (debridement/necrosectomy) and combined with a postoperative management concept that maximizes postoperative evacuation of retroperitoneal debris and exudate . Minimally invasive surgical procedures have to be regarded as an experimental approach and should be restricted to controlled trials . Cholecystectomy should be performed to avoid recurrence of gallstone-associated acute pancreatitis. Infect Control Hosp Epidemiol, 2003 Aug, 24(8), 613 - 7 A Chryseobacterium meningosepticum outbreak in a neonatal ward; Gungor S et al.; OBJECTIVE: To report epidemiologic, bacteriologic, and clinical features of a Chryseobacterium meningosepticum outbreak . DESIGN: Outbreak investigation . SETTING: A neonatal intensive care unit (NICU) of a referral teaching hospital . METHODS: During 2 weeks in September 2001, four neonates in the NICU developed sepsis and underwent laboratory investigation . Multiple samples were obtained for cultures from endotracheal tubes, mechanical ventilators and humidifier boxes, infant incubators, parenteral and antiseptic solutions, feeding bottles, sinks, faucets, doors, and healthcare workers . RESULTS: C . meningosepticum was isolated from the blood cultures of four patients . The first isolate was identified 5 days after the death of the index case . Although all isolates were ciprofloxacin susceptible in vitro, the remaining three patients did not respond to ciprofloxacin therapy given for 6 or 7 days . Therapy was switched to vancomycin and rifainpin and all three patients survived, with one having a complication (hydrocephalus) . Environmental surveillance revealed C . meningosepticum in the stock lipid solution as the source of the epidemic . The outbreak was controlled after discontinuation of intravenous lipid solution, restriction of further neonatal admissions, and thorough disinfection of the unit and its equipment . CONCLUSION: Early identification of an epidemic and its source is important in avoiding morbidity and mortality . A contaminated lipid stock bottle was the source of this outbreak associated with multiple cases and one death. Vet Microbiol, 2003 Sep 24, 95(4), 229 - 37 Evaluation of a newly developed real-time PCR for the detection of Taylorella equigenitalis and discrimination from T . asinigenitalis; Premanandh J et al.; A 'culture-LightCycler PCR' assay has been developed for the detection of Taylorella equigenitalis, the causative agent of contagious equine metritis (CEM) in horses . The primers and hybridisation probes were derived from the 16S rDNA sequence . Their specificity was determined in two closely related organisms and six commensal bacteria of the genital tract . The assay was specific for T . equigenitalis and discriminates T . asinigenitalis isolates . It also avoids misidentifications of morphologically and phenotypically similar organisms . The sensitivity was evaluated in comparison to a standard bacteriological culture method . It detected T . equigenitalis in 10 of 52 samples that had not been identified bacteriologically . The results indicated that the assay had a greater sensitivity . This is the first real-time PCR for the detection of T . equigenitalis and avoids PCR carry-over contamination . The 'culture-LightCycler PCR' assay is specific, sensitive and reproducible, and can be used effectively for the detection of T . equigenitalis infections. Leg Med (Tokyo), 2003 Mar, 5 Suppl 1, S233 - 6 Fatal outcome of varicella in children; Kernbach-Wighton G et al.; Varicella or chicken-pox are one of the most frequent diseases in childhood . Severe or even lethal complications are rare (in about 0.03 per thousand ) . Our paper presents two cases of varicella infections leading to sudden deaths (3- and 7-year-old children) . In one of these cases, the paediatrician in charge was accused of an impaired medical treatment . Both of the children showed multiple typical efflorescences in different stages . Furthermore were observed affections of the respiratory tracts and serious involvements of the hearts, the lungs, and the livers . In one case an immunological identification could be made of an acute varicella infection . Based on autoptical, histological, bacteriological, virological, and neuropathological findings is given an analysis of such uncommon and severe courses of chicken-pox in children being identified as haemorrhagic form and massive abscess-forming varicella pneumonia. Tunis Med, 2003 May, 81(5), 329 - 33 {Male gonococcal urethritis in the region of Sfax (1996-2000)}; Znazen A et al.; The sexually transmitted infections pose a real public health problem, mainly in developing countries . In Tunisia, the epidemiological state is not precise . The objective of our study was to determine the sociological, epidemiological and bacteriological characteristics of gonococcal urethritis in the area of Sfax . The study was performed on all patients attending at the CNSS of Sfax for urethritis for 5 years, from 1996 to 2000 . A urethral swab was carried out for each patient with a classic bacteriological exam . 256 cases were collected . The mean age was 29.7 years . 74.3% were workers . The direct exam was positive in 51.2% of cases and the culture enabled us to isolate 72 strains, of which 15.5% were productive of beta-lactamase and 23.9% were resistant to tetracyclin . There was no resistance to pristinamycin, ofloxacin nor spectinomycin. Nihon Kokyuki Gakkai Zasshi, 2003 Jul, 41(7), 457 - 62 {A case of Farmer's lung accompaign with caseous granuloma, monitored with serum KL-6 and SP-D}; Samukawa T et al.; A 65-year-old man was admitted to our hospital with a productive cough, fever, and dyspnea; his chest radiographs revealed diffuse nodular and ground-glass opacities . He had worked on a farm for 11 years . Six months earlier, he had presented with similar symptoms at another hospital, and was admitted with suspected atypical pneumonia . After treatment with antibiotics, his condition improved and he was discharged . Examination on admission to our hospital revealed markedly elevated serum KL-6 levels . Histological findings from specimens obtained by video-assisted thoracic surgical lung biopsy showed caseating and non-caseating epitheloid cell granuloma, lymphocyte infiltration, and alveolitis . Bacteriological tests for mycobacteria and fungi were all negative . Farmer's lung was diagnosed in accordance with the criteria for hypersensitive pneumonia . It is generally accepted that the distinguishing histological finding for Farmer's lung disease is non-caseating epitheloid cell granuloma, but in this case, caseous granuloma was also present. Am J Clin Pathol, 2003 Aug, 120(2), 256 - 64 Bacteriologic characterization of 36 strains of Roseomonas species and proposal of Roseomonas mucosa sp nov and Roseomonas gilardii subsp rosea subsp nov; Han XY et al.; We used a polyphasic approach (sequencing analysis of the 16S ribosomal RNA gene and phenotypic analyses) to characterize 36 strains of Roseomonas species isolated from blood . Five strains, represented by strain MDA5176 (M.D . Anderson Cancer Center), were identified as Roseomonas gilardii . One strain belonged to Roseomonas genomospecies 4 . The 22 strains represented by strain MDA5527 showed significant differences genotypically and phenotypically with R gilardii and other Roseomonas species and represented a new Roseomonas species; Roseomonas mucosa sp nov was proposed to denote its prominent mucoid, almost runny colonies . Eight strains, represented by strain MDA5605, had minor differences with R gilardii and displayed obvious pink to red colonies; Roseomonas gilardii subsp rosea subsp nov was proposed . For subspecies differentiation, R gilardii was proposed to be R gilardii subsp gilardii subsp nov . Unique patterns of biochemical reactions were established for these Roseomonas species, which may assist routine identification of these organisms . All 36 strains and 2 American Type Culture Collection strains were susceptible to amikacin and ciprofloxacin but resistant to cefepime and ceftazidime . They also were frequently susceptible to imipenem and ticarcillin-clavulanate but far less susceptible to ceftriaxone, trimethoprim-sulfamethoxazole, and ampicillin . R mucosa strains were most resistant, whereas R gilardii subsp gilardii strains were most susceptible. Shock, 2003 Sep, 20(3), 251 - 6 Orally inoculated Escherichia coli strains colonize the gut and increase bacterial translocation after stress in rats; Nettelbladt CG et al.; Coliforms are the members of the indigenous gut flora that most often translocate to mesenteric lymph nodes . Very few strains of Escherichia coli found in cecal contents of rats are able to translocate . The present study investigated the role of the composition of the gut flora for the occurrence of bacterial translocation . Two strains of E . coli (KI-C1 and KI-C2), previously shown to translocate in rats subjected to stress, were given by oral inoculation to rats lacking these strains . A biochemical fingerprinting method was used to identify bacteria in cecal contents, on cecal epithelium, and in mesenteric lymph nodes . In a challenge study, the inoculated E . coli strains were shown to colonize the rats and persist for up to 75 days in cecum . Subsequently, one group was starved for 24 h and a second group was subjected to experimental hemorrhage and then starved for 24 h before sampling for bacteriological analyses from blood, cecum, and mesenteric lymph nodes . Two parallel groups of rats served as controls and were not inoculated but otherwise received the same treatment before sampling . In the inoculated group, starved for 24 h, seven out of 11 rats showed translocation, whereas in the noninoculated group one of 11 rats showed translocation (P < 0.05) . In groups subjected to hemorrhage and then starved for 24 h, 15/22 rats in the inoculated and 5/20 rats in the noninoculated group showed translocation (P < 0.01) . These findings show that orally inoculated KI-C1 and KI-C2 strains can colonize the gut and can substantially increase bacterial translocation in rats subjected to mild and severe stress . The composition of the gut flora seems to be an underestimated factor in the pathophysiology of bacterial translocation. J Comp Pathol, 2003 Aug-Oct, 129(2-3), 100 - 10 Mycoplasma bovis-associated suppurative otitis media and pneumonia in bull calves; Maeda T et al.; Outbreaks of Mycoplasma bovis-associated otitis media and pneumonia occurred on four beef cattle farms in Hokkaido, Japan between 2000 and 2001 . The morbidity and mortality were estimated at 8-40 and 30-100%, respectively . Eight calves with bilateral ear droop and exudative otitis media were examined bacteriologically and histopathologically . M . bovis was isolated post mortem from nasal swabs and from the ears, lungs, lymph nodes (cranial and pulmonary), brain and heart of all calves . At necropsy, suppurative exudates were observed in the tympanic bullae of all cases . Numerous abscesses were also found in the petrous portion of the temporal bone and lungs in seven cases . Histopathologically, the exudates within the tympanic bullae consisted of a mixture of neutrophils, necrotic cell debris and fibrin, and the tympanic mucosa was thickened with neutrophil and macrophage infiltration and proliferation of fibrous connective tissue . Pulmonary lesions included extensive foci of coagulative necrosis surrounded by numerous neutrophils . Hepatocytes or renal tubular epithelial cells were enlarged with hyaline cytoplasmic inclusions in four calves . Immunohistochemical labelling confirmed the presence of M . bovis antigen in the cytoplasm of the inflammatory cells in the middle ear, temporal bone and lungs, and was also demonstrated within the cytoplasmic inclusions of the hepatocytes and renal tubular epithelial cells . Ultrastructurally, mycoplasma-like organisms, 200-500 microm in diameter, were found within not only hepatocytes and renal tubular epithelia but also within axons of the facial nerves . The present results show that M . bovis spreads to multiple organs and is capable of invading various kinds of host cell . The intracellular localization may be favourable for evading host immune responses. Rheumatol Int, 2004 Jan, 24(1), 9 - 13 Epub 2003 Aug 14. Diagnosing tuberculous spondylitis: patients with back pain referred to a rheumatology outpatient department; Kotevoglu N et al.; The onset of tuberculous spondylitis is insidious in nature, with various clinical presentations, slow development of radiographic abnormalities, and nonspecific constitutional symptoms . This lack of specific symptoms causes delays in diagnosis . Magnetic resonance imaging demonstrates osteitis, intraosseous abscesses, paravertebral and epidural soft tissue extensions and abscesses, discitis, multilevel involvement of spinal cord or nerve root compression, and scoliosis . We present six patients with tuberculous spondylitis referred to our outpatient department with back pain resistant to medical therapy . All of them were women aged from 25 to 58 years (mean 44.6) . The diagnosis of tuberculous spondylitis was based on clinical presentation, radiographic and/or MRI evidence of focal destructive vertebral lesions (with paravertebral mass), and positive bacteriological findings of Mycobacterium tuberculosis . The combined antituberculous chemotherapy consisted of 1.0 g/day streptomycin for 1 month, 25 mg/kg ethambutol or 25 mg/kg pyrazinamide, 600 mg/day rifampicin, and 300 mg/day isoniazid . The duration of therapy was 12 months . All the patients recovered without any sequelae . The mean follow-up period was 28 months (range 12-48) . Magnetic resonance imaging is considered the main imaging modality for patients with suspected tuberculous spondylitis; it must be included in differential diagnosis of back pain and, if it is diagnosed in early stages, antituberculous chemotherapy enables satisfactory outcome. J Heart Valve Dis, 2003 Jul, 12(4), 530 - 4 Antineutrophil cytoplasmic autoantibody-negative antiproteinase 3 syndrome presenting as vasculitis, endocarditis, polyneuropathy and Dupuytren's contracture; Stollberger C et al.; Antiproteinase 3 antibodies (antiPR3) are assumed to be subtypes of antineutrophil cytoplasmic autoantibodies (ANCA), with a high specificity for active Wegener's granulomatosis and microscopic polyangiitis . Thus, antiPR3 positivity in ELISA, together with negativity in indirect immunofluorescence (IIF) is a rare finding . A 56-year-old man with Dupuytren's contracture and polyneuropathy was admitted for leukocytoclastic vasculitis . Echocardiography, performed because of fever and dyspnea, detected aortic valve endocarditis . Because of severe aortic insufficiency the valve was replaced . Blood cultures and bacteriologic investigations of the explanted valve were negative . AntiPR3 were elevated (123-163 U/ml; normal <6 U/ml), together with negativity in IIF . This case shows that antiPR3 elevation with negative ANCA may be associated with vasculitis, endocarditis, polyneuropathy and Dupuytren's contracture . A causal relationship between the clinical presentation and antiPR3 elevation is likely . In order not to miss such cases of vasculitis, combined screening by IIF and ELISA is recommended in selected cases. Lin Chuang Er Bi Yan Hou Ke Za Zhi, 2003 May, 17(5), 291 - 3 {Bacteriologic examination in experimental maxillary sinusitis of rabbits}; Liu F et al.; OBJECTIVE: To investigate how to induce experimental maxillary sinusitis so as to explore its bacteriologic changes . METHOD: Forty New Zealand white rabbits were divided into six groups according to different methods to create experimental sinusitis . The purulent discharge of sinus and bacteria culture is investigated in different times . RESULT: The positive rate of bacteria culture are 0%(control group), 20%(sham-operation group), 84.6% (ostia-block group), 10%(bacteria inoculation group) and 100%(ostia-block plus bacteria inoculation group) . The cultivate bacteria are mainly inoculate ones when sinusitis induced shorter than 2 weeks . If maxillary sinusitis induced more than 3 weeks, the cultivate bacteria are mainly opportunistic pathogens of rabbits . CONCLUSION: Experimental maxillary sinusitis can be successfully induced by bacteria inoculation with an ostium closed . The cultivate rate of opportunistic bacteria is related to the process of sinusitis. Hong Kong Med J, 2003 Aug, 9(4), 263 - 8 Prevalence and predictors of default from tuberculosis treatment in Hong Kong; Chan-Yeung M et al.; OBJECTIVE: To determine the prevalence and risk factors of default from tuberculosis treatment in Hong Kong . DESIGN: Retrospective study . SETTING: Data were obtained from programme forms completed by physicians in the Hong Kong Government Tuberculosis and Chest Service and from medical records from Hong Kong chest clinics . PATIENTS: In all, 5917 patients registered for antituberculous drug therapy in 1996; medical records of 5757 patients were reviewed . MAIN OUTCOME MEASURES: Patients who defaulted treatment were defined as those who had failed to collect medication for more than 2 consecutive months after the date of the last attendance during the course of treatment . Demographic and clinical characteristics, including history, treatment, and outcome, were compared between defaulters and non-defaulters, both among the whole group and among those with pulmonary disease . RESULTS: There were 442 (8%) patients who defaulted from treatment . Forty-five percent of those who defaulted did so in the first 2 months of treatment . Key risk factors associated with non-compliance were a history of default, male sex, and a history of concomitant liver disease or lung cancer . Among patients with pulmonary tuberculosis (381 defaulters and 1537 non-defaulters), multiple drug resistance was also associated with default from treatment . Among defaulters with pulmonary disease, 39% were still bacteriologically positive at the time of default . CONCLUSION: Default from treatment may be partially responsible for the persistent high rates of tuberculosis in Hong Kong in the past decade . Health professionals should ensure that all barriers to treatment be removed and that incentives be used to encourage treatment compliance. Kisaengchunghak Chapchi, 1982 Dec, 20(2), 93 - 99 Studies On Intestinal Trematodes In Korea: V . A Human Case Infected By Fibricola Seoulensis (Trematoda: Diplostomatidae); Seo BS et al.; A 25-year old Korean male was admitted to Seoul National University Hospital on July 5, 1982 because of fever, epigastric discomfort and diarrhea . Laboratory examination revealed moderate eosinophilia, and large operculated helminth eggs in stool repeatedly . Other laboratory test resulted in normal range and bacteriological cultures were nefative . Under the impression of intestinal fluke infection, bithionol treatment with magnesium purgation was tried . From the diarrheal stool after treatment, a total of 79 small adult trematodes was collected, and identified as Fibricola seoulensis . The patient had eaten raw viscera of 2 snakes 9 days before admission in a rural village in Korea . It was assumed that this is the first record that described human infection by an adult diplostomatid fluke. Hist Cienc Saude Manguinhos, 2003 Jan-Apr, 10(1), 85 - 111 {On the abominable profession of being a vampire: Emílio Goeldi and Mosquitos in Pará (1905)}; Sanjad N; In the fields of public health and entomology, the turn of the 20th century was marked by an emphasis on insects as transmitters of disease . Physicians, bacteriologists and zoologists perseverently tried to understand the etiology of diseases like malaria and yellow fever and make an inventory of the species of insects associated with disease, studying their scientific and biological classification and establishing procedures to control epidemics . The Swiss zoologist Emilio Goeldi (1859-1917), who was then director of the Museum of Natural History and Ethnography of Para, in Belem, was an active participant in this scientific network and wrote a number of papers on mosquitos in the Amazon . His ideas and contributions to zoology and medical entomology are the focus of this paper. Hist Cienc Saude Manguinhos, 2003 Jan-Apr, 10(1), 13 - 83 {Adolpho Lutz: a biographical sketch}; Benchimol JL; This article portrays the family origins and life story of Adolpho Lutz (1855-1940) up to his transfer to the Instituto Oswaldo Cruz in 1908 . His life history is used as a motif for an analysis of the institution of pasteurian and tropical medicine in Brazil . His university and postgraduate study in German-speaking Europe are examined, as are his activities as a clinician and researcher on subjects related to helminthology, parasitology, veterinary medicine and bacteriology in the interior of Sao Paulo state; his stay at the Molokai leprosarium in Hawaii; and the medical controversies in which he participated as head of the Bacteriological Institute of Sao Paulo, especially those on cholera, dysenteries, typhoid fever, malaria and yellow fever. J Am Coll Surg, 2003 Aug, 197(2), 206 - 11 Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center; Byrne MF et al.; BACKGROUND: Standard treatment for acute cholecystitis is cholecystectomy, but some patients are at high risk for immediate surgery . Percutaneous cholecystostomy might be the procedure of choice in this group . We reviewed the experience of percutaneous cholecystostomy in a large tertiary center population . STUDY DESIGN: We performed a retrospective analysis of patients who underwent percutaneous cholecystostomy, and recorded indications for cholecystostomy, duration of tube placement, clinical outcome, death within 30 days of procedure, complications, bacteriology of aspirated bile, gallbladder contents, and performance of interval cholecystectomy . RESULTS: Forty-five patients (mean age 63 years) had cholecystostomy tubes placed from July 1999 to March 2002 . All had confirmed or presumed acute cholecystitis . Mean duration of tube insertion was 54.3 days . Thirty-six patients improved clinically within 5 days . Nine patients died within 30 days; only one death was directly related to gallbladder sepsis . Nine patients subsequently had laparoscopic cholecystectomy, eight had open cholecystectomy, and two had cholecystoenterostomy . Cholecystectomy was planned in another five patients . Cholecystostomy tubes leaked in two patients, blocked in four, and dislodged in one . One patient developed a hemoperitoneum . Bile aspirated at cholecystostomy was culture positive in 12 patients, negative in 16, and not sent or recorded in 17 . Twenty-two patients had gallstones, 10 had sludge, 9 had both, and 4 had neither . CONCLUSIONS: In experienced hands, percutaneous cholecystostomy is easy to perform, with low complication and high success rates . It is the procedure of choice in patients with acute cholecystitis unfit for emergency surgery . Patients often improve clinically, so that cholecystectomy can be done electively. An Sist Sanit Navar, 1999 May-Aug, 22(2), 177 - 87 {Evaluation of the Program for the Prevention and Control of Tuberculosis during the period January 1993 - June 1996}; Andueza J et al.; In 1992 a Technical Commission was formed in Navarra with the participation of different specialists who drew up the Program of Vigilance and Control of Tuberculosis . We present the results of the evaluation of this program for the period from January 1993 to June 1996 . In the 3.5 years of the study, 419 cases of tuberculosis were found, 317 belonging to respiratory forms and 102 to extra-respiratory forms . The annual rate of incidence of total tuberculosis, 22.8 cases per 100,000 inhabitants observed in Navarra, is the lowest of those registered at the level of the Autonomous Communities according to the TIR study of the SEPAR (acronym for Spanish Society of Pneumology and Thoracic Surgery) in 1996, and the second lowest, after Castilla-La Mancha, according to the multicentric study of the National Centre of Epidemiology . In Navarra the highest rates of incidence are produced in those over 65 years of age, following the pattern observed in the more developed countries . 13.9% of the patients with respiratory tuberculosis showed co-infection by HIV, and besides more than 90% of these were users of intravenous drugs . The percentage of immigrants, prisoners and the destitute observed in the Navarra series is lower than that found in areas such as Madrid, Barcelona or Zaragoza . 91% of the cases of respiratory tuberculosis showed bacteriological confirmation and 98% of the cases were diagnosed and treated in specialised care . Outstanding were the high follow-up of the cases until discharge and the high percentage of cures achieved, some 85.4%. Thorax, 2003 Aug, 58(8), 680 - 5 Resolution of bronchial inflammation is related to bacterial eradication following treatment of exacerbations of chronic bronchitis; White AJ et al.; BACKGROUND: Recent studies of the role of bacteria in chronic bronchitis have shown that bacterial colonisation is associated with enhanced inflammation and that purulent acute exacerbations of chronic bronchitis (AECB) are associated with bacteria and characterised by increased inflammation . Changes in bronchial inflammation in response to the success or failure of bacterial eradication following AECB were therefore studied . METHODS: Bacterial quantitative culture and sputum markers of inflammation (myeloperoxidase (MPO), neutrophil elastase, leukotriene B4 (LTB4), sol:serum albumin ratio, and secretory leukoprotease inhibitor) were measured in patients presenting with culture positive purulent AECB and repeated 10 days and 2 months later . 41 patients provided sputum sufficient for both bacteriology and assessment of inflammation at baseline and day 10, and 46 provided sufficient sample for bacteriology, 40 of which could also be analysed for inflammation at 2 months (when clinically stable) . RESULTS: At day 10, 17 of the 41 patient samples had a positive bacterial culture . In the stable state, 18 of the 46 samples had a positive culture, but with a significantly lower bacterial load than at presentation . Although there was no difference between the groups at presentation, the concentration of MPO was lower (p<0.05) in those in whom bacteria were eradicated by day 10 than in those with persisting bacteria . The LTB4 concentration was similarly lower (p<0.001) in those in whom bacteria were eradicated than in those with persistent bacteria . In the stable clinical state the concentrations of both MPO and LTB4 were lower in those in whom bacteria were eradicated than in patients with persisting bacteria . CONCLUSION: Resolution of bronchial inflammation following AECB is related to bacterial eradication . Those in whom bacteria continue to be cultured in their sputum have partial resolution of inflammation which may reflect continued stimulation by the reduced bacterial load. Cornea, 2003 Aug, 22(6), 569 - 72 How long can donor sclera be safely stored? Romanchuk KG, Nair P, Grahn B. PURPOSE: To determine whether after prolonged storage of sclera in glycerin, there is any bacteriologic contamination that will reactivate, whether reconstituted sclera retains its tensile strength, and whether sclera retains its microstructural integrity . METHODS: Sixty-six scleral shells stored in glycerin for 9 to 19 years, as well as 11 controls stored for 6 months to 4 years, were studied by cutting a small wedge of tissue from the anterior margin of each and directly inoculating into thioglycolate broth, cutting an equatorial ring and determining its break strength using a tensiometer, and cutting a small piece from the remaining posterior portion and examining by scanning electron microscopy . RESULTS: After such prolonged storage, bacteriologic contamination was not detected, tensile strength generally increased with increasing duration of storage, and ultrastructural integrity was maintained on scanning electron microscopy . CONCLUSIONS: This study suggests that storage of scleral shells can be safely prolonged; we hope this can facilitate an increased supply of donated sclera to patients and surgeons. Trends Microbiol, 2003 Jul, 11(7), 318 - 21 Gene-sequence-based criteria for species definition in bacteriology: the Bartonella paradigm; La Scola B et al.; The definition of new species is currently based on polyphasic classification that includes both determination of phenotypic characteristics and DNA-DNA homology . However, none of these techniques is convenient for the rapid characterization of fastidious or non-culturable bacteria . Using sequences available in the GenBank database, we compared the similarities of gene fragments among the currently recognized Bartonella species . This comparison led to both the definition of similarity values that discriminated Bartonella at the species level and assessment of the relative discriminatory power of each gene examined . In this perspective, rpoB and gltA were found to be the most potent. J Int Med Res, 2003 May-Jun, 31(3), 157 - 69 Oral telithromycin 800 mg once daily for 5 days versus cefuroxime axetil 500 mg twice daily for 10 days in adults with acute exacerbations of chronic bronchitis; Zervos MJ et al.; The efficacy and safety of a 5-day regimen of 800 mg telithromycin once daily was compared with a standard 10-day regimen of 500 mg cefuroxime axetil twice daily in a multicentre, randomized, double-blind, parallel-group trial involving 376 patients with acute exacerbations of chronic bronchitis (AECB) . In clinically evaluable patients (n = 282), post-therapy clinical cure rates were 86.4% with telithromycin and 83.1% with cefuroxime axetil . In bacteriologically evaluable patients (n = 53), eradication or presumed eradication of the pathogen was achieved in 76.0% and 78.6% of telithromycin and cefuroxime axetil patients, respectively . Adverse events were mostly mild; the most common were diarrhoea (12.8% versus 11.8%) and nausea (8.9% versus 3.2%) in telithromycin and cefuroxime axetil patients, respectively . The 5-day regimen of 800 mg telithromycin once daily was similar in efficacy and equally well tolerated as a 10-day regimen of 500 mg cefuroxime axetil twice daily in adults with AECB. Clin Ther, 2003 May, 25(5), 1453 - 68 Randomized, open-label, parallel-group, multicenter study of the efficacy and tolerability of IV gatifloxacin with the option for oral stepdown gatifloxacin versus IV ceftriaxone (with or without erythromycin or clarithromycin) with the option for oral stepdown clarithromycin for treatment of patients with mild to moderate community-acquired pneumonia requiring hospitalization; Correa JC et al.; BACKGROUND: Empiric therapy for community-acquired pneumonia (CAP) requires the use of antibiotics with activity against a broad spectrum of respiratory pathogens and suitable pharmacokinetic properties to simplify IV-to-oral step-down therapy switches . OBJECTIVE: The aim of this study was to compare the efficacy and tolerability of IV gatifloxacin with the option for oral stepdown gatifloxacin with a standard regimen of IV ceftriaxone (with or without erythromycin or clarithromycin) with the option for oral stepdown clarithromycin in patients with mild to moderate CAP requiring hospitalization . METHODS: In a randomized, open-label, parallel-group, multicenter study, adults with CAP received 7 to 14 days of treatment with either IV gatifloxacin 400 mg QD with the stepdown option or IV ceftriaxone 1 or 2 g QD (with or without erythromycin 0.5 or 1 g QID or clarithromycin 500 mg BID) with the stepdown option . RESULTS: One hundred seventy adults with CAP were included in the study . IV gatifloxacin was stepped down to oral gatifloxacin in 90.6% (7785) of patients; IV ceftriaxone was stepped down to oral clarithromycin in 87.1% (7485) of patients . Among clinically evaluable patients (n = 153), cure rates at 1 to 3 days after treatment were 97.4% in the gatifloxacin group (7476) and 90.9% in the ceftriaxone group (7077), with a 95% CI for the difference (-3.7% to 19.1%) indicating statistical equivalence . In patients in whom pathogens were isolated from pretreatment sputum cultures, bacteriologic eradication rates were 100.0% (2929) and 90.9% (3033), respectively . Both regimens were well tolerated; treatment-related adverse events occurred in 27.1% (2385) and 21.2% (1885) of patients, respectively . CONCLUSIONS: In the population studied, treatment with IV gatifloxacin with an option for oral stepdown gatifloxacin was as effective for achieving clinical cure as IV ceftriaxone (with or without concomitant IV erythromycin or clarithromycin) with an option for oral stepdown clarithromycin . Both regimens were well tolerated. Am J Vet Res, 2003 Jul, 64(7), 845 - 54 Effects of pico-tesla electromagnetic field treatment on wound healing in rats; Trostel CT et al.; OBJECTIVE: To evaluate the effects of a pico-tesla electromagnetic field (PTEF) on healing of sutured and open skin wounds and clinicopathologic variables in rats . ANIMALS: 64 male Fischer-344 rats . PROCEDURE: An incision made in the dorsal aspect of the neck was sutured (n = 32) or left open to heal (32) . In each group, 16 rats were not PTEF-treated (controls) . Wound treatment consisted of exposure to a PTEF once daily . Rats in each group were euthanatized at days 2, 4, 7, and 14 . Wounds were evaluated via tensiometry (sutured wounds), digital planimetry (open wounds), laser Doppler perfusion imaging, bacteriologic culture, and histologic examination . Blood samples were collected from all rats for analysis . RESULTS: At day 14, sutured wounds in PTEF-treated rats were stronger (ultimate stress) and tougher (strain energy) than were sutured wounds in control rats . Open wounds in PTEF-treated rats contracted more quickly at days 2 and 4 than did those in control rats . Compared with control wounds, histologic changes (indicative of improved healing) in sutured and open wounds in PTEF-treated rats were detected as early as day 4 . Laser Doppler perfusion measurements, results of CBCs, serum biochemical analyses, and bacteriologic cultures were not different between groups . CONCLUSIONS AND CLINICAL RELEVANCE: Exposure to the PTEF caused no adverse effects on clinicopathologic, histologic, or bacteriologic variables tested in this study . It appears that PTEF is a safe form of adjuvant treatment for wounds and improves strength of sutured wounds and speeds contraction of open wounds. Matrix Biol, 2003 May, 22(3), 241 - 9 Selective adhesion of osteoblastic cells to different integrin ligands induces osteopontin gene expression; Carvalho RS et al.; Skeletal homeostasis is partly regulated by the mechanical environment and specific signals generated by a cell's adhesion to the matrix . Previous studies demonstrated that osteopontin (OPN) expression is stimulated in response to both cellular adhesion and mechanical stimulation . The present studies examine if specific integrin ligands mediate osteoblast selective adhesion and whether opn mRNA expression is induced in response to these same ligands . Embryonic chicken calvaria osteoblastic cells were plated on bacteriological dishes coated with fibronectin (FN), collagen type I (Col1), denatured collagen/gelatin (G), OPN, vitronectin (VN), laminin (LN) or albumin (BSA) . Osteoblastic cells were shown to selectively adhere to FN, Col1, G and LN, yet not to VN, OPN or BSA . Opn mRNA expression was induced by adhesion to Col1, FN, LN and G, but neither OPN nor VN induced this expression . Examination of the activation of the protein kinases A and C second signaling systems showed that only adhesion to FN induced protein kinase A and protein kinase C (PKC) activity while adherence to Col1 induced PKC . Evaluation of the intracellular distribution of focal adhesion kinase (FAK) and p-tyrosine within cells after adherence to FN, VN or BSA demonstrated that adherence to FN stimulated FAK translocation from the nucleus to the cytoplasm and high levels of p-tyrosine localization at the cell surface . However, cell adherence to VN or BSA did not show these morphological changes . These data illustrate that osteoblast selective adhesion is mediated by specific integrin ligands, and induction of intracellular second signal kinase activity is related to the nature of the ligand. Riv Biol, 2003 Jan-Apr, 96(1), 137 - 44 Insect bacteria and hazelnut pests' biocontrol: the state of the art in Turkey; Yaman M; Turkey is first among all hazelnut producing countries . However, it lags far behind them in terms of amount harvested per unit area . A main reason for this is that hazelnut has many agricultural pests that can not be effectively controlled . Chemical pesticides utilized to control these pests have hazardous effects on the environment . Increasing problems with resistance of these pests to most commonly used synthetic insecticides have spurred the search for alternative pest management strategies that would reduce reliance on synthetic insecticides . Biological control of hazelnut pests is an alternative control method to chemical pesticides . It is very important ecologically because of production of honey, milk and fish in the surrounding areas of hazelnut fields in Turkey . Several promising bacteriological studies have been made to find some biological control agents against these pests in Turkey . This paper presents a review of the current status of bacteriological studies on biological control of hazelnut pests in Turkey. J Perinatol, 2003 Jul-Aug, 23(5), 404 - 8 Impact of race and ethnicity on the outcome of preterm infants below 32 weeks gestation; Petrova A et al.; OBJECTIVES: To determine the impact of race/ethnicity on mortality and morbidity such as intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD) and bacteriologically confirmed sepsis, assisted ventilation, surfactant administration, intrauterine growth retardation (IUGR), and patent ductus arteriosus (PDA) among very prematurely delivered infants . STUDY DESIGN: Retrospective study of a cohort of 1006 preterm neonates with gestational age ranging from 22 to 32 weeks discharged from the Neonatal Intensive Care Unit (NICU) between 1998 and 2001 . Subgroup analysis according to gestational age (GA) (22 to 24, 25 to 28, and 29 to 32 weeks) and plurality (singleton and multiple) was performed using the chi(2) test and an analysis of variance . RESULTS: Of the 1006 infants, 54.3% were white, 21.7% black, 13.7% Hispanic, and 10.3% were classified as Other . Multiple births among white infants were approximately twice that in (42.4%) black infants (22.1%), and was also significantly higher than in the Hispanic (28.3%) and other race/ethnic groups (25.2%) . Overall, a higher proportion of black infants were born with a GA <or=28 weeks (n=115, 55.3%) than white (n=201, 37.1%) and Hispanic (n=53, 38.4%), p<0.05 . Therefore, black neonates had a lower GA (27.9+/-2.9 weeks) and birth weight (1170+/-463 g) as compared to white (p<0.0002) and Hispanic infants (p<0.0001) . There was no significant impact of race/ethnicity on the mean gestational age in any of the gestational age categories . Infant mortality and morbidity in each gestational age category by race/ethnicity were comparable . The multiple birth bla