Bacteriological

Int J Tuberc Lung Dis, 2002 Nov, 6(11), 952 - 8
Treatment of isoniazid-resistant tuberculosis with isoniazid, rifampin, ethambutol, and pyrazinamide for 6 months; Nolan CM et al.; SETTING: In 1992 the Seattle-King County Department of Public Health Tuberculosis Clinic began to treat patients with isoniazid-resistant tuberculosis with a regimen of isoniazid, rifampin, pyrazinamide, and ethambutol daily for 6 months . OBJECTIVE: To conduct a review of clinical and bacteriological outcomes of treatment for patients who received the four-drug, 6-month regimen for isoniazid-resistant tuberculosis . DESIGN: A retrospective review of medical records of TB cases meeting the study criteria, a Mycobacterium tuberculosis isolate resistant to isoniazid, and intent to treat with a 6-month course of isoniazid, rifampin, pyrazinamide, and ethambutol . RESULTS: Through December 1999, 44 consecutive patients with isoniazid-resistant, rifampin-susceptible tuberculosis were started on the four-drug, 6-month daily regimen . Among 42 patients followed until completion of therapy, three required changes in the regimen due to side effects . There was one case of drug-induced hepatotoxicity . Among 39 patients with pulmonary involvement, 37 converted sputum cultures from positive to negative within 2 months of starting treatment . There were no treatment failures . On passive follow-up of at least 2 years on all patients, two patients relapsed . The single patient with bacteriological relapse did not develop further drug resistance . CONCLUSION: The regimen of isoniazid, rifampin, pyrazinamide, and ethambutol given daily for 6 months produced successful outcomes when used in a public health tuberculosis clinic as routine therapy for isoniazid-resistant tuberculosis.

Dis Colon Rectum, 2002 Dec, 45(12), 1665 - 71
Bacterial translocation in patients with Crohn's disease undergoing surgery; Takesue Y et al.; PURPOSE: Much evidence, derived from experimental studies, suggests that bacterial translocation indeed occurs, yet its clinical significance is still a matter of controversy in humans . The aims of this study were to determine the prevalence of bacterial translocation in patients with Crohn's disease undergoing laparotomy and to identify any association with postoperative septic complications or systemic inflammatory response syndrome . METHODS: Mesenteric lymph node and peripheral blood samples from 42 patients with Crohn's disease undergoing laparotomy were collected for bacteriologic assessments . RESULTS: Bacterial translocation to mesenteric lymph node was identified in 20 patients (48 percent) . The most common organism was (27 percent) . Blood cultures were positive in 2 of 20 patients in whom translocation to lymph node was identified . Bacterial translocation was associated with a greater than two-fold increase in the incidence of postoperative septic complications (35 14 percent), but this difference was not significant . In the analysis of the occurrence of systemic inflammatory response syndrome, a significantly higher incidence continued until the third postoperative day in patients with those without bacterial translocation . In a logistic regression analysis, bacterial translocation had a significant effect on the occurrence of systemic inflammatory response syndrome, even though septic complications were taken into account . CONCLUSIONS: Bacterial translocation to mesenteric lymph node predisposed patients with Crohn's disease undergoing laparotomy to systemic inflammatory response syndrome.

J Orthop Surg (Hong Kong), 2000 Dec, 8(2), 1 - 5
Bacterial load in tissues and its predictive value for infection in open fractures; Sen RK et al.; The role of quantitative bacteriology is considered controversial for the prediction of infection in open fractures . A study was done in 20 patients with open fractures . Post debridement pieces of skin, muscle and periosteal tissue were obtained for quantitative bacterial counts . Among a total of 50 samples from all of the tissues, 29 showed positive bacterial counts (16 of 20 skin, 11 of 20 muscle and 2 of 10 periosteum samples) . By quantitative estimation, the bacterial load was >10(5) per gram in 10 skin and 3 muscle tissue samples . Infection developed in 9 of the 20 cases within one month, and eight of these patients had contamination of >10(5) per gram in 8 of the skin but only 3 muscle samples . It was concluded that with tissue specific bacterial load estimation, prediction of subsequent infection can be made if skin tissue contains >10(5) per gram, or if muscle tissue carries any level of bacterial presence.

J Med Microbiol, 2002 Dec, 51(12), 1041 - 9
Isolation from a sheep of an attaching and effacing Escherichia coli O115:H- with a novel combination of virulence factors; Cookson AL et al.; Attaching and effacing (AE) lesions were observed in the caecum, proximal colon and rectum of one of four lambs experimentally inoculated at 6 weeks of age with Escherichia coli O157:H7 . However, the attached bacteria did not immunostain with O157-specific antiserum . Subsequent bacteriological analysis of samples from this animal yielded two E . coli O115:H(-) strains, one from the colon (CO) and one from the rectum (RC), and those bacteria forming the AE lesions were shown to be of the O115 serogroup by immunostaining . The O115:H(-)isolates formed microcolonies and attaching and effacing lesions, as demonstrated by the fluorescence actin staining test, on HEp-2 tissue culture cells . Both isolates were confirmed by PCR to encode the epsilon (epsilon) subtype of intimin . Supernates of both O115:H(-) isolates induced cytopathic effects on Vero cell monolayers, and PCR analysis verified that both isolates encoded EAST1, CNF1 and CNF2 toxins but not Shiga-like toxins . Both isolates harboured similar sized plasmids but PCR analysis indicated that only one of the O115:H(-) isolates (CO) possessed the plasmid-associated virulence determinants ehxA and etpD . Neither strain possessed the espP, katP or bfpA plasmid-associated virulence determinants . These E . coli O115:H(-) strains exhibited a novel combination of virulence determinants and are the first isolates found to possess both CNF1 and CNF2.

Tuberculosis (Edinb), 2002, 82(4-5), 161 - 5
Milk containing Mycobacterium bovis as a source of infection for white-tailed deer fawns (Odocoileus virginianus); Palmer MV et al.; SETTING: White-tailed deer represent the first wildlife reservoir of Mycobacterium bovis in the United States . The behavior of does with nursing fawns provides several potential mechanisms for disease transmission . Little information exists concerning transmission between doe and fawn, specifically transmammary transmission . OBJECTIVE: Determine if fawns can become infected by ingestion of milk replacer containing M . bovis, thus simulating transmission from doe to fawn through contaminated milk.DESIGN: Seventeen, 21-day-old white-tailed deer fawns were inoculated orally with 2 x 10(8) CFU (high dose, n=5), 2.5 x 10(5) to 2.5 x 10(6) CFU (medium dose, n=5), and 1 x 10(4) CFU (low dose, n=5) of M . bovis in milk replacer . Dosages were divided equally and fed daily over a 5-day period . Positive control fawns (n=2) received 1 x 10(5) CFU of M . bovis instilled in the tonsillar crypts . Fawns were euthanized and examined 35-115 days after inoculation and various tissues collected for bacteriologic and microscopic analysis . RESULTS: All fawns in the tonsillar, high oral and medium oral dose groups developed generalized tuberculosis involving numerous organs and tissues by 35-84 days after inoculation . Three of five fawns in the low-dose oral group had tuberculous lesions in the mandibular lymph node, and one of five had lesions in the medial retropharyngeal lymph node when examined 115 days after inoculation . CONCLUSION: White-tailed deer fawns can become infected through oral exposure to M . bovis . Therefore, the potential exists for fawns to acquire M . bovis while nursing tuberculous does.

Vet Dermatol, 2002 Dec, 13(6), 315 - 22
Macroscopic, cytological and bacteriological evaluation of anal sac content in normal dogs and in dogs with selected dermatological diseases; Pappalardo E et al.; Macroscopic and cytological aspects of anal sac content were evaluated in 40 normal dogs and 10 dogs each with pyoderma, Malassezia dermatitis associated with atopic dermatitis and uncomplicated atopic dermatitis . Bacteria isolated from anal sacs were compared with those from abdominal skin and hair in 20 normal dogs and 10 dogs with pyoderma . There was no difference between the groups in anal sac dimension, or in the colour, consistency or presence of granules in their content . Extracellular bacteria were found in higher numbers in diseased animals, whereas intracellular bacteria were observed in 40% of dogs with pyoderma and in only 2.5% of normal dogs . Malassezia spp . were present in 15.7% of dogs, with no difference between groups . Neutrophils were observed in 12.5% of normal dogs, 30% of dogs with Malassezia dermatitis with underlying atopic dermatitis and in 70 and 80% of dogs with pyoderma and uncomplicated atopic dermatitis, respectively . Seven bacterial species were isolated from anal sacs, with no difference between normal dogs and dogs with pyoderma . In five normal animals and in four dogs with pyoderma the same bacterial strains were isolated from anal sacs and from abdominal skin and hair.

Proc AMIA Symp . 2002;:270-4.
Informatics tools to monitor progress and outcomes of patients with drug resistant tuberculosis in Peru; Fraser HS et al.; Multi-drug resistant tuberculosis (MDR-TB) is an important and growing problem in many developing countries . New strategies have been developed to combat the disease but require complex treatment regimens and close monitoring of patients' bacteriology results . We describe a web-based medical record system deployed in Peru to support the management of MDR-TB . Web-based analyses have been developed to track drug sensitivity test results, patterns of sputum smear and culture results and time to conversion from positive to negative cultures . Individual and aggregate drug requirements can also be monitored in real time . Multiple analyses can be linked together and data can be graphed or downloaded to spreadsheets . Over 1200 patients are currently in the system . We argue that such a web-based clinical and epidemiological management system is an important component for successful implementation of complex health interventions in resource poor areas.

Arch Inst Pasteur Madagascar, 2000, 66(1-2), 13 - 7
{Extrathoracic forms of tuberculosis in Mahajanga hospitals (Madagascar)}; Ravolamanana Ralisata L et al.; Pathological samples issued from patients suspected of extrapulmonary tuberculosis were examined in Laboratories of Mycobacteria and of Histopathology at the Androva Hospital in the University Hospital Centre of Mahajanga . A retrospective study was carried out from 1989 to 1993 . During this period, 64 cases of extrapulmonary tuberculosis were recorded . Samples came from Androva Hospital, from Lutherian Hospital of Antanimalandy and from the Medical Centre of Mahabibo . The sex-ratio was of 1.28/1, mean age was 28 years old (extreme ages: 1-78 years old) . The diagnosis was confirmed by bacteriological and/or histopathological examinations . Ganglial tuberculosis were the most frequent (53.1%), then digestive tract tuberculosis (20.2%) and anal fistula tuberculosis (14%) . In front of chronic lesions, biopsies must be performed to obtain confirmation of diagnosis.

J Chemother, 2002 Oct, 14(5), 508 - 17
Comparison of the efficacy and tolerability of amoxycillin/clavulanic acid 875 mg b.i.d . with cefuroxime 500 mg b.i.d . in the treatment of chronic and acute exacerbation of chronic sinusitis in adults; Namyslowski G et al.; The efficacy and safety of amoxycillin/clavulanic acid (AMX/CA) (875/125 mg b.i.d . for 14 days) were compared with that of cefuroxime axetil (500 mg b.i.d . for 14 days) in a multicenter, open, parallel-group, randomized clinical trial in 206 adults with chronic or acute exacerbation of chronic sinusitis . Clinical response was similar, with 95% of AMX/CA-, and 88% of cefuroxime-treated, clinically evaluable patients cured (95% confidence interval; -0.6% to +15%) . In bacteriologically evaluable patients, cure rates, defined as eradication of the original pathogen with or without re-colonization with non-pathogenic flora, were also similar, with 65% of AMX/CA- and 68% of cefuroxime-treated patients cured (95% confidence interval; -18% to +15%) . However, clinical relapse was significantly higher in the cefuroxime group: 7% (7/89) of clinically evaluable patients, compared with 0% (0/98) in the AMX/CA (p=0.0049) group . A similar incidence of possible or definite adverse events related to the study drug was reported for both treatments (AMX/CA 4.4%, cefuroxime 4.3%), the most frequent being diarrhea . Four adverse events were recorded as serious or life-threatening with only one considered related to the study drug (urticaria, cefuroxime) . AMX/CA 875/125 mg b.i.d . for 14 days is as effective and well tolerated as cefuroxime axetil 500 mg b.i.d . for 14 days in the treatment of chronic, or acute exacerbation of chronic sinusitis, but is associated with a significantly lower clinical relapse rate.

J Gynecol Obstet Biol Reprod (Paris), 2002 Nov, 31(7 Suppl), 5S52 - 6
{Markers of infection and inflammation in the amniotic fluid: therapeutic contribution of amniocentesis}; Le Bouar G et al.; A part of preterm labor with intact membranes seems to be related to amniotic infection or local inflammatory process . In these cases, amniotic fluid is collected by amniocentesis for bacteriological studies: amniotic cultures are positive in 10% and polymerase chain reaction (PCR) in 40-50% . Interleukin 6 (IL6) concentrations are elevated in cases with amniotic infection and in some cases with negative cultures . IL6 amniotic concentrations are predictive of premature delivery and neonatal morbidity . Matrix metalloproteinases (MMP) are endogenous enzymes implicated in membrane weakening . Amniotic concentrations of these enzymes seem to be predictive of premature delivery and neonatal prognosis . Furthermore, at the time of genetic amniocentesis, IL6 and MMP concentrations are markers for preterm delivery . In the second half of gestation, amniocentesis is a safe procedure complicated in less than 1% of cases, although specific evaluation in cases of premature labor is missing . Nevertheless, as long as there is no evidence of any benefit in this procedure, there is no indication for amniocentesis in premature labor with intact membranes in general practice.

Biomed Tech (Berl), 2002, 47 Suppl 1 Pt 1, 476 - 8
Glycosaminoglycans--all round talents in coating technology; Hildebrandt P; The use of glycosaminoglycans for coating of medical implants had it's beginning in heparin coating of coronary stents and catheters to improve their haemocompatibility . Until now glycosaminoglycans proved as very potent in a variety of medical applications . Glycosaminoglycans not only show anticoagulant properties, also their crystal growth inhibiting effects in urology, inhibition of bacterial adherence and influence on the proliferation behaviour of human cells could be demonstrated . Beside an overview over the development of glycosaminoglycan coatings so far, recent outcomes of a bacteriological and a cell proliferation study with coated surfaces are presented.

Dtsch Tierarztl Wochenschr, 2002 Oct, 109(10), 442 - 3
Streptomyces sp., a cause of fistulous withers in donkeys; Elzein S et al.; Four of 10 donkeys, which showed lesions simulating fistulous withers, were examined clinically with the aim to cultivate and identify the causal agent . Aspiated purulent materials were subjected to bacteriological examination . The causal organisms were recovered in Tryptic Soya agar medium when incubated aerobically at 37 degrees C for up to 5 days . These organisms were found to be actinomycetes-like, Gam positive with stable branching filaments and to form heavy aerial hyphae on colony surface . The isolated organisms ere tentatively identified as Streptomyces sp . on the basis of morphological and cultural characteristics . The initial sequences analysis of the 16S rDNA gene conformed that one of the isolates (SD551) falls within the phylogenetic clade, which encompasses the genus Streptomyces . Studies are underway to further describe the disease and its causal agent . The report represents a good evidence to incriminate Streptomyces in the aetiology of the fistulous withers.

Hautarzt, 2002 Dec, 53(12), 822 - 5
{In memory of the 160(th) birthday and the 80(th) anniversary of the death of Heinrich Irenäus Quincke, as well as of his description of angioedema 120 years ago}; Goring HD; In the year 2002 we celebrate the 160(th) birthday and the 80(th) anniversary of the death of Heinrich Irenaus Quincke, former head of the department of internal medicine at the University of Kiel from 1878 to 1908 . Moreover we remember the description of the angioedema by Quincke in the "Monatsheften fur Praktische Dermatologie" 120 years ago . Because his name is so tightly linked with angioedema, Quincke's other discoveries and achievements are scarcely recalled today . Some of his other accomplishments include the invention of the lumbar puncture, the initiation of the term siderosis, the study of the resorption of inorganic iron to treat iron-deficiency anemia and his early contributions to pulmonary surgery . Quincke was the first to describe the causative organism of animal favus, which today is known as Trichophyton quinckeanum . Quincke suspected a syphilitic infection as the cause of aortic aneurysms and recommended antisyphilitic therapy . In the beginning of his career in Kiel, Quincke gave lectures not only in internal medicine but also in dermatology and venerology, pediatrics, bacteriology and public health, until chairs were established for these disciplines . Quincke was for four terms Dean of the medical faculty and in 1900 Rector of the University of Kiel.

Dent Traumatol, 2002 Aug, 18(4), 196 - 205
Consequences of crown fractures with pulpal exposure: histopathological evaluation in dogs; Harran-Ponce E et al.; When a crown fracture involving pulpal exposure is produced, the therapeutic treatment to be applied depends to a great extent on the general histopathological condition of the exposed pulp . Hence, the objective of this study was to evaluate histopathological and bacteriological changes occurring in dental tissue and periradicular tissue of crown-fractured teeth with pulpal exposure . Twenty-four anterior teeth (central and lateral incisors) from the maxillary teeth of four young, adult Mongrel dogs were used . At 48 and 72 h after performing the crown fractures, the animals were sacrificed and the results evaluated . Both observation periods revealed the existence of an area of superficial inflammation with the formation of hyperplastic tissue towards the external surface . Intense neutrophilic infiltrate was observed below it . Mean depth of inflammation was greater at 48 h (4633.33 microm) than at 72 h (3933.33 microm), perhaps coinciding with the bigger pulp chamber opening (x1332.14 microm at 48 h vs . x479.52 microm at 72 h) . Upon approaching the cervical portion, the inflammation became less . Bacterial contamination was constant in all the cases evaluated, worsening the histopathological findings with exposure time . This study demonstrates that when a crown fracture with pulpal exposure is produced, the success in treating it depends partly on how quickly therapeutic treatment is administered.

Gesundheitswesen, 2002 Nov, 64(11), 614 - 22
{"Health is a Crossroad"--Nature and society, individual and community, in safeguarding public health}; Paul N et al.; Any person actively engaged in the sphere of Public Health who refers to "molecular medicine" is bound to arouse suspicion . Nevertheless, neither Public Health nor public health protection or the health sciences in general can afford to ignore medicine and biology . This fundamental fact is explored in a historical and subsequently in an anthropological context . The connections between molecular medicine and public health are discussed at length . Accordingly, health on an individual as well as on a social level is essentially bound to the knowledge of genetically determined dispositions . We may expect that this molecular-genetic reality will become as "true" in future as the hygienic-bacteriological reality has become "true" today . The medicalisation of all human realities will be continued by their "molecularisation" . It is important to fundamentally understand the actual effects of this transformation, which is the subject of a wider public discussion . This is the only way to rationally estimate both the opportunities offered by molecular medicine and the involved risks . It is essential for a debate of this kind within public health care institutions that the public health movement addresses the current developments of molecular medicine in a critical but constructive manner . "Nature", and with it the medicine and biology of public health, is an essential aspect of protecting public health . This is the only way to clarify the sphere of activity of public health protection in general, to appreciate its dynamics and to develop adequate measures: "Health is a crossroad" according to Julio Frenk: "It is where biological and social factors, the individual and the community, and social economic policy all converge".

Kekkaku, 2002 Oct, 77(10), 647 - 58
{Preventive therapy in middle-aged and elderly persons selected from the population-based screening by mass miniature radiography--methodological aspect and adverse reactions}; Ohmori M et al.; The notification rate of tuberculosis in Japan was 31.0 per 100,000 in 2000 . The rate was especially high among the elderly population, reaching 85.5 per 100,000 among those over 65 years of age . We conducted a study of preventive therapy in middle-aged and elderly persons selected from the population-based screening by the mass miniature radiography . The eligible criteria were 50-79 years of age, fibrous lesion which were compatible with healed tuberculosis and showed no change for at least one year, no previous treatment for tuberculosis, normal liver function tests, and no serious disease at the time of study . The eligible criteria for liver function tests in this study was less than 50 IU/L of AST and ALT value, and less than 1.5 mg/dl of T-bil level . A total of 13,219 people underwent TB screening in 4 cities in 1997 and 2 cities in 1998 . Among them, 440 persons fulfilled the above criteria based on the screening records and chest X-ray films . The municipal offices sent letters to 418 people, except 22 whose addresses were unknown, to obtain permission to use their addresses and results of screening in our study . Permission was obtained from 137 persons and we sent them invitation letters for cost-free physical checkup service . Ninety-five persons visited us, and we offered them physical checkup and explained about our study . After obtaining the informed consent, we performed chest X-ray and sputum examination for 3 consecutive days . Finally 29 people were enrolled in the study . They were divided into 4 groups by sex and age, and were randomly assigned to one of two treatment groups . One group took 300 mg of INH per day for 6 months and the other group was only followed up by chest X-ray . Fourteen out of 29 persons began to take INH and received monthly liver function test . All the subjects were scheduled to follow by medical checkup every 6 months for 5 years . The proportion of taking INH tablets was estimated to range from 94% to 100%, based on the calendar for record of taking medication and the number of remaining tablets each month . Six (42.9%) of 14 persons reported adverse reactions . Two of 6 persons complained some of diarrhea, vomiting and gastrointestinal disturbance within 2 weeks, and discontinued taking INH, although none of them showed abnormal liver function tests . Two of 6 persons who reported some kinds of symptoms and 2 of 8 persons who did not complain of any symptoms showed abnormal liver function tests . The abnormal liver function tests had developed from 2 months after the beginning of INH taking in most of the persons and the abnormality improved after the completion of 6-month treatment . We have followed them for a maximum duration of 2.5 years, and 3 cases dropped out from the study . These defaulted cases had completed 6 months of INH . One person (69 y.o . male) was diagnosed as active TB by his chest X-ray film at the 6th month medical checkup, although it was not confirmed bacteriologically . One person (62 y.o . female) had the mastectomy for breast cancer 7 months before the entry to this study and relapsed at the 8th month after the entry . One person (73 y.o . female) was diagnosed as lung cancer at the medical checkup on 2.5 years . Besides them, 4 persons were suspected of worsening the abnormal shadows on chest X-ray films; one was from the INH group and three were from the follow-up group . However none of them was diagnosed clinically and bacteriologically as active tuberculosis.

Nippon Rinsho, 2002 Nov, 60(11), 2210 - 5
{Neonatal bacterial infection}; Sato Y; In our NICU, 70 patients with sepsis were examined and analyzed by birth weight, onset day, causative pathogens, clinical symptoms and clinical examination values . Our study result showed the relationship between the birth weight and bacteriological infection rate: the lower birth weight was, the greater infection rate was . For low birth weight newborns, their onset were relatively late as horizontal transmission . For 50% of matured infants, they showed clinical symptom by 6 days after the birth . E . coli or/and S . agalactiae were identified from 57% patients of vertical transmission, and S . aureus and E . cloacae were the major pathogens of horizontal transmission . Low birth weight newborns did not show typical clinical symptoms and examination values . To prevent nosocomial infection, it is important to culture for monitoring and management of skin in addition to taking standard precaution.

Pancreatology, 2002, 2(6), 565 - 73
IAP Guidelines for the Surgical Management of Acute Pancreatitis; Uhl W et al.; During 2002 the International Association of Pancreatology developed evidenced-based guidelines on the surgical management of acute pancreatitis . There were 11 guidelines, 10 of which were recommendations grade B and one (the second) grade A . (1) Mild acute pancreatitis is not an indication for pancreatic surgery . (2) The use of prophylactic broad-spectrum antibiotics reduces infection rates in computed tomography-proven necrotizing pancreatitis but may not improve survival . (3) Fine-needle aspiration for bacteriology should be performed to differentiate between sterile and infected pancreatic necrosis in patients with sepsis syndrome . (4) Infected pancreatic necrosis in patients with clinical signs and symptoms of sepsis is an indication for intervention including surgery and radiological drainage . (5) Patients with sterile pancreatic necrosis (with negative fine-needle aspiration for bacteriology) should be managed conservatively and only undergo intervention in selected cases . (6) Early surgery within 14 days after onset of the disease is not recommended in patients with necrotizing pancreatitis unless there are specific indications . (7) Surgical and other forms of interventional management should favor an organ-preserving approach, which involves debridement or necrosectomy combined with a postoperative management concept that maximizes postoperative evacuation of retroperitoneal debris and exudate . (8) Cholecystectomy should be performed to avoid recurrence of gallstone-associated acute pancreatitis . (9) In mild gallstone-associated acute pancreatitis, cholecystectomy should be performed as soon as the patient has recovered and ideally during the same hospital admission . (10) In severe gallstone-associated acute pancreatitis, cholecystectomy should be delayed until there is sufficient resolution of the inflammatory response and clinical recovery . (11) Endoscopic sphincterotomy is an alternative to cholecystectomy in those who are not fit to undergo surgery in order to lower the risk of recurrence of gallstone-associated acute pancreatitis . There is however a theoretical risk of introducing infection into sterile pancreatic necrosis . These guidelines should now form the basis for audit studies in order to determine the quality of patient care delivery .

Int J Antimicrob Agents, 2002 Nov, 20(5), 333 - 8
Impact of an antibiotic policy on antibiotic use in a paediatric department . Individual based follow-up shows that antibiotics were chosen according to diagnoses and bacterial findings; Berild D et al.; Guidelines and clinical Cupertino for rational antibiotic use were implemented in a Norwegian paediatric department in 1994 . From 1994 to 1998 the use of antibiotics and expenditures was reduced by 50% . There was an 80% decrease in the use of cloxacillin, a 74% decrease of aminoglycosides and a 59% decrease of cephalosporins . The use of penicillin V and G increased by 14% and ampicillins by 8% . Eight point prevalence studies showed that on average 23% (range 21-38%) of the patients were treated with antibiotics . Penicillins were used in 44% of courses, aminoglycosides in 35% of courses and cephalosporins in 9% of courses . Treatment was mostly adjusted to bacteriological findings . Compliance with guidelines was >90% . Guidelines for rational antibiotic policy and multidisciplinary co-operation lead to reduction in the use and expenses of antibiotics in a paediatric department.

Neth J Med, 2002 Aug, 60(7), 281 - 4
Contact tracing using DNA fingerprinting in an asylum seeker with pulmonary tuberculosis; van Loenhout-Rooyacke JH et al.; BACKGROUND: The diagnosis of tuberculosis in asylum seekers is followed by contact tracing, which is routinely performed by the Municipal Health Service (MHS) . We investigated cases of tuberculosis whose symptoms became apparent after closure of regular contact tracing . METHODS: Analysis of data from the DNA Fingerprinting Surveillance Project on all Mycobacterium tuberculosis isolates and contact tracing instances . RESULTS: Four additional cases of tuberculosis were detected, caused by bacteria of identical DNA fingerprints . No further contacts with a bacteriologically confirmed form of tuberculosis were found around these four new patients . CONCLUSION: DNA fingerprinting contributed to tracing instances of late manifestations of tuberculosis transmission.

Chest, 2002 Nov, 122(5), 1604 - 8
Should bronchoscopy be performed in the evaluation of suspected pediatric pulmonary tuberculosis?
Bibi H, Mosheyev A, Shoseyov D, Feigenbaum D, Kurzbart E, Weiller Z.
BACKGROUND: Pulmonary tuberculosis (PTB) infection in children is difficult to diagnose . OBJECTIVE: To evaluate the effectiveness of fiberoptic bronchoscopy in the diagnosis of PTB . METHODS: Four hundred twenty-two children underwent bronchoscopic evaluation . The study population was composed of 80 children (study group) who were suspected of having PTB and 342 children with chronic cough or recurrent/persistent pneumonia (control group) . Videotape reviews of each bronchoscopy were correlated with the results of smears and cultures . RESULTS: The majority of children in the study group (54 of 80 children) were new immigrants from Ethiopia, while most of the control group (323 of 342 children) were born in Israel . Among patients in the control group, physical anomalies such as laryngotracheomalacia were more common among children in the control group (105 of 342 children) compared with those in the study group (5 of 80 children; p < 0.03) . In the study group, external compression of the right main bronchus, usually at the entrance, was more common (32 of 80 children) compared with the control group (6 of 342 children; p < 0.001) . Cultures from BAL fluid revealed Mycobacterium tuberculosis in 3 of the 80 children from the study group compared with 2 children from the control group (p < 0.08) . The children with positive cultures from the control group had external compression of the right main bronchus that had been documented by bronchoscopy . CONCLUSION: Bronchoscopy in children with suspected PTB has a low yield and does not significantly aid bacteriologic confirmation . External compression at the entrance to the right main bronchus is suggestive of PTB infection.

Am J Gastroenterol, 2002 Nov, 97(11), 2768 - 75
Comparison of endoscopic ultrasound-guided fine needle aspiration for focal pancreatic lesions in patients with normal parenchyma and chronic pancreatitis; Fritscher-Ravens A et al.; OBJECTIVES: The clinical value of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of pancreatic lesions is uncertain in patients with normal parenchyma and chronic pancreatitis . The aim of this study was to analyze the diagnostic yield and influence of EUS-FNA on the clinical management of patients with pancreatic lesions, in the presence (CP) or absence (NP) of chronic pancreatitis . METHODS: A total of 207 consecutive patients with NP (n = 133) and CP (n = 74) were examined using linear array echo endoscopes for the procedure and 22-gauge needles . RESULTS: Adequate specimens were obtained from 200 lesions . A correct final diagnosis was established at histology (n = 108), bacteriology (n = 9), and clinical follow-up (n = 83) . Cytology gave 17 false-negative EUS-FNA results (overall sensitivity: 85%) . In patients with NP, 60 solid adenocarcinomas were detected, 32 other malignancies, and 38 benign lesions, with 11 false-negative results (sensitivity: 89%) . In patients with CP, only seven of 13 malignancies (all solid adenocarcinomas) were identified using FNA (sensitivity: 54%) . Overall, malignancy was identified in 116 patients, 32 of whom (27%) had lesions other than primary solid adenocarcinomas . Management was altered in 25 of these patients, which changed the surgical approach in 21% . EUS-FNA influenced the therapeutic approach in 44% of the total patient group . CONCLUSIONS: EUS-FNA was especially useful in patients with a focal pancreatic lesion with normal parenchyma . Its sensitivity in patients with CP was unacceptably low, and resection of the tumor using standard surgical techniques was still usually required to confirm the correct diagnosis . Diagnostic EUS-FNA influenced clinical management in nearly half of patients.

Presse Med, 2002 Oct 12, 31(33), 1546 - 50
{Correct and incorrect usage of antibiotics . Prevalence study in Franche-Comté}; Floret N et al.; OBJECTIVE: To report the results observed regarding the prescription of antibiotics according to various indications in the Franche-Comte area: curative for a community infection, curative for a nosocomial infection and prophylactic . METHOD: A total of 6,038 patients hospitalized in 32 hospital centers of the Franche-comte area were surveyed . RESULTS: Among the 1,016 (16.8% of the total) patients receiving anti-infection products, 47.7% received anti-infection agents for the treatment of a community infection, 25.9% for a nosocomial infection and 26.4% for prophylaxis . Multiple antibiotherapy was more frequent for the treatment of community infections than for nosocomial infections {p = 0.067, Relative Risk = 1.11, (confidence interval: 95%: 1.00-1.24)} . Sixty percent of the prescriptions of 3rd generation cephalosporines were within the community framework . This class of antibiotics was widely prescribed for the treatment of E . coli infections, multi-sensitive to antibiotics, not only before but after bacteriological documentation . Among the 83 patients treated with fluoroquinolone for a nosocomial infection, 47 (56.6%) were treated with monotherapy . Regarding prophylaxis, 3rd generation cephalosporine and fluoroquinolone, which are not indicated for this, were widely used, in contradiction with the recommendations of the Societe Francaise d'Anesthesie et de Reanimation (French Society of Anesthesia and Reanimation) . CONCLUSION: This survey, despite the limits related to the prevalence method, shows the high frequency of antibiotic prescriptions that do not conform to the recommendations of the ANDEM (French agency for the assessment of medical practice) and the scientific societies.

Water Res, 2002 Nov, 36(18), 4655 - 8
Delayed incubation as an alternative method to sample storage for enumeration of E . coli and culturable bacteria in water; Guardabassi L et al.; The effects of sample storage on enumeration of Escherichia coli in marine bathing water and culturable bacteria in drinking water were evaluated . Results showed that overnight storage at 0-5 degrees C significantly reduced the counts of E . coli in bathing water (p = 0.0001) with a mean reduction of 25% . A similar effect of sample storage was observed for the enumeration of culturable bacteria in drinking water at 22 +/- 2 degrees C for 66 +/- 4 h (p = 0.0074; mean reduction = 25%) or at 36 +/- 2 degrees C for 44 +/- 4h (p = 0.0353; mean reduction = 6%) . The use of a delayed incubation method, i.e . overnight storage at 0-5 degrees C of inoculated agar plates prior to incubation, did not significantly affect the counts of culturable bacteria when plates were incubated at 22 + 2 degrees C for 66 +/- 4 h, whereas it resulted in a significant increase of the bacterial numbers when plates were incubated at 36 +/- 2 degrees C for 44 +/- 4 h (p = 0.0002; mean increase = 32%) . Based on these results, it is suggested to avoid the use of overnight or longer sample storage for the enumeration of E . coli in bathing water samples, as well as for the enumeration of culturable bacteria in drinking water . The delayed incubation method appears to be a reliable procedure for the enumeration of culturable bacteria and could represent a valid alternative to sample storage in order to overcome problems associated with the performance of bacteriological counts during weekends or statutory holidays . However, a multi-laboratory study is needed to evaluate the reproducibility of the delayed incubation method for the enumeration of culturable bacteria and its possible use for the enumeration of E . coli by membrane filtration.

J Am Vet Med Assoc, 2002 Mar 1, 220(5), 656 - 9
Prevalence of Mycobacterium bovis infection in cervids on privately owned ranches; Kaneene JB et al.; OBJECTIVE: To determine prevalence of tuberculosis caused by infection with Mycobacterium bovis in cervids on privately owned ranches in northeastern lower Michigan . DESIGN: Epidemiologic survey . ANIMALS: Cervids on 96 privately owned ranches . PROCEDURES: A combination of slaughter and skin tuberculin testing was used to collect data . Infection with M . bovis was confirmed by use of standard necropsy and bacteriologic culture techniques . RESULTS: Cervids with tuberculosis were detected on 1 of the 96 ranches . The apparent prevalence of tuberculosis in cervids from the 96 ranches was 1.1 cases/100 cervids (21 cases/1,867 cervids tested) . For the ranch with infected cervids, prevalence of infection with M . bovis was 12.1 cases/100 cervids (21 cases/174 cervids tested) . No obvious gross lesions were seen in 8 of 21 white-tailed deer and 1 coyote with culture-confirmed M . bovis infection . CONCLUSIONS AND CLINICAL RELEVANCE: The lack of visible lesions in a substantial proportion of infected animals should be taken into consideration in studies involving detection and prevalence of tuberculosis.

Khirurgiia (Mosk), 2002, (2), 41 - 3
{Use of gas flow with nitrogen oxide (NO-therapy) in combined treatment of purulent wounds}; Lipatov KV et al.; NO-therapy was used in 40 patients with purulent wounds of soft tissues . Bacteriological, cytological and morphological examinations demonstrated acceleration of wound process compared with control group (40 patients without NO-therapy) . Laser doppler flowmetry demonstrated significant improvement of microcirculation in wound zone during NO-therapy . This method shortens by 3-5 days the time of preparation of wound surface for surgical closure.

J Indian Med Assoc, 2002 Jun, 100(6), 398 - 9
Evaluation of sparfloxacin eye drop in the management of conjunctival and corneal infection; Vyas U et al.; Sparfloxacin 03% eye drop was evaluated in consecutive culture proven cases of conjunctivitis and corneal infection . Sparfloxacin 03% eye drop was found to provide 100% cure rate clInIcally as well as bacteriologically . This can be due to better ocular penetration and higher therapeutic index of sparfloxacin 03% eye drops . Sparfloxacin seems to be a better antibiotic for topical application for themanagement of external ocular Infections like conjunctivitis, keratitis and corneal ulcers.

J Indian Med Assoc, 2002 Jun, 100(6), 376, 378 - 9
Pulmonary tuberculosis and diabetes mellitus--a study; Ezung T et al.; One hundred diabetes mellitus patients attending the diabetic clinic and those admitted in the medical wards of the Regional Institute of Medical Sciences, Imphal, were selected randomly to study the prevalence of pulmonary tuberculosis with the age-and the sexwise distribution in diabetes mellitus patients . The diagnosis of diabetes mellitus was established from the dinical symptoms and the estimation of blood sugar levels whereas pulmonary tuberculosis was diagnosed from clinical, radiological and bacteriological examinations . The majority of the patients were above the age of 40 years, the mean age was 55.4 years (SD +/- 13.5) . The prevalence of pulmonary tuberculosis in diabeties was 27% by radiological diagnosis and 6% by sputum positivity . Out of the 27 patients with radiological findings 11 had minimal lesions, 7 had moderate lesions and 9 patients were found to have far advanced lesions; cavitation was found in 3 patients, fibrosis in 4, homogeneous opacities in 6, heterogeneous opacities in 10, pleural effusion in 3 and consolidation and Fibrosis in only one patient . Mean duration of diabetes mellitus was 7.6 years (SD +/- 6.24) . Duration of diabetes mellitus did not correlate well with the prevalence of pulmonary tuberculosis . No correlation could be found with the history of contact with tuberculosis.

Blood, 2003 May 1, 101(9), 3501 - 8 Epub 2002 Oct 24.
Generation and genetic modification of dendritic cells derived from mouse embryonic stem cells; Senju S et al.; We developed a method to generate dendritic cells (DCs) from mouse embryonic stem (ES) cells . We cultured ES cells for 10 days on feeder cell layers of OP9, in the presence of granulocyte-macrophage colony-stimulating factor in the latter 5 days . The resultant ES cell-derived cells were transferred to bacteriologic Petri dishes without feeder cells and further cultured . In about 7 days, irregularly shaped floating cells with protrusions appeared and these expressed major histocompatibility complex class II, CD11c, CD80, and CD86, with the capacity to stimulate primary mixed lymphocyte reaction (MLR) and to process and present protein antigen to T cells . We designated them ES-DCs (ES cell-derived dendritic cells), and the functions of ES-DCs were comparable with those of DCs generated from bone marrow cells . Upon transfer to new dishes and stimulation with interleukin-4 plus tumor necrosis factor alpha, combined with anti-CD40 monoclonal antibody or lipopolysaccharide, ES-DCs completely became mature DCs, characterized by a typical morphology and higher capacity to stimulate MLR . Using an expression vector containing the internal ribosomal entry site-puromycin N-acetyltransferase gene or a Cre-lox-mediated exchangeable gene-trap system, we could efficiently generate ES cell transfectants expressing the products of introduced genes after their differentiation to DCs . ES-DCs expressing invariant chain fused to a pigeon cytochrome C epitope presented the epitope efficiently in the context of E(k) . We primed ovalbumin (OVA)-specific cytotoxic T lymphocytes in vivo by injecting mice with ES-DCs expressing OVA, thus demonstrating immunization with ES-DCs genetically engineered to express antigenic protein . The methods may be applicable to immunomodulation therapy and gene-trap investigations of DCs.

No Shinkei Geka, 2002 Oct, 30(10), 1075 - 80
{The efficacy of prophylactic administration of SBT/ABPC for postoperative infection in neurosurgical operations}; Idomari K et al.; We investigated prospectively the efficacy of sulbactam sodium/ampicillin sodium (SBT/ABPC), which is a combination drug of ampicillin and beta-lactamase inhibitor, as a preventive drug against postoperative infection in the field of neurological surgery . One hundred and six patients were given SBT/ABPC as follows: Before anesthetic induction at surgery, 1.5 g of SBT/ABPC was administrated by intravenous drip infusion, and further doses were continued at 12-hour intervals for 5 to 7 days . We assessed postoperative infection, type of surgery, duration of operation, and amount of hemorrhage . Search for related side effects and bacteriological examinations of the nasal cavity and throat before and after treatment were performed . The result was that postoperative infection was found in none of the patients . Adverse reactions due to SBT/ABPC such as apparent skin symptoms or gastrointestinal symptoms were not observed . Considering infections highly resistant to MRSA, SBT/ABPC would be effective to prevent postoperative infection in neurosurgical operations and could be used safely.

Thorax, 2002 Nov, 57(11), 964 - 6
Tobacco smoking and pulmonary tuberculosis; Kolappan C et al.; BACKGROUND: The prevalence of tuberculosis in adult men in India is 2-4 times higher than in women . Tobacco smoking is prevalent almost exclusively among men, so it is possible that tobacco smoking may be a risk factor for developing pulmonary tuberculosis . A nested case control study was carried out to study the association between tobacco smoking and pulmonary tuberculosis . METHODS: A tuberculosis disease survey was carried out in two Panchayat unions in the Tiruvallur district of Tamil Nadu in India . Eighty five men aged 20-50 years with bacteriological tuberculosis (smear and/or culture positive) were selected as cases and 459 age matched men without tuberculosis were selected randomly as controls . Information on smoking status, type of tobacco smoked, quantity of tobacco smoked, and duration of tobacco smoking was collected from cases and controls using a questionnaire . RESULTS: The estimated crude odds ratio (OR) of the association between tobacco smoking and bacillary tuberculosis was 2.48 (95% confidence interval (CI) 1.42 to 4.37), p<0.001.The age adjusted OR (Mantel-Hanszel estimate) was 2.24.(95% CI 1.27 to 3.94), p<0.05 . The ORs for mild (1-10 cigarettes/day), moderate (11-20/day), and heavy (>20/day) smokers were 1.75, 3.17, and 3.68, respectively (p<0.0001 test for linear trend) . The ORs for smokers with <10 years, 11-20 years, and >20 years of smoking were 1.72, 2.45, and 3.23, respectively (p<0.0001 test for linear trend) . CONCLUSION: There is a positive association between tobacco smoking and pulmonary (bacillary) tuberculosis (OR 2.5) . The association also shows a strong dose-response relationship.

Adv Perit Dial, 2002, 18, 158 - 60
Keeping the catheter exit site clean by sealing with a dressing film in patients under continuous ambulatory peritoneal dialysis; Tanaka S et al.; In patients on continuous ambulatory peritoneal dialysis (CAPD), exit-site care is troublesome . We developed a new method for exit-site care, using a dressing film . We investigated the possibility of keeping the exit site clean for up to 6 weeks, using seven protocols: Control group (n = 24)--the exit site was cleaned with a povidone iodine solution daily and a gauze dressing was applied . Group A (n = 120)--the exit site was cleaned with a povidone iodine solution once weekly, was covered with a small piece of gauze, and was completely sealed using a dressing film . Group B (n = 181)--as with Group A, except once every 2 weeks . Group C (n = 64)--as with Group A, except once every 3 weeks . And so on: Group D (n = 45)--once every 4 weeks . Group E (n = 8)--once every 5 weeks . Group F (n = 2)--once every 6 weeks . At each session, we examined the small gauze bacteriologically . In groups A-F, the patients were asked to bathe every day and not to do anything about the exit site for 1-6 weeks, as applicable . In the control group, the rate of positive bacterial culture was 87.5% . In the other groups, the rates were group A, 15%; group B, 6.6%; group C, 6.3%; group D, 2.2%; and groups E and F, 0% . In the film-method groups, the rates of positive bacterial culture were significantly low . We thought that the film method kept the exit site clean.

Vestn Otorinolaringol, 2002, (4), 36 - 8
{Efficient antibiotic therapy in radical surgery on the maxillary sinus}; Kriukov AI et al.; The study assessed efficiency of local antibiotic therapy with mupirocin and amoxicillin/clavulanate in 28 patients radically operated on the maxillary sinus (MS) . Early after the operation, MS tamponing with a latex tampon was made . The tampon was filled with mupirocin for patients of group 1 . In patients of group 2 and controls the tampon was sterile but in group 2 after the tampon removal postoperative maxillary washing was made with amoxicillin/clavulanate solution . The results of the study demonstrated high efficiency of local administration of mupirocin and amoxicillin/clavulanate and validity of bacteriological examination in planning antibiotic therapy early after surgery.

Rev Chir Orthop Reparatrice Appar Mot, 2002 Sep, 88(5), 467 - 74
{Total hip arthroplasty and femoral head osteonecrosis in renal transplant recipients}; Stromboni M et al.; PURPOSE OF THE STUDY: Osteonecrosis of the femoral head is reported in a very variable proportion of renal transplant recipients . When these patients require total hip arthroplasty (THA), immunosuppression and poor bone quality increase the risk of aseptic loosening and infection . In the literature, functional outcome has been satisfactory although rates of early and late complications have varied greatly . The purpose of our work was to determine the long-term outcome in a series of renal graft recipients who underwent THA for osteonecrosis of the femoral head.MATERIAL AND METHODS: Forty-eight THA were implanted for aseptic osteonecrosis of the femoral head (Ficat grade III and IV) in 32 renal transplant recipients between 1974 and 1995 (21 men and 11 women) . Mean age was 30 years at transplantation and 39 years at THA surgery . Thirty patients had been on hemodialysis for a mean 1 year prior to transplantation . Joint disease concerned 2 or more joints in 23 of the 32 patients . Fifteen hips had a surgical history: 8 drillings and 3 head arthroplasties . The THA was implanted under general anesthesia via the posterolateral approach . All implants were fixed with a gentamycin cement . A cephalosporin was used for the antibiotic prophylaxis in 20 cases and a cephalosporin/vancomycin combination in 24 . Functional outcome was assessed with the Postel-Merle-d'Aubigne (PMA) score . Functional gain was {(PMAreview-PMApreop)/PMApreop} . General or local complications were recorded at last follow-up . The complete or incomplete nature of lucent lines seen on the last follow-up x-rays and their evolution were also recorded . Reasons for second procedures were noted.RESULTS: Early complications were: phlebitis (n=1), hematoma (n=7), dislocation (n=1), deep infection (n=2) . At last follow-up (mean=5 years 7 months), four patients (6 THA) had died and six (7 THA) were lost to follow-up . Preoperatively, function was scored fair or poor in 91% of the patients . At last follow-up function was scored good, very good, or excellent in 75% . Mean functional gain was 38% . A second operation was necessary for seven THA due to aseptic loosening (mean delay 9 years 10 months), for five others for septic loosening (mean delay 6 years 8 months), and finally for two for instability (one early and the other after more than 2 years) . In all, 29% of the THA were reoperated . Two deaths were related to late THA infection . Active lucent lines were observed in 11% of the THA (excepting patients reperated for loosening) . DISCUSSION: The functional gain provided by THA in renal transplant recipients with aseptic osteonecrosis of the femoral head is clearly established . Implant survival remains a problem . The rate of early local complications was high in our series, mainly related to hematoma formation and infection . The infections observed were particularly severe requiring early comprehensive management at onset of clinical signs . For patients with suspected deep infection, we propose an aspiration biopsy of the joint to obtain a bacteriological sample . CONCLUSION: THA enables good functional outcome for renal transplant recipients suffering from osteonecrosis of the femoral head, but at the cost of a high risk of early and long-term complications not always reported in the literature.

Hepatogastroenterology, 2002 Nov-Dec, 49(48), 1567 - 70
Effect of acute portal hypertension on gut mucosa; Hashimoto N et al.; BACKGROUND/AIMS: Patients with cirrhosis are predisposed to develop spontaneous bacteremias and peritonitis, mainly by enteric bacteria . Portal hypertension, by producing congestion and edema of the bowel wall, could increase the passage of bacteria from the intestinal lumen to regional lymph nodes to the systemic circulation or to both, a process termed bacterial translocation . The aim of this study was to investigate bacterial translocation, brush border enzyme activity and intestinal permeability of experimental acute portal hypertension . METHODOLOGY: Twenty-six male Wistar rats were used for all experiments . Rats were studied two days after the induction of portal hypertension (n = 13) . Control animals were also studied two days after sham operation (n = 13) . Samples of mesenteric lymph nodes for standard bacteriological cultures and a fragment of ileum for histological examination and mucosal contents of protein, Alp were obtained . Moreover, we evaluated the intestinal permeability by using the phenolsulfonphthalein test . RESULTS: Two days after surgery, a significantly greater properties of rats with acute portal hypertension (12 of 13, 92%) had positive mesenteric lymph node cultures compared with control group: sham operated (2 of 13, 15%) . A significant increase in disappearance of phenol red from the luminal solution was observed in rats with acute portal hypertension . Brush border enzyme of Alp was also significantly decreased in acute portal hypertension, compared with in sham operated controls . CONCLUSIONS: The results of our study suggested that acute portal hypertension may be a major factor in the development of spontaneous infections in cirrhosis.

C R Biol, 2002 Aug, 325(8), 901 - 6; discussion 911-5
{Bacteriological risks: detection and tracing}; Grimont PA; Advances in molecular taxonomy of bacteria have generated many tools allowing identification of any bacteria, whether culturable or not . In addition to taxonomic identification, growing knowledge on pathogenicity mechanisms allows the detection of bacteria with given virulence genes . The problem is in asking the proper questions so that the most appropriate tools can be chosen . Some rapid identification tools (gene amplification, in situ hybridisation) require a starting hypothesis . Other tools (rrs gene amplification and sequencing) can be used without prior hypothesis, but take longer . To face the bioterrorist threat, particular attention should be given to laboratory and strain dispatch (within- and between-laboratory) organisation.

Lancet, 2002 Oct 5, 360(9339), 1050 - 5
Mycobacterium vaccae (SRL172) immunotherapy as an adjunct to standard antituberculosis treatment in HIV-infected adults with pulmonary tuberculosis: a randomised placebo-controlled trial; Mwinga A et al.; BACKGROUND: Mortality rates of HIV-infected patients treated for tuberculosis remain high . This study aimed to assess the effect on mortality of immunotherapy with single-dose SRL172 added to standard antituberculosis chemotherapy in such patients . METHODS: The double-blind trial enrolled 1229 patients aged 18-60 years, who had never received antiretroviral treatment and who presented with newly diagnosed, sputum-smear-positive pulmonary tuberculosis to referral centres in Lusaka, Zambia, and Karonga, Malawi . Both HIV-positive and HIV-negative patients were enrolled, to avoid stigmatisation . Participants were randomly assigned a single injection of SRL172 or matching placebo within 2 weeks of starting 8 months of antituberculosis chemotherapy and followed up for at least 12 months . The primary endpoint was time to death in the HIV-infected population . Analyses were based on 760 HIV-positive patients after exclusion of 84 patients with errors in storage of the injection, no bacteriological confirmation, or no HIV result . FINDINGS: Of 760 HIV-infected patients, 374 received SRL172 and 386 received placebo . SRL172 did not cause any serious adverse events . The follow-up rate was 88% at 12 months in both groups . Of the HIV-positive patients, 109 (19.5 per 100 person-years) of 372 assigned SRL172 and 107 (19.3 per 100 person-years) of 386 assigned placebo died . In the Cox's regression analysis, stratified by centre, the hazard ratio of deaths (SRL172/placebo) was 1.03 (95% CI 0.79-1.35) . There was no evidence of benefit to the group assigned SRL172 . INTERPRETATION: Immunotherapy with single-dose SRL172 as an adjunct to standard antituberculosis treatment in HIV-positive adults with pulmonary tuberculosis had no significant effect on survival or bacteriological outcome, though the treatment was safe and well tolerated.

Jpn J Thorac Cardiovasc Surg, 2002 Sep, 50(9), 391 - 4
Spontaneous parathyroid adenoma hemorrhage; Shundo Y et al.; We report a case of spontaneous parathyroid adenoma hemorrhage . A 50-year-old man with a sore throat, and swelling and ecchymosis of the entire anterior neck was found in cervical and chest computed tomography revealed to have a low-density area extending from the parapharyngeal region to below the carina, Suspecting descending necrotizing mediastinitis secondary to a peritonsillar abscess, we conducted mediastinal and cervical drainage, but found no abscess . No evidence was found, either, in bacteriological culture of sputum and pleural effusion . After the hematoma disappeared, cervical ultrasonography indicated parathyroid adenoma . Serum calcium was marginally increased, indicating that serum calcium should be determined if cervical or mediastinal hematoma develops without an obvious cause.

Adv Ren Replace Ther, 2002 Oct, 9(4), 282 - 9
The Acute Dialysis Quality Initiative--part VII: fluid composition and management in CRRT; Schetz M et al.; Fluid composition and management are important parts of continuous renal replacement therapy (CRRT) . Most commercially available CRRT solutions are able to reestablish electrolyte homeostasis provided some phosphate supplementation is given . Supraphysiologic glucose concentrations should be avoided . Predilution fluid replacement allows higher ultrafiltration rates and can be considered as an adjunct to the anticoagulation regimen . Lactate is an effective buffer in most CRRT patients . Bicarbonate is preferred in patients with lactic acidosis and/or liver failure . When citrate is used as anticoagulant, frequent monitoring of pH is required . The clinical consequences of CRRT-induced decreases of body temperature are not clear . Substitution fluid should be sterile, but the bacteriologic requirements for CRRT dialysate are less clear . There is no consensus on the optimal parameters to monitor fluid management . Integrated balancing systems have theoretical advantages over adaptive use of intravenous fluid pumps . Although there is evidence that volume overload is associated with adverse outcome, there is no evidence that fluid removal per se improves outcome in critically ill patients with or without acute renal failure .

Klin Khir, 2002 Sep, (8), 42 - 3
{Amoxiklav in the treatment of acute paraproctitis}; Kondratenko PG et al.; In 38 patients with an acute paraproctitis a new generation antibiotic Amoxiclave, owing broad spectrum of activity, was applied . While observing the wound clearance and healing process, together with clinical parameters, the results of bacteriological investigation were controlled . High efficacy of the preparation was observed as well as expediency of its application in the purulent wound surgery, for an acute paraproctitis in particular.

Pancreatology, 2002, 2(5), 449 - 55
The gut origin of bacterial pancreatic infection during acute experimental pancreatitis in rats; Samel S et al.; BACKGROUND: Infections are frequent complications and determine clinical course and outcome in severe pancreatitis . A novel animal model was used to assess minimal transit time of bacterial translocation (BT) across the gut mucosa in vivo using green fluorescent protein-transfected Escherichia coli and intravital video microscopy . METHODS: Three hours after induction of acute pancreatitis by i.p . injection of 40 microg/kg cerulein, 0.5 ml of a suspension of green fluorescent protein-transfected E . coli were injected into the lumen of a small bowel reservoir formed by ligature in anesthetized Wistar rats . Translocation of E . coli was assessed by intravital microscopy . Animals were sacrificed 5 h after induction of pancreatitis . RESULTS: BT across the mucosa and into the muscularis propria took a mean +/- SD of 36.4 +/- 8 min and 80.9 +/- 9.5 min, respectively, in sham animals . Pancreatitis resulted in a significantly shorter minimal transit time across the mucosa (16.4 +/- 4.9 min, p = 0.007) and into the muscularis propria (47.7 +/- 2.5 min, p = 0.001) . E . coli were detected on frozen cross-sections and on bacteriological examination of pancreatic tissue in animals with acute pancreatitis but not in controls . Discussion: Intravital microscopy of fluorescent bacteria is a new approach towards studying BT in vivo . Minimal transit time of BT serves as a novel functional aspect of mucosal barrier function during acute pancreatitis . The observation of fluorescent bacteria translocating from the small bowel lumen into the pancreas provides substantial experimental proof for the gut-origin-hypothesis of infectious complications in pancreatitis .

J AOAC Int, 2002 Sep-Oct, 85(5), 1037 - 44
Assurance enzyme immunoassay eight hour method for detection of enterohemorrhagic Escherichia coli O157:H7 in raw and cooked beef (modification of AOAC Official Method 996.10): collaborative study; Feldsine PT et al.; AOAC Official Method 996.10, Assurance Enzyme Immunoassay (EIA) for Escherichia coli O157:H7 (EHEC), was modified to incorporate a new enrichment protocol using BioControl EHEC8 medium for testing raw and cooked beef . Foods were tested by EIA and the U.S . Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) enrichment conditions and the FDA Bacteriological Analytical Manual (BAM) isolation and confirmation techniques . A total of 14 collaborators participated . Raw and cooked ground beef were inoculated with E . coli O157:H7 at 2 different levels: a high level where predominantly positive results were expected, and a low level where fractional recovery was anticipated . Collaborators tested 378 test portions and controls by both the 8 h EIA and the USDA/FSIS enrichment methods, for a total of 756 test portions . Of the 378 paired test portions, 75 were positive and 212 were negative by both methods . Thirteen test portions were presumptively positive by EIA and could not be confirmed culturally; 30 were negative by EIA, but confirmed positive by culture; and 65 were negative by the culture method, but confirmed positive by the EIA method . There was no statistical difference between results obtained with the Assurance EIA for EHEC 8 h method and the culture method for raw ground beef . The Assurance EIA had a significantly higher recovery for cooked beef.

J AOAC Int, 2002 Sep-Oct, 85(5), 1029 - 36
Visual immunoprecipitate assay eight hour method for detection of enterohemorrhagic Escherichia coli O157:H7 in raw and cooked beef (modification of AOAC Official Method 996.09): collaborative study; Feldsine PT et al.; AOAC Official Method 996.09, Visual Immunoprecipitate Assay (VIP) for Escherichia coli O157:H7, was modified to incorporate a new enrichment protocol using BioControl EHEC8 medium for testing raw and cooked beef . Foods were tested by VIP assay and the U.S . Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) enrichment procedure and the FDA Bacteriological Analytical Manual (BAM) isolation and confirmation techniques . A total of 15 collaborators participated . Raw and cooked ground beef were inoculated with E . coli O157:H7 at 2 different levels: a high level, where predominantly positive results were expected, and a low level where fractional recovery was anticipated . Collaborators tested 396 test portions and controls by both methods, for a total of 792 test portions . Of the 396 paired test portions, 75 were positive and 230 were negative by both the VIP and culture methods . Eleven test portions were presumptively positive by VIP and could not be confirmed culturally; 32 were negative by VIP, but confirmed positive by culture; and 65 were negative by the culture method, but confirmed positive by the VIP method . There was no statistical difference between results obtained with the VIP for EHEC 8 h method and the culture method except for cooked beef, where the VIP had significantly higher recovery for one inoculation level.

Scand J Infect Dis, 2002, 34(9), 648 - 53
Incidence and clinical significance of non-tuberculous mycobacteria isolated from clinical specimens during a 2-y nationwide survey; Thomsen VO et al.; A 2-y nationwide survey of patients in Denmark with non-tuberculous mycobacteria (NTM) cultures was undertaken . Patients were identified by means of records held at the International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Denmark . The objectives were to identify isolated NTM to species level, to describe the incidence of the various species and to evaluate the clinical significance of pulmonary NTM isolates other than M . avium complex (MAC) and M . gordonae . Identification was performed by means of hybridization or sequencing of 16S rDNA . The clinical significance of pulmonary NTM isolates was evaluated by means of questionnaires concerning patients (was sent to the clinicians!) patients who had NTM isolated for the first time using bacteriologic, radiographic and clinical criteria . A total of 1110 specimens (2.1%) from 525 patients grew NTM . After MAC (n = 198) and M . gordonae (n = 168), most patients had M . abscessus (n = 21), M . malmoense (n = 20) and M . xenopi (n = 17) isolated . Of the pulmonary patients, 50.6% met bacteriologic criteria, 75.3% radiographic criteria and 53.4% clinical criteria for significant infection . Almost half of the pulmonary patients met all the criteria for significant NTM infection that could be evaluated . Clinically significant infection was associated with underlying disease in most patients.

Ann Biol Clin (Paris), 2002 Sep-Oct, 60(5), 513 - 23
{RNA isolation and purification methods}; Bastard JP et al.; Recent advances in human, bacterial and viral genome projects and the development of quantitative real-time reverse transcription-polymerase chain reaction methods offer the possibility of analysing a large number of gene transcripts . These molecular developments represent an important advancein the field of genetics, cancer, virology, bacteriology and hematology . A limiting step remains the isolation of high quality mRNA purified from biological samples . This review describes the different methods used to isolate mRNA from biological samples and to verify RNA integrity and gives precise details about RNA storage conditions.

Ugeskr Laeger, 2002 Sep 2, 164(36), 4177 - 81
{Acute hematogenous osteomyelitis and purulent arthritis in childhood . A 10-year study from the county of Copenhagen with a follow-up}; Christiansen P et al.; INTRODUCTION: The proper treatment of patients with acute haematogenous osteomyelitis and acute suppurative arthritis is still controversial . Based on a previous study, a treatment regimen was recommended . We now report on the clinical, bacteriological, and radiological aspects of the diseases, with special attention to possible changes in the natural history of the diseases and the long-term prognosis . MATERIAL AND METHODS: A total of 69 children with acute haematogenous osteomyelitis and 48 with septic arthritis admitted in the period 1977-1987 were entered in a retrospective review . Epidemiological and bacteriological data were analysed and compared to those of an earlier study (1965-1974), confined to the same geographical area . Long-term outcome was assessed by a questionnaire and clinical-radiographic follow-up . RESULTS/CONCLUSIONS: A significant increase in the admission rate for both disorders was seen . The long-term outcome was favourable, with major sequelae found in only three patients (3%) and minor sequelae in two patients (2%) . The benign long-term outcome may well be related to quick admittance to hospitals and long-lasting, appropriate antibiotic treatment.

Int J Syst Evol Microbiol, 2002 Sep, 52(Pt 5), 1831 - 5
Halomicrobium mukohataei gen . nov., comb . nov., and emended description of Halomicrobium mukohataei; Oren A et al.; Haloarcula mukohataei, previously isolated from soils of salt flats in Argentina, was originally placed in the genus Haloarcula on the basis of 16S rRNA gene sequence comparison . However, its morphology and polar lipid composition differs from that of the other Haloarcula species . In addition, its phylogenetic distance from other Haloarcula species is rather large, and the 16S rDNA sequence does not contain many of the signature bases characteristic of the genus . Transfer of the species to a new genus was therefore recommended by the International Committee on Systematic Bacteriology Subcommittee on the taxonomy of Halobacteriaceae . A full description of the isolate, proposed as a member of a new genus, Halomicrobium, as Halomicrobium mukohataei comb . nov., is presented . The type strain is strain arg-2T (= JCM 9738T = DSM 12286T = ATCC 700874T = NCIMB 13541T).

Radiology, 2002 Oct, 225(1), 205 - 9
Utility of polymerase chain reaction for detecting Mycobacterium tuberculosis in specimens from percutaneous transthoracic needle aspiration; Kang EY et al.; PURPOSE: To determine the clinical utility of polymerase chain reaction (PCR) for detecting Mycobacterium tuberculosis in specimens from percutaneous transthoracic needle aspiration (PTNA) . MATERIALS AND METHODS: PCR for M tuberculosis detection in specimens from PTNA was performed prospectively in addition to cytologic and histologic analyses in 45 patients . On computed tomographic (CT) scans, tuberculosis (TB) versus malignant neoplasm or other infection was diagnosed in 28 patients; possible malignancy was diagnosed in 11, but TB was considered clinically because of young patient age or presence of tuberculous lesions in other areas of the lungs . In six of these patients, TB was diagnosed, but bacteriologic results were negative . PTNA was performed with a 21-gauge needle by one chest radiologist by using CT (n = 25), ultrasonographic (n = 5), or fluoroscopic guidance (n = 15) . Final diagnoses were malignant neoplasm (n = 19), hamartoma (n = 1), TB (n = 17), and pneumonia (including actinomycosis and aspergillosis) (n = 8) . Sensitivity, specificity, and positive predictive values of PCR in PTNA specimens for diagnosis of TB were calculated . RESULTS: In 17 patients with TB, PCR results were positive in 11 and negative in six . PCR results were negative in all cases of malignant neoplasm, hamartoma, and pneumonia . Cytologic and histologic analysis of PTNA specimens resulted in a specific diagnosis of TB in two (12%) of 17 patients . By adding the PCR results, diagnosis of TB was established in 12 (71%) of 17 patients . Sensitivity, specificity, and positive and negative predictive values of PCR for diagnosis of TB in PTNA specimens were 65% (11 of 17), 100% (28 of 28), 100% (11 of 11), and 82% (28 of 34), respectively . CONCLUSION: PCR for detection of M tuberculosis in PTNA specimens is a useful adjuvant to cytologic and histologic analysis for diagnosis of TB.

Child Trop, 1992, (196-197), 78 - 82
An Algerian experiment: short chemotherapy for tuberculosis; Anane T et al.; PIP: 427 Algerian children aged up to 15 years were treated at the Pediatric Clinic of the Beni-Messour University Hospital Centre, Algiers, between July 1979-January 1985 with a 6-month multi-drug course for tuberculosis (TB) . TB was diagnoses by clinical and x-ray findings in 56% and confirmed bacteriologically in the rest . Those with pulmonary, meningeal, osteoarticular, or renal TB received isoniazid and rifampicin daily for 6 months with streptomycin and pyrazinamide for the first 2 months . Those with primary TB, regional lymphadenitis, pleural, peritoneal, or other localized TB received the same drug regimen without initial streptomycin . 372 children completed the course, and, of these, all were cured, 99% definitely so . There were 3 relapses . Children who did not complete the drug treatment included 7 who died due to TB, 4 of them pulmonary and 3 meningeal; 1 who had drug toxicity; 17 who stopped treatment and were lost to follow-up; 30 who were lost to follow-up after completion of treatment and 5 who died of unrelated causes . The only adverse reactions were transient elevated liver transaminase in 4.6, and 1 case of jaundice in a child who received an accidental overdose . Besides its effectiveness, this short course treatment was considered beneficial because only 4% discontinued and were lost to follow-up, compared to 15% of a prior group given a 12-month treatment course .

Vie Sante, 1990 Oct, (5), 30 - 2
{AIDS in Senegal}; Ndoye I; PIP: In Senegal, AIDS was 1st discovered in December 1986 going from 6 cases in 1987, to 181 in 1988, to 269 in 1989, and to 361 in June of 1990 . Senegal has the HIV-2 virus, which has a longer incubation period than the HIV-1 virus and its incidence is becoming a growing problem . Unlike most other countries in Africa, Senegal did not institute an AIDS program with the World Health Organization; but signed a contract with Harvard, Tours and Lomoges Universities to undertake research on AIDS, sexually transmitted diseases, prostitution, tuberculosis, infectious diseases, cancer, and diseases of internal medicine . The project established: 1) an epidemiological surveillance system with prostitutes, patients with STD's, tuberculosis, cancer, problems of internal medicine and pregnant women; and 2) a diagnostic referral center for West Africa with a bacteriology-virology laboratory in le Dantec Hospital . This hospital has trained most West African biologists and produced the 1st epidemiological studies in West Africa . In 1986, after receiving the 1st results of an epidemiological survey on prostitutes and the incidence of STD's, the government created The National Multidisciplinary Committee for the Prevention of AIDS which includes a National Component made-up of an epidemiological, clinical, information and ethical/judicial and research groups; Regional Committees, an Executive Committee and a Mixed Committee for Follow-Up and Coordination . The Roles played by each of these committees interface at a National level to safeguard the fight against AIDS and STDs in Senegal .

Ann Natl Acad Med Sci, 1983 Jan-Mar, 19(1), 11 - 21
The case for B.C.G; Tripathy SP; PIP: A large BCG trial was undertaken by the Indian Council of Medical Research with the assistance of the World Health Organization and the US Public Health Service in Chingleput district in an effort to obtain reliable evidence of the efficacy of BCG in providing protection against tuberculosis and to investigate if there are differences between strains of BCG in their efficacy, if the vaccinating dose influenced the protective effect and whether nonspecific sensitivity interfered with the protective effect of BCG . A Leprosy Prevention Trial was superimposed on this study to determine if BCG provided protection against leprosy . The entire population of the Chingleput district -- about 360,000 persons -- was included in the trial . 2 BCG strains -- Danish and French -- were used to vaccinate randomly 2/3 of the population; the remaining 1/3 was administered a placebo injection . The vaccine was administered either in a normal dose of 0.1 mg or a lower dose of 0.01 mg, again by random allocation . The study design included an initial survey of prevalence of infection and disease and subsequent surveys at 2 1/2 year intervals to determine the incidence of tuberculosis in the vaccinated and control subjects . Approximately 270,000 subjects were vaccinated, of which about 1/3 were uninfected initially . These subjects formed the population for analysis of the protective effect of BCG . There were only 285 cases of tuberculosis within a 12-1/2 year period among 90,000 subjects, comprising about 1/5 of the expected incidence on the basis of a prevalence of 10.7 culture-positive cases/1000 subjects . There were at least as many cases of tuberculosis in each of the vaccinated groups -- 93 and 99 -- as in the placebo group -- 93, demonstrating that BCG vaccination either in a dose of 0.1 mg or 0.01 mg failed to protect against the development of bacteriologically positive pulmonary tuberculosis . Detailed analyses indicate that BCG most likely provided some protection . There was clear evidence of the presence of environmental mycobacteria, which caused sensitization and thus could detract from the possible beneficial effect from BCG by preempting BCG . Such an effect, even if it had occurred, could not account for the total absence of the protective effect of BCG . There was a 3% incidence of infection as assessed by tuberculin conversions among those subjects initially tuberculin-negative . The BCG protection provided at least 30% protection against leprosy in the vaccinated subjects .

Contracept Deliv Syst, 1981 Apr, 2(1), 145 - 56
Histological responses of the endometrium to the IUD; De Brux J et al.; PIP: Histological studies of endometria after IUD use were conducted in 592 women (mean age, 32 years; range, 22 to 48 years) . Duration of IUD retention was not considered in these studies . Bacteriological studies were also performed in 108 cases after IUD removal by sterile technique . The following conditions were observed: 1) direct mechanical action of the IUD on the endometrium; 2) hormonal modification; 3) pregnancy modification; 4) vascular modification; and 5) inflammatory modification . The observed conditions suggest that IUD action on the endometrium resembles that of a foreign body inserted into a semiclosed cavity . The IUD is constantly in contact with the uterine cavity, the tubes, and the peritoneum . It appears to enhance various germ infections and this was attributed to increase in number of sexual partners (due to little fear of pregnancy) and less rigorous hygienic care . Hemorrhages in the form of menorrhagias or metrorrhagias were found to be one of the most frequent complications associated with IUD use, and one of the main reasons for termination of IUD use . Although the endometrium contains mucosa which triggers its defense mechanisms by means of lysozomes, the IUD induces mechanical vascular and hormonal reactions which affect endometrial resistance to infection .

Contracept Deliv Syst, 1981 Apr, 2(1), 101 - 8
Infection and the IUD; Defoort P et al.; PIP: While certain complications of IUD use, such as perforation and pregnancy, are no doubt related to the infectious morbidity, IUD use accounts for only a moderate or even no increase of the PID rate . One problem hampering assessment and comparison of the magnitude of the risk involved is that little is known about the PID rate in the standard population . Furthermore, many findings related to the bacteriology of the IUD-containing uterine cavity and to the bacterial conductivity of tailless and tailed IUDs are contradictory, and claims of a very high PID risk in IUD-bearing nulliparas have not been unequivocally substantiated . Weaknesses inherent in case-control studies include difficult statistical interpretability coupled with an almost total disre.gard of technical aspects (e.g, patient selection, insertion technic, and IUD design) that may be of major prophylactic importance . It is imperative that the problem of IUD-related genital infection be further elucidated by prospective studies paying the necessary attention to these aspects . There is a body of literature and experience which suggests that, provided these risk factors are properly taken into account, the risk of IUD-related infection need not be significantly enhanced

JAMA . 1973 Apr 23;224(4):537.
Vacuum aspiration for second-trimester abortion not recommended; Nathanson BN; Question: Recently I observed the use of vaccuum aspiration in an attempt to induce abortion in a woman 16 weeks' pregnant, after dialation of the cervix to 14 mm under paracervical block anesthesia . Only amniotic fluid and a segment of the umbilical cord could be aspirated . The patient was returned to bed, and an oxytocin (Pitocin) infusion was begun . She aborted 24 hours later with no complications . Why is this procedure considered inferior to amniocentesis and saline solution instillation as a technique for inducing abortion? Answer: Transcervical rupture of the fetal membranes for the purpose of inducing second trimester abortion is unreliable as a method and is fraught with the most serious complication of intrauterine infection (Schwartz, R.H.: Septic abortion, Philadelphia, J.B . Lippincott, 1968, p . 17) . On the other hand, Roufa et al . (Clinical Obstetrics and Gynecology 14:119, 1971) report no failures of abortion and only 1 significant intrauterine infection in 229 patients aborted in the second trimester by the hypertonic, intraovular, saline solution instillation method . The cervicovaginal portion of the reproductive tract is bacteriologically a contaminated area teeming with a variety of organisms . White and Koontz (Obstetrics and Gynecology 32:402, 1968) cultured the cervices of 57 pregnant women in all trimesters of pregnancy, and a significant number of these women harbored pathogens . In general the skin is preferable to the cervicovaginal tract as a route of entry into the intraovular space . full text

Nihon Kokyuki Gakkai Zasshi, 2002 Jun, 40(6), 520 - 4
{A case of infective endocarditis accompanied with pulmonary complications in a drug addict}; Yoshimoto A et al.; A 21-year-old man who had a history of intravenous drug addiction was admitted with complaints of high fever and a productive cough . Chest CT on admission showed multiple consolidations, and pneumonia was initially diagnosed and treated . Because echocardiography after admission showed vegetation, with no bacteriological findings, attached to the tricuspid valve, right-sided infective endocarditis was diagnosed . After antibiotic therapy was changed, his fever was reduced and the inflammatory findings were eliminated . In the western world, most cases of right-side infective endocarditis are caused by drug addicts, but in Japan, this disease is very rare . Right-side infective endocarditis in drug addicts causes a high rate of pulmonary complications, in particular, septic pulmonary embolism . Many drug addicts suffering from pulmonary complications may consult doctors, but if the latter are not well-informed about this disease, it may not be possible to give an accurate diagnosis or proper treatment.

Di Yi Jun Yi Da Xue Xue Bao, 2002 Sep, 22(9), 830 - 2
{Application of BACTEC MGIT 960 system and molecular identification of mycobacteria in the diagnosis of spinal tuberculosis}; Zhou JS et al.; OBJECTIVE: To evaluate the clinical application of BACTEC MGIT 960 system and molecular identification of mycobacterium species in diagnosis of spinal tuberculosis . METHODS: Thirty-one specimens were obtained from patients with spinal tuberculosis, followed by culturing with BACTEC MGIT 960 system and in Lowenstein-Jensen (L-J) medium respectively . Mycobacterium species of the clinical isolates were identified with PCR amplification of IS986 and PCR-single-strand conformation polymorphism (PCR-SSCP) analysis of 16S rRNA, with the conventional identification approach serving as control . RESULTS: The positivity rates of mycobacterium culture with BACTEC MGIT 960 system and L-J medium were 83.87 % and 61.29 % respectively . The average detection time with BACTEC MGIT 960 were 11.3 d, 15.4 d shorter than that with the L-J medium (26.7 d) . The genetic identification of mycobacterium species was more rapid and accurate with consistent results with that from conventional method . CONCLUSION: BACTEC MGIT 960 system is preferable for detecting mycobacteria in spinal tuberculosis . The combined application of this instrument with genetic identification of mycobacteria is an effective strategy for the bacteriological diagnosis of tuberculosis.

Health Millions, 1995 Jan-Feb, 21(1), 49 - 52
Tuberculosis control programme in rural area: experiences from the field; Sudarshan H et al.; PIP: According to the Indian National Tuberculosis Program (NTP), only 30% of tuberculosis (TB) patients receiving conventional treatment and 52% of those receiving short-course chemotherapy (SCC) complete the treatment . Incompletely cured patients return to the community, and each sputum-positive case can infect 10-14 people in the course of a year . Direct monitoring of chemotherapy is a must for success, especially if rifampicin is used after accurate diagnosis based on bacteriological examination . The National Leprosy Eradication Program, which has involved voluntary organizations, provides an example to be followed by NTP . This example was considered when the Karuna Trust, a voluntary organization, launched a TB control program on January 1, 1992, for Yelandur taluk, covering a population of 69,484 in 40 villages . A staff consisting of a medical officer, a supervisor, a smear technician, and paramedical workers had undergone training at the National TB Institute in Bangalore . Detection of cases was carried out by house-to-house visits, which could detect about 65% of cases . It was also found that TB treatment had been started without a sputum examination, sputum-positive cases had been on rifampicin, and data recording was incomplete . Up to October 1994, a total of 231 cases were registered and compliance was ensured by home visits . Private practitioners were carrying out harmful activities by not enforcing full patient compliance and thereby contributing to the increasing number of drug-resistant cases . In contrast, this program had a default of only 19.1% among sputum-positive cases, but even these can be recovered with an interaction with private practitioners . Treatment failure amounted to 10.1%, all having been on rifampicin . Retreatment requires more expensive second-line drugs . Drug collection will be decentralized for the convenience of patients; and an adequate supply of drugs was secured . Some suggestions were also made concerning adequate resources, integration of the program, monitoring, and involving nongovernmental organizations in implementation and evaluation .

Imbonezamuryango, 1990 Apr, (17), 8 - 12
{Ten scenarios on the future of world population}; Niyibizi S; PIP: This work presents 10 hypotheses concerning possible catastrophes that might befall the world's population in the future . The perspective is pessimistic, but in most cases the hypotheses represent possibilities only . The 1st hypothesis is that demographic imbalances resulting from the excess of births over deaths will result in a total world population too large to be sustained by the earth's finite resources . A return of the great epidemic diseases of the past or the global warming that is already threatening are 2 other possible fates, along with cooling of the atmosphere and reglaciation . Atomic, bacteriologic, and chemical warfare represents a different sort of possibility . A collision of planets or of the numerous manmade satellites now circling the earth might have disastrous consequences, as might earthquakes or floods . The end of the world is foreseen in the Bible, although details are sparse . Finally, AIDS is viewed by many as divine punishment for the perversions of the human population and by others as a viral disease capable of decimating the world's population and returning once thriving areas to an uninhabited state .

S Afr J Obstet Gynaecol, 1971 Sep 11, 9(2), 37 - 41
The parameters of septic abortion; Botes M; PIP: A retrospective analysis of 50 cases of septic incomplete abortion is made . In order to evaluate the spread of infection, septic abortions were grouped into 3 types . In Group 1 were cases with infection limited to the uterus alone . Group 2 included cases with extrauterine spread of infection to parametrium and/or adnexa, and Group 3 cases had pelvic or generalized peritonitis . The purpose of the study was 1) to correlate bacterial cultures with the clinical classification and with special reference to the offensive vaginal discharge; 2) to determine whether there is a dominant clinical parameter; and 3) to evaluate, after consideration of 1 and 2, whether endotoxic shock can be prevented by prophylactic treatment . The clinical picture, vaginal discharge, bacteriologic cultures of the cervix and uterine cavity and the histopathological picture of the uterine curettements were correlated . The mean temperature on admission was 98.9 degrees F in Group 1, 101 degrees F in Group 2, and 102.4 degrees F in Group 3 . Of the cases with a history of criminal intervention 9 percent were in Group 1; 57 percent in group 2, and 86 percent in Group 3 . In Group 1, 14 percent had offensive discharge, although 23 percent yielded positive cervical cultures and 9 percent positive uterine cultures . In Group 2, the discharge occurred in 57 percent, and positive cervical and uterine cultures were 43 percent and 33 percent respectively . The cases with peritonitis (Group 3) showed a very strong correlation: 71 percent offensive discharge with 86 percent cervical cultures and 71 percent positive uterine cultures . Analysis of the positive neutrophil responses showed that in Group 1 there was a 75 percent positive and a 25 percent negative response, in Group 2 there was a 40 percent positive and a 60 percent negative response, and in Group 3 there was a 30 percent positive and a 70 percent negative . It appeared that the more overwhelming the infection, the less was the response of the body against the infection . It is suggested that suspicion of criminal intervention might still be the only dominant clinical parameter to justify aggressive prophylactic treatment, if the patient would only give this information more freely . It is concluded that a septic abortion is any abortion where tenderness (indicating infection) can be elicited on bimanual examination . A classification of cases into the 3 groups is suggested . Group 2 and 3 cases should be evacuated vaginally without delay .

Pneumonol Alergol Pol, 2002, 70(3-4), 155 - 66
{Tuberculosis in Poland 2000--at the turn of the century}; Szczuka I; The aim of this paper was to evaluate incidence, prevalence and mortality from TB in Poland in 2000 and to examine trends of TB incidence . Individual date on tuberculosis cases reported to National TB Register and data of prevalence and mortality from TB were analysed . The paper presents the epidemiological situation of TB in Poland in 2000 . The year of 2000 was the seventh consecutive year of decline at TB incidence after previous years (1991-1993) of increase . In 2000 there were 11,477 newly registered TB cases, of which 1428 were relapses . The incidence was 29.7 per 100,000 population, /26.0 were the new cases and 3.7 relapses/ . Relapses represented 12.4% of all registered cases . The incidence in 2000 was 5.7% lower than in 1999, but the rate of decline was smaller than in previous year--8.4% . Among the total number of newly registered cases there were 6518 cases--16.9 per 100,000--bacteriologically confirmed, of which 3.713 cases were sputum smear positive . The proportion of bacteriologically confirmed cases was 56.8% and of sputum smear positive--33.9% which is rather low, but similar to previous years . In view of sufficient network of laboratory services this low proportion of bacteriological confirmation of diagnosis may indicate low quality of bacteriological examinations . In 95.5% of cases the diagnosis was respiratory tuberculosis . Low proportion--4.5%--of extrarespiratory tuberculosis, which have continued for many years, may indicate inadequacies in diagnosis and registration of this form of disease . The incidence of tuberculosis increases with age, from 1.4 in children up to 62.4 among 65 and older . The proportion of cases in the age group 20-44 years is still high (34.7%) . The incidence in men (40.9) is two times higher than in women (19.1), and in rural population higher than in urban--30.5 and 29.2 respectively . The prevalence of tuberculosis at the end of 2000 was 38.5 (14,895 cases), of which 55.4% were bacteriologically confirmed cases (8252 cases) . In the latter group there were 232 cases bacteriologically positive for longer than one year, and 369 cases resistant to at least 1 drug . The proportion of resistant cases (3.9%) is similar to previous years and does not seem to influence the overall effectiveness of chemotherapy . There were 1.022 (1.024) deaths due to tuberculosis 995 (985)--respiratory tuberculosis and 27 (39) extrarespiratory tuberculosis) reported in 1999 i.e . (2.6) per 100,000 . Almost 43% of all deaths were in patients 65 year of age and older . Since many years the TB mortality is the order of 0.3% of total mortality . CONCLUSIONS: In recent years incidence of TB in Poland decreased . The incidence of tuberculosis in Poland was about 2 times higher than the average for E.U . countries, but lower than in other Eastern European countries . The distance between Poland and countries with lowest incidence in Europe is estimated at 25-30 years . Tuberculosis has been and will remain a major public health problem in Poland for many decades.

J Hist Biol, 2002 Summer, 35(2), 221 - 50
Representation of the microcosm: the claim for objectivity in 19th century scientific microphotography; Breidbach O; Microphotography was one of the earliest applications of photography in science . The first monograph on tissue organization illustrated with microphotographs was published in 1845 . In the 1860s, a large number of introductions to scientific microphotography was published by anatomists . They argued that microphotography was a means of documenting the results of microscopic analysis, uncontaminated by subjectivity of the observer . In the early decades of the 19th century, before the general acceptance of cell theory, such a technique was of special importance, so no criteria were available to distinguish between important and superficial characters in the description of tissue microstructures . Microphotography was praised as the method of choice for documenting the scientific observations of microscopic material . Some of the microphotographic practices described in these early manuals, however, did not conform with the idea of a purely mechanical process of documentation . The authors of these manuals saw photography not as a technique which produced artifacts, but as a complete and reliable substitute for the original preparations . Thus, according to these authors, the artificial world of photography was seen as the actual representation of the microworld . Consequently, they tried to understand the microcosm by analyzing photographs instead of the microscopic preparation themselves . Such attitudes discredited the use of microphotography in the sciences . Consequently, the definitive breakthrough of scientific microphotography was delayed until the 1880s and was largely due to the efforts of Robert Koch, who made microphotography a central tool of bacteriology.

J Obstet Gynaecol East Cent Africa, 1983 Mar, 2(1), 41 - 5
Contribution of endotoxic shock to gynaecological and maternal morbidity and mortality; Omu AE et al.; PIP: 60 cases of endotoxic shock in obstetrics and gynecology in a 7 year period, January 1974 to December 1980 in Nigeria are reviewed . The most common and causative conditions were septic abortion, puerperal sepsis and pyelonephritis in pregnancy . The commonest cultured organism was Eschericha Coli . There were 33 deaths, giving a mortality rate of 55%, which falls within the range reported in the literature . The mortality rate in the institution where this study was conducted has shown a downward trend . Early surgery is advocated in those cases with infected retained products of conception and pyoperitoneum, and more liberal use of steroids, hypertonic glucose solution and digoxin, especially in patients with cardiac decompensation . The patients of the sample met the following criteria: 1) the occurrence of hypotension with consistent reading of 80/50 mm Hg or less; 2) demonstrable evidence of infection as determined by fever, hematological and bacteriological studies; and 3) the presence of persistent tachycardia . Conditions related to pregnancy accounted for 50% of of all cases . A significant finding was that 14 out of 18 patients with induced abortion had it at 2 weeks before admission . A majority of the patients in this study had subnormal temperature . The presence of jaundice, pneumonia, persistent oliguria and hepatomegaly are ominous signs accompanied by high mortality . Pulmonary factors in shock are important in determining patient survival as well as lung functions afterwards . The mortality in endotoxic shock remains high despite widespread use of fluids, antibiotic and steroid therapy, indicating that eliminating bacteria and restoring blood pressure are not the only considerations in treating shock . Insufficient nutrition may contribute to cardiorespiratory deterioration in the acutely ill patient; important physiological variables are improved by administration of hypertonic glucose solution, which leads to increased clearance of E . Coli from the blood .

Contracept Fertil Sex (Paris), 1977 Sep, 5(6), 515 - 20
{Laparoscopy and genital infection}; Vascular prosthetic graft infection: epidemiology et al.; Cattedra di Chirurgia Vascolare, Universita Vita e Salute, IRCCS H . San Raffaele, Milano, Italy . chiesa.roberto@hsr.it

Vascular prosthetic graft infection remains a major surgical challenge . Prevention of risk factors and antibiotic therapy can reduced but not eradicate it . Management of infected vascular grafts depends on several factors, including the location of the infected prosthesis, the extent of infection, and the underlying micro-organism . Classic treatment consists of extra-anatomic bypass grafting . The disappointing results due to the high mortality and amputation rate have kindled interest in alternative approaches, such as in situ reconstruction with antibiotic-bonded prostheses, autogenous veins or arterial allografts . PURPOSE: We focused on the treatment of aortic graft infection by means of both fresh and cryopreserved arterial allograft . Here, the experience of the Italian Collaborative Vascular Homograft Group is reported . METHODS: Between March 1994 and December 2000 seventy-nine patients with aortic graft infection were treated . The results of 68 patients are analysed . Eleven patients were treated with fresh, and 57 with cryopreserved homograft . Emergency surgical procedures were performed in 12 patients (17%) . Aortoenteric fistula was diagnosed in 22 patients . The mean interval between the first procedure and the insertion of a homograft for patients with infected aortic graft was 3 years (range 1-15) . The mean duration of follow-up was 30 months (range 1-68) . Clinical and duplex scanning evaluation were routinely performed . Computer tomography (CT), magnetic resonance (MR), or arteriography were performed on the basis of duplex scanning results . RESULTS: The analysis was performed on 68 cases for which there were sufficient reliable data . Eleven deaths occurred during the early postoperative period (30 days), a mortality rate of 16% . There were also seventeen late deaths, a mortality rate of 25% . Eleven patients had graft occlusion; six cases were successfully treated with thrombectomy . In three cases leg amputation was necessary . The results of fresh and cryopreserved homografts were compared . No significant differences of early postoperative mortality, late mortality, homograft-related mortality, graft failure were observed . The presence of aortoenteric fistula is a negative predicting factor of perioperative early mortality, which causes a rapid decline in the survival curve . Thirty-six months after the surgery the actuarial survival of the patients was 57% and the actuarial patency of the allograft was 41% . CONCLUSION: No significant difference in terms of clinical outcome was observed when using fresh, rather than cryopreserved homografts . The only factor that significantly influenced the survival rate appeared to be the aorto-enteric fistula.

Vet Microbiol, 2002 Oct 22, 89(2-3), 211 - 21
Genomic variations among Bartonella henselae isolates derived from naturally infected cats; Kabeya H et al.; The purpose of this study was to understand the mechanisms of persistent infection with Bartonella henselae in cats . Blood samples were collected from three naturally infected cats for 24 months . These cats were confirmed to be persistently infected with B . henselae by serological and bacteriological examination . Relapsing bacteremia was found in all three cats with intervals of 3-19 months . Following the peaks of bacteremia, increases of specific antibody titer were observed in these cats . To examine the genetic differences among the isolates derived from the first and following bacteremia, the genome DNA patterns of the restriction enzyme fragment length polymorphism (RFLP) of the isolates were examined by pulsed field gel electrophoresis . The isolates derived from the first bacteremia showed an identical RFLP pattern in each of the three cats . The isolates derived from the following peaks, however, showed 1-3 of different RFLP patterns in these cats . Furthermore, the isolates showing different RFLP patterns from those of the first bacteremia were also detected at the following bacteremic peaks in all three cats examined . The 16S ribosomal RNA (rRNA) gene type of all isolates was found to be 16S rRNA type I . The emergence of genetically distinct organisms at various peaks of bacteremia may contribute to the establishment of persistent infection in the naturally infected cats.

Vet Microbiol, 2002 Oct 22, 89(2-3), 151 - 9
Transmission of Actinobacillus pleuropneumoniae in pigs under field-like conditions: emphasis on tonsillar colonisation and passively acquired colostral antibodies; Vigre H et al.; The objectives of this study were to elucidate at which age tonsillar colonisation by Actinobacillus pleuropneumoniae occurs in pigs and relate this occurrence to the presence of colostral antibodies to A . pleuropneumoniae . The infection patterns were studied in an isolated cohort of pigs, which consisted of the offspring from five sows originating from a conventional pig herd . The sows were transferred to isolated research facilities before farrowing . A . pleuropneumoniae was detected on the tonsils of all sows . After a nursing period of 3 weeks, the pigs were weaned and reared isolated from other pigs until slaughter . The pigs were examined repeatedly for the presence of A . pleuropneumoniae on the tonsils and for antibodies to A . pleuropneumoniae using bacteriological and serological techniques, respectively.A . pleuropneumoniae was detected in the tonsils of one pig as early as 11 days after birth, showing that A . pleuropneumoniae can be transmitted from sow to offspring during a 3-week nursing period . The cumulative proportion of pigs carrying A . pleuropneumoniae in their tonsils increased significantly between the age of 4-12 weeks . This age period corresponded to the age at which the proportion of pigs with detectable levels of colostral antibodies to the different serotypes of A . pleuropneumoniae was declining . Since these two events take place in the same age period, we expect a possible biological association between the level of the passive immunity and the degree of tonsillar colonisation . The median duration of tonsillar colonisation was estimated to approximately 7-8 weeks.

Cas Lek Cesk, 2002 Jul 19, 141(14), 449 - 55
{Tuberculosis in the Czech Republic in the year 2000}; Trnka L et al.; BACKGROUND: Incidence of tuberculosis (TB) in the Czech Republic (CR) during the year 2000 was evaluated on the basis of newly detected cases as well the restriction of known TB sources by antituberculosis treatment . Data from compulsory reported TB cases in the TB register for the year 2000 were used as well as data from the analysis of treatment in cohorts of patients reported quarterly in 1999 and evaluated 12 months later . METHODS AND RESULTS: 1442 cases of new diseases and TB relapses were reported in 2000 (14.1/100,00) . 1244 cases (12.1/100,000) were TB of the respiratory system, 198 cases (2.0/100,000) belonged to the extra-respiratory TB . 61.9% of cases were bacteriologically verified TB of the respiratory system . In comparison with the year 1999, the number of TB cases was lower by 11.7%, respectively by 9.3% in TB of the respiratory system . The positive trend in TB incidence recorded in CR since 1998 has continued . From 1442 cases of the TB, 916 were males (63.5%) and 526 females (36.5%) . Majority of patients was older than 65 years . 143 (9.9%) of TB cases were patients born extra CR ("foreigners"), namely coming from Ukraine (41), Vietnam (16), and Romania (14) . 74 patients died of tuberculosis, mostly those older than 65 years . The youngest was the 24-year-old Ukrainian and a 38 year old homeless person, the citizen of CR . The highest incidence of TB was in West Bohemia, in Prague and in North Moravia; the lowest incidence was in South Moravia and in South Bohemia . TB was identified because of patient's troubles (68.0%), in the risk groups (13.3%), and by examination of contact persons (4.7%) . Other mycobacteriosis than TB was identified in 92 patients . The treatment was evaluated in 606 persons with the pulmonary TB, which was bacteriologically verified; analysis was done in cohorts of patients reported quarterly in 1999 . 70.1 to 77.5% of patients in individual cohorts were successfully treated, in 3 patients the treatment failed and 9 patients interrupted the treatment . Remaining 25% of patients either died before or during the treatment . The high mortality rate resulted from the high age and other diseases in some of the patients . CONCLUSIONS: WHO includes CR between countries with low TB incidence . Within the stabile population of CR the continuous decrease of TB incidence should continue, unless some unfavourable effects occur.

Enferm Infecc Microbiol Clin, 2002 Aug-Sep, 20(7), 326 - 31
{Enhanced quality in a hospital microbiology laboratory: from automation to clinical advice}; Garcia-Irure JJ et al.; BACKGROUND: Quality policies focussed on the patient and applied to a hospital microbiology laboratory have led us to investigate clinicians' needs when requesting test results . The aim of this study was to analyze these requirements and to implement a plan to improve attention to the clinicians, considered as direct customers, particularly in the process of providing results . METHODS: Phase 1: To determine clinicians' needs, we studied the calls made to the Bacteriology Unit . Over a period of two weeks the information requested, the reasons for the call and the hospital Service calling were recorded . A descriptive analysis of this information was performed and the most frequent reasons for calling were identified . Phase 2: A quality improvement plan was designed to improve laboratory reporting of bacteriologic results . One month after its implementation, the results of this quality effort were assessed by analysis of calls to the Unit and use of a questionnaire to determine clinicians' satisfaction . RESULTS: Phase 1: among the total calls made, 43.8% asked for information on specimens being processed, 17.7% for information on specimens processed in other units, 16.1% demanded test results that had not been received within the expected time, and 22.4% were for other reasons . The hospital departments requesting information included 31% Infectious Diseases, 16% Internal Medicine, 13% Intensive Care Unit (ICU), and 40% others . Phase 2: within the quality plan, a microbiologist attended clinical sessions in the above mentioned departments in order to provide information on the specimens being processed, to discuss alternative diagnostic tests, and to comment on treatment prescribed to the patients . EVALUATION: Microbiologists attended two sessions per week during one month in the IM and ID Departments and ICU, and his/her participation was evaluated through analysis of calls and a satisfaction questionnaire . CONCLUSION: Automation of many laboratory tasks has allowed a reorientation of the activity of laboratory professionals toward satisfying the needs of the medical staff and improvements in the reporting process . The direct participation of laboratory professionals in discussions on patient care resulted in an enhancement of the overall quality of the health care provided to the patient.

Southeast Asian J Trop Med Public Health, 2002 Jun, 33(2), 352 - 4
Clinical features of diphtheria in thai children: a historic perspective; Pancharoen C et al.; To study the clinical and laboratory features of childhood diphtheria, the cases of 381 children with clinical and bacteriological diagnoses of diphtheria who were treated at the Children's Hospital between 1976 and 1985 were reviewed . Of these, 191 were males and 190 were females . The mean age was 4.6 years . Approximately 75% of the patients had no history of immunization . Common manifestations of diphtheria included patch (100%), fever (92.4%), upper respiratory tract infection (91.6%), upper airway obstruction (42.3%), hoarseness (36.7%), and bull neck (11.3%) . The mean duration of fever prior to admission was 3.3 days with a range of 0-11 days . Patch sites included the tonsils (91.9%), the pharynx (55.9%), the larynx (27.8%) and others (24.4%) . Complications included upper airway obstruction (42.3%), cardiac complications (10.0%) and neurological complications (4.7%) . The mortality rate was 5.8% . There were significant associations between death and the presence of bull neck, laryngeal patch, airway obstruction and cardiac complications . Early recognition and prompt treatment will decrease complications and mortality in this group of patients.

Kekkaku, 2002 Aug, 77(8), 547 - 54
{Relative relatedness of 11 mycobacteria species by microplate hybridization methods considering delta Tm}; Fukasawa Y; Intra-species variance within Mycobacterium xenopi, Mycobacterium gordonae or Mycobacterium szulgai has been reported in identification employing chemotaxonomic characteristics, 16 S rRNA gene sequences or relative relatedness (relative color index) of genomic DNA-DNA Hybridization . Genomic DNA-DNA reassociation at the constant temperature was found to be unreliable for classification of mycobacterial species . However, nonspecific DNA reassociation could be avoided by hybridization at 56 degrees C after 45 degrees C overnight, and this technique was named delta DDH method in the preceding paper . The present report shows relative relatedness (relative color index) of genomic DNA in delta DDH method among mycobacterial species . Relative relatedness was below 70% among BCG, M . kansasii, M . simiae, M . asiaticum, M . szulgai, M . gordonae, M . xenopi and M . nonchromogenicum . The results satisfied the criteria for bacterial classification, which was proposed by the International Committee for Systematic Bacteriology in 1987 . In regard to Mycobacterium avium complex, relative relatedness between M . avium and M . intracellulare were approximately 75% . It appeared that M . avium and M . intracellulare could be classified into one species . It has been recognized, moreover, that there are intermediate strains between M . avium and M . intracellulare . Previously, numerical classification raised a concept of Mycobacterium avium-intracellulare-scrofulaceum complex . The present study revealed that relative relatedness of M . avium and of M . intracellulare to M . scrofulaceum were around 75%, while the percentiles of M . scrofulaceum relative to M . avium and that to M . intracellulare were both less than 50% . The relative relatedness of M . ulcerans against M . marinum was nearly 65%, whereas the relative relatedness of M . marinum against M . ulcerans was approximately 90% . The data may be partly explained by the horizontal gene transfer mechanism.

Saudi Med J, 2002 Aug, 23(8), 1002 - 4
Cold cellulitis . An unusual presentation of cutaneous leishmaniasis; Shelleh HH et al.; We describe a case of cutaneous leishmaniasis, which presented as what we call "cold cellulitis" . This may be differentiated from classical cellulitis/erysipelas by 1 . Lesser local reaction like pain and tenderness 2 . No systemic symptoms 3 . No leucocytosis 4 . Negative bacteriological and serological assay for bacterial cellulitis/erysipelas, 5 . Longer course of illness and 6 . Failure to respond to antibiotics . However, awareness of this type and frequent skin smears or skin biopsy will settle the right diagnosis . A review of different leishmanial presentations is given for comparison.

Int J Tuberc Lung Dis, 2002 Sep, 6(9), 771 - 9
Tuberculosis in the elderly in Hong Kong; Chan-Yeung M et al.; BACKGROUND: The rate of tuberculosis in Hong Kong has declined dramatically since the 1950s, but has remained high during the past decade, at around 110/100,000 . The reason for the persistent high rate is not clear . OBJECTIVES: To study the trend of tuberculosis in Hong Kong during the past decade (1989 to 1998) and the clinical characteristics of tuberculosis patients > or = 60 years of age, and compare them with those of the younger age groups . METHODS: Notification rates of tuberculosis from 1989 to 1998 were obtained from the Hong Kong Government Tuberculosis and Chest Service (Chest Service), Department of Health, Hong Kong . In addition, all patients registered at the Chest Service for treatment of tuberculosis in 1996 were studied . RESULTS: During the past decade, the notification rate of tuberculosis, which included both bacteriologically confirmed and clinically active but bacteriologically not confirmed cases, decreased in those under 60, remained unchanged in those between 60-69, and increased in those > or = 70 years of age . An increase in the rate of bacteriologically confirmed cases (sputum smear or culture positive for Mycobacterium tuberculosis) in the older age groups was observed during the same period . In 1989, 31.9% of tuberculosis cases were over the age of 60 years; this proportion increased to 45.4% in 1998 . The increase in the number of cases in those > or = 60 years could almost account for the total increase in number of cases during the last decade . Patients in the older age groups had more advanced disease at the time of diagnosis, and a higher proportion had comorbid illnesses . They also had significantly higher mortality compared with the younger age groups . CONCLUSION: The increasing longevity of the population and the high rate of tuberculosis in the elderly are important factors contributing to the persistent high rate of tuberculosis in Hong Kong in the past decade.

Swiss Surg, 2002, 8(4), 159 - 63
Intracranial subdural empyema and its management . A review of the literature with comment; Stephanov S et al.; Intracranial subdural empyema is a rare form of suppuration in Europe and North America, and is a potentially dangerous but treatable disease . The clinician must be aware that this complication requires prompt diagnosis and urgent neurosurgical intervention . The etiology, pathology, bacteriology, clinical features, diagnostic procedures and the different surgical approaches to this disease are reviewed . It seems that there is no single best surgical approach for treating subdural empyema, however, multiple burr holes drainage and craniotomy remain the most frequently used approaches.

Probl Tuberk, 2002, (6), 42 - 6
{Clinical picture of genital tuberculosis in different forms of its pathogen}; Kochorova MN et al.; Improvement of bacteriological diagnosis is of great value for the clinical picture of genital tuberculosis . The purpose of the study is to reveal the clinical features of genital tuberculosis in L-forms of Mycobacterium tuberculosis (MBT) versus traditional bacteriological methods and polymerase chain reaction (PCR) test with MBT DNA . A hundred and fourteen patients with verified active genital tuberculosis were examined . They were divided into 3 groups: 1) 36 patients with L-forms of MBT in the endometrial scrapes; 2) 32 with bacteriologically verified GT; 3) 46 with positive PCR test . A control group (Group 4) comprised 120 patients with NGD . Among the patients with L-forms there were prevalent females aged 21-40 years (83.4%) . These patients had a history of spontaneous abortions more frequently than patients from other groups, in a third was found to have MBT with their L-variants . Signs of intoxication were observed in 47.2% . Oviductal obliteration and specific changes typical of tuberculosis were revealed on a hysterogram in 63.9%, other forms of prior and current extragenital tuberculosis were detected in a half of cases, traces of prior pulmonary tuberculosis were observed in 15%, 63.9% of the patients with L-forms and in 87% of those with positive PCR test were found to have pathological changes in the endometrium, which is indirectly indicative of its lesion . Thus, detection of L-forms of MBT in the endometrial scrapes leads to the conclusion that this is an active sluggish hematogenic tuberculous process, which is evidenced by a complex clinical and laboratory study.

Probl Tuberk, 2002, (6), 21 - 4
{Clinical value of microchip technology in determination of drug resistance of Mycobacterium tuberculosis}; Vasil'eva IA et al.; The patients with multiresistant tuberculosis were divided into 2 groups: the sensitivity of Mycobacteria tuberculosis to antituberculous drugs was evaluated in Group 1 by the methods of absolute concentrations and in Group 2 by biological microchips determining mutations in the rpo3 gene responsible for rifampicin resistance . The results of the drug sensitivity test were obtained after 3 months of treatment in Group 1 and several days prior treatment in Group 2 . By taking into account the test results, reserve drugs was used in Group 2 patients . Subsequently, the results of the drug sensitivity tests carried out by the bacteriological method in Group 2 patients showed that isoniazid resistance was simultaneously noted if there were mutations in the rpo-B gene . Timely treatment with reserve drugs exhibited higher efficiency of treatment with its shorter duration in Group 2 than in Group 1.

Anesteziol Reanimatol, 2002 Mar-Apr, (2), 38 - 42
{Morphological aspects of diagnosis of acute opiate poisoning}; Zimina LN et al.; Clinical anatomical analysis, forensic chemical, morphological, bacteriological, and immunological investigations of material from 62 subjects dead from acute poisoning with opiates before hospitalization (31 cases) and in hospital (31 cases) were carried out . Organ and tissue lesions typical of opiate poisoning were detected . The outcome of acute poisoning with opiates is largely determined by severe dystrophic and inflammatory processes in organs and tissues, typical of narcomaniacs.

Vet Microbiol, 2002 Sep 24, 88(4), 385 - 92
Evaluation of serology, bacteriological isolation and polymerase chain reaction for the detection of pigs carrying Actinobacillus pleuropneumoniae in the upper respiratory tract after experimental infection; Chiers K et al.; Pigs, asymptomatically infected with Actinobacillus pleuropneumoniae in their upper respiratory tract, can transmit the infection . Detection of such animals is indispensable to prevent the intake of the disease in a herd . This study was conducted to evaluate bacteriology, polymerase chain reaction (PCR) and serology for the detection of subclinically infected pigs . Pigs were inoculated onto the tonsils with an A . pleuropneumoniae serotype 9 strain (n=12, group 1) or phosphate buffered saline solution (PBSS) (n=5, group 2) . To prevent infection of the lungs, pigs of group 1 were treated three times with sodium ceftiofur as an aerosol . A third group (n=5) was inoculated intranasally with the same strain . All animals were euthanized 30 days post-inoculation (dpi) . In pigs of group 1, clinical signs were not observed . A small lung lesion was found in only one pig and A . pleuropneumoniae was isolated from this lesion . The bacterium was not isolated from the lungs of animals that did not develop lung lesions . A . pleuropneumoniae was demonstrated in tonsils of 9/12 animals using bacteriological isolation, whereas it was demonstrated in mixed bacterial cultures from tonsils of all 12 animals by PCR . In non-infected animals (group 2), clinical signs were not observed and A . pleuropneumoniae was not demonstrated in any sample . All intranasally infected animals (group 3) developed disease signs and lung lesions . High antibody titers against ApxI, ApxII and heat-stable antigens were detected in animals that developed lung lesions . Antibody titers against these antigens were low or absent in all other pigs . It was concluded that pigs carrying A . pleuropneumoniae in the upper respiratory tract generally do not show measurable antibodies in serum . Therefore, sensitive methods for the detection of the etiological agent such as PCR are required to identify carrier animals, while serological methods are not suitable.

Vet Microbiol, 2002 Sep 24, 88(4), 351 - 66
Development of a capture ELISA for the detection of antibodies to enteropathogenic Escherichia coli (EPEC) in rabbit flocks using intimin-specific monoclonal antibodies; Vandekerchove DG et al.; A capture enzyme-linked immunosorbent assay (cELISA) was developed using intimin-specific monoclonal antibodies to detect specific antibody in rabbits that have been in contact with enteropathogenic Escherichia coli (EPEC) . Sera from 121 EPEC-negative, minimum-disease-level (MDL) rabbits were used for negative controls, and sera from 25 MDL rabbits, experimentally infected with EPEC of bio-/serotype 3-/O15, for positive controls . These were used to determine a cut-off value for a positive cELISA result . The value selected gave the test a sensitivity of 80.0% and a specificity of 98.4% on an individual level . At this value, a flock level sensitivity and specificity of 79.2 and 85.2%, respectively were calculated for a flock with a prevalence of seven per cent, if 40 animals were tested, and a minimum of two reactors were obtained . The test characteristics improve with increasing prevalence . To evaluate the diagnostic potential of the cELISA, sera from 40 to 50 slaughter rabbits per flock from 25 rabbit flocks with bacteriologically determined EPEC status were tested . The results demonstrated that this test can be a useful tool to determine the EPEC status of a rabbitry, provided that it is used at regular intervals.

J Infect, 2002 Aug, 45(2), 88 - 9
Outcome of the treatment of culture negative tuberculosis (respiratory and non-respiratory): Blackburn 1996-2000; Ormerod LP et al.; OBJECTIVE: To determine the outcome of treating patients without culture confirmation of tuberculosis, with a regimen of two months of isoniazid, rifampicin, pyrazinamide and ethambutol followed by four months of isoniazid and rifampicin (2HRZE/4HR) in a setting with a rate of isoniazid resistance of 7.5% in culture confirmed cases . SETTING: Tuberculosis patients treated in the Blackburn, Hyndburn and Ribble Valley districts of the UK between 1996 and 2000 inclusive . METHODS: Patients from a detailed prospective clinical and epidemiological data base for all tuberculosis patients were studied for the years 1996-2000 . RESULTS: One hundred and fourteen cases, all but two of Indian subcontinent ethnic origin, without culture confirmation had received 2HRZE/4HR . Twenty had pulmonary, 55 other respiratory and 39 non-respiratory tuberculosis . There was no bacteriologically confirmed relapse, 1 case was retreated as a clinical relapse . CONCLUSION: The treatment of tuberculosis cases without culture confirmation with a regimen of 2HRZE/4HR gives highly acceptable results . The clinical relapse rate was 0.85% (1/114), and the cure rate 99.15%.

Acta Cient Venez, 2002, 53(1), 36 - 43
{Immune response and anergy . Study in tuberculosis patients from the Universitary Hospital, Maracaibo, Venezuela }; Montiel M et al.; With the aim of evaluate the anergy in Mycobacterium tuberculosis individuals infected we study 57 patients and 15 healthy controls, both sex and with different age, which to practice Sputum Bacteriology culture (BK) and the la reaction intradermic with PDD . The test of tuberculine on skin was achieve inoculate 0.1 ml de PPD intradermic via, the results were obtained at 72 h . 28 patient total result BK+ and 29 BK- . The Group BK+, 15 result PPD+ and 13 PPD-, the lastet were classify as anergic patients (BK+ PPD-) . From the 29 patient residual (BK-), 20 was PPD+ and 9 PPD- . All the controls resulted BK- PPD- . Only the anergy in patient BK was evaluated + (28 individuals) patient . Was classified from the point of clinical view in three series: N series: 27 patient TBC+ BK-, P Series: 28 patient TBC+ BK+ and EP Series: 2 patient with extra pulmonary TBC . According to the grade of pulmonary complication, the patient separated in two groups, according to the extension and type of lesion found in the evaluation with X . rays The "group 1" with 9 patient (32.14%) it introduced lesions on one side with or without caverns and the "group 2" with 19 patient (67.85%) with bilateral lesions with or without caverns . Was carried out the Lymphoblastic Transformation Test (TTL) stimulating with PHA and PPD, for which patterns of outlying blood with heparina were gathered . The concentrations of IL-4, IL-6 and INF-gamma was gotten inmunoenzimatic in supernatants of cultivations for rehearsals and in plasm, hind to the stimulation with the PPD . The statistical analysis was carried out utilizing the Test T of Student in pair, Varianza Analysis and the square Chi . Only the controls and the patient BK-, they showed normal response to the PHA, in contrast, the patient BK+ PPD+ they introduced a suppression of the response opposite the PHA of aprox . 90% . The patient PPD+ they showed a superior response in cultivation that the patient PPD- . The concentration of IL-4 in the plasm of the anergic patient (PPD-) showed a significant difference (P < 0.05) with concerning the PPD group+ . The concentration of INF-gamma was lower in the anergic patient significantly different to the of the patient PPD+ . Similar result was gotten in the mensuration of IL-4 and INF-gamma in supernatants of cultivation . One could observe the presence of patient with IL-4+ INF-gamma, and INF-gamma or IL-4 only . In the patient classified clinical like series "P", the concentration of IL-4 was old in the "group 2" with concerning the "group 1." the opposite occurred with the concentrations of the INF-gamma which were old in the "group 1" (both differences were not significant statistical) . The increase of IL-4 next to low concentrations of INF-gamma in anergic patient and committed clinical, it suggest a prevalence of the pattern Th2 (T2) in the immune response.

Am J Trop Med Hyg, 2002 May, 66(5), 622 - 7
Genetic and ecologic characteristics of Bartonella communities in rodents in southern China; Ying B et al.; Ecologic and bacteriologic observations of small mammals captured in Yunnan Province in the People's Republic of China indicated that Bartonella infections occurred at a high prevalence among some rodent species . Sequence analyses of the citrate synthase genes of these Bartonella demonstrated that rodents in this region harbored a diverse assemblage of strains . The Bartonella isolates obtained from Apodemus, Eothenomys, and Rattus typically clustered separately by genus of rodent host . Cultures obtained from Rattus rats were genetically related to Bartonella elizabethae, a recognized human pathogen . The finding of Bartonella species in a high proportion of the rodent samples from Yunnan suggests the need to investigate whether these agents might be responsible for cases of febrile illnesses of unknown etiology in southern China and elsewhere in southeastern Asia.

Haemophilia, 2002 Sep, 8(5), 622 - 8
Efficacy and safety of a factor VIII-von Willebrand factor concentrate 8Y: stability, bacteriological safety, pharmacokinetic analysis and clinical experience; Lubetsky A et al.; The present study was undertaken to evaluate stability, pharmacokinetic profile and efficacy of continuous infusion of 8Y in patients with different types of von Willebrand disease (vWD) . Following reconstitution, 8Y levels of von Willebrand factor ristocetin cofactor (vWF:Rco), vWF antigen and factor VIII coagulant activity (FVIII:C) decreased to about 80% of the baseline levels; addition of low molecular weight heparin decreased the level of FVIII:C even further . Reconstituted 8Y was found to be sterile for up to 6 days postreconstitution . Ten vWD patients (four with type 2A, three with type 3, two with type 1 and one with 2N) underwent pharmacokinetic analysis . The recovery of vWF: RCo was significantly lower in patients with type 3 vWD (1.4 +/- 0.05% U(-1) kg(-1)) compared with that of the patients with types 1 (2.3 +/- 0.52% U(-1) kg(-1)) or 2A (2.0 +/- 0.06% U(-1) kg(-1)) vWD (P = 0.015) . Type 3 vWD patients exhibited significantly higher vWF:RCo clearance (5.1 +/- 1.1 mL kg(-1) h(-1)) compared with that of patients with type 2A (2.8 +/- 0.7 mL kg(-1) h(-1)) and type 1 (2.6 +/- 1.0 mL kg(-1) h(-1)) vWD (P = 0.028) . Accordingly, terminal half-life was lower in patients with type 3 vWD (8.0 +/- 0.6 h(-1)) compared with type 2A (12.7 +/- 5.9 h(-1)) or type 1 (14 +/- 1.2 h(-1)) vWD patients . Multimeric pattern of vWF from patients' plasma was similar to that of 8Y . In two patients treated with 8Y by continuous infusion for prevention or treatment of bleeding haemostasis was achieved . Thus, 8Y is suitable and haemostatically effective for continuous infusion treatment in patients with vWD.

Postgrad Med, 2002 Aug, 112(2), 57 - 60, 63-4, 67-70
Bacteria as agents of biowarfare . How to proceed when the worst is suspected; Tjaden JA et al.; Recognition of an increasing incidence of uncommon pneumonias with a high mortality rate, clusters of cases, or a high incidence of pet illnesses or death should alert medical personnel to the possibility of terrorism with bacteriologic agents . Prompt reporting of such unusual occurrences to the local health department is of paramount importance for early identification of cases, treatment initiation, and institution of preventive measures.

Differentiation, 2002 Aug, 70(6), 221 - 6
Marshall Barber and the century of microinjection: from cloning of bacteria to cloning of everything; Korzh V et al.; A hundred years ago, Dr . Marshall A . Barber proposed a new technique - the microinjection technique . He developed this method initially to clone bacteria and to confirm the germ theory of Koch and Pasteur . Later on, he refined his approach and was able to manipulate nuclei in protozoa and to implant bacteria into plant cells . Continuous improvement and adaptation of this method to new applications dramatically changed experimental embryology and cytology and led to the formation of several new scientific disciplines including animal cloning as one of its latest applications . Interestingly, microinjection originated as a method at the crossroad of bacteriology and plant biology, demonstrating once again the unforeseen impact that basic research in an unrelated field can have on the development of entirely different disciplines.

Phys Rev E Stat Nonlin Soft Matter Phys . 2002 Jun;65(6 Pt 1):061111 . Epub 2002 Jun 28.
Morphological instability and dynamics of fronts in bacterial growth models with nonlinear diffusion; Muller J et al.; Depending on the growth condition, bacterial colonies can exhibit different morphologies . As argued by Ben-Jacob et al . there is biological and modeling evidence that a nonlinear diffusion coefficient of the type D(b)=D(0)b(k) is a basic mechanism that underlies almost all of the patterns and generates a long-wavelength instability . We study a reaction-diffusion system with a nonlinear diffusion coefficient and find that a unique planar traveling front solution exists whose velocity is uniquely determined by k and D=D(0)/D(n), where D(n) is the diffusion coefficient of the nutrient . Due to the fact that the bacterial diffusion coefficient vanishes when b-->0, in the front solution b vanishes in a singular way . As a result the standard linear stability analysis for fronts cannot be used . We introduce an extension of the stability analysis that can be applied to singular fronts, and use the method to perform a linear stability analysis of the planar bacteriological growth front . We show that a nonlinear diffusion coefficient generates a long-wavelength instability for k>0 and D<D(c)(k) . We map out the region of stability in the D-k-plane and determine the onset of stability that is given by D(c)(k) . Both, for D-->0 and k--> infinity the dynamics of the growth zone essentially reduces to that of a sharp interface problem that is reminiscent of a so-called one-sided growth problem where the growth velocity is proportional to the gradient of a diffusion field ahead of the interface . The moving boundary approximation that we derive in these limits is quite accurate but surprisingly does not become a proper asymptotic theory in the strict mathematical sense in the limit D-->0, due to lack of full separation of scales on all dynamically relevant length scales . Our linear stability analysis and sharp interface formulation will also be applicable to other examples of interface formation due to nonlinear diffusion, like in porous media or in the problem of vortex motion in superconductors.

Przegl Lek, 2002, 59(4-5), 262 - 4
{The efficacy of the Helicobacter pylori eradication in people of an advanced age}; Kopanski Z et al.; In a group of 112 patients aged 65 to 72 years with chronic gastritis (48 persons), a peptic ulcer (30 persons), a duodenal ulcer (34 persons) bacteriological examinations were conducted aiming at determining the sensitivity to antibiotics of Helicobacter pylori (H . pylori) strains isolated from the month (gingival pockets), the stomach or duodenal mucous, from stool samples and from the skin of the hands . The sensitivity to antibiotics was tested with the diffusive-disc method taking into consideration 23 chemotherapeutic agents . It was shown that with the use of single antibiotics the chance of efficiently elimination the H . pylori infection from the area of the whole alimentary canal (month, stomach, duodenum, large bowel) amounted to 14.3-35.7% depending on the chemotherapeutics used, where with the use of a two-medicine therapy (metronidazol + amoxycillin) it increased to 42.9% . This means that in people of an advanced age the chemotherapy carried out with the aim of liquidating the infection in the stomach or duodenum mucousa creates possibilities for the H . pylori infection to persist in other parts of the alimentary canal ranging from 64.3 to 85.7% . This way the patient treated may then undergo self-infection as well as be a source of infection for other persons.

Kyobu Geka, 2002 Aug, 55(9), 763 - 7
{Relation between intraoperative salvaged blood transfusion and postoperative infection after cardiac surgery}; Ishida T et al.; In cardiac surgery, several studies have shown bacterial contamination rates of intraoperative salvaged blood ranging from 12.7 to 96.8% . We evaluated the relation between intraoperative salvaged blood transfusion produced by the Cell Saver 5 device (Haemonetics Corp., Braintree, MA, USA) and postoperative infection determined by bacteriological study and the postoperative clinical course after cardiac surgery . Seven cases of cardiac surgery were investigated by bacteriological study . Although bacteria were cultured from all salvaged blood, no bacteria were cultured from the patients' blood 24 hours after salvaged blood infusion . Another 26 patients who underwent cardiac surgery, were divided into groups: group CS (n = 15) with salvaged blood transfusion after operation and group N (n = 11) without salvaged blood transfusion, and were evaluated in relation to the postoperative clinical course . There were no statistically significant differences between group CS and group N in the data of WBC, CRP and maximum body temperature . One case of deep sternal wound infection and 2 cases of local wound infection were observed in group CS, but none in group N (p = 0.18) . These complications were treated by primary closure without muscle flaps . We conclude that salvaged blood autotransfusion was not related to postoperative infections in cardiac surgery.

Klin Oczna, 2002, 104(2), 112 - 4
{Estimation dacryocystorhinostomy with temporary intubation of lacrimal canaliculi}; Korporowicz D et al.; The purpose of the study was to present the results of treatment of lacrimal ducts obstruction . The authors describe the advantages of temporary intubation of lacrimal canaliculi with simultaneous dacryocystorhinostomy . The findings have been based on 38 operations within a sixteen-year period . Obstruction of the lacrimal drainage pathway was due to: trauma, postinflammatory stenosis of the nasolacrimal duct, tumors and jatrogenic injuries of the naso-lacrimal drainage system often following operations of the maxillary sinus . Treatment was based on clinical examination by: slit lamp exam, probing and irrigation of the lacrimal system, X-ray picture of the maxillary sinus, laryngology examination and bacteriological culture from conjunctival sac . CONCLUSION: Anatomical and functional results indicate the necessity of this surgery method in selected cases.

Reprod Domest Anim, 2002 Aug, 37(4), 211 - 6
New strategies to prevent mastitis; Pyorala S; Bovine mastitis remains as the disease causing the biggest economic losses to the dairy industry, despite the intensive research and prevention measures at herd level carried out for decades . Antibiotics are widely used to combat mastitis, but focus should be shifted from treatment to more economical and efficient prevention . The bacteriological aetiology of mastitis has changed from contagious to environmental pathogens, which has reduced the efficacy of the traditional mastitis control strategies . Considerable progress in the understanding of epidemiology, immunology, diagnostics and pathogenesis of mastitis has been made . The modern molecular biological methods offer good possibilities for the research of the epidemiological and virulence aspects of bacteria, which may help in building-up specific mastitis control strategies for dairy herds . Studies on the host response and relationship between somatic cell count and susceptibility to mastitis offer tools for genetic improvement of dairy cows . Biotechnological approaches for mastitis prevention are in the developmental stage, but many problems are associated, e.g . with vaccination of dairy cows against mastitis . Different methods of immunomodulation for the prevention of mastitis have shown promise in experimental trials, but the evidence is not yet enough to support commercial applications . Improving nutrition, housing and environment of dairy cattle are still crucial in the prevention of mastitis, especially during the most susceptible period after parturition . New milking techniques including robotic milking may provide better possibility for proper milking and improved udder health . Mastitis control should be part of the herd health programme in the dairy herds . In this paper, results from recent research and proposals for new prevention strategies in the field of mastitis are reviewed.

New Microbiol, 2002 Jul, 25(3), 307 - 13
Cat scratch disease . Survey on the presence of Bartonella henselae among cats of Tuscany; Ebani VV et al.; To verify the presence of Bartonella henselae-infection in cats living in Tuscany (central Italy) serological and bacteriological surveys were carried out . The blood serum samples of 427 cats, 254 living in private houses and gardens and 173 in public or private catteries, were tested for anti-B . henselae antibodies by indirect immunofluorescence assay (IFA) . Among these samples, 35 were examined by IFA to detect antibodies against Bartonella quintana . Bacteriological examinations were performed on the blood samples, collected in EDTA (ethylene diaminetetraacetic acid), of 18 cats (10 seropositive to B . henselae and 8 negative) . From each of the same 18 specimens DNA was extracted and used as template in polymerase chain reaction (PCR) . The primers p24E and p12B were employed in the PCR assay to amplify a 296 bp fragment of the Bartonella 16S rRNA gene . IFA detected 98 (22.95%) B . henselae-positive serum samples (40-40.82% from cats living in houses and gardens and 58-59.18% from cats of catteries) at different antibody titers (70 at 1:64 titer, 4 at 1:128, 22 at 1:256, 2 at 1:512) . Among the 35 sera tested to detect antibodies against B . quintana, 9 (25.71%) resulted positive at 1:64 titer; all these samples showed higher antibody titers to B . henselae . Out of the 26 negative sera, 20 were negative to B . henselae too and 6 had antibodies against B . henselae at 1:64 . Hemocultures gave negative results . PCR scored positive with DNA of 4 B . henselae-seropositive cats, two of which belonged to two children with cat scratch disease (CSD).

J Med Microbiol, 2002 Aug, 51(8), 656 - 60
Sensitivity and specificity of an indirect enzyme-linked immunoassay for the diagnosis of Brucella canis infection in dogs; Lucero NE et al.; The diagnosis of B . canis infection in dogs is based on bacteriological examination and serological methods including agglutination and gel diffusion tests . Bacteriological studies are the only methods that have been considered specific but, as intermittent periods of abacteraemia may occur, a negative blood culture cannot be used as a criterion for excluding canine brucellosis . Close contact between people and infected dogs increases the risk of transmission; however, its impact on public health is probably underestimated due to lack of reporting and inadequate diagnostic services . This paper describes an indirect enzyme-linked immunoassay (IELISA) procedure for the diagnosis of brucellosis caused by B . canis in a population of normal and infected dogs previously screened by the buffered plate antigen test (BPAT) and rapid slide agglutination test (RSAT) . The serological survey was performed with 446 field sera . The 270 sera from the asymptomatic group found negative by BPA, RSAT and blood culture showed IELISA specificities of 96.7% and 100%, respectively, when cut-off values of OD 0.237 and 0.281 were selected . For 52 sera from culture-positive dogs, IELISA sensitivity was 100% with cut-off values of OD414 0.237 and 0.281 . OD414 0.281 was selected because this value provided the highest accuracy with minimal false-negative and false-positive results . This cut-off value was used to study 124 blood culture-negative but RSAT positive sera . IELISA produced 107 positive results; the 17 sera that were negative by IELISA presented a wide range of reactivities by RSAT (2 were RSAT positive at 1 in 2 dilution and 15 were weakly positive with pure serum) . These samples were probably from animals at an early stage of the infection or were false-positive results . The IELISA described here detects IgG and IgA antibodies that are useful for evaluating the clinical status of dogs . Although RSAT is a practical screening test, a supplementary technique such as IELISA should be used on all positive RSAT samples to ensure diagnostic specificity . Furthermore, people in contact with infected dogs could be investigated for possible transmission . The procedure described in this study was relatively simple and could have widespread applications.

Probl Tuberk, 2002, (5), 49 - 52
{Improvement of bacteriological diagnosis of tuberculosis}; Nuratinov RA et al.; The study was undertaken to design a new effective and inexpensive culture medium to be used in the bacteriology of tuberculosis . Replacement of sodium glutaminate by the yeast autolysate S . cerevisie and ammonium citrate--ammonium oxalate in the Finn-II medium, addition of n-alkanes (C12-C18) and potato extract were found to stimulate growth rates and biomass stimulation and to enhance the sensitivity of the medium in the indication of mycobacteria while seeding both laboratory strains and homogenates of biological materials.

Probl Tuberk, 2002, (5), 24 - 7
{Tuberculosis in patients with hemoblastoses}; Karachunskii MA et al.; Examining 2321 patients admitted for various forms of hemoblastoses (HB) to the Hematology Research Center, Russian Academy of Medical Sciences, in 1990-1999 revealed active forms tuberculosis in 60 (2.6%) patients . Among them generalized tuberculosis and predominantly extrapulmonary tuberculosis were detected in 8 (10.1%) and 10 (12.7%) patients, respectively . Bacteriological and morphological studies confirmed the diagnosis only in 22 (27.8%) patients, including in 15 (22.9%) patients with pulmonary tuberculosis . In the bulk of patients {n = 51 (64.6%)}, the diagnosis of tuberculosis was suspected on the basis of a complex of clinical and X-ray data and evidenced by the beneficial effect of antituberculous chemotherapy . The clinical and X-ray manifestations of tuberculosis were similar in patients with different forms of HB . They are characterized by an aptness to hematogenous dissemination of the process, by the incidence of generalized and extrapulmonary lesions involving blood-forming organs, and by the significant extent of infiltrative changes in the lung with a relatively formation of single and small decay cavities . Antituberculous chemotherapy according to the standard regimen recommended by the WHO yielded a prompt and significant effect by improving the patients' status, eliminating fever, and ceasing bacterial isolation . Deaths occurred in 6 (7.6%) patients with lifetime undiagnosed generalized tuberculosis untreated with antituberculous drugs.

Ann Urol (Paris), 2002 Jul, 36(4), 277 - 85
{Perineo-scrotal gangrene: apropos of 31 cases}; el Mejjad A et al.; Fournier's gangrene is a fascitis of the perineum and of the external genitalia . It is a serious infection with rapid evolution and a severe prognosis . It is also unpredictable towards the necrosis . It concerns a series of 31 cases of the perineal scrotal gangrene supervised in the department of surgical visceral emergency of the Ibn Rochd University hospital of Casablanca between 1992 and 2000 . In this investigation, the male predominance is important and the mean age is 49 years . The diagnostic delay is 12 days . The symptomatology was dominated by edema and erythema signs, fever and pain . The skin necrosis was seated in the perineum and the scrotum . A septic shock was noticed in six patients and a condition of deep coma in two other patients . Etiology of gangrene was of coloproctologic origin in 15 cases and of urogenital origin in five patients . The bacteriological parietal swabs was positive in 11 cases . The therapeutic take-in-charge consisted of urgent measures of reanimation for six patients . The likely wide spectrum antibiotic therapy consisting of a triple association (beta lactam antibiotic, nitrite-imidazole compound and aminoglycoside) with a secondary adaptation that was recommended for all patients . All the patient underwent surgical debridement of the necrotic tissue with incisions and drainage of the involved areas of the of all the operated-on patients, 26 had colostomy, five among them had both colostomy and cystostomy . The overall evolution was favorable except in eight cases of death . In all, the authors insist on the positive diagnosis as well as the early take-in-charge of the disease to avoid complications of local or general order and recommended the preventive treatment with the precocious treatment of the causing infection.

Otolaryngol Pol, 2002, 56(3), 377 - 80
{A case of actinomycosis of the palatine tonsils--diagnostic difficulties}; Wiech AD et al.; Here authors present a rare case of actinomycosis of the pallatinal tonsilla, which had a form of tumor . Bacteriological tests revealed only some saprophytical bacteria in pharynx . After surgical treatment of disease was done, patient got back to health quickly, and histopathological exam showed that this was actinomycosis.

Nippon Funin Gakkai Zasshi, 1980 Apr, 25(2), 64 - 8
{Clinical experience of vaginal contraceptive film containing the spermicide, polyoxyethylene nonylphenyl ether (c-film study group) (authors' transl)}; Iizuka R et al.; PIP: A new vaginal contraceptive in the form of a film containing the spermicide, polyoxyethylene nonylphenyl ether (C-Film) was put into clinical trials . To evaluate spermicidal activity of C-film, an in vitro test was performed . After 1 minute, no motile sperm could be seen in the C-film solution which was diluted 32 times by a 5% glucose solution . When the sperm contacted the C-film solution diluted 8 times, the sperm stopped moving . C-film was used by 168 women for 1 and one-half years from December 1977 to May 1979 for a total period of 2161 months . Only 1 pregnancy occurred, thus giving a pregnancy rate of 0.56/100 women-years . During the use of C-film, 16 cases (9.5%) complained about an increase of vaginal discharge, 8 cases (4.8%) felt unfamiliar with the insertion, and 7 cases (4.2%) complained about unusual feelings caused by the presence of the C-film . A total of 9 cases (5.4%) stopped using C-film; 3 due to irritation, 2 due to troublesome use; and others due to vaginal discharge, burning sensation, pregnancy, and reasons unknown . No significant changes were observed in the vaginal bacteriology, cervical cytology, liver function, or renal function . The study indicates that C-film is very effective, well-tolerated, and has a low incidence of side effects . (Authors' modified)

Przegl Epidemiol, 2002, 56(1), 57 - 64
{Yersiniosis--unappreciated infectious disease}; Jagielski M et al.; Yersiniosis is an acute or chronic zoonosis caused by rods belonging to species Y . enterocolitica and Y . pseudotuberculosis . The natural reservoirs of these rods are domestic and wild living animals . Pathogens are transmitted to host by contaminated food, water, and soil . The clinical manifestations of yersiniosis are variable from mild diarrhoeas to serious pathological organic lesions . The diagnosis of yersiniosis is often possible only on the results of the bacteriological or serological examinations because of lack of typical clinical manifestations . The antibiotic treatment is necessary in case of yersiniosis involving enterocolitis, septicemia, and organic lesions.

Ann Ital Med Int, 2002 Apr-Jun, 17(2), 117 - 20
{Tuberculosis as a cause of fever of unknown origin in the elderly: a case report}; Gandolfo E et al.; In the last decade, the incidence of tubercular disease in Italy has increased . The age-groups 20-39 and 65-80 years are the ones mainly involved . However, compared to younger age-groups, the presentation of the disease in the elderly is often poorly characteristic, and for this reason a correct diagnosis is often delayed . We describe the case of an elderly man who came to our observation for the persistence of fever (since 20 days, mainly in the evening) associated with decreased leukocyte and platelet counts and with progressively worsening of his general conditions . The laboratory data and bacteriological and instrumental examinations were not diagnostic, whereas a bone marrow biopsy provided evidence of tubercular granulomas . The confirmation of the diagnosis of disseminated tuberculosis has been supplied subsequently with cultural test of smear . The patient's conditions rapidly improved after antitubercular treatment . This case underlines the relevance of bone marrow biopsy in the diagnosis of fever of unknown origin in the elderly, especially when the serious clinical conditions of the patient do not allow one to wait for the results of the cultural examination.

Pneumonol Alergol Pol, 2002, 70(1-2), 5 - 11
{Meaning of the radiometric method bactec 460 TB for the application of antituberculosis therapy}; Ryszard O et al.; Retrospective analysis of 143 patients without AFB in sputum in direct bacteriological examination was performed . In 84 patients tuberculosis was suspected on the basis of chest x-ray picture, positive tuberculine skin test and pleural fluid analysis (lymphocytes > 50%) . Bacteriological analysis of sputum, BAL and pleural fluid by BACTEC and L-J culture allowed to recognise tbc in 55 patients: 41/84 patients suspected of tbc and in 14/55--not previously suspected of tbc . Generally tuberculosis was diagnosed in 82 pts . In 16 of 55 patients antituberculous treatment was introduced according to BACTEC results . It was especially important in 10 patients not suspected of tbc.

J Am Osteopath Assoc, 2002 Jul, 102(7), 397 - 400
Associate investigations: detection of tuberculosis infections in children resulting in discovery of undiagnosed tuberculosis in adults; Moonan PK et al.; The authors present the design and implementation of associate investigations of young children with positive tuberculin skin test results . Case study analysis of an associate investigation was done using epidemiologic surveillance techniques, medical interviewing, sociogram mapping, tuberculin skin testing, radiographic evidence, and bacteriologic analysis . Deoxyribonucleic acid fingerprinting of the Mycobacterium tuberculosis isolates using a standardized IS6110-based restriction fragment length polymorphism analysis and IS6110-independent DNA spoligotyping methods was done to track and identify specific bacterial strains . Deoxyribonucleic acid fingerprinting and spoligotyping done on isolates obtained from family members demonstrated same-strain transmission of M . tuberculosis . Three adults with active pulmonary disease and six individuals with latent tuberculosis (TB) were discovered during this investigation . The arrival of a family member from Mexico who had the same strain suggests that the source case lives in Mexico . A child with positive tuberculin skin test results indicates recent and potentially ongoing transmission of TB in the community . Targeted tuberculin skin testing performed on high-risk groups by primary care physicians allows for detection of TB infections . When TB infections are discovered in children, associate investigations can result in the discovery of undiagnosed adult cases and prevent further transmission within the community.

Soc Sci Med, 2002 Jul, 55(1), 155 - 65
The role of French-language contributors to the development of medical geography (1782-1933); Barrett FA; In the literature it is L . L . Finke's three volume work Versuch einer aligemeinen medicinisch-praktischen Geographie, 1792-1795, that is commonly cited as the first to use the term "medical geography" . However, Rofort's investigations on the 18th and 19th century development of medical topography in France (1987, 1988) has revealed that a French physician, Dehorne, used the term a decade earlier, and in 1784 Dehorne suggested that a project be undertaken by the Royal Medical Society of Paris on a "Medical Geography of France" . The proposal was debated in the Journal de Medecine Militaire in 1786 . This correspondence probably is the earliest critique of the concept of medical geography . It was also the French who were the first to have entries on medical geography in dictionaries and encyclopedias . Dr . Jean-Noel Halle wrote a lengthy piece conceptually placing medical geography as a foundation for medical hygienics in Encyclopedie Methodique (1787, 1792) . In 1817 Julien Virey wrote a 66 page entry on medical geography in the Dictionnaire des Sciences Medicales . Throughout the nineteenth century authors writing in the French language continued to make advances and in 1933 the French geographer Max Sorre suggested new directions for the field in the light of bacteriological discoveries and the re-orientation of medicine.

Kansenshogaku Zasshi, 2002 Jun, 76(6), 439 - 49
{Epidemiological and bacteriological investigation of enterohemorrhagic Escherichia coli infection in the Chugoku-Shikoku area}; Tanaka H et al.; We investigated the occurring tendency of enterohemorrhagic Escherichia coli (EHEC) infection in the prefectural and municipal public health institutes in the Chugoku-Shikoku area from 1996 to 1999, and the bacteriological characteristics of EHEC isolated from these cases . Consequently, epidemiological analysis of the EHEC infection in this district was performed . 22 outbreaks in the various facilities showed the tendency occurred in infants and aged groups, and the serotypes of EHEC isolated from these outbreaks were O26, O111 etc . as well as O157 . In 4 cases, EHEC were isolated from specimens of buckwheat noodles, salad, sand box, and goat feces, and these were determined as the source of infection . In 898 sporadic cases, including familial infection, the EHEC isolates were classified into 24 serotypes, and the genotypes of EHEC O157:H7 isolates by pulsed-field gel electrophoresis (PFGE) also varied . Moreover, since many asymptomatic carriers were detected in the adult group with familial infection, the existence of healthy carriers is as important as the source of infection . The drug-resistance test of EHEC isolates showed that 24% of the 924 isolates were resistant to drugs.

J Am Geriatr Soc, 2002 Jul, 50(7), 1219 - 26
Tuberculosis in older people: a retrospective and comparative study from Hong Kong; Leung CC et al.; OBJECTIVES: To compare tuberculosis (TB) in older and younger patients . DESIGN: A retrospective and comparative observational study . SETTING: Four chest clinics and two chest hospitals in Hong Kong . PARTICIPANTS: All notifications from the participating hospitals and clinics in 1996 were extracted from the TB notification registry . The characteristics of patients aged 65 and older were compared with a one-in-three random sampling of those aged 16 to 64 . MEASUREMENTS: Demographic, clinical, radiological, and laboratory data of the two groups were compared alongside treatment and outcomes . RESULTS: Older people with TB were more likely to be male, to smoke, to have had TB previously, to have coexisting medical diseases, to be socioeconomically disadvantaged, and to weigh less than younger people with TB . Dyspnea, weight loss, and malaise were more common, whereas extrathoracic lymph node enlargement was less common . Chest radiograph showed more extensive disease and lower zone involvement . Positive tuberculin test was present in only 61.9% . Sputum bacteriology was more likely to be positive . There was a longer delay in presentation and commencement of treatment, and 77.2% required at least one admission . Adverse effects of treatment, notably hepatic dysfunction, occurred more commonly . Fluoroquinolones appeared well tolerated . Only 72.5% of the older people were cured or completed their treatment . Mortality was 16% . Age of 65 and older, comorbidity, socioeconomic disadvantage, moderate-extensive disease, positive sputum smear, and poor adherence were factors independently associated with unfavorable outcomes (P <.001 to P = .01; odds ratios = 1.61-27.02) . CONCLUSION: Substantial differences were found between older and younger TB patients . Many of these were associated with unfavorable outcome . Increased awareness in disease recognition and better medical and social support are therefore needed in addressing the growing problem of TB in older people.

Probl Tuberk, 2002, (4), 19 - 21
{The detection rate and clinical and diagnostic values of L forms of the pathogen in patients with pulmonary or extrapulmonary tuberculosis}; Bobchenok AP et al.; The detection rate and clinical and diagnostic values of L-forms of pathogens were determined in patients with pulmonary and extrapulmonary tuberculosis . Simultaneous culturing the specimens for typical and L forms of Mycobacterium tuberculosis (MBT) increased the number of positive results by isolating only L-forms by 10.3% in patients with pulmonary tuberculosis and by 27.7% in those with extrapulmonary tuberculosis . No bacterial isolation in tests only for typical forms of MBT is shown not to be true and a purposeful search for L-forms of MBT enhances the efficiency of a bacteriological test . This is of great significance in confirming the specific nature of the disease, its progression, in choosing a treatment policy, in evaluating is efficiency, in defining prognosis, and in correcting preventive measures in the focus of tuberculous infection . With extrapulmonary tuberculosis, the tuberculous nature of isolated L-forms has been evidenced by the polymerase chain reaction.

Ann Dermatol Venereol, 2002 Apr, 129(4 Pt 2), 533 - 49
{Mother-infant and indirect transmission of HSV infection: treatment and prevention}; Henrot A; INTRODUCTION: Neonatal herpes is a serious condition . The objectives of this critical review of the literature are to: 1) define the modes of mother-infant and indirect transmission of HSV infection; 2) determine current treatments and perspectives for the future . METHOD: We searched for articles published since 1980 in databases using a series of key words . The articles were classed into three categories by level of scientific proof: good (level 1), fair (level 2), poor (level 3, 4 or 5) . General reviews were excluded . RESULTS: We selected 153 articles and retained 96 . Man to woman contamination was generally reported: 10p.100 of the couples were serodiscordant . Presence of anti-HSV1 antibodies was partially protective against HSV2 infection . Neonates can be contaminated in utero via transplacental hematogenic transmission, at delivery (the most frequent route), or during the postnatal period (indirect transmission) . The risk of neonatal contamination is greatest for primary infection (PI) or non-primary infection occurring the last month of pregnancy (50p.100), but transmission is low for maternal recurrence during the week before delivery (5p.100) . Cesarean section is mandatory in case of genital PI or non-primary maternal infection during the last month of pregnancy, especially in case of membrane rupture<6 hr, but does not protect the infant in two-thirds of the cases . The decision for cesarean is controversial in case of recurrence . Antiviral treatment of the mother using aciclovir (ACV) is well tolerated . ACV-cesarean combination provides maximal protection for the neonate . A neonate with proven or suspected HSV infection should be isolated from other neonates but not from the mother . Breastfeeding is contraindicated in case of breast lesions . Parenteral ACV 60 g/kg/d is preferred over vidarabine . It should be started immediately after the first virology samples . The risk of recurrence is estimated at 7p.100 for all neonates and warrants treatment using a high oral dose (90-100mg/kg/d) due to the low bioavailability, if the number of recurrences is>3 in 6 months . Antiviral treatment is formally indicated if: 1) neonate viral cultures are positive at day 1 and day 3, 2) clinical lesions suggest herpes, 3) neurological disorders or signs of sepsis with negative bacteriology are present and the mother has a history of herpes or contact with labial herpes; and can be discussed if: 4) PI is proven at delivery or during the last month of pregnancy (irrespective of the delivery route, even if the mother is treated or if the membranes are intact), 5) late cesarean (membrane rupture>4 h) with clinical herpes at delivery, 6) vaginal delivery and recurrent herpes within the last month with associated clinical risk factor(s) . CONCLUSION: Many points remain to be clarified concerning optimal management of the mother-infant couple in case of maternal herpes during pregnancy or at delivery . New perspectives concerning diagnosis and prevention of neonatal contamination include: identification of asymptomatic primary infections using rapid identification of genital viral antigen during delivery, identification of women with a risk of asymptomatic excretion using specific serology tests for the pregnant woman and her partner, antiviral treatment for men, topical genital treatments, vaccination of women at risk, monoclonal antibodies, new antiviral agents with mechanisms of action independent of viral thymidine kinase.

Eur J Med Res, 2002 Jun 28, 7(6), 290 - 1
Mycobacterium tuberculosis gene-amplification in breath condensate of patients with lung tuberculosis; Schreiber J et al.; The applicability of Mycobacterium tuberculosis-gene-amplification test (NAT) in breath condensate (BC) was examined in lung tuberculosis (TB) . Ten patients with bacteriologically confirmed lung TB have been examined by ligase chain reaction (LCx) . In BC the NAT were negative in all patients as well as the examination of acid fast smears and of solid phase or liquid media cultures were . This indicates that the use of NAT in BC can not replace or complement sputum or materials obtained invasively in patients with lung TB.

Sheng Wu Hua Xue Yu Sheng Wu Wu Li Xue Bao (Shanghai), 1999, 31(5), 558 - 562
Site-directed Mutagenesis of the Active Center of Penicillin Acylase from E . coli ATCC 11105; Dai MH et al.; Site-directed mutagenesis and chemical modification were performed at Ser290 of the penicillin G acylase from E . coli ATCC11105 . The Ser290 was substituted by Cys or Secys . Wild type and mutant proteins were purified, and the activities and kinetic constants of penicillin acylases for hydrolysis and synthesis were determined, respectively . Although their K(m) values were not changed, the k(cat) values of the thiol-PGA and seleno-PGA were decreased from 135s(-1) to 0.63s(-1) and 0.38s(-1) against NIPAB, and from 34.38s(-1) to 0.23s(-1) and 0.06s(-1) against penicillin G . Contrary to Choi's report(Choi K S (et al . J Bacteriology), 1992, 10 6270-6276), we found that hydrolysis activity was certainly kept in the mutant of penicillin acylase . In addition, the specific activities of synthesis were decreased by 5-fold and 20-fold, respectively.

Eur J Ophthalmol, 2002 May-Jun, 12(3), 232 - 7
Ocular complications associated with brucellosis in an endemic area; Gungur K et al.; PURPOSE: To report the ocular manifestations associated with brucellosis in an endemic area . METHODS: We prospectively evaluated 147 patients with the diagnosis of brucellosis between May 1996 to May 2000 and recorded the ocular and systemic findings . The diagnosis was based on clinical findings, positive serological and bacteriological tests (Brucella agglutination test: over 1/160 titer, blood culture) . RESULTS: Thirty-eight patients (26.0%) with brucellosis had ocular complications: conjunctivitis in 26 (17.7%), anterior uveitis in six (4.1%), posterior uveitis in one (0.7%), dacryoadenitis in two (1.4%), episcleritis in three (2.1%) . Three of the seven patients with uveitis had spondylitis associated with brucellosis . Osteoarticular complications in brucellosis were more frequent in the patients with ocular involvement though the difference was not statistically significant compared with patients without ocular involvement . CONCLUSIONS: Ocular manifestations are frequent in brucellosis so an ophthalmologic examination should be routinely performed in patients with brucellosis in endemic areas.

J Infect Chemother, 2002 Jun, 8(2), 151 - 4
Evaluation of panipenem/betamipron (PAPM/BP) in pneumonia in elderly patients; Shibuya Y et al.; The present multicenter study evaluated the clinical and bacteriological efficacy and safety of panipenem/betamipron (PAPM/BP) for treating pneumonia in elderly patients . Forty-three episodes of pneumonia in 43 patients were treated with PAPM/BP as the sole antibiotic agent . All patients were 65 years of age or older, and were given PAPM/BP at a total daily dosage range of 0.5-2.0 g . The clinical efficacy rate, expressed as a percentage of the total number of excellent and good responses, was 56.4% . Of the 43 patients, 13 were evaluated bacteriologically . In these 13 patients, the eradication rate, expressed as a percentage of the total number of "eradicated" and "replaced" efficacies, was 30.8% . Adverse effects and abnormal laboratory findings occurred in 2 patients, which was 4.6% of the total number of patients evaluated . No serious adverse effects were observed . We concluded that PAPM/BP was well tolerated overall, and was effective and safe for most of the elderly patients.

Ned Tijdschr Geneeskd, 2002 Jun 22, 146(25), 1161 - 5
{Signs of miliary tuberculosis: which diagnostic tests and when to treat?}; Verhave JC et al.; Three patients, men aged 21, 57 and 53 years, presented with variable non-specific symptoms such as general malaise, weight loss, elevated temperature, abdominal pain, cough, pulmonary crepitations and elevated liver enzymes . Diffuse fine nodular infiltration was seen on chest radiography in the last two cases . The first patient refused to be tentatively treated with tuberculostatics and died . Mycobacterium tuberculosis complex grew on Lowenstein medium a week later . The two other patients received tuberculostatic treatment . The second patient recovered, while the third patient suffered a cerebrovascular accident on top of emaciation and respiratory insufficiency and died . In the Netherlands, currently more than one hundred patients with tuberculosis disease die each year . The disease is mostly seen in people from the high-risk groups for tuberculosis such as asylum seekers and immigrants . Even after extensive diagnostic procedures it can be difficult to obtain rapid bacteriological confirmation . When miliary tuberculosis is suspected it is important to carry out the complete range of tests (Ziehl Neelsen microscopy, PCR, Lowenstein cultivation) and to start therapy immediately and not to await the results of the diagnostic tests . However, in many cases this may still be too late, with an estimated mortality of 20%.

Prog Urol, 2002 Apr, 12(2), 253 - 9
{Postoperative osteitis of the pubis: diagnosis, treatment and results}; Almeras C et al.; OBJECTIVE: Osteomyelitis of the pubis is a possible complication of urological and gynaecological surgery . This article reviews this disease which is still a source of controversy . MATERIAL AND METHODS: Between 1984 and 1997, five patients with osteomyelitis of the pubis, following complementary investigations, underwent resection of the symphysis pubis with histological and bacteriological examination, combined with antibiotic therapy . The follow-up was 1.5 months to 4 years . RESULTS: The time to onset of first symptoms was 2 weeks to 5 years . Pain initially presented inflammatory features during the early postoperative period and subsequently became mechanical as the disease became chronic, with intermittent acute episodes in 3 cases . Radiation of the pain and the abnormalities observed on imaging were predominantly unilateral in all patients . Fever and laboratory signs of inflammation were inconstant . Bacteria were identified in 4 cases in the absence of antibiotics and lesions of chronic osteomyelitis were observed in every case . Antibiotics were administered by intravenous injection for 3 to 7 weeks, then orally for 1.5 to 3 months . Good functional and infectious results were obtained in 4 patients, while the remaining patient presented posterior instability . CONCLUSION: Postoperative pubic osteomyelitis is an infectious disease . Acute osteomyelitis, which can be treated by antibiotics in the absence of a collection and bone sequestrum, is distinguished from chronic osteomyelitis, in which every effort must be made to identify the bacteria responsible . Infected tissues must be widely excised in combination with prolonged antibiotic therapy . Posterior instability is the main complication.

Rev Med Interne, 2002 Jun, 23(6), 549 - 53
{Tubercular abscess of the psoas without associated spinal involvement . A case report}; Younes M et al.; INTRODUCTION: Tuberculous psoas abscess outside of locoregional causes is uncommon and can cause a problem of differential diagnosis . EXEGESIS: We report a case of unilateral tuberculous abscess of the psoas which first clinical and radiological features presented like a retroperitoneal tumor . Exploration laparotomy discovered a bulky abscess of the left psoas muscle . Bacteriologic and histologic evaluation confirmed the tuberculous origin . Radiological study of the spine did not show any signs of spondylodiscitis . Under antituberculosis treatment a crural collection occurred and a surgical drainage was performed . Five years later, there was a recurrence of a crural collection which responded well to antituberculosis treatment . CONCLUSION: Tuberculous psoas abscess is usually secondary to spinal involvement, more uncommonly to digestive, urologic or genital tuberculosis . Primary abscess was rarely described and the pathogenesis remains unclear . Psoas contamination is supposed to be hematogenous or lymphatic in origin . Ultrasonography and computed tomography (CT) transformed the diagnosis and the therapeutic approach by percutaneous puncture and drainage.

Int J Tuberc Lung Dis, 2002 Jul, 6(7), 628 - 34
Pulmonary disease caused by Mycobacterium avium-intracellulare in HIV-negative patients: five-year follow-up of patients receiving standardised treatment; Domestic transmission routes of pathogens: the problem of in-house contamination of drinking water during storage in developing countries; Department of Veterinary Microbiology, The Royal Veterinary and Agricultural University, Frederiksberg, DenmarkEven if drinking water of poor rural communities is obtained from a 'safe' source, it can become contaminated during storage in the house . To investigate the relative importance of this domestic domain contamination, a 5-week intervention study was conducted . Sixty-seven households in Punjab, Pakistan, were provided with new water storage containers (pitchers): 33 received a traditional wide-necked pitcher normally used in the area and the remaining 34 households received a narrow-necked water storage pitcher, preventing direct hand contact with the water . Results showed that the domestic domain contamination with indicator bacteria is important only when the water source is relatively clean, i.e . contains less than 100 Escherichia coli per 100 ml of water . When the number of E . coli in the water source is above this value, interventions to prevent the domestic contamination would have a minor impact on water quality compared with public domain interventions . Although the bacteriological water quality improved, elimination of direct hand contact with the stored water inside the household could not prevent the occasional occurrence of extreme pollution of the drinking water at its source . This shows that extreme contamination values that are often thought to originate within the domestic domain have to be attributed to the public domain transmission, i.e . filling and washing of the water pitchers . This finding has implications for interventions that aim at the elimination of these extreme contaminations.

Can J Ophthalmol, 2002 Jun, 37(4), 228 - 37; discussion 237
Treatment of acute bacterial conjunctivitis: 1% fusidic acid viscous drops vs . 0.3% tobramycin drops; Jackson WB et al.; BACKGROUND: A frequent cause of conjunctivitis is an acute bacterial infection, presenting with mucopurulent discharge and conjunctival hyperemia . The authors compared the clinical and microbiologic efficacy, safety and acceptability of 1% fusidic acid viscous drops (Fucithalmic) with 0.3% tobramycin ophthalmic solution (Tobrex) in the treatment of suspected bacterial conjunctivitis . METHODS: Patients were recruited at 20 sites in Ontario, Saskatchewan and Alberta from October 1995 to December 1998 . Patients who presented to their primary care physician with suspected bacterial conjunctivitis, as identified by conjunctival hyperemia and purulent or mucopurulent discharge, were eligible for the study . Patients were randomly assigned to receive 7 days of treatment with either 1% fusidic acid (one drop applied twice daily) or 0.3% tobramycin (one to two drops applied four to six times daily) . The investigators were blinded as to treatment status . Bacteriologic samples were taken from the inferior conjunctival cul-de-sac on day 0 and at the end of treatment . Signs and symptoms of conjunctivitis were assessed at baseline and after 3 and 7 days of treatment . The acceptability of treatment was assessed by having the patient or the parent or guardian complete a questionnaire on degree of compliance and ease of use after 3 and 7 days of treatment . RESULTS: Conjunctival swabs were obtained from 484 patients (410 over 9 years of age and 74 aged 2 to 9 years) to determine baseline bacteriology . Of the 484, 319 (65.9%) (63% of the older patients and 80% of those aged 2 to 9 years) had positive results of culture for bacteria . Ninety-four patients (19%) (63 {15%} of the older patients and 31 {42%} of those aged 2 to 9 years) had per-protocol pathogens as defined by quantitative bacteriology criteria . There was a direct correlation between the presence of mucopurulent discharge and the presence of per-protocol pathogens . There were no significant differences in clinical or bacteriologic efficacy between the treatment groups . Treatment compliance was similar between the treatment groups for the older patients; however, for those aged 2 to 9 years, compliance was significantly better in the fusidic acid group than in the tobramycin group (85% vs . 47%) (p < 0.001) . Significantly more patients in the fusidic acid group than in the tobramycin group rated treatment as convenient or very convenient, particularly among younger patients (97% vs . 54%) (p < 0.001) . INTERPRETATION: The clinical and bacteriologic efficacy of fusidic acid viscous drops combined with the convenience of a twice-daily dosage regimen establishes this antibiotic as first-line treatment for suspected acute bacterial conjunctivitis and a favourable alternative to other broad-spectrum antibiotics.

Dis Aquat Organ, 2002 Apr 24, 49(1), 77 - 81
Pericarditis and myocarditis in farmed Atlantic halibut Hippoglossus hippoglossus; Johansen R et al.; Farming of Atlantic halibut Hippoglossus hippoglossus is a growing industry in Norway . This study comprises the first description of heart morphology in fish from one Atlantic halibut farm . Fish with no clinical signs of disease were randomly sampled (8 to 12 mo old, weight 1 to 50 g) . The hearts were studied by light and electron microscopy and samples were taken from the kidney and pericardial cavity for bacteriological examination . Slight to severe changes were found in most hearts at all samplings . The most serious pericardial and myocardial changes were seen in larger fish (15 to 50 g) . In some of the hearts the affected pericardium formed multifocal protrusions . Eight fish had an adhesion between the apex of the ventricle and the parietal wall of the pericardial cavity . Results of bacteriology and immunohistochemistry investigations for common disease agents were negative.

Antibiot Khimioter, 2002, 47(2), 16 - 9
{Eradication of Helicobacter pylori in patients with duodenal ulcer following the short course of treatment with azitromycin and amoxycillin}; Reshetniak VI et al.; The efficacy of short-term treatment with azithromycin in 17 patients with acute doudenal ulcer associated with H . pylori was evaluated . Bioptats of the gastric mucosa taken at the beginning and after one month of treatment were investigated for H . pylori presence by histological, bacteriological methods, by urease test and by PCR . All the patients with positive H . pylori test were treated with Gastrozol (omeperazole, ICN Pharmaceutical) 40 mg per day for 1 week followed by 20 mg per day for 3 weeks, Sumamed (azithromycin, peira) 0.5 g once daily for 3 days and amoxycillin 0.5 mg four times a day for 10 days . Bioptats analysis before treatment revealed H . pylori in 100% for PCR methods, in 94.1% for urease test, in 88.2% for histological test . After the treatment H . pylori was revealed in 12.5% for urease and histological test, in 18.8% for bacteriological test and in 25% for PCR test . Thus the treatment efficacy was 75% . Side effects for short-term azithromycin therapy were shown in 5.9% cases.

Chir Narzadow Ruchu Ortop Pol, 2002, 67(1), 69 - 72
{Osteomyelitis concomitant with psoriasis}; Olszewska-Konarska M et al.; The paper presents a case of child suffered from osteomyelitis concomitant with psoriasis . Similar clinical and radiological course was observed in another two cases . The disease was chronic, recurrent and school children were affected . Normal temperature and increased blood sedimentation were observed . Enlarged of metaphysis, "marbled" structure of the bone with many little osteolitical focus and thickening of cortical bone were observed, too . This disease was progressive and the whole of the diaphysis was affected . Pus was never found during operation . The bone was fragile sclerotic in some places, with thickened periosteum . Histopathological examination indicated chronic osteomyelitis . Bacteriological examination was always negative . The treatment performed usually in acute osteomyelitis wasn't effective.

Adv Ren Replace Ther, 2002 Apr, 9(2), 116 - 24
Moncrief-Popovich catheter and implantation technique: the AV fistula of peritoneal dialysis; Dasgupta MK; Despite the decrease in peritonitis rate from touch contamination caused by the use of disconnect systems, technique failure in peritoneal dialysis (PD) from pericatheter and exit-site infections in PD remains unchanged . This indicates a failure of current PD catheters to prevent bacterial transfer from exit site to the peritoneal cavity . In 1991, Moncrief and Popovich introduced a new catheter design and implantation technique to address this problem . The catheter is made of silastic, has a coiled tip with 2 cuffs, and an arcuate bend between the cuffs . This would prevent catheter malfunction and leakage of PD fluid . The implantation technique involves embedding of the external segment of the catheter in the subcutaneous tunnel at insertion . The catheter segment is kept embedded for 4 to 6 weeks before externalization . This procedure will allow time for tissue ingrowth on into the external cuff and catheter surfaces between the 2 cuffs, preventing bacterial colonization of the catheter surfaces from the exit wound and thereby reducing pericatheter infections . Thus, the new technique will establish a more effective bacteriologic barrier between the exit wound and the peritoneal cavity than the conventional catheters . Ten years after validation of the catheter design and implantation technique by Moncrief and Popovich, various clinical studies confirm that this new technique of catheter implantation increases catheter life expectancy and reduces pericatheter infections in PD . Like the arteriovenous fistula of haemodialysis, this new catheter remains embedded in subcutaneous tunnel, is exteriorized electively when patient needs to be started on dialysis, and reduces pericatheter and exit-site infections in PD . The new technique, therefore, is widely accepted as a simple, safe, and cost-effective procedure for quality care of PD patients around the world .

Zentralbl Gynakol, 2002 Apr, 124(4), 220 - 2
Rupture of coliform pyosalpinx in a nine-year old girl; Habek D et al.; The authors report on an atypical clinical picture of an acute abdomen syndrome caused by the rupture of an atypically located pyosalpinx in a 9-year old girl.A perforated right-sided pyosalpinx was found at two locations, firmly adhering to a vesicouterine excavation . Right-sided salpingectomy, appendectomy, pelvic cavity lavage and drainage of the Douglas cavity were performed . The pathohistology indicated a perforated pyosalpinx and catarrhal appendicitis . On bacteriological analysis, Escherichia coli was isolated from the vaginal discharge and from the pus collected from the small pelvis.

Water Sci Technol, 2002, 45(9), 317 - 24
Development of a risk-based TMDL assessment approach using the integrated modeling system GIBSI; Rousseau AN et al.; Using the integrated modeling system GIB SI and a case study, this paper presents the development of a risk-based TMDL assessment approach that links wet (nonpoint/diffuse) and dry weather (point) sources to a probability of exceeding water quality standards (WQS) governing wateruses . The case study focused on determining whether WQS defining recreational uses of water requiring direct and prolonged contact were attainable if the waste water effluent of a small town was treated using aerated lagoons and if the agricultural nonpoint source (NPS) loads were reduced using different fertilization rates . Dry weather sources were assumed to solely contribute to bacteriological impairment of the studied river reach . Meanwhile, both wet and dry weather sources were assumed to contribute to aesthetic impairment . Simulation results showed that treating the waste water effluent while reducing the agricultural NPS loads by 27% allowed on average over a four-year study period for attainment of the bacteriological WQS 100% of the summer time while lowering the probability of exceeding the aesthetic WQS from 0.32 to 0.19 (30 to 18 days) . The results of this study showed this risk-based assessment approach was well suited to establish TMDL . These probabilities should be evaluated using long meteorological series.

Antibiot Khimioter, 2002, 47(1), 18 - 20
{Sparfloxacin (Sparflo) in the treatment of urological infections}; Lopatkin NA et al.; Sparfloxacin efficacy evaluation for the treatment of urogenital tract infections is presented . The trial was performed on 43 patients with chronic complicated infections of urogenital tract (pyelonephritis, prostatitis) . Sparfloxacin (once daily for 7-14 days) was highly effective in the infection management according to clinical and bacteriological results (83.7 per cent and 78.1 per cent subsequently).

Antibiot Khimioter, 2002, 47(1), 12 - 7
{Comparison of linezolid and vancomycin in nosocomial pneumonia: results of the multicenter double-blind study}; Grudinina SA et al.; The results of multicenter, randomized, double-blind comparative study of linezolid and vancomycin efficacy, safety and tolerability in the treatment of nosocomial pneumonia are presented . The trial was performed on 69 patients . Clinical efficacy of linezolid was 83 per cent, of vancomycin--79 per cent . Bacteriological effect (pathogen eradication) was 83 per cent for linezolid group and 86 per cent for vancomycin group . During the study good clinical tolerability of linezolid was demonstrated along with lower side effects incidence and shortened recovery period when compared to vancomycin.

Clin Ther, 2002 May, 24(5), 736 - 51
A controlled, double-blind, multicenter study comparing clarithromycin extended-release tablets and levofloxacin tablets in the treatment of community-acquired pneumonia; Gotfried MH et al.; BACKGROUND: Macrolides and fluoroquinolones are frequently used for the empiric treatment of community-acquired pneumonia (CAP) . OBJECTIVE: The aim of the study was to compare the safety profile and efficacy of clarithromycin extended-release (ER) tablets with those of levofloxacin tablets for the treatment of CAP in ambulatory adult patients . METHODS: In a Phase III, double-blind, randomized, parallel-group, multicenter study, ambulatory adult patients (> or = 18 years) with signs and symptoms of CAP received a 7-day course of treatment with either clarithromycin ER (two 500-mg tablets once daily) or levofloxacin (two 250-mg tablets once daily) . A diagnosis of CAP was confirmed by radiography of the chest and physical examination, and sputum samples were analyzed to identify etiologic pathogen(s) . Tolerability was assessed through subjective reports of adverse events and through changes in physical findings, concomitant medications, and laboratory values . RESULTS: There were no statistically significant differences between treatment groups in terms of sex, age, race, or body weight . The mean age was 50 years (range, 18-91 years) . Of 299 patients randomized and treated, 252 were clinically evaluable (128 clarithromycin ER, 124 levofloxacin) . The 95% CI for the difference between cure rates demonstrated equivalence of the 2 treatments . Among clinically evaluable patients at the test-of-cure visit, clinical cure rates were 88% (113/128) and 86% (107/124), and radiographic success rates were 95% (117/123) and 88% (104/118) for clarithromycin ER and levofloxacin, respectively . Both treatment regimens were effective in resolving and improving clinical signs and symptoms of CAP . Among clinically and bacteriologically evaluable pa- tients, bacteriologic cure rates were 86% (80/93) and 88% (85/97) for clarithromycin ER and levofloxacin, respectively . No statistically significant differences were observed between the 2 treatment groups in the overall incidence of adverse events . Conclusions: Clarithromycin ER demonstrated equivalent efficacy and tolerability to the fluoroquinolone levofloxacin in a group of ambulatory adult patients with CAP . Clarithromycin ER also appeared to be safe in the population studied.

Commun Dis Public Health, 2002 Mar, 5(1), 43 - 7
Practical lessons from the management of an outbreak of small round structured virus (Norwalk-like virus) gastroenteritis; Lachlan M et al.; An outbreak of viral gastroenteritis caused illness in 92 people during October 2000 . All the cases had an association with one hotel and 80% of cases identified had attended one of two buffet meals on 18th October 2000 . Cohort analysis did not implicate any particular foodstuff in this outbreak . All bacteriological tests on food samples were negative . Small round structured virus (SRSV)/Norwalk-like virus (NLV) particles were seen by electron microscopy in 6 out of 27 stool samples submitted for analysis . This paper describes the outbreak and in particular the lessons learned from the management and control of it . These include practical points with regard to the outbreak control team, liaison with the microbiology laboratory, handling data, agreeing a case definition, and occupational health issues . All can be applied elsewhere by those responsible for managing outbreaks at a local level.

Int J Hyg Environ Health, 2002 May, 205(4), 269 - 79
Fungal flora in groundwater-derived public drinking water; Gottlich E et al.; In order to assess the dissemination of hygienically relevant fungi via the public drinking water distribution system, a 12-month survey was performed on groundwater-derived drinking water from 29 water supplies in North Rhine-Westphalia, Germany . Frequencies of contaminated water samples, and the prevalent species and patterns of occurrence in raw water, waterworks, the network and house installations were studied on the basis of 2657 water samples . Results were obtained by long-term incubation of 1 ml aliquots of water samples on agar-based culture media, following bacteriological procedures documented in the German drinking water regulations (Anon, 1990) . No correlation with standard hygiene indicators, such as E . coli or other coliform bacteria was observed . Common opportunistic and allergenic Aspergillus species were encountered only rarely . The fungal flora was dominated by a limited number of species of Acremonium, Exophiala, Penicillium and particularly Phialophora; some of them occurred throughout the entire drinking water system and are thought to constitute a resident fungal flora . Phialophora sp . nov., to be described as a new species elsewhere, was ubiquitous; it was found in 26.6% of the samples positive for fungi (7.5% of 2657) . Fungal diversity in the network itself was significantly lower than in raw water and house installations, indicating that not all fungi gaining access to the system are capable of surviving for longer periods . For species such as Verticillium lecanii, found exclusively after the introduction of newly buried pipes and remaining localized at those sites, introduction via arthropod vectors is likely . The resident species of Phialophora, Exophiala and Acremonium are particularly significant as they are shown to be disseminated efficiently by public drinking water.

Probl Tuberk, 2002, (3), 6 - 8
{Epidemiology of tuberculosis in Vladivostok}; Zheburtovich NV; In the early 1990s there was a great change in the tuberculosis situation in Vladivostok . Since 1992, the average total tuberculosis morbidity has increased by 22.7% and in 2000 it amounted to 91.0 per 100,000 . Its morbidity among children increased by 90% in the same period . The morbidity due to tuberculosis in its risk groups is several times higher than that in the general population . The reasons for this rise were socioeconomic crisis, high population density in Vladivostok, intensive, virtually uncontrolled migration . The basic methods of detection of tuberculosis in Vladivostok, as in Russia as a whole, remain as follows: fluorography, bacteriology, and tuberculin diagnosis . The efficiency of each method is associated with the organization and financing of activities in detecting and with the potentialities of methods, personnel qualification . It is necessary to pay attention to the detection of tuberculosis in the risk groups, by making their register in order to enhance the effectiveness and to reduce the cost of existing methods . Strict control and management of a migration process and solution of social problems are needed.

Avian Dis, 2002 Apr-Jun, 46(2), 485 - 92
Reovirus infection in psittacine birds (Psittacus erithacus): morphologic and immunohistochemical study; Sanchez-Cordon PJ et al.; In this paper we report on an outbreak of reovirus, herpesvirus (Pacheco disease), and/or mycosis infection (Aspergillus spp . and Zygomyces spp.) affecting a batch of young African grey parrots (Psittacus erithacus), with 80% morbidity and 30% mortality . Study material was taken from five birds (four dead and one euthanatized) with a range of clinical symptoms (depression, diarrhea, respiratory symptoms) . Diagnosis was confirmed by immunohistochemical detection of avian reovirus, electron microscopy, and virus isolation . Viral antigen of reovirus was detected mainly in large mononuclear cells in the bursa of Fabricius and the spleen, pancreas epithelial cells, and circulating cells; lymphoid organs displayed the largest number of immunopositive cells and severe lymphocyte depletion . Bacteriologic study was negative . Reovirus infection was common in all birds studied, whereas Pacheco disease and mycosis were found in only some, suggesting that reovirus could be the initial cause triggering the outbreak and facilitating infection by other agents and their swift spread through the batch.

Acta Vet Hung, 2002, 50(1), 5 - 16
Occurrence of porcine dermatitis and nephropathy syndrome in Hungary; Molnar T et al.; In the past few years a characteristics, often fatal disease associated with cutaneous lesions and nephropathy has been observed in several large pig herds and household pig stocks of Hungary . In addition to general symptoms and slight fever in several cases, the disease was characterised by cutaneous lesions occurring mostly on the ventral part of the thorax and abdomen, on the extremities and ear pinnae, and in the nasal and perianal region . In the acute phase, circumscribed hyperaemic, confluent, crust-covered areas were seen . Histological examination revealed necrosis of the epithelial layer and lympho-histiocytic vasculitis in the corium, here and there accompanied by thrombosis and fibrinoid degeneration . The kidneys were pale brown and harder to tear, with cortical petechiae in most cases . By histopathological examination, intra- and extracapillary glomerulonephritis accompanied by fibrinoid exudation was seen . Some of the renal tubules were dilated, others were atrophied, and in advanced cases proliferation of the intertubular connective tissue and inflammatory cell infiltration also occurred . Necrotic vasculitis was also observed in some cases . By immunohistochemical examination IgA, IgG and IgM, and in a single case C3 belonging to the complement system were observed in the pathologically changed skin areas and kidneys . By polymerase chain reaction (PCR), porcine circovirus type 2 (PCV-2) was detected . Bacteriological and serological examinations did not reveal infections of aetiological importance.

Berl Munch Tierarztl Wochenschr, 2002 May-Jun, 115(5-6), 203 - 6
{Parasites of the common crane Grus grus (L.) in Europe}; Gottschalk C et al.; 28 species of parasites (8 coccidia, 6 trematodes, 1 cestode, 6 nematodes, 1 tick, 6 mallophages) were found at the Common Crane . After presenting the interconnection of parasites with different carriers as vectors, intermediate and several final hosts in the biocoenosis of Common Cranes, the results of parasitological examination of 421 samples of cranes resulted in varying parasitization at different seasons and flyways . Further studies are needed to interprete these facts correctly . Changes of presented localities of diverted feedings and their parasitological and bacteriological control at resting places may avoid concentration of pathogens in soil, intermediate hosts and carriers.

Int J Syst Evol Microbiol, 2002 May, 52(Pt 3), 1043 - 7
Report of the ad hoc committee for the re-evaluation of the species definition in bacteriology; Stackebrandt E et al.; An ad hoc committee for the re-evaluation of the species definition in bacteriology met in Gent, Belgium, in February 2002 . The committee made various recommendations regarding the species definition in the light of developments in methodologies available to systematists.

Int J Syst Evol Microbiol . 2002 May;52(Pt 3):1039.
Correction of the connecting vowel and gender of the specific epithet in the name Sphingomonas macrogoltabidus Takeuchi et al . 1993 to Sphingomonas macrogolitabida; Yabuuchi E; In accordance with the Bacteriological Code (1990 Revision), the connecting vowel and gender of the specific epithet macrogoltabidus in combination with the generic name Sphingomonas must be -i- and the ending must be changed to -a to agree with the gender of the generic name, respectively . Thus Sphingomonas macroboltabidus Takeuchi et al . 1993 should be Sphingomonas macrogolitabida corrig . Takeuchi et al . 1993.

Hautarzt, 2002 Apr, 53(4), 230 - 7
{Current status of dermatomicrobiology . An overview}; Sonntag AK et al.; The new German laws dealing with protection against infectious diseases (Infektionsschutzgesetz of 1.1.2001) have reconfirmed the importance of microbiology as a basic science and infectiology as a multi-disciplinary clinical discipline . Concerning dermatological diagnosis and therapy, the implementation of molecular biological techniques has a decisive influence . The discovery of new (e.g . Helicobacter pylori) and the better detection of known organisms (e.g . Chlamydia, Borrelia) suggested findings in questions of causality and therapeutic developments . Concerning the infections of the skin this synopsis provides the state of the art of diagnostic process and treatment in mycology, bacteriology and virology.

Pneumologia, 2002 Jan-Mar, 51(1), 26 - 32
{The child in tuberculosis hotbeds}; Raduta M; The city of Cluj-Napoca and the Cluj County, once situated in the comfortable zone of tuberculosis incidence, below the country, average, have registered a permanent and alarming increase in the both adult and child incidence of tuberculosis the last 5 years, which made us find the analysis of the phenomenon useful and constructive--having in view children mainly . Therefore we started to study all the adult bacillary hotbeds, bacteriologically confirmed in the city (150, totaling 172 cases) and having in contact between 1995-2000 with 280 children; superposing period of the 1995-2000 . Antituberculosis National Programme reviewed in 1997 . Statistical correlation between clinical forms of tuberculosis identified in children has been analyzed as well as aspects connected to: sources (number, contagiousness, intimacy of contact etc), epidemiological inquiry, intradermoreaction, groups of age, bacteriological confirmation (of adults and children), X-ray aspects, B.C.G, treatment (place of application, regime), prophylaxis . In spite of the growing incidence, the clinical forms of tuberculosis registered in children have been benign, no death registered and a positive evaluation after a year (90% achieved healing and treatment) which demonstrates a good epidemiological, therapeutical and prophylactic covering of a pediatric cases from the patent hotbeds of adult tuberculosis, but which must be completed and sustained by a socio-economical and better cultural context.

Klin Med (Mosk), 2002, 80(4), 34 - 7
{Predictive value of echocardiography in infectious endocarditis}; Demin AA et al.; 182 patients with infectious endocarditis (IE) were examined for correlations between valvular bacterial vegetations and IE activity, course, results of bacteriological and morphological findings . 81 of the patients had primary IE, 71 patients had secondary IE which had developed in uncorrected valvular heart disease, in 30 patients secondary IE had developed after surgical correction of rheumatic heart disease . It is shown that echocardiographic detection of bacterial vegetations does not determine IE severity, course and outcome.

Ter Arkh, 2002, 74(4), 35 - 8
{Various approaches to tuberculosis diagnosis in patients with hemoblastosis}; Iuldasheva NE et al.; AIM: To characterize diagnosis of tuberculosis in hemoblastosis patients . MATERIAL AND METHODS: Diagnosis of active tuberculosis in 2.6% from 2123 hemoblastosis patients admitted to Hematological Research Center in 1990-1999 shows that such patients can be referred to high risk group in relation to tuberculosis infection . Methods and terms of tuberculosis diagnosis in hemoblastosis patients are analysed . RESULTS: Bacteriological and histological tests were positive in 27.8% examinees with hemoblastosis . In extrapulmonary tuberculosis location, histological diagnosis was positive in 60% . Especially helpful is a complex of clinical and x-ray examinations in high tuberculosis alertness . This allowed to suspect the infection in 51.9% patients (63.9% had pulmonary location) . A marked positive response to antituberculosis treatment proved tuberculosis diagnosis . CONCLUSION: Difficulties of tuberculosis diagnosis in hemoblastosis patients are explained by low informative effectiveness of most common methods of this infection verification . Therefore, in addition to bacteriological and histological examinations, clinical diagnostic techniques should be employed keeping alert in relation of tuberculosis in hemoblastosis patients who are at risk to catch this infection.

Ter Arkh, 2002, 74(4), 25 - 35
{Diagnosis of pulmonary lesions in acute respiratory insufficiency in patients with depressed hemopoiesis}; Galstian GM et al.; AIM: To analyse causes of acute respiratory failure (ARF) and methods of diagnosis of pulmonary lesions in patients with depressed hemopoiesis (DH) . MATERIAL AND METHODS: 50 patients with DH and ARF were examined according to the protocol including x-ray, computed tomography, fibrobronchoscopy with bronchoalveolar lavage, cytological, bacteriological, virusological studies of the lavage fluid, biopsy of the lung . The algorithm of the protocol is provided . RESULTS: Sensitivity of the lavage fluid in diagnosis of fungal, bacterial, pneumocystic and cytomegaloviral infections was 84, 78, 93 and 93%, respectively . The cytologic examination of the lavage fluid may detect lung infiltration with blood tumors . In complicated diagnostic cases lung biopsy verified pulmonary lesion but its conduction aggravated the patients' condition . ARF patients with DH, bacterial flora, fungi, cytomegalovirus and pneumocystic infection, pulmonary tumor involvement, pulmonary lesions in ATRA-syndrome, non-infectious lesions of the lungs after bone marrow transplantation were found in 38, 18, 40, 18, 8 and 4% of cases, respectively . CONCLUSION: DH patients with ARF should be examined by the protocol including both non-invasive and invasive diagnostic methods . Accurate diagnosis of ARF causes is the basic reserve in the treatment of such patients.

J Vet Intern Med, 2002 May-Jun, 16(3), 287 - 92
Atypical parapoxvirus infection in sheep; Smith GW et al.; This report describes the clinical and laboratory findings for 5 sheep from 3 different flocks with extensive proliferative skin lesions grossly resembling warts on the distal limbs . The lesions affected the front and rear extremities in all sheep, and 2 sheep also had lesions around the head . The sheep exhibited signs of pain when the lesions were touched, and most sheep were reluctant to move . Various empirical treatments, including systemic antibiotics, topical antibiotics, and antifungal ointments, were administered without clinical improvement . Diagnostic tests including skin biopsy and histopathology, examination of skin scrapings, bacteriology, mycology, electron microscopy of lesions, and immunohistochemical analysis demonstrated that the lesions were the result of parapoxvirus infection . All 5 animals were euthanized either because of the lack of resolution of clinical signs or a decision by the owner . These animals illustrate an atypical presentation of parapoxvirus infection in sheep (orf, contagious ecthyma, and scabby mouth) . The infection appeared to be minimally contagious; however, the lesions did not spontaneously resolve . This appears to be the 1st report of such lesions in multiple sheep in North America, although similar lesions have been reported in Israel and the United Kingdom.

J Wildl Dis, 2002 Apr, 38(2), 287 - 90
Experimental Brucella ovis infection in mouflon (Ovis musimon); Cerri D et al.; Brucella ovis was isolated for the first time in Italy in 1994 from the genital organs of two domestic rams . In subsequent years bacteriologic and serologic investigations demonstrated an increasing distribution of this disease in domestic sheep . Mouflon (Ovis musimon) occur in several hilly and mountainous areas of Italy where they can potentially contact domestic sheep . To determine if this species may have a role in the epidemiology of B . ovis, four male and four female mouflon, serologically negative for B . ovis and other Brucella spp., were infected intra-conjunctivally with B . ovis strain BG1/94 . Physical examinations, including collection of blood samples for serology and bacteriology, were performed weekly . The animals were euthanized 8 mo postinoculation (p.i.) . Samples of retropharyngeal, parotid, and iliac lymph nodes; bone marrow; kidneys; spleen; epididymis; testicle; bulbourethral glands; seminal vesicles; uterus; and oviducts were collected from each animal as appropriate for histopathology and bacteriology . At the time of euthanasia none of the animals exhibited obvious clinical signs of brucellosis . The animals seroconverted 2 wk p.i . and became seronegative 24 wk p.i . Bacterial cultures, including hemocultures, were negative . No lesions due to B . ovis infection were revealed by histologic examinations . Brucella ovis probably did not infect mouflon and this wild sheep is not likely to play a role in the epidemiology of contagious epididymitis caused by B . ovis.

J Clin Microbiol, 2002 Jun, 40(6), 2291 - 6
Expression of the bundle-forming pilus by enteropathogenic Escherichia coli strains of heterologous serotypes; Gismero-Ordonez J et al.; The production of the bundle-forming pilus subunit BfpA was investigated in 44 enteropathogenic Escherichia coli (EPEC) diarrheal isolates after growth on several conventional bacteriological media . In all, the use of brucella agar supplemented with 4.5 mM sodium bisulfite resulted in a higher detection of BfpA-producing EPEC.

Ultrastruct Pathol, 2002 Mar-Apr, 26(2), 89 - 98
Electron microscopic detection of tin accumulation in biliopancreatic concrements after induction of chronic pancreatitis in rats by di-n-butyltin dichloride; Jonas L et al.; The organotin compound di-n-butyltin dichloride (DBTC) is able to induce an acute and later a chronic pancreatitis in rats . In previous papers the authors demonstrated this DBTC pancreatitis as a rat model for an interstitial pancreatitis with tendency to transduction to the chronic form . DBTC is excreted according to its lipophilic nature by liver and bile . Therefore, the bilio-pancreatic main duct is necrotized by the tin-loaded bile . The duct system is blocked by cell debris and later by epithelial proliferations . In the chronic phase, numerous rats develop concrements in the main duct . In the present paper, the authors report about bacterial growth in some bilio-pancreatic concrements . Whereas the electron microscopic detection of tin by energy-dispersive X-ray analysis (EDX) in SEM or electron energy loss spectroscopy (EELS) in TEM was negative in the parenchyma of pancreas and liver, some concrements with bacterial cells were positive for this element . Tin mapping with energy spectroscopic imaging (ESI) in TEM demonstrated the congruency of tin signals and electron-dense particles inside these bacteria and of electron-dense accumulations in the matrix of these concrements . The low content of tin in pancreatic and liver tissue and the higher quantity of tin inside the bacterial contaminated concrements were supported by atomic absorption spectrophotometry (AAS) . The paper discusses the long time preservation of tin in the concrements as an action of heavy-metal- accumulating bacteria, which should be classified in the future by bacteriological methods.

Biomaterials, 2002 Jun, 23(12), 2527 - 34
Enhanced expression of the osteoblastic phenotype on substrates that modulate fibronectin conformation and integrin receptor binding; Stephansson SN et al.; Integrins represent the primary mechanism of cell-extracellular matrix interactions and control cell morphology, proliferation, and differentiation . We have previously shown that substrate-dependent modulation of adsorbed fibronectin (Fn) conformation alters alpha5beta1 integrin binding to Fn and directs C2C12 myoblast proliferation and differentiation (Mol . Biol . Cell 10 (1999) 785) . The model substrates used in these experiments were bacteriological (untreated) polystyrene (B), tissue culture polystyrene (T), and type-I collagen-coated T (C) . In the present study, we examined MC3T3-EI osteoblast-like cell differentiation on Fn-coated B, T, and C substrates . Immunofluorescence staining revealed substrate-dependent differences in integrin alpha5beta1 binding and clustering into focal adhesions (C > T > B), consistent with our previous integrin binding analysis . Alkaline phosphatase activity and matrix mineralization showed substrate-dependent differences (C > T > B, p < 0.05) . Similar trends were observed for alkaline phosphatase, osteocalcin, and bone sialoprotein gene expression . Blocking experiments with antibodies directed against Fn completely inhibited matrix mineralization on Fn-coated C, indicating that Fn is critical to expression of the osteoblastic phenotype on this extracellular matrix component . These substrate-dependent differences in osteoblast differentiation correlated with differences in alpha5beta1 binding, suggesting that these differences arise from substrate modulation of integrin-matrix interactions . Substrate-dependent modulation of cell function may provide a versatile mechanism to control cell responses in numerous biomedical applications.

Aten Primaria, 2002 Apr 30, 29(7), 425 - 9
{Epidemiological profile of tuberculosis in a health area of the Valencian Community (1998-2000)}; Molina Quilis R et al.; OBJECTIVE: To find the epidemiological characteristics of cases of tuberculosis (TB) notified in Health Area 09 of the Valencian Community during 1998-2000.Design . Descriptive, observational, epidemiological study . SETTING: Unit of epidemiology in the Public Health Centre of Alzira, Area 09 of the Valencian Community.Participants . Cases of TB that met the clinical or bacteriological definitions according to the protocols of the National Network of Epidemiology Protection . MAIN MEASUREMENTS AND RESULTS: The epidemiological questionnaire for TB declaration in the Valencian Community was used . The variables included were: sex, age, town, risk factors, associated pathology, location, origin and study of contacts . A univariate statistical analysis was run, with the SPSS version 9.01 . Cases numbered 118 . The rate of annual occurrence ranged between 25.5 per 100 000 in 1999 and 43.5 per 100 000 in 1998, similar to that in the year 2000 (42.5 per 100 000) . 64.4% were men and 26.3% were between 25 and 34 years old . 64.4% were admitted . There was a study of contacts in 73.7% . 78% of cases were declared by the referral hospital . CONCLUSIONS: TB in Area 09 was concentrated in young adults needing hospital admission . TB declaration was usually made from the hospital.

Klin Khir, 2002 Mar, (3), 33 - 6
{Early surgical treatment of injured persons with subfascial electric burn of extremities in combination with preparation Betadine}; Fistal' EIa et al.; Basing on the clinical material analysis, on bacteriological investigation data, smear-"prints", the authors recommend application of 10% solution of Betadine for sanatation of the electric wounds with subfascial structures affection, what have permitted to accelerate the wound surface clearance, to reduce exudation, to activate the primary granulation tissue development to prepare the wound for its plastic closure . Application of Betadine in conditions of aseptic inflammation had promoted the secondary necrosis occurrence in the tissue ischemia after deep burn occurrence.

J Trop Pediatr, 2002 Apr, 48(2), 88 - 92
Angiographic and immunologic studies in acute necrotizing jejunoileitis; Chandrasekharam VV et al.; Eighteen cases of laparotomy-proven acute necrotizing jejunoileitis were treated during the period 1992-1998 . Routine laboratory investigations and bacteriological studies were non-contributory towards establishing an etiological basis for the diagnosis . Superior mesenteric artery digital subtraction angiography, carried out in five patients, demonstrated extensive neovascularization . IgG, IgM and IgA were normal in all eight children in whom it was measured; IgE levels were grossly elevated (mean 900 IU/ml; normal range 0-100 IU/ml) . Four cases had evidence of hypersensitivity reactions (type I in one patient and type III in three patients) on histopathological examination of the resected small bowel . In addition, histopathological examination also showed the neovascularization observed on angiography . The evidence suggests an immunologically mediated insult resulting in intense vasculitis, which in turn causes ischemic damage to the bowel wall.

Antimicrob Agents Chemother, 2002 Jun, 46(6), 1746 - 54
Randomized controlled trial of sequential intravenous (i.v.) and oral moxifloxacin compared with sequential i.v . and oral co-amoxiclav with or without clarithromycin in patients with community-acquired pneumonia requiring initial parenteral treatment; Finch R et al.; The objective of the present trial was to compare the efficacy, safety, and tolerability of moxifloxacin (400 mg) given intravenously (i.v.) once daily followed by oral moxifloxacin (400 mg) for 7 to 14 days with the efficacy, safety, and tolerability of co-amoxiclav (1.2 g) administered by i.v . infusion three times a day followed by oral co-amoxiclav (625 mg) three times a day, with or without clarithromycin (500 mg) twice daily (i.v . or orally), for 7 to 14 days in adult patients with community-acquired pneumonia requiring initial parenteral therapy . A total of 628 patients were enrolled and assessed by evaluation of their clinical and bacteriological responses 5 to 7 days and 21 to 28 days after administration of the last dose of study medication . Although the trial was designed, on the basis of predefined outcomes, to demonstrate the equivalence of the two regimens, the results showed statistically significant higher clinical success rates (for moxifloxacin, 93.4%, and for comparator regimen, 85.4%; difference {Delta}, 8.05%; 95% confidence interval {CI}, 2.91 to 13.19%; P = 0.004) and bacteriological success rates (for moxifloxacin, 93.7%, and for comparator regimen, 81.7%; Delta, 12.06%; 95% CI, 1.21 to 22.91%) for patients treated with moxifloxacin . This superiority was seen irrespective of the severity of the pneumonia and whether or not the combination therapy included a macrolide . The time to resolution of fever was also statistically significantly faster for patients who received moxifloxacin (median time, 2 versus 3 days), and the duration of hospital admission was approximately 1 day less for patients who received moxifloxacin . The treatment was converted to oral therapy immediately after the initial mandatory 3-day period of i.v . administration for a larger proportion of patients in the moxifloxacin group than patients in the comparator group (151 {50.2%} versus 57 {17.8%} patients) . There were fewer deaths (9 {3.0%} versus 17 {5.3%}) and fewer serious adverse events (38 {12.6%} versus 53 {16.5%}) in the moxifloxacin group than in the comparator group . The rates of drug-related adverse events were comparable in both groups (38.9% in each treatment group) . The overall incidence of laboratory abnormalities was similar in both groups . Thus, it is concluded that monotherapy with moxifloxacin is superior to that with a standard combination regimen of a beta-lactam and a beta-lactamase inhibitor, co-amoxiclav, with or without a macrolide, clarithromycin, in the treatment of patients with community-acquired pneumonia admitted to a hospital.

Dig Dis Sci, 2002 May, 47(5), 978 - 86
Oral cavity as a potential source of gastric reinfection by Helicobacter pylori; Karczewska E et al.; Helicobacter pylori (Hp) is a common pathogen colonizing the a gastric mucosa, but some reports indicated that it may also be found in the oral cavity, which could serve as a reservoir of the bacteria and a source of gastric reinfection . Accordingly, we aimed to study whether the oral cavity, particularly gingival pockets, are colonized by Hp and whether it could be the source of gastric reinfection . We studied 329 patients with dyspeptic symptoms (257 with chronic gastritis, 15 with gastric ulcer, and 57 with duodenal ulcer) . The {13C}urea breath test (UBT), gastroscopy, and Hp culture from gastric biopsies were carried out, and material was collected from the oral cavity (gingival pocket) for bacteriological culture and genomic DNA studies . The serum was obtained for anti-Hp IgG and anti-CagA assays and saliva for anti-Hp IgA determination using the ELISA technique . Bacteria in material from gingival pockets and biopsies from the corpus and antrum of stomach of 30 DU patients before and after Hp eradication were also examined by PCR technique, using primers specific for 16S rRNA . All Hp-positive patients (276) were subjected to one week of triple therapy (omeprazole 2 x 20 mg twice a day, clarithromycin 2 x 500 mg twice a day, and metronidazole 2 x 500 mg twice a day) . The measurements described above were then repeated at four weeks and six months . Bacteriological culture showed the presence of Hp in the material from oral cavity in about 50% of patients, whereas UBT, used as a gold standard, revealed gastric Hp infection in about 84% of these patients . The eradication was successful in the majority of patients (87%), but about 13% of them were still Hp positive after four weeks and about 21% after six months . Four weeks after Hp therapy, Hp was found in culture from oral samples in 23% (P < 0.05 vs initial) and after six months in 35.1% . The IgA levels recorded in saliva were in a close agreement with UBT results . Hp DNA assessed by PCR in 30 DUs before eradication of Hp was detected in 95% of antral mucosa, 90% in corpus mucosa, and in 35% of gingival pocket material, and after eradication therapy Hp DNA values fell to 25%, 20%, and 10%, respectively . In conclusion, Hp is commonly detected in the oral cavity of patients with dyspeptic symptoms, but the gastric reinfection does not appear to occur in the patients despite oral Hp colonization.

Curr Infect Dis Rep, 2002 Jun, 4(3), 201 - 205
Etiology, Diagnosis, and Treatment of Orbital Infections; Schwartz G; In the past 10 years a significant number of changes have been made in the treatment of orbital infections . Previously, these infections required admission to the hospital, extensive evaluation, and often surgery . Presently, preseptal cellulitis can be treated in a clinician's office with the use of oral antibiotics . Although orbital infections are still treated with parenteral antibiotics, they less frequently require surgical drainage . Many of these changes have been due to the changing bacteriology of orbital infections . This change in bacteriology has allowed clinicians to be much less aggressive in treating these infections.

Indian J Pediatr, 2002 Apr, 69(4), 299 - 303
Diagnostic criteria for Tuberculous Meningitis; Seth R et al.; OBJECTIVE: Tuberculous Meningitis is associated with a high morbidity and mortality if there is a delay in diagnosis . The diagnosis is based on clinical evaluation since the bacteriological diagnosis takes time and has a low yield . This study attempts to validate these criteria in children with TBM . METHODS: Forty-two children clinically suspected to have TBM were enrolled in the study . History, examination, CT scan and CSF findings were utilized to categorize patients into "definite", "highly probable", "probable" and "possible" TBM based on the criteria laid down by Ahuja et al . The validity of these criteria was tested against bacterial isolation and response to treatment . RESULTS: Thirty one children, with complete data, were included for analysis . Using "improvement on therapy as a criterion for definite TBM, we analyzed the sensitivity and specificity of the Ahuja criteria in diagnosing TBM . Using the criteria of "highly probable" TBM, the sensitivity was 65% with a specificity of 75% . When the criteria of "probable" TBM were used, the sensitivity increased to 96% while the specificity dropped to 38% . In an attempt to make these criteria more appropriate for children, we modified the criteria by including mantoux reaction, and family history of exposure in the criteria . The modified criteria gave a sensitivity of 83% and a specificity of 63% . DISCUSSION: A sensitivity of 65% (highly probable group) implies that 35% of TBM patients will be missed, while the probable criteria gave a 63% false positive rate suggesting that the trade-off for a higher sensitivity makes the criteria very unreliable . Our modification of the criteria gave us a reasonable sensitivity of 83% with a higher specificity of 63% . The false positive rate was also reduced to 38% . Thus the modified Ahuja criteria worked better for children with TBM . CONCLUSION: The modified Ahuja criteria are better applicable for use in pediatric patients with TBM . Since the number of patients was small in this study, the study needs to be validated with a larger sample size.

Zhonghua Liu Xing Bing Xue Za Zhi, 2002 Apr, 23(2), 119 - 22
{Study on diarrhea disease caused by enterohemorrhagic Escherichia coli O157:H7 in Xuzhou city, Jiangsu province in 2000}; Li H et al.; OBJECTIVE: To investigate the proportion of hemorrhagic colitis (HC) caused by Escherichia coli O157:H7 in bacterial diarrhea in Xuzhou city, Jiangsu province . METHODS: All stool samples from patients with diarrhea were screened for O157 antigen, using Immuno-gold kits . Positive samples were cultured to detect the existence of pathogens . All of the HC patients confirmed by bacterial isolation and identification were investigated for clinical symptoms and laboratory tests . RESULTS: Of the diarrhea patients identified in Feng county in May, and in Tongshan county of Xuzhou city in June 2000, Jiangsu province 0.98% and 5.89% were caused by Escherichia coli O157:H7 respectively, confirmed by bacteriological isolation and identification of stool samples . At the early phase of hemorrhagic colitis, 18.5% patients had at least one abnormal clinical laboratory test results including protein in urea and increased BUN or creatinine that indicating the possibility of kidney damage . In 27 strains of E . coli O157:H7 isolated from those patients, 13 and 14 were identified as Shiga toxin producing and Shiga-toxin negative E . coli O157:H7 (Stx-positive or Stx-negative) respectively . By analysis of the two groups of patients divided by according to the nature of Shiga toxin, four of 13 patients of Stx-positive group showed positive urea protein . However only 1 of the 13 patients of Stx-negative group was urea protein positive . The decreased Platelets counts were observed in 6 of 13 patients with Stx-positive group, but only in 1 of 14 patients with stx-negative group . These differences were statistically significant . CONCLUSION: HC patients caused by E . coli O157:H7 were commonly seen (up to 5.89%) in Xuzhou city, Jiangsu province . Early laboratory tests should be conducted for HC patients as early as possible in order to find early indictor of kidney failure which was critical for prevention of hemolytic uremic syndrome.

Med J Malaysia, 2001 Dec, 56(4), 478 - 90
Typhoid fever in Malaysian children; Malik AS et al.; A prospective study of 102 children with bacteriologically confirmed typhoid fever, admitted to Hospital Universiti Sains Malaysia over 5 years was conducted . The average age at presentation was 91.3 (range 6 - 159) months . Fever (900%), abdominal pain (56%) and diarrhoea (44%) were common symptoms . Findings included: hepatomegaly (85.3%), splenomegaly (27.5%), anaemia (31%), leukopenia (15%) . thrombocytopenia (26%), positive Widal (62.5%) and Typhidot test (96%) . Patients were treated with ampicillin (n = 54) or chloramphenicol (n = 49) and 1/3 developed complications like hepatitis (n = 19), bone marrow suppression (n = 8) and paralytic ileus (n = 7) . A patient with splenomegaly, thrombocytopenia or leukopenia was at higher risk of developing complications.

Klin Lab Diagn, 2001 Mar, (3), 51 - 3
{Laboratory diagnosis in tuberculosis}; Arsenin SL et al.; The most reliable signs of tuberculosis infection is detection of M . tuberculosis complex in biological fluids and biopsy specimens from focus of lesions . The sensitivity of laboratory diagnostic methods is different for different biological materials, which dictates the utilization of a complex laboratory approach, including microscopy, bacteriological methods, detection of specific IgG, IgM, IgA, and polymerase chain reaction.

Chemotherapy, 2002 May, 48(2), 100 - 8
Efficacy and tolerability of once-daily therapy with telithromycin for 5 or 10 days for the treatment of acute maxillary sinusitis; Roos K et al.; BACKGROUND: The efficacy and tolerability of oral telithromycin 800 mg once daily for 5 vs . 10 days were assessed in patients with acute maxillary sinusitis (AMS) . METHODS: Adults (n = 341) with confirmed AMS diagnosed on clinical signs and symptoms and sinus X-ray showing total opacity or air-fluid level were randomized to receive oral telithromycin for 5 days (followed by placebo for 5 days; n = 170) or 10 days (n = 171) . Causative pathogens were isolated by pretreatment sinus puncture (day 1) . Clinical and bacteriologic outcomes, and safety and tolerability endpoints were assessed . RESULTS: Clinical cure rates post-therapy (per-protocol; days 17-21) were comparable (91.1% in the 5-day group, n = 123; 91.0% in the 10-day group, n = 133) . Bacteriologic eradication rates (per-protocol) were also similar (90.7 vs . 91.3%) . Both regimens were well tolerated . CONCLUSIONS: A 5-day course of telithromycin 800 mg once daily is an effective, well-tolerated treatment for adults with AMS, comparable to a 10-day regimen .

Dermatology, 2002, 204 Suppl 1, 59 - 62
Evaluation of the disinfective efficacy of povidone-iodine with the use of the transparent film dressing OpSite Wound; Takahashi K et al.; To determine the duration of efficacy of disinfection with povidone-iodine (PVP-I) conducted before application of OpSite Wound (Smith and Nephew, UK), bacteriological evaluation was carried out . In 9 healthy adults, 3 sites on the forearms or other parts were chosen for application of OpSite Wound after adequate disinfection with PVP-I . As compared to the bacterial count score of 1.67-2.00 before disinfection, a significant reduction of the score was observed on removal of OpSite Wound on days 1, 2 and 3 . The score of 0.5-0.67 immediately after disinfection did not change or deteriorate until removal of OpSite Wound . This finding supports the fact that unnecessary dressing changes could be avoided postoperatively for at least 3 days by disinfection with PVP-I and application of OpSite Wound particularly for operations categorized as 'clean surgery' .

Res Vet Sci, 2002 Feb, 72(1), 17 - 21
Concentrations of triiodothyronine (T3), tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in milk from healthy and naturally infected quarters of cows; Slebodzinski AB et al.; The effect of naturally acquired bacterial infection of the bovine udder on the activity of 5'-thyroxine monodeiodinase (5'-MD), and on the concentrations of the pro-inflammatory cytokines interleukin (IL)-6 and tumour necrosis factor (TNF)-alpha in milk, from healthy (control) and inflamed quarters, was determined . The diagnostic procedure included history and clinical examination of the udder, macroscopic evaluation of secretions, the Californian Mastitis Test, determination of somatic cell counts and bacteriological examination of milk . It has been found that the milk triiodothyronine (T3) content and the 5'-MD activity from inflamed quarters were decreased when compared with controls . The decrease in the milk T3 from subclinical mastitic quarters was manifested when somatic cell counts were > 10(6) ml(-1) . TNF-alpha was on average 2-fold higher in infected milk, and the concentration of IL-6 was unchanged . These results suggest that the decreased T3 content in mammary secretions during naturally occurring mastitis is associated with the severity of inflammation, increased TNF-alpha concentration and impaired enzymatic activity of 5'-MD.

J Anim Sci, 2002 Apr, 80(4), 1068 - 73
Relationship between postpartum changes in 13, 14-dihydro-15-keto-PGF2alpha concentrations in Holstein cows and their susceptibility to endometritis; Seals RC et al.; Uterine infections (i.e., endometritis) can have a major economic impact on dairy production . Identifying cows that are susceptible to endometritis and improving the diagnosis of endometritis could lead to a reduction in the impact of such infections . Thus, we used Holstein cows to determine whether postpartum changes in 13, 14-dihydro-15-keto-PGF2alpha (PGFM), a metabolite of PGF2alpha, could be used to identify cows that are susceptible to endometritis and to improve the diagnosis of endometritis . Cows were assigned to three treatments . 1) Control (n = 10) had no clinical or bacteriological signs of endometritis during the study . 2) Treated (n = 11) developed endometritis spontaneously and were treated i.m . with 25 mg of PGF2alpha immediately after clinical diagnosis (d 17.6 +/- 0.8 postpartum; mean +/- SEM) . 3) Untreated (n = 10) developed endometritis spontaneously and were not treated after diagnosis (d 20.0 +/- 0.5) . Examinations of external and internal genitalia and bacteriological data were used to diagnose endometritis . From d 0 (calving) until approximately d 63 postpartum, jugular blood was collected three times weekly . Progesterone and PGFM were quantified in plasma . For PGFM, the treatment x day interaction was significant (P < 0.01) . Overall PGFM profiles for Control and Treated differed (P < 0.05), but the Untreated profile did not differ from either Control or Treated . To better understand the interaction, PGFM data from d 0 to 35 postpartum were partitioned into consecutive 7-d periods, and d-36 and greater data were partitioned into one period . Effects of treatment, day, and the treatment x day interaction were then evaluated within period . Except for the d-15 to -21 period, PGFM was greater (P < 0.03) in Control than in Treated and Untreated . In Treated and Untreated, PGFM increased during the d-15 to -21 period . For progesterone, treatment did not affect the profiles, but day was significant (P < 0.001) . Progesterone concentrations were basal from d 0 until approximately d 12, and they generally increased after d 12 . Onset of endometritis was associated with increased progesterone concentrations . Treatment did not affect the interval from calving to first detected estrus (29.5 +/- 4.9 d) or from calving to AI (73.3 +/- 8.7 d) . We conclude that PGFM measures have the potential to be used to identify cows that are more likely to develop endometritis and that PGFM may aid in the diagnosis of endometritis.

J Am Vet Med Assoc, 2002 May 1, 220(9), 1336 - 40, 1313-4
Isolation and identification of Mycobacterium kansasii from pleural fluid of a dog with persistent pleural effusion; Pressler BM et al.; A 3-year-old spayed female Whippet was examined for cough and respiratory distress . Lung lobe torsion with pleural effusion was diagnosed, and lung lobectomy was performed . Pleural effusion recurred during the following 27 months; conventional bacteriologic cultures of pleural effusion did not result in bacterial growth . A second lung lobectomy, pleuroperitoneal shunt placement . and pericardectomy were subsequently performed . Mycobacterium kansasii was eventually isolated from pleural fluid and identified by polymerase chain reaction amplification and DNA sequencing . The dog was euthanatized before therapeutic response could be evaluated . To our knowledge, this is the first report of M . kansasii infection in a dog . Additionally, this is the first report of mycobacterial isolation from pleural fluid, and one of few reports of antemortem mycobacterial isolation from a body fluid, as opposed to identification in specimens during histologic examination . Routine bacteriologic culture methods are insufficient to isolate mycobacterial agents, and special methods are indicated in dogs with persistent pleural effusion.

J Am Vet Med Assoc, 2002 Apr 15, 220(8), 1203 - 6, 1162
Nonlethal clinical techniques used in the diagnosis of diseases of fish; Smith SA; Numerous nonlethal clinical techniques can be used on live fish to yield valuable diagnostic information . These techniques include skin, fin, and gill biopsies; bacteriologic cultures of gill or skin lesions; tissue and fluid aspiration; and radiography Most techniques can be performed on live fish without the use of anesthesia, although light sedation of the fish often simplifies the procedure, making the procedure more easily accomplished and less stressful on the fish . Because water conditions have a considerable effect on the health and well-being of aquatic animals, an in-house evaluation of water quality (eg, temperature, pH, ammonia, nitrites, nitrates, and salinity) is also paramount to any clinical diagnostic evaluation . As with domestic animals, a complete and accurate history and thorough external examination are prerequisite to the selection of appropriate diagnostic techniques as well as the formulation of any management or therapeutic plan . Through the correlation of clinical history, water quality variables, and results of diagnostic testing, an informed plan of action can be devised to correct acute or chronic problems in aquatic animals.

Ceska Gynekol, 2002 Mar, 67(2), 58 - 65
{Prediction of premature labor--multifactorial analysis of a prospective clinical study}; Mara M et al.; OBJECTIVE: To evaluate, which of selected anamnestic, laboratory and ultrasonographic (USG) parameters could contribute to the prediction of prematurity . DESIGN: Prospective, observational, clinical study . SETTING: Department of Obstetrics and Gynecology, 1st Faculty of Medicine and the General Faculty Hospital, Charles University, Prague . METHODS: 349 women with the singleton pregnancy were followed from the half of the 2nd trimester until the end of gestation . At each woman the anamnestic (age, parity, pregravid BMI, weight gain until 20th week, significant risk from patient's history, cigarette smoking, risk pregnancy symptoms until 20th week), laboratory (maternal serum concentration of AFP, hCG, and uE3/triple test/at 16th week, the blood count and ferritin concentration at 18th-20th week, bacteriological cultivation of the smear from the cervix at 34th-36th week), and USG (transvaginal cervicometry and doppler flowmetry of the uterine arteries at 18th-20th week) data were established . With the aid of one-dimensional and multi-dimensional analysis the dependence of completed gestational age and preterm delivery (before completed 37th week) on above mentioned parameters was tested . RESULTS: 314 women completed the study . We proved a significant dependence of prematurity on the following markers: risk pregnancy symptoms until 20th week (RR 2.94), abnormal triple test (RR 4.63), cultivation of pathogens from the cervix (RR 5.49), USG established cervical length (P < 0.0001), abnormal result of cervicometry (RR 19.02), both doppler parameters (RI of uterine arteries: P < 0.0001; presence of early diastolic notch: RR 2.84) . The results of multi-dimensional analysis confirmed superiority of USG cervicometry in prediction of both measured outcomes . CONCLUSION: The predictive value of some of selected anamnestic, laboratory, and USG markers of premature delivery was proved at random population of women with singleton pregnancy . The abnormal result of transvaginal USG cervicometry was the most significant predictor of prematurity . We recommend a routine performing of cervicometry (as a part of USG screening at 18th-20th week) for early selection of women with significantly increased risk of prematurity.

J Gastrointest Surg, 2001 Jul-Aug, 5(4), 364 - 70
Effect of platelet-activating factor antagonists (BN-52021, WEB-2170, and BB-882) on bacterial translocation in acute pancreatitis; de Souza LJ et al.; Bacterial translocation is an important source of pancreas infection in acute pancreatitis . The effect of platelet-activating factor (PAF) in the pathogenesis of acute pancreatitis has been proved in various studies . The aim of this study was to determine whether potent PAF antagonists influence bacterial translocation in acute pancreatitis . Acute pancreatitis was induced in 62 Wistar rats by injection of 2.5% sodium taurocholate into the biliopancreatic duct . The rats treated with PAF factor antagonists received intravenous injection of WEB-2170 (10 mg/kg), lexipafant (5 mg/kg), and BN-52021 (5 mg/kg) 30 minutes before induction of acute pancreatitis . Six hours after induction of acute pancreatitis, bacteriologic cultures and histologic scoring of tissues were performed . There was a statistically significant reduction in bacterial translocation to the mesenteric lymph nodes and liver but not to the pancreas of the rats treated with PAF antagonists . No significant increase in the intestinal bacterial population of any group was found . There were no statistical differences between the pancreatic histologic scores of the groups . PAF antagonists reduced bacterial translocation to distant sites other than the pancreas, preventing the bacterial dissemination that occurs in the early phase of acute pancreatitis and may have beneficial effects on the evolution of this disease.

Presse Med, 2002 Apr 6, 31(13), 603 - 6
{Portal vein thrombosis and Prevotella melanigenica revealing an appendicular abscess}; Paneri G et al.; INTRODUCTION: The misleading aspects of appendicitis are multiple . We report an observation, original not only from a clinical and bacteriological point of view but also because of the presence of a portal vein thrombosis . OBSERVATION: A 48 year-old man was hospitalized for prolonged fever . Examination revealed a thrombosis of the portal vein . Several hemocultures were positive for Prevotella melaninogenica . There was no abnormality in blood crasis and/or thrombophilia . Since the digestive and endoscopic control was negative, as well as the scanographic and sonographic exploration of the appendix area, exploratory laparotomy was performed and revealed an abscess on the appendix, which was responsible for the clinical, biological and radiological images . Appendectomy led to complete, immediate and permanent regression of the fever . COMMENTS: The discovery of a Prevotella-type germ disputes the pathogenicity of such an anaerobic germ, at distance from a site where it is normally saprophyte.

Braz J Infect Dis, 2002 Feb, 6(1), 29 - 39 Epub 2003 Mar 18.
Evaluation of disease patterns, treatment and prognosis of tuberculosis in AIDS patient; Atomiya AN et al.; Patterns of disease, diagnosis, treatment and prognosis of tuberculosis in 100 patients co-infected with AIDS at Casa da AIDS clinic was studied . Demographic characteristics were as follows: 76 male patients, 24 female patients, 67 caucasian, average 35.8 years-old (SD +/- 8.5) . Sexual transmission of HIV was reported in 68 patients . Pulmonary tuberculosis was seen in 40 patients, extrapulmonary in 11, and combined in 49 patients . In 63 patients, TCD(4)(+) counts were below 200/mm(3) when tuberculosis was diagnosed . Fifty-five patients had their diagnoses confirmed by bacteriological identification of Mycobacterium; either through direct observation and/or culture . Tuberculosis was treated with rifampin, isoniazid and pyrazinamide in 60 patients, reinforced treatment in 14 and alternative treatment in the other 13 patients . Tuberculosis therapy lasted up to 9 months in 66% of the patients . Fifty-four patients were treated with a two-drug antiretroviral regimen and the remaining 46 patients received a triple regimen, which included a protease inhibitor . Among the latter, 35 patients were co-treated with rifampin . The occurrence of hepatic liver enzyme abnormalities was statistically related to alternative antiretroviral regimens (p = 0.01) and to the co-administration of rifampin and protease inhibitor (p = 0.019) . Clinical resolution of tuberculosis was obtained in 74 patients . Twelve patients died during tuberculosis treatment . Resolution of tuberculosis was statistically significant related to antituberculosis treatment adherence (p = 0.001) . The risk of no response to the treatment was 1.84 times more frequent among patients treated with alternative regimens regardless of the duration of the therapy . We conclude that the characteristics of tuberculosis in HIV infected patients requires that special attention be directed to the types and duration of both antiretroviral and anti-TB therapy in order to achieve the highest level of care.

Med Trop (Mars), 2001, 61(6), 500 - 2
{Corneal complications of traditional local ocular treatment in the Democratic Republic of the Congo}; Mwanza JC et al.; The purpose of this retrospective study was to determine the relationship between the use of local traditional eye medicine and the occurrence of corneal ulcers . The study population included 53 patients who consulted from January 1998 to October 1999 at two hospitals in Kinshasa, Democratic Republic of the Congo, after visiting a traditional healer . Clinical examination of the eye was performed in all cases and bacteriological tests in most . Local traditional eye medicine is used in both urban and rural areas . Factors associated with the use of local traditional eye medicine include level of education and social class . A cause-and-effect relationship was found between the use of local traditional eye medicines and development or worsening of corneal ulcers . Peripheral corneal ulcers were the most common . Corneal perforation was more frequent in association with peripheral ulcers . Use of traditional eye medicine often leads to corneal ulcers with perforation and destruction of the eye in most cases . For this reason these practice must be curtailed . However further study is needed to identify the active agents in plants used by traditional healers as well as to determine their efficacy and toxicity for the eye.

Pneumologia, 2001 Jul-Sep, 50(3), 159 - 66
{Prophylactic measures in tuberculosis hotbeds}; Raduta M; Starting with the premise of preventing tuberculosis by watching the epidemiological succession (earliest discovery and medical attendance of new cases, interception of the transmitting ways by annihilating the hotbed and measures taken for the contacts, strengthening the specific resistance by the BCG vaccination and sanitary education) we have analyzed the application of these measures in adult cases, both bacteriologically confirmed (M+C+, M-C+) between 1995-2000 and found in those 280 contact children after the epidemiological investigation in Cluj-Napoca . The TSS/DOTS correctly and completely applied, no matter the place of application (hospital or ambulatory treatment) has drawn to a 75% rate of healings and debacillations in adults and to over 90% in children . Chronics and deaths have been registered in adults only through unconformity to treatment (failure + abandon + lost) . The measures applied to the contacts were correct, finding out children with only the benign type of tuberculosis and, exceptionally only, (1%) with more severe forms, no deaths being registered in this period . The measures applicable to the home hotbed, the sanitary education as well as the protective measures of the sanitary medical staff, employed to supervise and control tuberculosis admits improvement still being far from the theoretic ideal.

Rev Chir Orthop Reparatrice Appar Mot, 2002 Feb, 88(1), 51 - 61
{Secondary infection of joint implants: diagnostic criteria, treatment and prevention}; Lortat-Jacob A et al.; Peroperative contamination is the most frequent cause of infection after arthroplasty . For other cases of infection subsequent to bacteremia or a neighboring focus, it would be more appropriate to use the term "secondary" infections rather than hematogeneous infections . Arguments favoring secondary infection include long symptom-free interval between prosthesis implantation and the infectious episode, a causal germ not generally responsible for peroperative infection, presence of a distant infectious focus, positive blood culture, and a positive bacteriological sample from the prosthesis level showing the same strain as grown from the distant focus or blood samples . Both acute and chronic infections are observed, leading to prosthesis dysfunction . History taking generally identifies a neglected acute but transient episode . Search for a bacteriological diagnosis must be completed before initiating an antibiotic regimen . If detected very early, washing with open synovectomy and resection of suspicious tissue should be attempted in order to maintain the implant if possible . Local antibiotics have proven efficacy . Beyond a certain delay, treatment for chronic infection usually requires removing the prosthesis, cleaning the bone interface, and new arthroplasty delayed or not . Search for the portal must be undertaken early in order to initiate appropriate local treatment . The causal event may be any invasive procedure, with or without material implantation . The risk-benefit ratio for antibiotic prophylaxis remains to be determined.

Acta Radiol, 2002 Jan, 43(1), 44 - 7
Correlation of immunologic status with high-resolution CT and distributions of pulmonary tuberculosis; Yabuuchi H et al.; PURPOSE: To investigate the correlation of cluster of differentiation (CD)4 lymphocyte counts with high-resolution CT (HRCT) findings and distribution of pulmonary tuberculosis . MATERIAL AND METHODS: Thirty-seven bacteriologically proven pulmonary tuberculosis, clinically non-AIDS, patients underwent HRCT and CD4 lymphocyte counts in peripheral blood cells were obtained within 3 days after the CT examinations . Patients were categorized into four groups according to CD4 lymphocyte counts (A >800; B 800-500; C 500-200; D <200) . HRCT findings analyzed were as follows: typical, atypical, and mixed findings of post-primary tuberculosis, common, uncommon, and mixed distribution, and number of lobes involved . RESULTS: CD4 lymphocyte counts correlated with the degree of the mixture of atypical CT findings (rho=0.565, p<0.001) and the degree of the mixture of uncommon distribution (rho=0.431, p<0.01) . Number of involved lobes showed no statistically significant correlation (rho=0.209, p=0.21) . CONCLUSION: In patients with low CD4 levels, atypical HRCT findings co-exist with typical findings, and uncommon sites are involved in addition to common sites.

Clin Orthop, 2002 May, (398), 114 - 20
Unusual manifestations of osteoarticular tuberculosis; Babhulkar SS et al.; Unusual manifestations of osteoarticular tuberculosis, especially tubercular osteomyelitis, are described . Diagnostic problems may arise and lead to delay in treatment if these conditions are not considered in the differential diagnosis . The importance of bacteriologic and histopathologic confirmation of the disease is stressed.

Presse Med, 2002 Mar 23, 31(11), 503 - 4
{Isolation of three species of Nocardia in a patient receiving long-term corticosteroid therapy}; Hidri N et al.; INTRODUCTION: Nocardia are saprophyte bacteria of the environment responsible for systemic infections in immunodepressed patients, due essentially to long-term corticosteroids . OBSERVATION: A patient having received corticosteroids for sarcoidoses for a year was hospitalised because of disseminated granulomatosis (neurological, respiratory, abdominal and cutaneous) . Culture of various bacteriological samples isolated three species of Nocardia: N . otitidiscaviarum in uretheral pus and pus from the right gland, N . nova and N . asteroides in respiratory samples (protected distal sampling and broncho-alveolar washing) . COMMENTS: Other than the mixed Nocardia infections described habitually, infections with two different species of Nocardia have recently been reported . Our case report is the first to have isolated three concomitant species of Nocardia.

Infect Immun, 2002 May, 70(5), 2414 - 8
Vaccination of pregnant dams with intimin(O157) protects suckling piglets from Escherichia coli O157:H7 infection; Dean-Nystrom EA et al.; Cattle are important reservoirs of enterohemorrhagic Escherichia coli (EHEC) O157:H7 that cause disease in humans . Both dairy and beef cattle are asymptomatically and sporadically infected with EHEC . Our long-term goal is to develop an effective vaccine to prevent cattle from becoming infected and transmitting EHEC O157:H7 to humans . We used passive immunization of neonatal piglets (as a surrogate model) to determine if antibodies against EHEC O157 adhesin (intimin(O157)) inhibit EHEC colonization . Pregnant swine (dams) with serum anti-intimin titers of < or =100 were vaccinated twice with purified intimin(O157) or sham-vaccinated with sterile buffer . Intimin(O157)-specific antibody titers in colostrum and serum of dams were increased after parenteral vaccination with intimin(O157) . Neonatal piglets were allowed to suckle vaccinated or sham-vaccinated dams for up to 8 h before they were inoculated with 10(6) CFU of a Shiga toxin-negative (for humane reasons) strain of EHEC O157:H7 . Piglets were necropsied at 2 to 10 days after inoculation, and intestinal samples were collected for determination of bacteriological counts and histopathological analysis . Piglets that ingested colostrum containing intimin(O157)-specific antibodies from vaccinated dams, but not those nursing sham-vaccinated dams, were protected from EHEC O157:H7 colonization and intestinal damage . These results establish intimin(O157) as a viable candidate for an EHEC O157:H7 antitransmission vaccine.

Zhonghua Jie He He Hu Xi Za Zhi, 2002 Jan, 25(1), 12 - 4
{Study on epidemic trend and control policy of tuberculosis in Sichuan province}; Wu J et al.; OBJECTIVE: To evaluate efficacy of tuberculosis control policy and provide scientific evidence for drawing up tuberculosis control program . METHODS: Data of the epidemiological survey for tuberculosis in Sichuan in 2000 were analyzed and part of the results were compared with that before . RESULTS: The prevalence of active pulmonary tuberculosis, the bacteriological positive prevalence and smear positive prevalence of pulmonary tuberculosis in 2000 were 544/100 000, 250/100 000 and 144/100 000, respectively, decreased by 41.8%, 30.0% and 35.0% respectively in comparison with 1990, and the annual reduction rates were 5.3%, 3.5% and 4.2% respectively during the past 10 years . The mortality of tuberculosis and pulmonary tuberculosis was 24/100 000 and 22/100 000, respectively, decreased by 20.0% and 12.0% respectively in comparison with 1990 . The prevalence of tuberculosis in minority area and mountainous area were higher than that in city, countryside and hills . 71% of infectious patients were newly detected, 33.3% of which were re-treatment cases . The economic status was found the key factor affecting the implementation of tuberculosis control . CONCLUSIONS: The modern tuberculosis control strategy, which mainly targeted infectious patients and advocated DOTS policy, is the guarantee of sustainable development of tuberculosis control, though the prevalence of pulmonary tuberculosis decreased slowly in Sichuan during the past 10 years.

Zhonghua Jie He He Hu Xi Za Zhi, 2002 Jan, 25(1), 8 - 11
{Report on fourth epidemiological survey for tuberculosis in Heilongjiang province}; Group Of Technical Guidance For Tuberculosis Epidemiological Survey In Heilongjiang Province Office Of Tuberculosis Epidemiological Survey In Heilongjiang Province et al.; OBJECTIVE: To investigate the epidemiological trend of tuberculosis, to evaluate the efficacy of control measures and to provide scientific evidence for provincial 2001 approximately 2010 tuberculosis control programme . METHODS: Tuberculin testing was carried out and BCG scar was examined among 0 approximately 14 years old children; fluroscopy was carried out for >/= 15 years old population and children of tuberculin testing positive; chest X-ray film, sputum smear and culture, drug sensitivity test were done for the patients of fluroscopy abnormal; the survey of tuberculosis infection rate for all population was carried out in 2 investigation points; a retrospective study of tuberculosis mortality was conducted at all investigation points; social economic study was done for the active pulmonary tuberculosis cases . RESULTS: The overall examination rate was more than 95% . The prevalence of active pulmonary tuberculosis was 512/100 000, the prevalence of smear positive pulmonary tuberculosis was 121/100 000 and the prevalence of bacteriological positive pulmonary tuberculosis was 146/100 000 . In comparison with 1979, the annual reduction rates were 3.2% for the prevalence of active pulmonary tuberculosis and 2.0% for the prevalence of smear positive pulmonary tuberculosis.In comparison with 1990, the annual reduction rates were 1.49% and 0, respectively . The prevalence increased slightly in city and decreased slowly in countryside . CONCLUSIONS: The smear positive prevalence has not decreased since 1990 . The governments at different levels must pay more attention to tuberculosis control programme, increase the budget, strengthen law management, implement DOTS strategy.

Zhonghua Jie He He Hu Xi Za Zhi, 2002 Jan, 25(1), 3 - 7
{Report on fourth national epidemiological sampling survey of tuberculosis}; National Technic Steering Group Of The Epidemiological Sampling Survey For Tuberculosis et al.; OBJECTIVE: To investigate the epidemiological trend of tuberculosis, to evaluate the efficacy of control measures and to provide scientific basis for making National Tuberculosis Control Programme 2001 approximately 2010 . METHODS: Tuberculin testing was carried out among 0 approximately 14 years old children; fluroscopy was carried out for >/= 15 years old population and children with >/= 10 mm reaction of tuberculin testing; chest X-ray film, sputum smear and culture were done for the patients of fluroscopy abnormal and suspects of tuberculosis symptom (persistent cough for 3 weeks or more); drug sensitivity test was done for the patients with culture positive; a retrospective study of tuberculosis mortality in 1999 was conducted at all investigation points; social economic study was done for the active pulmonary tuberculosis cases; the survey of tuberculosis infection rate for all population was carried out in 59 investigation points . RESULTS: The population actually examined in this survey numbered 365 097 . The examination rate was more than 95% . The prevalence of active pulmonary tuberculosis was 367/100 000, the prevalence of smear positive pulmonary tuberculosis was 122/100 000 and the prevalence of bacteriological positive pulmonary tuberculosis was 160/100 000 . In comparison with 1979, the annual reduction rates were 4.5% for the standardized prevalence of active pulmonary tuberculosis and 3.8% for the standardized prevalence of smear positive pulmonary tuberculosis . In comparison with 1990, the annual reduction rates were 5.4% and 3.2%, respectively . The smear positive prevalence standardized showed a 44.4% decrease in the regions of implementing project of Health V but only 12.3% decrease in the regions without the project . The prevalence in the west region was higher than national average prevalence . CONCLUSIONS: The epidemic of tuberculosis is still serious and prevalence decrease was slow . The governments at different levels must pay more attention to tuberculosis control programme, increase budget, implement DOTS strategy.

Acta Ophthalmol Scand, 2002 Apr, 80(2), 183 - 7
Treatment of acute neonatal bacterial conjunctivitis: a comparison of fucidic acid to chloramphenicol eye drops; Normann EK et al.; PURPOSE: To compare the clinical and bacteriological effects of fucidic acid (Fucithalmic: 1.0%) and chloramphenicol (Minims(R): 0.5%) eye drops in neonates with a clinical diagnosis of acute conjunctivitis of suspected bacterial origin . METHODS: A TOTAL OF 456 N: ewborns with gestational age > 32 weeks with acute conjunctivitis of suspected bacterial origin acquired within the first 28 days of life were included in the study . They were randomly assigned to a 7-day treatment with eye drops using either fucidic acid (1.0%) (Fucithalmic) applied twice per day, or chloramphenicol (0.5%) (Minims Chloramphenicol) applied six times per day . The subjects were followed up with two visits (on days 1 and 8) and by telephone 2 weeks after the end of treatment . RESULTS: Eighty-nine per cent of the neonates treated with Fucithalmic were cured, compared to 87.9% of those treated with Minims Chloramphenicol (n.s) . The drug was used as instructed in 90.7% of patients treated with Fucithalmic and in 78.0% of those treated with Minims Chloramphenicol (P < 0.001) . CONCLUSION: Treating neonatal conjunctivitis with fucidic acid is easier than with chloramphenicol and is equally effective.

Angiology, 2002 Mar-Apr, 53(2), 191 - 7
Clinical, bacteriologic and echocardiographic evaluation of infective endocarditis in Ankara, Turkey; Heper G et al.; This study consists of a retrospective evaluation of microbiologic, echocardiographic, and clinical characteristics of patients with infective endocarditis seen at Turkiye Yuksek Ihtisas and SSK Ihtisas Hospitals during the previous 5 years to provide a basis for comparison with other series . The study was performed retrospectively . The mean age of the patient population, which consisted of 74 cases, was considerably low (24.6+/-12.3 yr) . The majority of the patients were male (male/female = 1.96) . Rheumatic valvular disease was the underlying cardiac pathosis in 66% of the cases . Congestive heart failure, embolic episodes, and mortality were more frequent among those with echocardiographically demonstrable cardiac vegetations . The microbiologic profile was considerably different from that of other series . In addition, this population showed a higher rate of congestive heart failure compared to other series . The patients with infective endocarditis in this series in the previous 5 years were found to be different from series reported from western countries.

Rev Argent Microbiol, 2002 Jan-Mar, 34(1), 45 - 51
{Study of Mycobacterium bovis in milk using bacteriological methods and the polymerase chain reaction}; Perez A et al.; The frequency of Mycobacterium bovis detection in milk samples obtained from infected animals was explored in an intensive dairy area in Argentina . To this end, an "in house" polymerase chain reaction (PCR) method was developed using Mycobacterium tuberculosis Complex specific INS1-INS2 primers, and its performance was compared with that of bacteriological methods . The decontamination procedures previous to culture reduced M . bovis viability . The pathogen was identified in milk samples from 1 of 143 infected cows and in none of 43 uninfected ones . Even though PCR sensitivity was found to be 2-20 times higher than that of bacteriology in experimentally inoculated milk samples, all 186 field samples resulted negative by PCR, including the bacteriologically-confirmed one . In spite of the high prevalence of bovine tuberculosis in Argentinian dairy herds, the detection of M . bovis in milk is an unusual finding.

Int J Tuberc Lung Dis, 2002 Mar, 6(3), 253 - 8
{Peritoneal tuberculosis: 27 cases in the suburbs of northeastern Paris}; Thoreau N et al.; SETTING: Peritoneal tuberculosis did not disappear from France during the 1990s . OBJECTIVE: To determine the characteristics of peritoneal tuberculosis in the north-eastern suburbs of Paris . METHOD: A retrospective study of cases diagnosed with peritoneal tuberculosis between 1990 and 1998 in five suburban hospitals in the north-east region of Paris . RESULTS: Twenty-seven cases of adult peritoneal tuberculosis were diagnosed . There were nine women and 18 men, with a mean age of 37.5 years, 88.9% of whom were foreign born . General and digestive symptoms--abdominal pain and/or ascites--were present in 96.3% of the cases . The mean delay in treatment was 30 days . Peritoneal involvement was isolated in 25.9% of cases, and associated with pulmonary tuberculosis in 40.7% or hepatic tuberculosis in 25.9% . Co-infection with HIV (human immunodeficiency virus) was present 14.8% of cases . Culture of ascites fluid, laparoscopy and/or laparotomy (n = 17), with directed biopsy, aided in the formal diagnosis of peritoneal tuberculosis in 59.2% . One relapse and one case of multiresistance were observed . The mean duration of treatment was 9 months (range 6-12 months) . Three patients received treatment with corticosteroids, and 91.2% of the patients achieved cure without sequelae . CONCLUSION: Peritoneal tuberculosis is not rare in the Paris region . The diagnosis should be suspected in case with ascites and fever, and can be confirmed by laparoscopy with sampling for bacteriology and histology . The methods of treatment need to be standardised.

Rev Biol Trop, 2001 Jun, 49(2), 517 - 23
Effect of storage temperatures on growth and survival of Escherichia coli O157: H7 inoculated in foods from a neotropical environment; Arias ML et al.; Escherichia coli O157: H7 has emerged as a new pathogen and is found worldwide . We studied the effect of several storage temperatures on the survival of this bacterium in common foods from a neotropical environment (Costa Rica) because at least seven clinical cases have been reported from the country, and no epidemiological link or probable food association has been described . High (10(6)-10(8) CFU/ml) and low (10(4)-10(6) CFU/ml) populations of E . coli were inoculated (three replications) in ground meat, chopped cabbage, chicken giblets and pasteurized milk and incubated at 0, 6 and 12 degrees C for 24, 48 and 72 h . Vegetables and milk were also stored at 22 degrees C for the same periods . The E . coli O157: H7 enumeration was done according to the methodology described in the Bacteriological Analytical Manual . Populations of E . coli O157: H7 showed either an increasing or decreasing trend, according to temperature, time or food base . Our data indicate that E . coli O157: H7 is capable of surviving and growing in meat, cabbage, milk and chicken giblets; food items commonly consumed by Costa Ricans.

Zentralbl Chir, 2002 Mar, 127(3), 165 - 73
{Diagnostic approach to sepsis - state of the art}; Brunkhorst FM et al.; Early diagnosis of the different severities of septic inflammation is important for early implementation of specific therapies . Sepsis and severe sepsis are accompanied by clinical and laboratory signs of systemic inflammation . However, patients suffering from non-infectious inflammation may present with similiar signs and symptoms making it difficult to diagnose infection based on clinical findings alone . Bacteriological evidence of sepsis, though definitive and specific, may not be obtainable, is time-consuming and even may not occur concurrently with clinical signs of sepsis . It is therefore important to identify markers, which, by enabling an early diagnosis of sepsis and organ dysfunction, would allow early specific therapeutic interventions . Wheras C-reactive Protein is a more sensitive parameter for the diagnosis of non-systemic infections, Procalcitonin seems to be a useful parameter to improve the diagnosis and monitoring of therapy in patients with severe sepsis and septic shock.

Int J Tuberc Lung Dis, 2002 Mar, 6(3), 259 - 65
Chemotherapeutic treatment for spinal tuberculosis; van Loenhout-Rooyackers JH et al.; AIM: To evaluate whether 6 months of chemotherapy for patients with spinal tuberculosis prevents relapse as effectively as more than 6 months of chemotherapy . METHOD: Literature review . Medline search including references, from January 1978 to November 2000 . Inclusion criteria for publications: diagnosis of spinal tuberculosis confirmed bacteriologically and/or histologically, or probable on the basis of clinical and radiological parameters; treatment regimen (whether or not in combination with surgery) included isoniazid (H), rifampicin (R) and pyrazinamide (Z); follow-up period after completion of treatment of 12 months or more . Exclusion criteria: patients with relapse who had previously been treated adequately for tuberculosis . OUTCOME PARAMETERS: Relapse rate . RESULTS: Four publications were found with HRZ regimens of 6 months' duration and 10 publications with HRZ regimens of >6 months' duration . A number of patients had received HRE (E = ethambutol) for > or = 9 months . In the results, no distinction was made between treatment groups . HRZ for 6 months led to a relapse rate of 0% (0/56, 95%CI 0.0-6.4); follow-up after surgical intervention ranged from 6 to 108 months . HRZ for > or = 9 months (> or = 119 patients) or HRE for > or = 9 months (< or = 71 patients) led to a relapse rate of 2% (4/218, 95%CI 0.6-5.0); follow-up after surgical intervention was 6-168 months . Despite the small number of studies, 6 months of therapy is probably sufficient for patients with spinal tuberculosis.

Int J Tuberc Lung Dis, 2002 Mar, 6(3), 192 - 7
Implementation of the DOTS strategy for tuberculosis in the Leningrad Region, Russian Federation (1998-1999); Ruohonen RP et al.; SETTING: The DOTS pilot project for tuberculosis control in the Leningrad Region of the Russian Federation, supported by the Finnish Lung Health Association and the World Health Organization (WHO) . OBJECTIVE: To assess the efficacy of WHO-recommended standard short-course chemotherapy in newly detected pulmonary tuberculosis cases positive by smear or with extensive lung lesions suggestive of culture positivity, under project conditions . METHODS: Analysis of data on case detection, sputum smear conversion and treatment outcome based on standardised (WHO) registers from districts and a central computerised database . RESULTS: Of 859 adult pulmonary tuberculosis cases (292 smear-positive) notified in the Leningrad Region in the study period, 312 new cases were included in the project . The sputum conversion rate at the end of the second month was 82.8% and 91.1% at the end of the third month . Of bacteriologically confirmed cases, 71.3% were successfully treated, 4.9% died, 11.7% defaulted and 8.1% failed . CONCLUSION: In the first year of the pilot project in the Leningrad Region, the DOTS strategy revealed feasibility and moderate efficacy among new pulmonary tuberculosis cases who were either smear-positive or showed extensive lung lesions on chest X-ray, and who were therefore of high epidemiological and medical priority.

J Wound Care, 2002 Mar, 11(3), 107 - 10
Effect of bacteriological status on pressure ulcer healing in patients with advanced cancer; Sopata M et al.; OBJECTIVES: This study aimed to identify the quantitative and qualitative bacteriological status of pressure ulcers in patients with advanced cancer, and the effects on the healing process . METHOD: We recruited 34 patients with advanced cancer who had 38 superficial grade II and III pressure ulcers . Patients were randomly allocated to treatment with Lyofoam/polyurethane foam dressing (Seton) or Aquagel/hydrogel dressing (Wytw.Opatrunkow) . Efficacy, treatment times and healing rates were noted . Qualitative studies were undertaken on 38 pressure ulcers and quantitative bacteriological studies on 19 ulcers . RESULTS: There was no statistical difference between the two treatment groups in efficacy, healing rates and treatment times . Bacteriological assessment identified 92 species . CONCLUSION: The bacteria did not cause any clinical signs of infection . Variations in the number and types of bacteria in individual wounds did not correlate to the grade of ulcer or the dressing used.

Int J Tuberc Lung Dis, 2002 Feb, 6(2), 121 - 9
Effect of screening of immigrants on tuberculosis transmission; Verver S et al.; SETTING: In The Netherlands all immigrants from highly endemic countries undergo obligatory entry screening by X-ray, followed by voluntary half-yearly screening for 2 years . OBJECTIVE: To estimate the contribution of screening of immigrants to reductions in tuberculosis transmission . DESIGN: All bacteriologically confirmed tuberculosis patients diagnosed between 1994 and 1999 with mycobacterial isolates exhibiting identical DNA fingerprints were assigned to clusters . Clusters were assumed to be a consequence of recent transmission and to have had the first patient as their source case . Among patients with pulmonary tuberculosis from highly endemic countries, the characteristics of source patients were compared with those of non-clustered patients . RESULTS: Of the 1438 selected patients, 187 (13%) were the first in a cluster, 386 (27%) were in a cluster but were not the first case, and 865 (60%) were not clustered . Independent risk factors for being the first in a cluster were young age, nationality, early year of diagnosis, longer duration of treatment and no concurrent extra-pulmonary tuberculosis . In univariate analysis, passively detected patients and patients with a long duration of stay in The Netherlands were more likely to be the first in a cluster than patients detected by screening and recent arrivals, respectively . However, these variables were strongly associated . CONCLUSION: Screening of immigrants can reduce tuberculosis transmission . This effect is in part due to confounding by duration of stay.

Int J Tuberc Lung Dis, 2002 Jan, 6(1), 85 - 8
Increase in tuberculosis incidence among the staff working at the Tuberculosis Demonstration and Training Centre in Addis Ababa, Ethiopia: a retrospective cohort study (1989-1998); Eyob G et al.; The incidence rate of tuberculosis was studied among the staff of the Tuberculosis Demonstration and Training Centre (TDTC) of Addis Ababa between 1989 and 1998, by reviewing all clinical charts of the 175 staff members for evidence of tuberculosis . During the study period, 24 cases of tuberculosis were diagnosed, including 12 who were bacteriologically confirmed . The incidence rate of tuberculosis increased from 1695 per 100000 person-years (py) in 1989 to 5556/100000 py in 1998 (test for trend, P < 0.001) . Urgent measures are required for better protection of the staff from human immunodeficiency virus infection and tuberculosis.

Int J Tuberc Lung Dis, 2002 Jan, 6(1), 19 - 24
Contact examination for tuberculosis in Hong Kong is useful; Noertjojo K et al.; SETTING: The tuberculosis programme of the Hong Kong Government Tuberculosis and Chest Service . OBJECTIVE: To determine the outcome of examination of household contacts in Hong Kong . DESIGN: A retrospective cohort study of all household contacts of 970 randomly selected index cases from a total of 5757 registered for treatment with the Chest Service . RESULTS: Of 2678 household contacts (three/index case) identified, 90% were examined; 41 active cases were found, at a rate of 1720/100000 (95%CI 1238-2329) . The rate was highest among two extremes of age, 3604/100000 (95%CI 990-3615) in children < or = 5 years and 3347/100000 (95%CI 1456-6489) in those >60 years of age . Contacts of index cases whose sputum smear and culture were positive had the highest rate of disease, 2904/100000 (95%CI 1669-4673); but contacts with negative bacteriology also had a high rate of 1478/100000 (95%CI 678-2789) . Active cases identified through contact tracing could be source cases rather than secondary cases . Eight per cent of children aged < or = 5 years had positive tuberculin reactions; as BCG vaccination is given to all newborns, with 99% coverage in Hong Kong in the past 30 years, it was difficult to estimate the rate of infection in these children . CONCLUSION: In Hong Kong, an area with an intermediate burden of tuberculosis, contact investigation is a very useful procedure for active case finding.

Ned Tijdschr Geneeskd, 2002 Mar 16, 146(11), 518 - 20
{Recurrent otitis media and mastoiditis due to atypical mycobacteria}; Vreede RW et al.; An eleven-year-old girl was operated on due to right-sided chronic otitis media with effusion . After three months, an impressive enlargement of the mucosal lining developed, for which thorough debridement of the middle ear and mastoid was performed . Histological examination revealed a granulomatous inflammation, with negative Ziehl-Neelsen staining . Standard bacteriological cultures revealed no pathogenic micro-organisms . Three weeks later the same clinical picture developed, once again followed by extensive surgical debridement . After a thorough diagnostic work-up an atypical mycobacterium was found, namely Mycobacterium abscessus--formerly named M . chelonei subspecies abscessus . Following appropriate antibiotic therapy the patient was symptom-free . Mycobacterial infections should be part of the differential diagnosis of persistent otorrhoea.

Rev Pneumol Clin, 2001 Dec, 57(6), 423 - 6
{Radiographic and bacteriologic data on pulmonary tuberculosis in Bamako as a function of HIV status}; Kayantao D et al.; This prospective study included patients treated for tuberculosis between January 998 and April 1999 in the pneumology unit of the Point G Hospital in Bamako . The purpose was to analyze chest x-ray and bacteriological findings in HIV+ and HIV- patients . All patients had clinical and radiographic signs suggestive of tuberculosis with one or several sputum samples and HIV serology . Among the 127 patients, 36 were HIV positive (28.3%) . There was no sex predominance in the HIV+ patients (p = 0.3) . The most common radiographic aspect associated nodules and infiltration irrespective of the immune status (p = 0.014) . Characteristic features of the chest x-rays in HIV-positive patients were: frequent military forms and rare cavernous forms (p = 0.007) . Sputum tests were positive more often in HIV-negative than HIV-positive patients (p = 0.0003) . The diagnosis of tuberculosis was retained in 11.7% of the patients with negative microbiology despite repeated samples . A normal chest x-ray was observed solely in one HIV-negative patient.

J Clin Microbiol, 2002 Apr, 40(4), 1475 - 80
Identification of the Brucella melitensis vaccine strain Rev.1 in animals and humans in Israel by PCR analysis of the PstI site polymorphism of its omp2 gene; Bardenstein S et al.; Adverse effects of strain persistence and secretion in milk have been encountered with the Brucella melitensis vaccine strain Rev.1 . Field isolates obtained from vaccinated animals and from a human resembled the vaccine strain Rev.1 by conventional bacteriological tests . The lack of a specific molecular marker that could specifically characterize the commercial vaccine strain prevented confirmation of the homology of the Rev.1-like field isolates to the vaccine strain . The composition of the omp2 locus from two gene copies with differences in their PstI restriction endonuclease sites was used to establish an epidemiologic fingerprint for the omp2 gene in the Rev.1 vaccine strain . Primers designed to amplify DNA sequences that overlap the PstI site revealed a single 282-bp DNA band common to all Brucella spp . Agarose gel electrophoresis of the PstI digests of the PCR products from strains 16M and the vaccine strain Rev.1 revealed a distinctive profile that included three bands: one band for the intact 282-bp fragment amplified from omp2a and two bands resulting from the digestion of the amplified omp2b gene fragment, 238- and 44-bp DNA fragments, respectively . Amplified fragments of 37 Rev.1-like isolates, including 2 human isolates, also exhibited this pattern . In contrast, DNA digests of all other Israeli field isolates, including atypical B . melitensis biotype 1 and representatives of the biotype 2 and 3 isolates, produced two bands of 238 and 44 bp, respectively, corresponding with the digestion of both omp2a and omp2b genes . This method facilitates identification of the Rev.1 vaccine strain in both animals and humans in Israel.

J Am Vet Med Assoc, 2002 Mar 15, 220(6), 794 - 7
Microbiologic evaluation of commercial probiotics; Weese JS; OBJECTIVE: To evaluate contents of commercial probiotic products marketed for veterinary or human administration . DESIGN: Microbiologic culture assay . SAMPLE POPULATION: 8 veterinary probiotics and 5 human probiotics . PROCEDURE: Quantitative bacteriologic culture was performed on all products, and isolates were identified via biochemical characteristics . Comparison of actual contents versus label claims was performed . RESULTS: Label descriptions of organisms and concentrations accurately described the actual contents of only 2 of 13 products . Five veterinary products did not specifically list their contents . Most products contained low concentrations of viable organisms . Five products did not contain 1 or more of the stated organisms, and 3 products contained additional species . Some products contained organisms with no reported probiotic effects; some of these organisms could be pathogens . CONCLUSIONS AND CLINICAL RELEVANCE: Most commercial veterinary probiotic preparations are not accurately represented by label claims . Quality control appears to be poor for commercial veterinary probiotics.

Eur J Nucl Med Mol Imaging, 2002 Apr, 29(4), 547 - 51 Epub 2002 Feb 23.
Imaging of low-grade bone infection with a technetium-99m labelled monoclonal anti-NCA-90 Fab' fragment in patients with previous joint surgery; Ivancevic V et al.; Low-grade bone infection represents a serious clinical problem . Diagnostic options are often insufficient, yet the therapeutic implications of proven disease are important, especially in patients with prosthetic joint replacement . Technetium-99m labelled monoclonal anti-NCA-90 granulocyte antibody Fab' fragment (MN3 Fab') has been shown to be useful in bone and joint infection, but there are no data specifically referring to low-grade bone infection . We therefore analysed 38 scans in 30 consecutive patients (age range, 30-85 years; median age, 62 years) referred for suspected low-grade bone infection . There were 17 patients (21 scans) with total hip arthroplasty (THA), six with total knee arthroplasty (TKA), three who had undergone hip or knee surgery for trauma and five (seven scans) with resected hips and no endoprostheses (Girdlestone situations); one of these five patients had been investigated before with THA in situ and another prior to surgery for low-grade coxitis . There were no patients with rheumatoid arthritis as the underlying disease . Results were verified by means of bacteriological cultures, histopathological findings and/or follow-up and compared with the respective Zimmerli scores, which were used for clinical assessment of inflammatory activity . In one patient, the final diagnosis could not be established . One, 5 and 24 h after intravenous injection of up to 1.1 GBq of MN3 Fab', whole-body and planar scans were performed using a dual-head gamma camera . Scans were analysed visually and semiquantitatively adopting an arbitrary score ranging from 0 to 3 . There were 13 true positive, 14 true negative and 10 false positive outcomes, yielding an overall sensitivity of 100%, an overall specificity of 58%, an accuracy of 73% and positive and negative predictive values of 57% and 100%, respectively . In patients with THA or TKA, accuracy was 81% and 80%, respectively, while it dropped to 43% in patients with Girdlestone situations owing to a high proportion of false positive findings (4/7) in this subgroup . Scintigraphic score was 1 in all of the false positive and in 11/13 true positive findings . The two remaining true positive findings displayed scintigraphic scores of 2 and 3, respectively . Scintigraphic and Zimmerli scores were loosely correlated (Spearman rho=0.38, P<0.05) . Infection was excluded in 22/24 investigations with Zimmerli scores of <6 . In this group, there were 13 scintigraphically true negative, nine false positive outcomes, and just two true positive outcomes . In 11/12 investigations with Zimmerli scores of 6 or 7, infection was verified and scintigraphic outcome was accordingly true positive, while the remaining patient was true negative . In conclusion, MN3 Fab' scintigraphy proved to be highly sensitive but not specific in diagnosing low-grade infections of the hip and knee regions in patients with previous joint surgery . The method seems reliable in excluding but not in proving the presence of infection . MN3 Fab' scintigraphy should not be applied in patients with Girdlestone situations . Assessment of infection using the Zimmerli score was more reliable than MN3 Fab' scintigraphy in this group of patients without rheumatoid arthritis as the underlying disease . Considering results from the literature concerning leucocyte scintigraphy, MN3 Fab' scintigraphy may be clinically useful in evaluating low-grade bone infection in THA and TKA patients with Zimmerli scores above 5 and concomitant rheumatoid arthritis or other inflammatory diseases.

J Dairy Sci, 2002 Feb, 85(2), 378 - 83
Influence of estrus on somatic cell count in dairy goats; McDougall S et al.; The effect of estrus on the somatic cell count (SCC) of goat's milk was examined by inducing estrus in 24 of 48 seasonally anestrus, lactating dairy goats . Goats were blocked by infection status and ranked on SCC from three preceding herd tests and randomly allocated (within block) to the following three treatment groups: a) "Short," in which an intravaginal progesterone-releasing device was inserted for 12 d plus equine chorionic gonadotropin and dinoprost tromethamine 2 d before device removal (n = 12), b) "Long," in which an intravaginal progesterone-releasing was inserted for 17 d plus equine chorionic gonadotropin on the day of device removal (n = 12), or c) "Control," in which the goats were left as untreated controls (n = 24) . Bacteriological status of each gland of each goat was determined before and after synchronization (d -23 and +13) and SCC and milk volumes were determined on d -2, 0, 1, 2, 3, 4, 14, and 25, where d 0 was the day of intravaginal device removal . Goats in the Short group were in estrus before those of the Long group, who were, in turn, in estrus before the Control group . The log10 and log10 absolute SCC (SCC cells/ml x volume) were higher in the Short than in the Control group on d 1, 2, 3, and 4, whereas those of the Long group were higher than those of the Control group on d 2 and 4 . These data indicate that estrus resulted in an increase in SCC, and that the increase in SCC was independent of the decline in milk volume at estrus.

Leuk Lymphoma, 2001 Nov-Dec, 42(6), 1255 - 64
High dose cyclophosphamide plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) in the treatment of follicular, low grade non-Hodgkin's lymphoma: CALGB 9150; Lichtman SM et al.; The main objectives of this study were to determine the feasibility of administering high doses of cyclophosphamide plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) every 14-21 days to patients with follicular small cleaved cell lymphoma . For each patient, the treatment was not considered feasible if fewer than four cycles of cyclophosphamide chemotherapy could be administered on schedule (i.e . at least every 29 days) or (1) hospitalization of the patient for longer than three days was necessary for neutropenic fever (38 degrees C) or bacteriologically documented infection in > 50% of the cycles, or (2) grade > or = 2 hemorrhage in association with thrombocytopenia of grade > or = 3 severity occurred in > 50% of the cycles or (3) non-hematologic toxicity (excluding nausea/vomiting and alopecia) of grade > or = 3 occurred in > 50% of cycles . The goal was to have a treatment program feasible in 75% or more of the treated patients . The secondary objectives were to determine the toxicities, the complete and partial response rates, and the time to treatment failure (TTF) . The trial also attempted to assess the effectiveness of this treatment program in eradicating Bcl-2 rearrangements by PCR, and to assess complete remission duration in relationship to PCR results in patients who respond to this chemotherapy program . Patients were required to have histologically documented non-Hodgkin's lymphoma of the subtypes follicular, predominantly small cleaved cell (IWF-B) or follicular mixed, (IWF-C) . Patients were required to have Stage IV disease including histologic evidence of bone marrow involvement . Measurable disease was required and patients were also required to have one of the following risk factors: > or = 2 extranodal sites, node or nodal group > or = 5 cm . Submission of fresh bone marrow for molecular genetic studies for the presence of Bcl-2-Ig fusion DNA was mandatory in previously untreated patients . Patients had to be between 18 and physiologic age 55 years (carefully selected patients over age 55 years were also eligible), expected survival > 2 years, performance status 0-1, and have adequate renal, hepatic and bone marrow function, and a cardiac ejection fraction > or = 50% . Cyclophosphamide 4.5 g/m2 i.v . was given with mesna every 14 days with rhG-CSF support . Twenty-nine patients were accrued to this trial . The median follow-up time is 5.0 years, with a range of 2.5-6.7 years . The overall response rate was 75% (9 CRs 37.5%, 9PRs 37.5%) . The median duration of survival is 5.53 years . The 1-year estimated probability of freedom from treatment failure was 50% and of survival at 1 year was 92% . No strong association was observed between TTF and age, symptomatic stage, histology performance status, number of extranodal sites or baseline Bcl-2 status . At 3 years the survival of all patients was 78% and failure free survival was 17% . 15 (62%) of the 24 eligible previously untreated patients met the criteria for feasibility specified in the protocol . The 95% CI for the feasibility rate is (44 and 82%) . Twenty-two of the 24 (92%) previously untreated patients had specimens submitted for testing for Bcl-2 rearrangements . Thirteen of the 22 (59%) were found to have rearrangements at baseline . Post-treatment specimens were submitted for seven of the 13 patients . Four of the seven converted to Bcl-2 negative following treatment . Eight of 13 Bcl-2 positive patients (62%) had a clinical response to treatment . The 95% exact binomial CI for the total response rate in this subgroup is (28 and 88%) . This study demonstrates that repetitive doses of cyclophosphamide at 4.5 g/m2 every two weeks with rhG-CSF support can be administered to selected younger patients with advanced follicular lymphoma with morphologic involvement of the bone marrow with acceptable non-hematologic toxicity.

Ned Tijdschr Tandheelkd, 1993 May, 100(5), 235 - 8
{A.a.: the bacterium with the long name}; Mikx FH; The introduction of Kodak's chairside test kit, Evalusite, for Actinobacillus actinomycetemcomitans (A.a.) and two other oral bacteria has stimulated this study of the relation between A.a . and periodontal destruction . A.a . has been associated with oral abscesses, brain abscesses, endocarditis and localized juvenile periodontitis . However, in all periodontal studies A.a . also has been observed in 'ordinary' periodontal pockets and subjects without active periodontal destruction . Based on longitudinal studies it is concluded, that there is no proof for a causal relationship between A.a . and periodontal destruction, that the detection of A.a . is not indicative for future alveolar bone loss and that the sensitivity of a test of A.a . is too low for the diagnosis of progressive periodontitis . The sheer presence of A.a . in spite of its virulence factors is not sufficient to cause periodontal destruction . It is stated that, in order to prevent overtreatment and medicalization, the use of bacteriological tests and broad spectrum antibiotics should be restricted to patients with progressive periodontal destruction not responding to standard treatment.

Water Sci Technol, 2002, 45(3), 273 - 9
Performance of partially separate sewer systems and impacts on receiving waters; Ferreira FM et al.; The aim of this document is to present and discuss the results of the experimental work undertaken in Laje stream, in a section near the village of Oeiras in Portugal . The work was developed with the main objective of characterising stormwater quality in Portuguese drainage systems, and to predict the effects of the performance of partially separate sewer systems on receiving waters . For this purpose, volume and characteristics of stormwater carried by a partially separated sewer system were estimated, both in terms of flow and Chemical Oxygen Demand (COD) loads . The study also analyses the eventual implementation of non-conventional solutions, as a way of reducing problems of bacteriological contamination of seawaters . This aspect is particularly important in Portugal, where the population is mainly concentrated in urban areas located down-stream of important drainage basins, close to the coastline . Therefore, sanitary sewer overflows discharging directly into receiving waters are frequent, with possible consequences in terms of bacteriological contamination of bathing areas . Based on experimental research and available data it was possible to collect informations regarding stormwater average COD and overflow coliform loads, and the occurrence of first flush effects.

J Gastroenterol Hepatol, 2001 Nov, 16(11), 1217 - 21
Influence of Helicobacter pylori infection on the prevalence of reflux esophagitis in Japanese patients; Fujishiro H et al.; BACKGROUND AND AIM: Reflux esophagitis is caused by esophageal motor dysfunction in patients with sufficient gastric acid secretion . Helicobacter pylori causes atrophic gastritis and influences gastric acid secretion . Hiatus hernia (HH) of the esophagus causes motor dysfunction in the lower esophagus . Therefore, this study aimed to test whether H . pylori infection, gastric mucosal atrophy and HH are predictive factors for reflux esophagitis . METHODS: Helicobacter pylori infection was examined in 781 patients by the measurement of serum immunoglobulin (Ig)G antibody, bacteriological culture and histological examination of biopsy specimens . The prevalence of HH, endoscopically identified gastric mucosal atrophy (closed- or open-type) and reflux esophagitis were investigated by reviewing endoscopic films . Investigated patients were divided into three age groups, under 49, 50-69, and over 70 years . The prevalence of esophagitis, H . pylori infection, gastric mucosal atrophy, and HH were compared to identify the possible predictive factors for reflux esophagitis by using logistic regression analysis . RESULTS: Sixty-nine patients with reflux esophagitis were found among the 781 investigated cases . The odds ratios of negative H . pylori infection, endoscopically identified closed-type gastric mucosal atrophy, and HH for the prevalence of reflux esophagitis were 1.342, 1.751 and 5.527, respectively . These results indicated that the presence of H . pylori infection was only a weak negative risk factor, and that HH was the most reliable endoscopic predictive factor for reflux esophagitis . CONCLUSION: Helicobacter pylori infection is a weak negative risk factor for the prevalence of reflux esophagitis, while HH is the most reliable predictive factor.

J Wound Ostomy Continence Nurs, 2002 Mar, 29(2), 83 - 7
Bacterial counts and types found on wound care supplies used in the home setting; Zwanziger PJ et al.; OBJECTIVE: Our objective was to determine the length of time that wound care supplies can be stored in the home setting before they become contaminated . With the rise in the numbers of antibiotic-resistant organisms, we wanted to try to determine if we were using safe practices when storing supplies in the home . DESIGN: This was a prospective, exploratory study . Setting and Subjects: The setting was homes of persons who required wound care by a home health care agency in the Midwest . The types of wounds included postoperative wound complications, diabetic foot ulcer, pressure ulcer, venous stasis ulcer, chemotherapy extravasation, and radiation burn . Methods and Instruments: Cultures were collected from wound care supplies when the package was opened and on day 7 and day 14 with use of standard laboratory techniques . Two data collection tools were developed: a flow sheet used to record the length of time the package was opened and a tool that reported the laboratory's bacteriologic results to the investigator . RESULTS: Cultures were obtained from 3 sterile items, including one package of 4 x 4 gauze, one disposable suture set, and one bottle of (1/4)-inch packing gauze, before they were placed in the patient's home . These 3 baseline cultures were the control samples; they showed no growth . Cultures of the open packages of reusable supplies in the home began to show growth of different organisms by day 7 . Cultures of the open packages left in the home for longer periods of time almost always showed a larger growth and variety of organisms that potentially could become problematic for a patient . CONCLUSION: This study identified the number and types of organisms found on wound care supplies used in the home setting on day 7 and day 14 . Some colonies of organisms were large enough to be pathogenic to certain patients . This information was used to develop protocols for orientation of new staff, to perform skills testing of current staff, and to reinforce storage practices of wound care supplies left in the home.

J Hand Surg {Am}, 2002 Mar, 27(2), 347 - 9
High-pressure cement injection injury of the hand: a case report; Barr ST et al.; Modern equipment allows injection of substances at much higher pressures than previously . We describe a high-pressure cement injection injury to the hand and how its management differs from other injection injuries . This injury was treated by the established standard for this surgical wound: immediate debridement . The wound had the same mechanism, pathology, bacteriology, and treatment as other similar wounds . Prognosis after high-pressure injection injuries, however, also depends on the substance injected . Treatment for cement injection injuries differs because of the unique properties of cement . Immediate intervention is necessary for decompression and minimization of chemical burn . Removing the final few fragments of cement after they have hardened may decrease the number of debridements and soft tissue destruction . Serial x-rays can be used to guide debridements, but if serial x-ray films are not obtained, a final x-ray is mandatory to ensure removal of all cement.

Vet Microbiol, 2002 May 1, 86(3), 245 - 56
Cloning and expression of the superoxide dismutase gene of the feline strain of Porphyromonas gingivalis: immunological recognition of the protein by cats with periodontal disease; Love DN et al.; Recent evidence suggests that feline members of the genus Porphyromonas are of consequence in periodontal disease in cats . Several possible virulence factors from feline strains of Porphyromonas gingivalis have been described that have similarities to those of human P . gingivalis . Both human and feline strains of P . gingivalis produce superoxide dismutase (SOD) which has been proposed as modulator of the inflammatory response during infection . The objective of this study was to clone the superoxide dismutase gene of feline P . gingivalis, to compare the characteristics of its product with that of the native enzyme and to determine its immunoreactivity in cats with periodontal disease . The sod gene of the feline strain Veterinary Pathology and Bacteriology (VPB) 3457 of P . gingivalis was amplified by PCR and cloned in frame with the alpha-peptide of the LacZ gene of E . coli in plasmid pUC19 . This construct expressed SOD activity in E . coli with characteristics similar to those of the native SOD enzyme of P . gingivalis human strain 381 and the parent feline strain VPB 3457 . The recombinant SOD had an apparent molecular weight of 54,700+/-1300 (S.E.M.) and was inactivated by 5mM hydrogen peroxide but not by 2mM KCN . There was a significant association (P=0.005) between the immunoreactivity of cats to P . gingivalis VPB 3457 soluble whole cell proteins on immunoblots and their responsiveness to the SOD protein . This suggests that cats showing a marked serum responsiveness to P . gingivalis itself, react to the SOD enzyme and further supports the role of feline P . gingivalis in periodontal disease.

Probl Tuberk, 2002, (2), 27 - 9
{Experience with rovamycin and roxithromycin in patients with chronic bronchitis in the presence of posttuberculous changes}; Sobeleva LG et al.; Rovamycin and roxithromycin were comparatively studied for their effects in 25 patients with chronic bronchitis and posttuberculous changes in the lung . Ten patients received oral rovamycin, 3,000,000 IU, twice daily and 15 had oral roxithromycin, 150 mg, twice daily . The therapy averaged 9 days . Clinical cure was observed in 90% of cases on rovamycin and in 86.7% on roxithromycin . There were no adverse effects of these drugs . The findings suggest that due to their high therapeutical and bacteriological activities, both rovamycin and roxithromycin show their good clinical efficacy in the treatment of exacerbations of chronic bronchitis in patients with residual posttuberculous changes.

Acta Cient Venez, 2001, 52 Suppl 1, 52 - 4
{Diagnosis of tuberculosis meningitis by detection of adenosine deaminase activity and amplification of nucleotide sequences with PCR}; Correa MF et al.; Tuberculous meningitis (TBM) is the most severe and lethal form of tuberculosis . The rapid bacteriological diagnosis with the conventional techniques is nearly impossible in TBM . There for many patients are treated with anti-TBC drugs without a definitive diagnosis . A more fast and accurate diagnostic method is necessary, in order to initiate the treatment on time to prevent the irreversible neurologic sequel or death . We evaluated the use of two rapid methods: Adenosine deaminase activity (ADA) and polymerase chain reaction (PCR) for IS6110 and mtp40 sequences on cerebrospinal fluid (CSF) from chronic meningitis patients . For ADA activity > 8.0 U/L the sensibility and specificity was 80% and 91% . PCR sensibility was 80% and specificity 97% . ADA activity and PCR on CSF could be specially useful as complementary tools in the early diagnosis of TBM.

Acta Cient Venez, 2001, 52 Suppl 1, 23 - 5
{Bacteriological techniques for the design and identification of Mycobacterium tuberculosis}; Hernandez C et al.; This review summarizes the classic bacteriologic techniques used to diagnose M . tuberculosis and others mycobacterial infection . This methodology involves special methods such as staining, recovery in culture media and identification by phenotypic and biochemical characteristics . New methods for rapid diagnosis are been developed and the laboratories should be alert in order to incorporated them in their routine.

J Chemother, 2002 Feb, 14(1), 59 - 64
Questionnaire survey of perioperative antibiotic prophylaxis in Italian surgical departments; Colizza S et al.; Correct antibiotic prophylaxis reduces the incidence of postoperative infections . 600 questionnaires on perioperative antibiotic prophylaxis were sent to Italian Surgical Departments . Each questionnaire included a series of 17 multi-choice-questions concerning the specific approach of the department to: organization, type, timing, duration, auditing of prophylaxis . 435 departments (72.5%) responded to the questionnaire; 50 of these were blank, so 385 out of 435 (88.5%) were suitable for statistical evaluation . Results were as follows: 90.5% of departments perform some form of prophylaxis under the control, in 90.5% of cases, of surgeons; 89.3% differentiate antibiotics according to class of operation; 67.4% give the antibiotic preoperatively and prefer i.v . injection (61.0%), mostly in the ward (56.2%); in 33.3% of cases the prophylaxis is standard (more than 2 doses), but 55.8% of Italian surgeons do not give a boost-dose in operations longer than 3 h; 54.2% of patients receive a cephalosporin (mostly III generation), with a rotation of molecules in 53.9% of cases; 71.7% of departments register the incidence of infections, but only 43.2% control the patients 30 days after surgery; finally, 54.2% of departments work together with a bacteriology laboratory active 24 hours, while in 81.7% of cases the hospital has an Infection Committee which meets together usually without a programmed date (60.3%) . In conclusion, antibiotic prophylaxis in Italian Surgery Departments appears adequate, even though some problems still remain regarding time-dose-duration-schedule, rotation of molecules, excess of cephalosporins, availability of a 24-h bacteriological laboratory and infection surveillance after discharge.

J Chemother, 2002 Feb, 14(1), 33 - 40
A 10-year survey of Mycobacterium tuberculosis isolates in Pavia and their drug resistance: a comparison with other Italian reports; Fietta A et al.; A retrospective review was made of the bacteriological and medical records of patients with culture-confirmed pulmonary tuberculosis who attended the IRCCS San Matteo Polyclinic of Pavia, between 1990 and 2000 . Altogether, 279 patients were included in the survey: 220 new cases and 59 prior treatment cases . Resistance to at least one drug, and resistance to both isoniazid and rifampicin (MDR) were more common among previously treated patients than among new cases (86.4% vs . 34.1%, and 44% vs . 5.9%, respectively) . While the frequency of resistance to any drug showed no variation in the period examined, a trend toward a progressive decrease in the frequency of primary MDR-TB was observed (from 11.9% in 1990-1992 to 1.3% in 1998-2000) . The level of resistance observed in our study suggests that all isolates of Mycobacterium tuberculosis should be tested for drug susceptibility, especially when obtained from patients who report a previous episode of the disease.

Ostomy Wound Manage, 2001 Oct, 47(10), 44 - 9
High bacterial load in asymptomatic diabetic patients with neurotrophic ulcers retards wound healing after application of Dermagraft; Browne AC et al.; Diabetic neuropathic foot ulcers are a major healthcare burden . These chronic wounds always have a bacterial load, and although normal flora is not harmful, increased tissue burden may impede healing before clinical signs of infection are evident . In this study, chronic noninfected diabetic neuropathic foot ulcers (those with adequate blood supply and pressure offloading) were assessed for bacterial burden immediately before the application of a skin substitute . Eight patients with diabetic neuropathic foot ulcers greater than 1 cm2 and free of necrotic tissue had 3-mm tissue biopsies taken from the ulcer base for quantitative bacteriology . Five of the eight patients (75%) had greater or equal to 10(5) colony forming units/gram organisms present despite the absence of clinical signs of infection . Wound healing rates were linked to bacterial load as determined from quantitative biopsy--no growth was associated with a wound healing rate of 0.2 cm per week, 10(5) to 10(6) colony forming units/gram was associated with a healing rate of 0.15 cm per week, and greater than 10(6) colony forming units/gram was associated with 0.05 cm/per week healing rate . High bacterial burden impeded healing both before and after the application of the skin substitute . The authors will change their clinical practice to assess all diabetic neuropathic foot ulcers using quantitative skin biopsies before applying skin substitutes . All patients will be treated with combination antibiotics and repeat biopsies obtained with decreased bacterial burden (< 10(6) colony forming units/gram) prior to using any bioengineered skin substitute or growth factor treatment.

Eur J Cardiothorac Surg, 2002 Mar, 21(3), 502 - 7
Decortication in chronic pleural empyema - effect on lung function; Rzyman W et al.; OBJECTIVE: The aim of the present study is to evaluate the lung function before and after the lung decortication in patients with chronic pleural empyema (CPE) . METHODS: Twenty-six patients with diagnosis of CPE were evaluated in a prospective manner by lung perfusion scintigraphy, blood gas analysis and spirometry before and 35 weeks (+/-17) after the lung decortication . RESULTS: Preoperative scintigraphy showed reduction of lung perfusion on the affected side to 24.5% (+/-12.6%) in 11 right side empyemas (predicted value 55%) and to 18% (+/-8%) in 15 left side empyemas (predicted value 45%) . The postoperative measurements showed improvement in perfusion to 45.2% (+/-7.7%) in patients with right side empyema and 34.1% (+/-8.5%) with the left side affection . The preoperative vital capacity (VC) was reduced to 62.3% (+/-13.8%) of the predicted value and forced expiratory volume in 1s (FEV1) to 50% (+/-15.5%) of the predicted value . Postoperatively, slight improvement was achieved to 79.8 % (+/-12.9%) for VC and 69.2% (+/-12.7%) for FEV1 . Blood gas analysis showed decreased values in majority of the patients before operation and significant improvement in postoperative evaluation . CONCLUSIONS: Perfusion and spirometry improves significantly in patients with CPE after the lung decortication but function of the affected lung remains impaired . There was no influence of the age, gender, side of the disease, bacteriology or duration of the empyema before operation on lung function.

Ann Acad Med Singapore, 2002 Jan, 31(1), 92 - 6
Bacteriologically-negative pulmonary tuberculosis--the Singapore tuberculosis control unit experience; Pek WY et al.; INTRODUCTION: Patients with radiological features suggestive of active pulmonary tuberculosis (PTB) from areas with a high prevalence of the disease have a high clinical likelihood of PTB regardless of the bacteriological findings . It is the established practice in many countries to initiate therapy in such patients . Our study aimed to determine if treatment for bacteriologically-negative PTB in our local population was appropriate and to identify features at presentation that would be predictive of active PTB, as defined by good and appropriate response to anti-tuberculous treatment . MATERIALS AND METHODS: A retrospective review of a randomised sample consisting of 100 bacteriologically-negative PTB patients given a course of anti-tuberculous treatment at the Singapore Tuberculosis Control Unit (TBCU) . Based on their treatment response and outcome, patients were classified as probable active or unlikely active PTB . Patients' characteristics, clinical presentation and radiological findings were analysed for their association with likelihood of probable active PTB . RESULTS: Fifty-six per cent of patients in this study had probable active PTB . The decision to treat this group of patient was appropriate . There was no serious adverse reaction in the patients treated . The presence of symptoms, especially cough at presentation, a history of contact with tuberculosis and cavitation on chest radiograph, were associated with an increase risk of probable active disease . CONCLUSION: The TBCU's practice to treat patients suspected of having radiological PTB in the setting of negative sputum smear and culture seems to be appropriate in the majority of cases.

Acta Paediatr, 2002, 91(1), 55 - 8
Antibiotic treatment for five days is effective in children with acute cystitis; Abrahamsson K et al.; Short courses of antibiotics are often recommended to treat children with acute cystitis despite lack of firm evidence to support such management . The aim of this study therefore was to analyse the short-term outcome of such treatment . The retrospective analysis included 300 children (252F, 48M) fulfilling the criteria of first-time acute cystitis and managed according to a protocol recommending 5 d treatment . In 214 (71%) the treatment was given according to the protocol and in the others for 7 or 10 d . Nitrofurantoin was used in 150 (50%) and trimethoprim without or with sulfonamide in 129 (43%) . The short-term results were excellent with 96% of the children being free from symptoms at the first follow-up visit after a median of 6 d . Only 2 girls had persisting bacteriuria and thus the frequency of bacteriological treatment failure was 1% . Recurrence within 30 d occurred in 4 girls (2%) . Conclusion: A 5 d treatment with antibiotics is adequate in children with acute cystitis . Routine follow-up visits after a first acute cystitis may not be necessary, providing that the bacteria causing the infection are sensitive to the prescribed antibiotic and that there is no history of defective bladder or bowel emptying.

J AOAC Int, 2002 Jan-Feb, 85(1), 56 - 71
Dry rehydratable film method for rapid enumeration of coliforms in foods (3M Petrifilm Rapid Coliform Count plate): collaborative study; Kinneberg KM et al.; A rehydratable dry-film plating method for coliforms in foods, the 3M Petrifilm Rapid Coliform Count plate method, was compared with the U.S . Food and Drug Administration's Bacteriological Analytical Manual method for nondairy foods and the American Public Health Association's Standard Methods for the Examination of Dairy Products (SMEDP) method for dairy foods . Six food types, vanilla ice cream, cheddar cheese, fresh refrigerated uncooked pasta, wheat flour, prepared frozen macaroni and cheese, and frozen hash browns, were analyzed for coliforms by 11 collaborating laboratories . For each food product tested, the collaborators received 8 blind samples consisting of a control sample and 3 levels of inoculated sample, each in duplicate . The mean log counts for the methods were comparable . The repeatability and reproducibility variances of the Petrifilm Rapid Coliform Count method at 14 and 24 h were not significantly different from those of the standard methods.

Khirurgiia (Mosk), 2002, (1), 36 - 9
{Ozone-ultrasonic therapy in the treatment of purulent wounds}; Lipatov KV et al.; Based on planimetric, bacteriologic and histologic study high efficiency of local ozonotherapy of wound in combination with low-frequency ultrasound was demonstrated experimentally on rat model of infected purulent skin wound . This method was used in 45 patients with purulent wounds of soft tissues (postoperative, posttraumatic, burn, sore spot) that led to fast cleaning of wound surface, decrease of bacterial contamination and granulations . It permitted to eliminate inflammation and to create optimum conditions for wound closure.

Int J Lepr Other Mycobact Dis, 2001 Sep, 69(3), 187 - 94
Impact of combined Mycobacterium w vaccine and 1 year of MDT on multibacillary leprosy patients; De Sarkar A et al.; A total of 20 bacteriologically positive multibacillary (MB) leprosy patients older than 18 years of age with a bacterial index (BI) of 2+ or greater were given standard World Health Organization multiple drug therapy (MDT-MB) for 12 consecutive months plus four intradermal doses of Mycobacterium w vaccine at 3 monthly intervals (Study group) . Twenty age-matched MB patients were given WHO/MDT alone (Control group) . The patients of both groups were followed up for 1 year . Improvements in the patients were periodically monitored by clinical (Ramu's score), bacteriological (SSS), histopathological (skin biopsy) and immunological (lepromin conversion) parameters . Study group patients showed more significant improvements in all parameters except for lepromin conversion compared to patients in the Control group . The incidence of type 1 reaction was more in the Study group (30% vs 10%), while the incidence of type 2 reaction was more in the Control group (25% vs 15%) . Neuritis associated with reactions was seen more often in the Control group compared to the Study group (20% vs 10%) . The addition of Mycobacterium w vaccine as an adjunct to the 1-year WHO/MDT regimen appears to be significantly more beneficial in MB leprosy patients with a high initial BI compared to WHO/MDT given alone . Studies on larger numbers of patients with extended follow up will be in order.

Clin Diagn Lab Immunol, 2002 Mar, 9(2), 344 - 7
Immunocytochemical method for early laboratory diagnosis of tuberculous meningitis; Sumi MG et al.; A simple immunocytochemical method was standardized for the direct demonstration of mycobacterial antigen in cerebrospinal fluid (CSF) specimens of patients with tuberculous meningitis (TBM) . CSF-cytospin smears were prepared from 22 patients with a clinical diagnosis of TBM and also from an equal number of patients with nontuberculous neurological diseases (disease control) . Immunocytological demonstration of mycobacterial antigens in the cytoplasm of monocytoid cells was attempted, by using rabbit immunoglobulin G to Mycobacterium tuberculosis as the primary antibody . Of the 22 CSF-cytospin smears from TBM patients, 16 showed positive immunostaining, while all of the CSF-cytospin smears from the disease control showed negative immunostaining for mycobacterial antigen . The technical aspects of this immunocytological method for the demonstration of mycobacterial antigens are simple, rapid, and reproducible, as well as specific, and therefore can be applied for the early diagnosis of TBM, particularly in patients in whom bacteriological methods did not demonstrate the presence of M . tuberculosis in the CSF.

Cochrane Database Syst Rev . 2002;(1):CD001090.
Intravenous immunoglobulin for treating sepsis and septic shock; Alejandria MM et al.; BACKGROUND: Death from severe sepsis and septic shock is common, and researchers have explored whether antibodies to the endotoxins in some bacteria reduces mortality . OBJECTIVES: To estimate the effects of intravenous immunoglobulin (IVIG) in patients with bacterial sepsis or septic shock on mortality, bacteriological failure rates, and duration of stay in hospital . SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group specialized register up to November 2001; the Cochrane Controlled Trials Register, The Cochrane Library issue 4, 2001; MEDLINE 1966 to November 2001; and EMBASE 1988 to September 2001 . We contacted investigators active in the field for unpublished data . SELECTION CRITERIA: Randomised trials comparing intravenous immunoglobulin (monoclonal or polyclonal) with placebo or no intervention, in patients with bacterial sepsis or septic shock . DATA COLLECTION AND ANALYSIS: Inclusion criteria, trial quality assessment, and data abstraction were done in duplicate . We conducted pre-specified subgroup analyses by type of immunoglobulin preparation . MAIN RESULTS: Twenty-seven out of 55 studies met our inclusion criteria . Pooled analysis of all types of IVIG preparations revealed a significant trend toward reduction of mortality (n= 8,856; RR=0.91; 95%CI 0.86-0.96) . Overall mortality was reduced in patients who received polyclonal IVIG (n=492; RR=0.64; 95% CI 0.51 to 0.80) . For the two high-quality trials on polyclonal IVIG, the RR for overall mortality was 0.30, but the confidence interval was wide (95% CI 0.09 to 0.99, n=91) . Mortality was not reduced among patients who received monoclonal antibodies such as anti-endotoxins (n=2,826 in 5 good-quality studies; RR=0.97; 95% CI 0.88 to 1.07) or anti-cytokines (n=4,318; RR=0.93; 95% CI 0.86 to 1.01) . A few studies measured secondary outcomes (deaths from sepsis or length of hospitalisation) but no differences in the intervention and control groups were identified except among those who received polyclonal IVIG, where sepsis-related mortality was significantly reduced (n=161; RR=0.35; 95% CI 0.18 to 0.69) . REVIEWER'S CONCLUSIONS: Polyclonal IVIG significantly reduced mortality and and is a promising adjuvant in the treatment of sepsis and septic shock . However, all the trials were small and the totality of the evidence is insufficient to support a robust conclusion of benefit . Adjunctive therapy with monoclonal IVIGs remains experimental.

Clin Microbiol Infect, 1997 Jun, 3 Suppl 3, S37 - S42
Pharmacokinetics of antibiotics in the middle ear; Barry B et al.; The middle ear mucosa is described as a non-specialized site where drug substances diffuse passively . However, precise pharmacokinetic studies on antibiotic penetration into middle ear effusion (MEE) are difficult to conduct in humans because of ethical and methodological problems: (1) studies must involve the population in which acute otitis media (AOM) is most frequent (i.e . in children from 3 months to 3 years of age); (2) studies are commonly performed during surgery for chronic otitis media with effusion, whereas drug penetration into MEE is higher during AOM; (3) kinetics are deduced from data per individual obtained in groups with marked interindividual variations . Furthermore, the results of different studies are difficult to compare because of differences in protocols, antibiotic assay methods and interpretation . Clinical studies have nonetheless shown the poorly predictive nature of serum concentrations, given the large differences in drug delivery to the MEE among antibiotic classes, among members of the same class, and among individuals receiving a given antibiotic . Experimental studies can help to narrow the gap between in vitro and clinical data, as the more precise pharmacokinetic data they yield can throw light on the link between drug/host/pathogen factors and bacteriologic efficacy.

Clin Microbiol Infect, 1997 Jun, 3 Suppl 3, S34 - S36
Acute childhood otitis media: the diagnostic value of bacterial samples from the nasopharynx; Gehanno P et al.; OBJECTIVE: To compare bacteriologic results in acute otitis media (AOM) from middle ear otorrhea and rhinopharyngeal samples . METHODS: Three hundred and fifty-four children suffering from AOM were included . Two samples were obtained for each patient, one in the middle ear fluid, and another in the rhinopharynx . RESULTS: The rhinopharyngeal sample shows a poor predictive value for the pathogen responsible for the AOM (only 30%) . But antibiotic sensitivity from each bacteriologic sample (otorrhea and rhinopharynx) for the whole population showed a very good correlation . CONCLUSIONS: The collection of nasopharyngeal cultures should therefore be promoted for their collective epidemiologic value, especially with reference to the monitoring of pneumococcal susceptibility in children.

Clin Microbiol Infect, 1998 Jul, 4(7), 385 - 391
Nosocomial legionellosis outbreak over a three-year period: investigation and control; Berthelot P et al.; OBJECTIVE: To investigate the epidemiologic relatedness of nosocomial infections due to Legionella pneumophila serogroup 1 diagnosed between 1992 and 1994 in six immunocompromised patients of the same hospital and to describe the measures which were developed to control the outbreak . METHODS: Legionella strains isolated from patients and from potable hot water were compared using three typing methods: monoclonal antibody analysis, arbitrarily primed PCR and ribotyping . RESULTS: Environmental investigations revealed the presence of high levels of L . pneumophila serogroup 1 in hot water . The typing methods gave concordant results for demonstrating (1) the persistence of an epidemic strain of L . pneumophila serogroup 1 in the major water distribution circuit of the hospital over a 3-year period, and (2) the identity between patients' and environmental strains . Five of the six patients were probably infected via aerosols of hot tap water following inappropriate therapeutic procedures . Repetitive heat flushings associated with regular bacteriologic surveillance allowed correct disinfection of the water distribution systems . Specific recommendations concerning aerosol delivery and oxygen therapy were implemented in order to prevent further nosocomial legionellosis . CONCLUSIONS: The same strain of L . pneumophila had been able to colonize the main water circuit of the hospital for at least 3 years; the relatedness between clinical and environmental strains was easily confirmed by the use of molecular markers.

Clin Microbiol Infect, 1997 Jun, 3(3), 329 - 334
Ear infections with Shewanella alga: a bacteriologic, clinical and epidemiologic study of 67 cases; Holt HM et al.; OBJECTIVE: To present bacteriologic and clinical data on 67 patients from the island of Funen, Denmark, with Shewanella alga, a bacterium rarely seen in Scandinavia, isolated from ear swabs . Included in the study is an examination of the occurrence of S . alga in sea water around the island . METHODS: Bacteriologic examination and antibiotic susceptibility testing of 67 clinical isolates, 11 sea-water isolates and two reference strains were conducted . Clinical information was obtained from the referring physicians . RESULTS: During 6 months S . alga was isolated from 67 patients, in 33 cases in pure culture . Seventy per cent of the patients were children between 3 and 15 years old who had clinical symptoms of acute or chronic otitis media . Previous ear disease was common (76%) . Most of the cases (85%) occurred in August or September, and 47 of 55 patients reported contact with sea water shortly before symptoms developed . From seven of the patients, S . alga was isolated more than once . The species was also isolated from five of 10 bathing areas around the island of Funen . CONCLUSIONS: The patients were probably infected with S . alga during sea-water bathing in the unusually warm summer of 1994 . Infections with marine bacteria are possible in countries with a temperate climate; patients with previous ear disease are at special risk.

Eur J Vasc Endovasc Surg, 2002 Feb, 23(2), 127 - 33
Systemic and local antibiotic prophylaxis in the prevention of prosthetic vascular graft infection: an experimental study; Lehnhardt FJ et al.; AIM: to determine if local, in addition to systemic antibiotic prophylaxis (compared to that provided by systemic prophylaxis alone) provides additional benefit in terms of reducing graft infection . METHODS: gelatin-sealed Dacron grafts were interposed in the infrarenal aorta of 36 mongrels and inoculated with 1 ml of a S . aureus suspension . Group 1 (control group) received no prophylaxis and were inoculated with 1 ml containing 10(9)cfu/ml . Group 2 (n=6) received systemic prophylaxis (1 g cephamandole) and were inoculated with 10(5) cfu/ml (n=3) or 10(7) cfu/ml (n=3) . Group 3 received systemic prophylaxis (1 g cephamandole) and were inoculated with 109 cfu/ml . Group 4 received systemic prophylaxis (2 g cephamandole) and were inoculated with 10(9)cfu/ml . In group 5 and 6 grafts were soaked in a rifampicin solution before use and inoculated with 10(9) cfu/ml . Group 5 received no systemic prophylaxis and group 6 received systemic prophylaxis (1 g cephamandole) . Grafts were harvested at 2 weeks, and peritonitis, perigraft abscess, anastomotic disruption and graft occlusion recorded . Swabs were taken of the graft, the perigraft tissues and the peritoneal fluid . Graft segments were incubated in broth medium . RESULTS: inoculation with 10(9) cfu/ml ensured graft infection . Systemic or local prophylaxis alone failed to prevent graft infection . Only systemic and local antibiotic prophylaxis provided significant better results than no prophylaxis at all (p<0.01) and local prophylaxis alone (p<0.05) . However, total "graft sterility" was not achieved as bacteriologic analysis of the graft segments showed low bacterial counts (<10 bacteria/graft) in 5 of 6 grafts . CONCLUSION: local and systemic prophylaxis provided more protection as demonstrated by the significant decrease in the incidence of "overt" graft infection . Total "graft sterility" cannot be expected in the case of an overwhelming bacterial challenge .

Probl Tuberk, 2001, (9), 6 - 10
{Significance of mycobacterial drug resistance in pulmonary tuberculosis surgery}; Repin IuM et al.; The outcomes of surgical treatment of 546 patients with pulmonary tuberculosis were analyzed in relation to the bacteriological characteristics . Seeding detected sputum bacterial isolation in 52.4% of cases . Mycobacterial drug resistance was detected in 83.6% of the tested cultures . It has been concluded that the resistance is a first-order infectious agent whose action is shown in lowering the efficiency of preoperative courses of chemotherapy by 2.5 times, in increasing the incidence and severity of postoperative pleural and pulmonary complications by 6-7 times, in deteriorating the immediate outcomes of surgical treatment to 82.4% with a 7.4% mortality rate . Intensive bacterial isolation unarrested by surgery is a second-order infectious agent which more clearly shows a relationship of the efficiency of surgical treatment to a reduction in the cure rate to 74.2% with a total mortality of 15.2% . There is evidence for that it is advisable to apply an active surgical policy in a group of patients having an infectious risk factor.

Vet Microbiol, 2002 Apr 2, 85(4), 343 - 52
Actinobacillus pleuropneumoniae infections in closed swine herds: infection patterns and serological profiles; Chiers K et al.; Many farrow-to-finish herds are endemically infected with Actinobacillus pleuropneumoniae . In order to control the disease efficiently, a better knowledge of the ages at which pigs become infected is necessary . Furthermore, no information is available concerning the influence of maternally derived antibodies on the colonization of the upper respiratory tract . Therefore, A . pleuropneumoniae infection patterns were studied in five farrow-to-finish pig herds (A-E) with a history of pleuropneumonia . A longitudinal study was carried out in herds A and B . In these herds, piglets from sows carrying A . pleuropneumoniae in their noses or tonsils were sampled . Nasal and tonsillar swabs as well as sera, were collected from these animals at the age of 4, 8, 12, 16 (herds A and B) and 23 weeks (herd B) . At these ages other pigs from the same sows were euthanized . The lungs were macroscopically examined and samples from nose, tonsils and lungs were collected at necropsy . A cross-sectional study was performed in herds C-E . In these herds nasal and tonsillar swabs, as well as sera, were taken from 10 animals of 4, 8, 12 and 16 weeks of age . Lung, nasal and tonsillar samples were tested for the presence of A . pleuropneumoniae by routine bacteriology and PCR with mixed bacterial cultures . The sera were examined for the presence of Apx toxin neutralizing antibodies . In herd A, A . pleuropneumoniae serotype 2 and 10 strains were isolated, whereas serotype 2, 3, 5b and 8 strains were demonstrated in herd B . In most herds, A . pleuropneumoniae was detected in mixed bacterial cultures of tonsillar and/or nasal samples by PCR from the age of 4 weeks onwards . Colonization of the lungs and development of lung lesions was observed in 12- and 16-week-old animals of herd A and 23-week-old animals of herd B . In most herds, high antibody titres were detected in 4-week-old piglets . These titres decreased during the first 12 weeks of age, but thereafter, increased . It was concluded that PCR with mixed bacterial cultures from tonsillar swabs is a valuable tool for the detection of infected animals . It was also concluded that colonization of tonsils and nasal mucosae can occur in the presence of maternally derived antibodies . Infection of the upper respiratory tract without lung involvement did not result in development of Apx toxin neutralizing antibodies . Therefore, such serological assays cannot be used for the detection of subclinically infected animals.

Clin Microbiol Infect, 1999 Jan, 5(1), 16 - 22
Hemolytic uremic syndrome in Belgium: incidence and association with verocytotoxin-producing Escherichia coli infection; Cornu G et al.; OBJECTIVE: To evaluate the incidence of hemolytic uremic syndrome (HUS) in Belgium and to determine the role of verocytotoxin-producing Escherichia coli O157:H7 and other serotypes (non-O157 VTEC) . METHODS: Twenty-two centers, including the seven university hospitals, registered prospectively all cases of HUS; they collected clinical samples for isolation of VTEC strains and serum for detection of specific O-lipopolysaccharide antibodies . RESULTS: Forty-seven cases of HUS (including five incomplete cases) were recorded . Three cases were seen in non-residents . The incidence of complete HUS in Belgian residents was 4.3 cases/100 000 in children <5 years old, 1.8 cases/100 000 when all children <15 years were considered, and 0.42/100 000 when patients of all ages were taken into account . By combining bacteriologic and serologic results, evidence of VTEC infection was obtained in 64% of the patients, mainly but not exclusively in children with prodromal diarrhea . The 13 VTEC isolates belonged to serotypes O157:H7 (nine isolates), O26:H11, O121:H---, O145:H--- and O172:H--- (one each) and all produced VT2 (+VT2vh-a in three O157 strains) and were positive for the eaeA gene . CONCLUSIONS: The incidence rate found in this study and the high mortality and morbidity linked with this syndrome warrant further registration of pediatric and post-diarrheic adult HUS cases and also examination of stools for both O157 and non-O157 VTEC strains . For effective prevention of this disease, further study of the serotypes and accessory virulence factors associated with HUS is needed.

Korean J Intern Med, 2001 Dec, 16(4), 236 - 41
Predictors for benign solitary pulmonary nodule in tuberculosis-endemic area; Kim H et al.; BACKGROUND: Solitary pulmonary nodule (SPN) may show different presentation in tuberculosis (TB)-endemic countries . The aim of this study was to identify clinical and radiological predictors favoring benign or malignant SPN in TB-endemic region . METHODS: Two hundred one SPNs in 201 consecutive Korean patients were included (< 3 cm in diameter, all confirmed by pathology or bacteriology, 93 benign and 108 malignant diseases) . For clinical parameters, age, sex, smoking status and amount, and past history of pulmonary tuberculosis and diabetes mellitus were investigated retrospectively . For radiological parameters, size, location, margin characteristics, presence of calcification, pleural tag, surrounding satellite nodule, cavitation, internal low attenuation, open bronchus sign, surrounding ground-glass opacity, enhancement pattern of the SPNs and mediastinal lymph node (LN) enlargement were analyzed on chest CT scans . RESULTS: Patients with a older age (60.7 +/- 9.6 vs 56.2 +/- 13.1, p = 0.008) and more than 40-pack years smoking (27.8% vs 14.0%, p = 0.017) were more frequently related with malignant than benign SPN . On chest CT scans, spiculated margin, contrast enhancement more than 20 Hounsfield unit and presence of pleural tag and mediastinal LN enlargement were more frequently observed in malignant than benign SPNs . In contrast to previous studies, satellite lesions (21.5% vs 1.9%, p < 0.001) and cavitation (20.4% vs 5.6%, p = 0.001) were more frequently seen in benign than malignant SPN . Positive predictive values of benignity were 90.9% and 76.0%, respectively, when satellite lesions and cavitation were found in cases of SPN . CONCLUSION: Satellite lesions and cavitation on chest CT scan could be useful predictors for benign SPN in TB-endemic areas.

Transfus Med, 2001 Dec, 11(6), 459 - 61
Autologous placental blood transfusion after a planned neonatal pacemaker implantation; Domanovic D et al.; A fetal third-degree atrio-ventricular block was diagnosed in a 22-year-old woman at 24 weeks of gestation . During clinical follow-up a mild to moderate tricuspid regurgitation was detected at 35 weeks and maternal connective tissue diseases were excluded . Early postnatal cardiac pacing therapy was planned and autologous placental blood transfusion was proposed for the treatment of probable blood loss due to pacemaker implantation . A male infant was delivered at 38 weeks vaginally and 87 mL of placental blood was collected from the undelivered placenta . The placental blood was negative for viral markers and syphilis . Subsequent tests for bacteriological cultures were also negative . Within 6 h of delivery, the baby underwent cardiac pacemaker implantation and received 45 mL of autologous placental blood . Autologous placental blood transfusion was successfully used for the treatment of predicted blood loss after a planned neonatal surgical procedure.

Soz Praventivmed, 2001, 46(6), 355 - 60
Methods of outbreak investigation in the "era of bacteriology" 1880-1920; Hardy A; The advent of bacteriological methods in the later 19th century has been seen, on the examples of America and Germany, to have been followed by a new laboratory-based, contact-tracing method of investigating outbreaks of epidemic disease . In Britain, however, this new approach never took firm root, and practising epidemiologists continued to follow an observational and deductive tradition in field investigations, rejecting any primary dependence on bacteriological methods . Alongside this persistent observational practice, there emerged a new statistical approach, based in Pearsonian biometrics, which allied itself with experimental laboratory techniques to develop a more systematic, theoretical trajectory for explaining disease outbreaks in the years after World War I.

Laryngorhinootologie, 2002 Jan, 81(1), 8 - 13
{Acquired fibrotic atresia of the external auditory canal}; Strohm M; BACKGROUND: There are very few communications on this pathologic entity, which is also called "postinflammatory medial meatal fibrosis" (PIMMF), its etiology and the adequate therapy . Apparently the cause is a chronic inflammation (or chronic ekzema) of the medial part of the external meatus or also a long-lasting otorrhea in chronic otitis media . The stratified epithelium of the eardrum and of the adjacent bony meatus is destroyed and replaced by fibrotic tissue . The lateral part of the auditory canal remains open and has the form of the finger of a glove, it may contain granulations, but often it is lined with a smooth stratified epithelium . A severe conductive hearing loss is the result of this anomaly . PATIENTS: During the last 10 years we operated on 46 patients (52 ears) for this pathology: after retroauricular opening, which allows the best control of the anterior tympanomeatal angle, the fibrotic tissue was removed keeping the lamina propria intact . The bony canal was widened, if necessary . The eardrum and the bony canal were covered with split skin graft from the retroauricular region, then the canal filled with an antibiotic package for 3 weeks . RESULTS: Underneath the fibrotic tissue we detected 3 cholesteatomata of the annular region, so it is important to remember, that the atresia may also cover a dangerous pathology . 6 times a second operation was necessary, besides that, we observed 14 recurrencies . All other patients had a wide epithelialized ear canal, their conductive hearing loss disappeared, and the results were stable over several years . Bacteriological and histological examinations were not helpful to clear up the etiology of this disease . CONCLUSIONS: Surgery is the treatment of choice of the acquired atresia of the external meatus . We suppose that in these patients a individual disposition causes the formation of this excessive fibrosis, which has some similarity with keloid formation.

Rheumatol Int, 2002 Jan, 21(4), 153 - 7
Pulmonary tuberculosis in patients with rheumatoid arthritis (four case reports); Dursun AB et al.; Pulmonary involvement is one of the most common extra-articular manifestations of rheumatoid arthritis (RA) . We studied four smear-positivepulmonary tuberculosis patients who had had RA for 2.5-12 years . Three of them were using corticosteroids at the time of diagnosis . The clinical, radiological and bacteriological features of all the patients were examined . We conclude that when patients with RA have symptoms related to pulmonary involvement, tuberculosis should be considered, particularly in developing countries.

Indian J Lepr, 2001 Jul-Sep, 73(3), 239 - 46
Poor correlation of systemic immunological parameters with clinical features in macular leprosy; Narayan NP et al.; On the basis of clinical features and bacteriological status, macular skin lesions of nine cases of leprosy were classified as falling within a spectrum between the tuberculoid at one end and the lepromatous at the other . While histologic correlation was seen in 60% of cases, humoral and cellular systemic immunologic features were found to be uncharacteristic . It is suggested that macular lesions form an early stage in the development of leprosy where the systemic immunological response is yet to set in fully.

Med J Aust, 2001 Dec 3-17, 175(11-12), 600 - 2
Screening for conditions of public health importance in people arriving in Australia by boat without authority; King K et al.; OBJECTIVE: To determine the prevalence of tuberculosis, hepatitis B carriage and markers of hepatitis C and HIV infection in people detained in immigration reception and processing centres in Australia . DESIGN AND SETTING: Eighteen-month survey of medical conditions of public health importance in people detained at the immigration reception and processing centres at Curtin and Port Hedland in Western Australia and Woomera in South Australia . PARTICIPANTS: 7000 detainees (5742 adults and 1258 children and teenagers aged < 18 years) between 1 January 2000 and 30 June 2001 . MAIN OUTCOME MEASURES: People treated for active tuberculosis; issuing of health undertakings to report to a chest clinic for follow-up of inactive tuberculosis; and confirmation of hepatitis B carrier status or hepatitis C or HIV infection . RESULTS: Eleven people required treatment for tuberculosis (in nine the diagnosis was confirmed bacteriologically), representing a prevalence of 157 cases per 100,000 population . This rate is much higher than the incidence in Australia in 1998 of 4.93 cases per 100,000 population, but comparable with rates in the source countries . Health undertakings were issued to 973 people (13.9%) . Of these, 682 (70.1%) were for inactive tuberculosis (26 in association with hepatitis B carriage or hepatitis C infection); and 156, 58 and two health undertakings were for hepatitis B carriage, and hepatitis C and HIV infection, respectively . CONCLUSIONS: The health-screening program at immigration reception and processing centres detects significant numbers of conditions of public health importance, enabling treatment and surveillance to the benefit of the people detained and the Australian community.

J Assoc Physicians India, 2001 Aug, 49, 808 - 12
A clinico-bacteriological study of peripheral tuberculous lymphadenitis; Aggarwal P et al.; OBJECTIVE: Tuberculous lymphadenitis is the commonest form of extra-pulmonary tuberculosis . It is most often caused by M . tuberculosis though several reports from other countries have shown mycobacteria other than tuberculosis (MOTT) to be responsible for a significant proportion of tuberculous lymphadenitis cases . The present study was conducted to find the prevalence of M . tuberculosis and MOTT as aetiological agents in patients with peripheral tuberculous lymphadenitis . METHODS: A total of 138 patients with tuberculous lymphadenitis were included in the study . Diagnosis of tuberculosis was established on the basis of fine needle aspiration cytology, histopathology, presence of mycobacteria on Ziehl Neelson stain or auramine rhodamine stain, or aspiration of pus with negative Gram's stain and pyogenic cultute with radiologic evidence of pulmonary tuberculosis . Mycobacterial cultures were performed on aspirated material and species identified using standard methods . RESULTS: Of 138 patients, single lymph nodal enlargement was found in 48.6% patients while others had more than one lymph nodes . Lymph nodes were matted in 26.8% cases while fluctuation could be elicited in 12.3% patients . Chest X-ray showed evidence of active pulmonary lesions or mediastinal lymphadenopathy in 28.3% cases . The fine needle aspiration cytology was positive for tuberculous lymphadenitis in 41.3% cases while it revealed granulomas or necrosis in another 13% cases . The Ziehl-Neelson and the auramine-rhodamine staining were positive in 19.6% and 26.8% patients, respectively . On culture, the lymph node aspirate was positive for Mycobacterium species in 40.6% patients . In all but two cases, the culture revealed presence of Mycobacterium tuberculosis . The other two cultures revealed growth of Mycobacterium fortuitum chelonae complex . Of the two HIV-positive patients, M . tuberculosis could be isolated in one case . CONCLUSION: Findings of this study suggest that M . tuberculosis is still the most common cause of tuberculous lymphadenitis and MOTT are responsible for very few cases . However, such studies need to be carried out frequently at various centres so as to see any periodic and geographic variations within India.

Vestn Khir Im I I Grek, 2001, 160(4), 50 - 3
{Bacteriological features of peritonitis in perforative gastroduodenal ulcer}; Stoiko IuM et al.; Bacteriological investigation of 137 probes of the exudate from the abdominal cavity has revealed positive results in 60.6% . The detection of microbial flora was the more frequent the greater was the spread and degree of peritonitis . The monoculture was revealed in 92.8%, the colibacillus being the most frequent . The isolated microbial flora was sensitive to antibiotics of the cephalosporin group.

Presse Med, 2002 Jan 12, 31(1 Pt 1), 27 - 32
{Blood culture update}; Muller-Serieys C et al.; BACKGROUND: Blood culture is one of the most important bacteriological examinations with important clinical and therapeutic consequences . Blood cultures should be ordered in all patients with signs suggesting septicemia, endocarditis or severe infection (pneumococcal pneumonia, bacterial meningitis with bloodstream dissemination) . Blood culture methods have evolved considerably over the last twenty years . After using manual methods for many years, read by non-standardized visual methods, the development of media with defined compositions and supplemented to allow growth of bacteria difficult to culture has been associated with the development of automatic blood culture devices . AUTOMATIC DEVICES: These devices have undergone rapid improvement . Semi-automatic devices (Bactec NR-660) were rapidly followed by completely automatic techniques, including four devices currently available: since 1989 Bio-Argos (Rio-Rad) and Bact/Alert (Organon-Teknika) and in 1993, Bactec 9240 (Becton-Dickinson) and Vital (BioMerieux) . All these devices allow automatic detection of CO2 produced during bacterial growth . Automatic reading systems provide continuous output avoiding the need for invasive methods and thus the risk of contamination in addition to saving time . Potential application to achieve quantitative blood cultures for intensive care units is in the development stage . CONSEQUENCES: The reliability of these devices is well recognized and their contribution to severe bacterial infection is undeniable . There are certain limitations however related to material cost and the non-identification of the pathogen involved . Molecular biology techniques open new perspectives in this field . The evolution of techniques, definitions, and pathogenic approach to septicemia must be revisited as new infectious situations have been identified at the same time as new investigation tools resulting from considerable technological progress . New methods of blood culture have largely contributed to this progress.

Drugs Exp Clin Res, 2001, 27(4), 135 - 9
Azithromycin and doxycycline in the treatment of female patients with acute urethral syndrome caused by Ureaplasma urealyticum: significance of duration of clinical symptoms; Skerk V et al.; One hundred ninety-two female patients with acute urethral syndrome caused by Ureaplasma urealyticum were examined . First, patients were divided into two groups: those with clinical symptoms present for less than 3 weeks before the start of treatment and those with clinical symptoms 3 weeks or longer before the beginning of therapy . The patients were then further divided into groups and randomized to receive azithromycin once daily in a single dose of 1 g or 500 mg once daily for 6 days, or to receive doxycycline 100 mg b.i.d . for 14 days or 100 mg b.i.d . for 7 days (eight study groups in all) . Clinical and bacteriological efficacy were evaluated 3 weeks after the end of therapy . In the group of patients with disease symptoms lasting for 3 weeks or longer, eradication and clinical cure rates were significantly higher after the administration of azithromycin at a dose of 1 x 500 mg/6 days than after a single dose of 1 g (p < 0.001).

World J Gastroenterol, 2001 Aug, 7(4), 476 - 81
Management of necrotizing pancreatitis; Slavin J et al.; Infection complicating pancreatic necrosis leads to persisting sepsis, multiple organ dysfunction syndrome and accounts for about half the deaths that occur following acute pancreatitis . Severe cases due to gallstones require urgent endoscopic sphincterotomy . Patients with pancreatic necrosis should be followed with serial contrast enhanced computed tomography (CE-CT) and if infection is suspected fine needle aspiration of the necrotic area for bacteriology (FNAB) should be undertaken . Treatment of sterile necrosis should initially be nonoperative . In the presence of infection necrosectomy is indicated . Although traditionally this has been by open surgery, minimally invasive procedures are a promising new alternative . There are many unresolved issues in the management of pancreatic necrosis . These include, the use of antibiotic prophylaxis, the precise indications for and frequency of repeat CE-CT and FNAB, and the role of enteral feeding.

Magy Seb, 2001 Dec, 54 Suppl, 63 - 7
{Cryopreserved homografts in arterial reconstructions}; Biro G et al.; The use of cryopreserved homologous vessels (CHV) in arterial reconstructions is indicated in cases when no suitable autologous material is available and the use of prosthetic grafts is contraindicated . In the presentations authors overview their 4 years' experiences with homografts in case of aneurysms and lower limb obliterative arterial disease . Forty four CHV grafts were implanted in 41 patients from May 1997 to May 2001 . Following explantation and preparation the grafts are treated in a special preservation solution containing 10% DMSO, antibiotic and antimycotic drugs . Using a cryostat the graft packages get deep frozen and are stored in fluid nitrogen, therefore these grafts are available even after years . Donor and patient data are recorded and processed following strict bacteriological examination . No postoperative immunosuppression therapy was administered . Twenty six greater saphenous veins, 12 superficial femoral arteries, 2 iliac arteries, 3 aortic bifurcations and one thoracic aorta segment were used as graft material--24 grafts were implanted in femoro-crural, 7 in distal femoro-popliteal, 2 in proximal femoro-popliteal, 2 in ilio-femoral, 2 in femoro-femoral crossover, one in aorto-femoral, 3 in bifemoral and one in aorto-aortic position . Successful redo surgery was performed in case of graft occlusion in 6 cases, 11 limbs were amputated because of failed thrombectomy . One patient underwent surgery due to a pseudoaneurysm at the diaphysis of a femoro-crural graft, this case is presented in details . The three year graft and limb patency were 23% and 64% subsequently following infrainguinal reconstructions, graft reocclusion occurred in 17 cases, 11 limbs were amputated . Eight patients died in 30 days following CHV implantations, the causes of death were septic bleeding in 4 cases, acute myocardial infarction in 2 cases and cardiorespiratory insufficiency in 2 cases . According to the authors' results and to the literature based on well defined indication use of cryopreserved homologues vessels are a good choice for vascular reconstruction in cases, when implantation of biologic material is essential for restoring circulation.

Anim Reprod Sci, 2002 Feb 15, 69(3-4), 239 - 49
The effects of endometrial scarification on uterine steroid receptors, bacterial flora and histological structure in the bitch; Dhaliwal GK et al.; Following laparotomy, the endometrium of six nulliparous Beagle bitches was scarified at the base of one uterine horn during early metoestrus, when the peripheral plasma P(4) concentration was >10 ng/ml; intrauterine swabs were taken at the same time for bacteriological culture . Twenty-one days later, a bilateral ovariohysterectomy was performed and segments of the scarified and non-scarified parts of the tubular genital tract removed; at the same time, swabs were taken from the uterine lumen . Tissue samples were collected and examined for histopathological structure, and the presence of nuclear oestrogen (ER) and progesterone (PR) receptors using an immunocytochemical method . The immunoreactivity was scored semiquantitatively, incorporating both the intensity and distribution of specific staining of the receptors using a simplified histoscore (H-score).All uterine swabs were sterile, and in three of the six bitches there were noticeable changes with distension of the uterine lumen with secretions and debris and distension of the endometrial gland ducts of the scarified uterine segment . There were no statistically significant differences in the H-scores of ER or PR between scarified and non-scarified segments, except for PR H-scores in the glandular epithelium where the values for the scarified were significantly higher than for the non-scarified endometrium (mean+/-S.E.M . is 129.9+/-22.8 versus 59.5+/-12.6; P<0.05) . Thus, trauma can modify the structure of the endometrium and the characteristics of the PR . Whether changes in PR expression are involved in the pathogenesis of CEH/pyometra in the bitch could not be ascertained from this study.

Nephrologie, 2001, 22(8), 413 - 5
{Surveillance of permanent central venous access for hemodialysis}; Bosc JY et al.; Central venous catheters have emerged as a valuable alternative for permanent access in hemodialysis . Thanks to steady improvements of materials and design they have been successfully used as bridging solution until another vascular access became available or even long term solution for patients with limited or insuffisant vascular resources . Since the use of central venous catheters is affiliated with a higher dysfunction rate and morbidity, special attention is indicated . This should include regular surveillance, clinical examination and intervention using specific methods, bacteriological exams and regular dialysis quantification . Such a constant quality control followed by strict and adapted rules for catheter handling are essential necessities to reduce catheter-related complications and assure an adequate dialysis.

Commun Dis Intell, 2001 Nov, 25(4), 261 - 5
Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 1998-1999: report of the Australian Mycobacterium Reference Laboratory Network; Dawson D; Who Collaborating Centre in Tuberculosis Bacteriology et al.; The Australian Mycobacterium Reference Laboratory Network collected and analysed laboratory data on new diagnoses of infection with Mycobacterium tuberculosis complex in 1998 and 1999 . Totals of 700 and 760 cases were identified, representing annual reporting rates of 3.7 and 4.0 cases of laboratory confirmed tuberculosis (TB) per 100,000 population in the years 1998 and 1999 respectively . Australia's TB reporting rates have varied little in the past decade, ranging from 3.7 to 4.1 cases per 100,000 population . Reporting rates vary between States, reflecting differences in the distribution of persons in 'high-risk' categories for TB . The male:female ratio decreased to almost 1:1 . The median age for males with culture-confirmed TB is in the 45-49 age group; for females, the median is in the 35-39 age group . Pulmonary disease was diagnosed in 63 per cent of cases whereas disease of lymph nodes accounted for 21 per cent of all cases . Children have the lowest rates of culture-confirmed TB; males in the older age groups have the highest rates . Microscopy was positive for 60 per cent of culture-positive sputa, and for approximately 45 per cent of bronchoscopy specimens . The frequency of multi-drug resistance (less than 1%) was slightly lower than in previous years.

Orthopade, 2001 Dec, 30(12), 903 - 14
{Pott triad and Schmorl nodules . A historical overview of kyphosis with special reference to tuberculous spondylitis and Scheuermann disease}; Rauschmann MA et al.; This report provides an overview of the history of the different types of kyphosis (arcuated and angulated forms) . Especially tuberculous spondylitis and Scheuermann's disease are pointed out from among the large group of kyphotic diseases . Therefore, Beckhterew's disease, the combination of rickets and kyphosis as well as the dysraphic diseases and constitutional kyphosis caused by faulty posture are only mentioned . These two special types of kyphosis (Scheuermann's disease and tuberculous spondylitis) are presented from the first description with diagnostic findings, the ideas of pathogenesis and aspects of treatment through to the different periods of medical history . This article describes the way of thinking and discussing of opinion leaders at the beginning of the century and the influence of new techniques and developments (asepsis, antisepsis, anesthesia, bacteriology, X-ray, antibiotics) on the differential diagnosis and therapy . It is impossible to give a complete overview of all aspects during the centuries concerning tuberculous spondylitis or arcuated kyphosis . The authors of this article have focussed their studies on developments from the first descriptions until World War II, based mainly on literature from German journals and historical books from the library of the German Museum for Orthopedic History and Science.

Ann Transplant, 2001, 6(1), 23 - 5
Evaluating the competence of venous valves preserved with denaturation in cold ischaemia; Dunal M et al.; AIM OF STUDY: The aim of this study was to evaluate the competence of venous valves preserved with denaturation in cold ischaemia . MATERIAL AND METHOD: Eight segments of saphenous veins with 20 competent valves were analysed in the study . The material was collected during multiorgan retrievals . After harvesting, 15 cm long venous fragments were assessed with respect to valve presence . A 4-cm fragment with a valve was used for the analysis . Valve competence was assessed twice: after sampling and after 21 days of preservation . The valves were subjected to 136 cm water column pressure test . Denaturation in cold ischaemia consists of preservation of vessels at 4_C in a preservation medium containing antibiotics . Bacteriological and morphological examinations by light microscopy were performed . RESULTS: After the preservation period, all the valves retained their mechanical properties . Well-preserved elastic elements of vascular wall were maintained in all vessels . Minor fragmentation of elastic fibres was observed and the structure of vascular wall was usually regular . CONCLUSIONS: Our study indicates that denaturation in cold ischaemia allows for the maintenance of the properties and physiological functions of the valves after preservation . This effect is related to the good condition of elastic fibres, venous wall structure and the valve itself.

Zhonghua Jie He He Hu Xi Za Zhi, 2001 Jan, 24(1), 43 - 7
{The immunotherapeutic effect of Mycobacterium vaccae vaccine on initially treated pulmonary tuberculosis}; Luo Y; National Cooperation Group On Clinical Study Of Mycobacterium Vaccae Vaccine; OBJECTIVE: To evaluate the effect and safety of Mycobacterium vaccae vaccine (M . vaccae vaccine) on initially treated pulmonary tuberculosis . METHODS: 342 cases of initially treated pulmonary tuberculosis with smear and culture positive were divided into immunotherapy (M, 171 cases) group and control (C, 171 cases) group at random pair . The group M were treated by chemotherapy with a regimen of 2HRZE/2HR and immunotherapy with M . vaccae vaccine for 6 months . The group C were treated only by chemotherapy with a regimen of 2HRZE/4HR . RESULTS: The sputum smear-negative conversion rates in group M 1, 2 and 6 months after treatment were 36.8%, 80.1% and 98.2% respectively; those in group C were 19.9%, 54.4% and 98.8% respectively . The sputum culture-negative conversion rates in group M 1, 2 and 6 months after treatment were 47.4%, 85.9% and 99.4% respectively; those in group C were 19.3%, 67.8% and 98.8% respectively . The sputum-negative conversion rates of group M were significantly higher than those of group C after 1 and 2 months treatment (P < 0.01), but there were no statistically significant differences between the two groups at the end of 6 months after treatment (P > 0.05) . Compared with group C, group M were better in improving of X-ray manifestation, increasing of the percentage of CD(3) and CD(4) T cell and the ratio CD(4)/CD(8) and closing of cavity (P < 0.01) . The side effects of M . vaccae vaccine were rare and slight . The bacteriological relapse rates in group M, C were 3.0%, 5.6% respectively (P > 0.05) . CONCLUSIONS: As an adjunct to chemotherapy, immunotherapy with M . vaccae vaccine is helpful for patient with initially treated pulmonary tuberculosis, and it is possible to further shorten the duration of short-course chemotherapy with a combination of chemotherapy and M . vaccae vaccine.

Laryngoscope, 2002 Jan, 112(1), 18 - 20
Use of bacteriologic studies in the outpatient management of peritonsillar abscess; Cherukuri S et al.; OBJECTIVE: To examine whether obtaining bacterial Gram stain and aerobic/anaerobic cultures alters management of patients with peritonsillar abscess . STUDY DESIGN: Retrospective study . MATERIALS AND METHODS: A total of 221 cases of suspected peritonsillar abscess from July 1990 to February 1999 were analyzed with regard to outcomes and management patterns of those who had bacteriologic studies performed and those who did not . RESULTS: Pus was aspirated in 153 (69%) . Eighty-two had bacterial studies performed whereas 71 did not . Of patients that followed up, all patients had complete resolution in the first group based on initial management . Three patients of the latter group had a complicated course secondary to dehydration and antibiotic noncompliance (P =.24) . Of the 82 cultures sent, sensitivities were conducted on only 17 (21%) . Nine of 17 grew organisms that were penicillin-resistant . No patient in the study had any treatment decisions based on microbiologic studies . CONCLUSION: In the routine management of peritonsillar abscess, bacteriologic studies are unnecessary on initial presentation . They should be reserved for patients with a high likelihood of infection by resistant organisms, i.e., diabetics, immunocompromised patients, and patients with recurrent peritonsillar abscess.

Tuberculosis (Edinb), 2001, 81(5-6), 335 - 41
Tumour necrosis factor alpha (-238 and -308) and beta gene polymorphisms in pulmonary tuberculosis: haplotype analysis with HLA-A, B and DR genes; Selvaraj P et al.; SETTING: A study of tumour necrosis factor alpha and beta (TNFalpha and beta) gene polymorphism and haplotype analysis with HLA in pulmonary tuberculosis . OBJECTIVE: To determine whether TNFalpha (-238 and -308) and TNFbeta (Nco I polymorphism in intron 2) genes either alone or in combination with human leucocyte antigens (HLA) as haplotypes afford susceptibility or resistance to pulmonary tuberculosis as well as bacteriological relapse of the disease . DESIGN: Tumour necrosis factor alpha -238, -308 (TNFalpha -238, -308) and TNFbeta (Nco I) gene polymorphisms were carried out in HLA-A,B and DR typed pulmonary tuberculosis patients (n=210) and 120 normal healthy control subjects . RESULTS: No difference in the genotype frequencies of TNFalpha-238 and -308 and TNFbeta was seen between control subjects and pulmonary tuberculosis patients . Of the HLA-TNF haplotypes analysed, the infrequent allele (A) of TNFalpha238 was in strong linkage disequilibrium with HLA-A1 (P corrected: Pc=0.001), B17 (Pc<0.0001) and DR7 (Pc=0.01) in control subjects and with B17 (Pc<0.0001) in pulmonary tuberculosis . The infrequent allele 2 of TNFalpha-308 and the infrequent allele 2 of TNFbeta were in strong linkage disequilibrium with HLA-B21 . An increased haplotype frequency of HLA-B17-TNFalpha-238/A (P=0.05), B17-TNFalpha308/2 (P=0.03) and B17-TNFalpha308/2 (P=0.01) was observed in bacteriological relapse patients than quiescent patients . CONCLUSION: The present study suggests that TNFalpha (-238 and -308) and TNFbeta gene variants are not associated independently with the susceptibility to pulmonary tuberculosis . However, in combination with the HLA genes/gene products such as HLA-A1, B17, B21 and DR7, the TNFalpha and beta genes as haplotypes are associated with protection against the disease as well as an increased susceptibility to bacteriological relapse .

Zhonghua Nei Ke Za Zhi, 1999 Dec, 38(12), 806 - 9
{A study on the endotoxin and bacterial contamination in reverse osmosis water and dialysis fluids}; Liu H et al.; OBJECTIVE: To evaluate the endotoxin (ET) and the bacterial contamination in reverse osmosis (RO) water and dialysis fluids for hemodialysis treatment . METHODS: Specimens of RO water and dialysis fluids were obtained at random from 18 hospitals in Beijing . ET was measured with chromogenic limulus amoeboeyte lysate (LAL) assay . Bacteriologic samples were processed on heterotrophic plate count agar with pour plate technique . The plasma IL-1, IL-6 and TNFalpha were tested with enzyme-linked immunosorbent assay (ELISA) . RESULTS: The level of ET in RO water was 0.116 +/- 0.063 EU/ml, and the culture of bacteria had 2 positive results, both counting 100 CFU/ml . The level of ET was much higher in acid concentrate (Protocol B) than in basic concentrate (Protocol A) . The culture of bacteria had 11 positive results in Protocol B concentration with 8 samples equal or higher than 2,000 CFU/ml . The culture of bacteria had only 3 positive results in Protocol A concentration, all being lower than 2,000 CFU/ml . Another investigation showed that the level of ET in dialysis inlet was higher than 0.5 EU/ml in 5 cases of a total of 16 . Their plasma IL-1 and TNFalpha levels were significantly increased . CONCLUSION: Both ET and bacterial contamination exist in RO water and dialysate . It is essential to examine the level of ET and perform bacterial culture, as well as to disinfect RO and dialysate tank at regular intervals in order to reduce pyrogenic reactions.

Med Mycol, 2001 Dec, 39(6), 487 - 93
Production of the mycelial phase of Malassezia in vitro; Saadatzadeh MR et al.; To study the pathogenicity of Malassezia, the agent of pityriasis versicolor, it is necessary to obtain the mycelial form in vitro . A range of different components and conditions were tested to induce yeast cells of the organism to produce mycelia in vitro using different culture media . A mycelial culture medium was developed that consisted of bacteriological peptone, glucose, yeast extract, ox bile, glycerol, glycerol monostearate, Tween 80, squalene, glycine, potassium nitrate, sodium chloride, ferrous sulphate and magnesium sulphate with or without agar . The liquid and solid medium had a pH of 5.6 and the temperature of incubation was 30 degrees C . Cultures were incubated in air . This medium was able to induce some strains of Malassezia to produce up to 40% mycelium in vitro . In total, 33 different strains of Malassezia obtained from the skin of the healthy individuals and patients with pityriasis versicolor were tested for mycelium production . The strains of Malassezia capable of producing mycelium in vitro all possessed the serovar A antigen.

Isr Med Assoc J, 2001 Jul, 3(7), 479 - 83
Epidemiological analysis of tuberculosis treatment outcome as a tool for changing TB control policy in Israel; Chemtob D et al.; BACKGROUND: Sensing an inadequacy of tuberculosis control due to an influx of TB associated with immigration, we analyzed TB treatment outcome in Israel by population groups . OBJECTIVES: To provide an epidemiological basis necessary for any new national TB control policy, and to bring it to the attention of the medical profession in Israel and abroad since its results led to a change in Israel's TB control policy . METHODS: We reviewed all TB cases notified during the period 1990 to September 1992 . "New cases" (820 cases, 93.5%) and "re-treatment cases" (57 cases, 6.5%) were analyzed according to three mutually exclusive groups: "successful outcome," "death," and "potentially unsatisfactory outcome" (according to WHO/IUATLD definitions) . RESULTS: Of 820 "new cases," 26.6% had a "satisfactory outcome," 68.5% had a "potentially unsatisfactory outcome" and 4.9% died; compared to 47.4%, 45.6% and 7% among 57 "re-treatment cases," respectively . Using logistic regression analysis, outcome was associated with the district health office (P < 0.0001), the TB "experience" of the notifying clinic (P < 0.0001), and the form of TB (P = 0.02) . No significant relationships were obtained for population groups, gender and age, interval between arrival in Israel and TB notification, and bacteriological results . CONCLUSIONS: Non-supervised TB treatment resulted in poor outcomes regardless of population groups . Better outcomes occurred in the larger TB clinics . Therefore, in addition to measures such as adequate drug supplies, reorganization of TB laboratories and training of TB personnel, we recommend the "directly observed treatment short-course" for all cases as well as reducing the number of treatment centers thereby increasing their case load.

Acta Microbiol Immunol Hung, 2001, 48(3-4), 587 - 99
Fifty years of dysentery research at the Pécs University; Ketyi I et al.; Karoly Rauss was appointed as head of the Department of Public Health of the Elisabeth University of Pecs in 1946, Professor Rauss's carrier had started working with Professor Hugo Preisz in Budapest . During his residency years he was already appointed to the Department of Bacteriology chaired by Lovrekovics at the National Institute of Public Health . In this institution--as in all organizations affiliated with the Rockefeller Institute--the state of art diagnostic work together with research focusing on problems derived from everyday medical and public health practice was considered as to be of primary importance . Stimulated by this scientific environment Rauss's interest turned towards enteric pathogens . In cooperation with Lovrekovics he developed a typhoid vaccine containing a trichloracetic acid extract of the pathogen adsorbed to aluminum hydroxide . This vaccine was introduced in 1938 when ca . 6-8000 enteric fever cases were registered in Hungary annually . The vaccination, supported by the public health work concerning carriers, eventually lead to the eradication of the disease in Hungary.

Invest Clin, 2001 Dec, 42(4), 255 - 67
{Viral agents in patients with infectious processes of the central nervous system}; Valero N et al.; Local statistics report a great number of cases of neurological diseases of unidentified cause . The purpose of this research was to determine the presence of viral agents in patients with affection of the central nervous system, in Zulia State, Venezuela . In different health centers throughout the state, we collected 129 randomized samples of cerebrospinal fluid (CSF) and serum from patients ranging from 1 day to 41 years of age, showing symptoms of CNS disease and whose bacteriological test resulted negative . The serum/CSF albumin ratio was determined to exclude contaminated CSF samples, thus 54 optimal samples were obtained for the research . We determined serum IgM and CSF IgG specific for Venezuelan equine encephalomyelitis (VEE), Herpes simplex (HSV), Epstein Barr (EBV), Dengue, Rubella and Measles virus, through ELISA and indirect immunofluorescence techniques . Of the 54 samples studied, 33 (61.11%) were positive . %) . The etiological agents implicated were VEE 14 cases (42.42%); HSV 11 cases (33.33%); EBV 5 cases (15.15%) and Dengue 3 cases (9.09%) . We did not detect Rubella o Measles . Regarding the age distribution, the most affected group was that of children under 12 (83.34%) . We analyzed the clinical manifestations and the CSF characteristics and did not find differences suggestive of an specific etiological diagnosis, even though certain signs could be considered early indications of CNS alterations due to viral causes . Our study shows that a large percentage of CNS affections of unknown etiology are produced by viral agents, indicating that in our region, most of this cases are not registered.

Respiration, 2001, 68(6), 595 - 600
Pulmonary tuberculosis in patients with diabetes mellitus; Bacakoglu F et al.; BACKGROUND: Diabetes mellitus has been reported to modify the presenting features of pulmonary tuberculosis, but there are varying data, particularly regarding the association with lower lung field involvement . OBJECTIVES: To determine whether diabetes mellitus alters the clinical and radiographic manifestations of tuberculosis in nonimmunocompromised hosts and to define the determinants of lower lung field involvement . METHODS: A retrospective review of the records of all patients with tuberculosis and diabetes mellitus seen during a 14-year period and of an age- and sex-matched nondiabetic control group with tuberculosis was carried out . The duration of symptoms, tuberculin reaction, bacteriologic and radiographic findings of the two groups were compared . RESULTS: The presence of diabetes mellitus was found not to have an effect on patients' symptomatology, bacteriology results, tuberculin reaction and localization of pulmonary infiltrates . On the other hand, fewer diabetic patients were smear-positive and fewer had reticulonodular opacities compared with the control patients . A higher number of insulin-dependent diabetic patients presented with cavitary disease as compared with nondiabetic controls . Lower lung field tuberculosis was significantly associated with female gender and, in patients older than 40 years, was more frequently observed in diabetics . CONCLUSION: These data show that diabetes does not affect the presenting features of pulmonary tuberculosis to a large extent and is only associated with lower lung field disease in older patients .

Rev Clin Esp, 2001 Nov, 201(11), 632 - 7
{Pyogenic liver abscesses in cancer patients}; Alvarez Perez JA et al.; OBJECTIVE: To analyse the clinical behaviour of pyogenic liver abscesses among cancer patients, and to determine whether there is any difference between clinical behaviour among patients without malignancies . PATIENTS AND METHODS: Retrospective, multicentric study with 133 patients with pyogenic liver abscesses diagnosed during 13 years . Patients were divided into two groups: 29 patients with malignant tumors identified during the five years prior to abscess development (group 1) and 104 patients without malignant tumors (group 2) . Clinical, biological and bacteriological findings, morphology and lesional topography, treatment and particularly, clinical course were analysed . RESULTS: Abscesses with portal pathogenesis were more common in group 1 (24% versus 10%; p = 0.03) . Clinical and biological data were similar in both group but jaundice (31% versus 18%; p = 0.09), liver enlargement (38% versus 21%; p = 0.06) and pleural effusion (48% versus 28%; p = 0.03), which were more common in group 1 . In the same group, the mean AST level was also higher (112 149 versus 60 88; p = 0.07 ) . Morphology and lesional topography, as well as bacteriology in both groups did not differ significantly . In group 1, surgical drainage was performed less frequently (21% versus 38%; p = 0.09) and mortality rate was higher (24% versus 11%; p = 0.08) . Nevertheless, no significant differences were observed between hospital stay and morbidity . Among patients treated with antibiotics only, the mortality rate was higher in group 1 (50% versus 10%; p = 0.06) . CONCLUSIONS: In pyogenic liver abscess in patients with malignant tumor disease a predominance of portal pathogenesis was observed . The presence of cancer among patients with pyogenic liver abscesses did not imply a significantly different clinical presentation; however, the clinical course was worse than that observed in cases without cancer.

Zhonghua Jie He He Hu Xi Za Zhi, 2000 Feb, 23(2), 85 - 8
{Immunotherapeutic effect of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis}; Luo Y et al.; OBJECTIVE: To evaluate the immuNotherapeutic effect of M . vaccae on multi-drug resistant (MDR) pulmonary tuberculosis . METHODS: 90 cases of MDR pulmonary tuberculosis with bacteriological positive were divided into immunotherapy (M, 28 cases), control (C, 28 cases) group at random pair and self control (S, 34 cases) group . The group M were treated by chemotherapy and M . vaccae for 6 months, the group C only treated by chemotherapy for 6 months, while group S only by chemotherapy in the first 3 months and in combination with M . vaccae in the next 6 months . RESULTS: After 6 months, the sputum negative conversion rates of group M were 43% in smear positive cases and 46% in culture positive cases, both of which were significant higher than those of group C (21%, 18%, P < 0.01) . The sputum negative conversion rates of group S were 3%, 3% in smear and culture positive cases after 3-month chemotherapy, which increased to 44%, 41% respectively when M . vaccae was added for 6 months . Compared with group C, group M was better in improving of X-ray manifestation and cell-mediated immunity and closing of cavity (P < 0.05) . The bacteriological relapse rates in group M, C, S were 8%, 20% and 7% respectively . CONCLUSION: As a adjunct to chemotherapy, M . vaccae is helpful for patients with MDR pulmonary tuberculosis by improving the cell-medicated immunity, sputum negative conversion and X-ray manifestation.

Zhonghua Jie He He Hu Xi Za Zhi, 2000 May, 23(5), 281 - 3
{Clinical and pathological analysis of 114 patients with postoperative wound infections by M . abscessus}; Huang L et al.; OBJECTIVE: To evaluate the pathological findings of postoperative wound infections by M . abscessus . METHODS: Proven sources of infections in 114 patients with postoperative wound infections were contaminated instrument disinfection liquid . According to the wound exudates cultivation and bacteriologic identification, the pathogen of postoperative infections was proved M . abscessus . Pathological features of postoperative wound infections were analyzed retrospectively . RESULTS: The postoperative wound infections in 114 cases involved cutaneous and subcutaneous tissue 95(83.3%), deep muscular tissue 21(18.4%), local lymph nodes 13(11.4%) and visceral organ, peritoneum and mesentery 3(2.6%) . The main pathological appearances were granulomatous lesions and nonspecific chronic pyogenic inflammations . The granulomatous lesions include pyogenic tuberculosis-like granuloma, atypical tuberculosis-like granuloma and tuberculosis-like granuloma . The three types of granuloma could be seen in the same case and the percentage of three types was 75.4%, 28.1%, 59.6% respectively . 38 cases (33.3%) were showed red mycobacterium at acid-fast stain . CONCLUSIONS: The pathological appearances of most postoperative wound infections by M . abscessus were more or less different from those of tuberculosis . Awareness of the pathologic features of the postoperative wound M . abscessus infections will facilitate the diagnosis so that appropriate therapy may be initiated before the disease is far advanced and prevent infection dissemination.

Zhonghua Jie He He Hu Xi Za Zhi, 1999 Jul, 22(7), 393 - 5
{Postoperative infection outbreak of M . chelonae subsp . abscessus}; Hu Q et al.; OBJECTIVE: To study the pathogen of postoperative infection outbreak in a hospital in Shenzhen . METHODS: According to the Laboratory Science Procedure of Diagnostic Bacteriology in Tuberculosis published by Chinese Antituberculosis Association, Bergey's Manual of Determinative Bacteriology (ninth edition), and the Clinical Bacteriology Examination & Development, 97 wound exudates were cultivated by the traditional bacteriologic method . The strains were identified with three standard strains of M . chelonae subsp . chelonae, M . chelonae subsp . abscessus and M . fortuitum as controls . RESULTS: 26 fast-acid positive and fast growth nontuberculous mycobacterium were isolated from 97 exudates, then 41 strains including other 15 strains which were collected from the hospital were identified as M . chelonae subsp . abscessus . CONCLUSION: The outbreak of the postoperative infection happened in the hospital was caused by M . chelonae subsp . abscessus.

Otol Neurotol, 2002 Jan, 23(1), 18 - 20
Preoperative topical ofloxacin solution for tympanoplasty: a randomized, controlled study; Tong MC et al.; OBJECTIVE: To establish the efficacy of immediate preoperative ototopical ofloxacin eardrops in eradicating middle ear pathogens and improving operative outcome . STUDY DESIGN: Single-blind, randomized control study . SETTING: Tertiary referral center, ambulatory clinic, and hospital setting . PATIENTS: Consecutive patients with chronic suppurative otitis media for Type I tympanoplasty (myringoplasty) . INTERVENTIONS: The patients were randomly assigned to 3 groups: Group A underwent 10-minute daily treatments with eardrops for 2 weeks before surgery, Group B underwent 3-minute daily treatments for 2 weeks before surgery, and Group C underwent no treatment . MAIN OUTCOME MEASURES: Preoperative and perioperative bacteriology and success of the surgery as defined by an intact tympanic membrane in the eighth week postsurgery . RESULTS: There were 101 patients entered in the study . The preoperative, perioperative, and postoperative observation of discharge and quantity of the discharge were compared, and no differences were found among the groups (Kruskal-Wallis test) . The perioperative culture results were analyzed and 18/21 (86%) became culture negative in Group A, 23/27 (85%) became culture negative in Group B, and 3/21 (14%) became culture negative in the control group (Group C versus Group A or Group B, chi(2) tests p < 0.001) . The success rates of surgery as defined by an intact tympanic membrane showed no difference: 28/33 (85%), 27/33 (82%), and 31/35 (89%) in Groups A, B, and C, respectively . The preoperative positive bacteriology rate in the surgical failures was 10/15 (67%), compared with 16/76 (21%) for the successful procedures (p < 0.001) . CONCLUSION: Our study has shown that ofloxacin successfully eradicates most bacterial flora preoperatively . We cannot, however, confirm the benefits of its preoperative usage in improving the graft success rate.

Zhonghua Jie He He Hu Xi Za Zhi, 2001 Oct, 24(10), 608 - 10
{Clinical research of pasinizid on retreated sputum positive pulmonary tuberculosis in senilities}; Yu D et al.; OBJECTIVE: To observe and evaluate the effect and safety of pasinizid on treatment of the senile pulmonary tuberculosis with bacteriological positive . METHODS: 115 cases of the senile pulmonary tuberculosis with bacteriological positive were divided into therapy group(group A) and control group(group B1 and B2) randomly . Chemotherapy regimen: group A were treated by 3DZL2E/5DL2E mainly composed of pasinizid; group B1 were treated by 3HPZL2/5HL2E(abbreviated HP regimen); group B2 were treated by 3DZL2E/5DL2E(abbreviated SH regimen) . RESULTS: When the chemotherapy was over, the sputum negative conversion rates were 92%, 72%, 71% in group A, group B1 and group B2 respectively . The conversion rate in group A was significantly higher than that in group B1 and group B2 (P < 0.05); focal absorption rates were 75%, 50%, 50% respectively, while the vanishing rates of cavity were 85%, 46%, 50% respectively . The rate in group A was significantly higher than that in group B1 and B2(P < 0.05); Rates of side effects were 17%, 58%, 18% respectively . The rates in group A and group B2 were apparently lower than that in group B1(P < 0.01) . Bacteriological relapse rate of 2 years were 5%, 19%, 18%, respectively . The rate in group A was lower than that in group B1 and B2 (P < 0.01) . CONCLUSIONS: The effect of pasinizid on senile retreated sputum positive pulmonary tuberculosis was better than HP and SH regimen . Due to its lower rates of side effects, it is recommended for clinical usage.

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