Bacteriological

Arch Orthop Trauma Surg, 2001 Nov, 121(10), 566 - 70
Pathomorphological and quantitative bacteriological findings in various forms of primary surgery on gunshot wounds of extremities; Zhang YD et al.; It is well-known that 'wound excision' is essential in the primary treatment of wounds in war, particularly thorough debridement of the devitalized tissues around the path of a penetrating projectile . Nowadays, the gunshot wounds in peacetime have become prevalent . Instead of the traditional method of 'wound excision' (excision), we used the method of 'incision and drainage' (incision) in the primary surgery of these gunshot wounds of extremities . To determine the treatment effectiveness of these different surgical methods (incision and excision), two groups of dogs were shot in the proximal part of one hind leg with an American M-16 rifle . One group was treated by the method of 'excision'; in the other group 'incision' were performed . No difference in infection rate was noted between the two groups . Similarly, no difference in bacterial count was found between the two groups during the observation period . Also, there was no difference in healing time; the wounds in both groups had healed by 19.2-21.4 days . Microscopic examination revealed a little normal muscle tissue in the necrotic zone of the incision group which might augment the repair process . These results suggest that there are no differences in the effectiveness in preventing infection between the two methods . 'Incision' might be superior to 'excision' for the management of the gunshot wounds of extremities in peacetime, as it involves a simple operation and there are advantages for tissue healing.

West Afr J Med, 2001 Apr-Jun, 20(2), 173 - 5
Pyogenic thyroiditis and HIV infection; Orkar KS et al.; Infective thyroiditis remain rare disease entity . Six patients were seen in Jos, Nigeria in the last five years . All of them were HIV positive . The presentation and management of these patients are high-lighted . The clinical features and bacteriology were similar to those previously documented for infective thyroiditis.

Int J Food Microbiol, 2001 Dec 4, 71(1), 87 - 92
Evaluation of techniques for enrichment and isolation of Escherichia coli O157:H7 from artificially contaminated sprouts; Weagant SD et al.; Because sprouted seed products are kept wet during and after production, have high levels of nutrients, and a neutral pH, they are subject to the outgrowth of pathogens such as Escherichia coli O157:H7 . For these same reasons, these products also contain high levels of heterotrophic organisms and in particular coliform bacteria . Recent outbreaks have focused attention on the need to improve methodology for isolating this pathogen from sprouts . When 40 E . coli O157:H7 strains were grown in pure culture in enterohemorrhagic E . coli enrichment broth (EEB) as prescribed in the U.S . FDA-Bacteriological Analytical Manual (FDA-BAM) and in EEB modified by varying the cefixime concentration, outgrowth for all strains in EEB was inhibited at 0.05 mg/l but for only 2 of 40 strains when the cefixime level was adjusted to 0.0125 mg/l . These two enrichment formulae were compared to modified E . coli broth (mEC), modified Tryptic Soy Broth with 20 mg/l novobiocin (mTSB + N), modified Buffered Peptone Water (mBPW), and mBPW with added 10 mg/l acriflavin, 10 mg/l cefsulodin, and 8 mg/l vancomycin (mBPW + ACV) for isolation of E . coli O157:H7 from sprouts . These comparisons were performed using low-level (0.12 to 0.42 cfu/g) artificially contaminated alfalfa and mixed salad sprouts . After enrichment, two isolation methods were compared for recovery; direct plating to Tellurite-Cefixime Sorbitol MacConkey agar (TCSMAC) and immunomagnetic separation (IMS) (Dynabeads anti-E . coli O157, Dynal, Oslo, Norway) followed by plating to TCSMAC . In addition, an immunoprecipitin detection kit, VIP (BioControl, Bellevue, WA), was evaluated for detection after enrichment . We found that five of the six enrichments were equivalent for detection or recovery while one enrichment (mTSB + N without agitation) was less productive . Incubation for 24 h was more effective in recovering E . coli O157:H7 from sprouts than 6 h for all enrichment broths . Plating after IMS was more productive than direct plating at these low levels of contamination, yielding recovery in 70 of 90 trials compared to 37 of 90 trials without IMS for six enrichments . The sensitivity of VIP for detection of E . coli O157:H7 varied depending on the enrichment broth . Because of the rapid rate of growth of E . coli O157:H7 in mBPW, the high productivity of mBPW + ACV after 24-h enrichment and its compatibility with both IMS and detection with immunoprecipitin tests, mBPW + ACV at 42 degrees C with agitation was found to be the most promising enrichment protocol for testing sprouts.

Khirurgiia (Mosk), 2001, (11), 39 - 43
{Diagnosis and treatment of pancreatic peritonitis}; Sovliov SA et al.; Results of diagnosis and treatment of 71 patients with general pancreatogenic peritonitis (7.3% of all patients with general peritonitis) are analyzed . The main diagnostic methods were ultrasound (100% cases), computed tomography (29.5%), laparoscopy (60%) . Based on clinical, instrumental, bacteriologic and morphologic examinations primary and secondary pancreatogenic peritonitis are distinguished . Optimal policy of treatment depended on peritonitis forms . In primary (enzyme peritonitis) minimally invasive methods of treatment were used: laparoscopic drainage of abdominal cavity and bursa omentalis, therapeutic blockades etc . in secondary (bacterial) peritonitis wide laparotomy with sanations of abdominal cavity and minor bursa omentalis were used . Consecutive necrectomies and sequestrectomies were preferred (70.2%) . Advantages of hemofiltration over other methods of efferent therapy are demonstrated . The above methods of treatment permitted to decrease postoperative lethality in secondary purulent pancreatogenic peritonitis from 68 to 44%.

Mar Pollut Bull, 2001 Nov, 42(11), 1155 - 60
Public perceptions of environmental quality: a survey study of beach use and perceptions in Los Angeles County; Pendleton L et al.; Despite documented successes in the battle to clean up the coastal waters of Southern California, Los Angeles County residents continue to view the ocean more as a place of pollution than a vibrant and healthy place for bathing and swimming . This study shows that residents of Los Angeles County tend to hold perceptions of marine water quality that are at odds with data on bacteriological measures of water quality collected by local sanitation districts (and reported by not-for-profit Heal the Bay) . Summary results of a survey of 400 randomly chosen households in Los Angeles County are given . Respondents were asked about their beach use and perceptions of environmental quality: both coastal water quality and air quality . The results suggest that perceptions of coastal water quality may be influenced less by "current coastal education campaigns" and more by the media and other factors.

Mar Pollut Bull, 2001 Nov, 42(11), 1150 - 4
Effect of sampling frequency on shoreline microbiology assessments; Leecaster MK et al.; More than 80,000 shoreline bacteriological samples are collected annually in southern California to protect beachgoer health, but sampling frequency varies from daily to monthly among sampling sites . To assess the effectiveness of various sampling frequencies, we used five years of data from 24 Los Angeles area sites that have been monitored daily to simulate five alternative sampling strategies: five weekdays, five days per week including a weekend day, three days per week, weekly, and monthly . For each of these sampling strategies, we included in the simulation the local custom of adaptive sampling, in which a site is resampled the following day if bacterial concentrations exceed the State of California's beach water quality standards . We found that sampling five times per week resulted in observing about 80% of the events in which State standards were exceeded . This frequency dropped to 55%, 25%, and 5% for three times per week, weekly, and monthly sampling, respectively . Adaptive sampling was ineffective because nearly 70% of the water quality exceedences were single-day events, even at the most frequently contaminated sites . This high frequency of single-day events is of concern because the public is typically notified about water quality conditions 24-48 h after samples are collected, meaning that most warnings are out-of-date when they are issued.

Biomaterials, 2002 Jan, 23(1), 19 - 26
Investigation of primary cell-biomaterial interactions using silver nitrate staining of nucleolar organising regions; Flynn JM et al.; The quantification of silver nitrate staining of nucleolar organising regions (AgNORs) within the nucleus of the cell has been shown to give a relative measure of the metabolic activity of the cell . In the present study, silver nitrate staining was utilised to identify metabolic variations in cells cultured on different surfaces and compared with proliferative activity assessed using bromodeoxyuridine (BrdU) uptake . Primary osteoblast and periosteal cells, isolated from the calvaria of neonate rats, were cultured on tissue culture-grade (TCPS) and bacteriological-grade (BACPS) polystyrene petri dishes for 3, 5, 7 and 9 days (silver nitrate) or 14 days (BrdU) . The phenotype of the cells was examined using RT-PCR of the mRNA for osteocalcin, collagen 1a, alkaline phosphatase and osteopontin . The number and area of AgNORs and the proportion of BrdU positive cells were statistically different in cells cultured on TCPS compared with BACPS at each culture period tested . The results suggest that the metabolic activity and proliferation of cells were affected by the substrate which they colonise.

Pol Merkuriusz Lek, 2001 Sep, 11(63), 276 - 8
{Single non-parasitic liver cysts}; Wysocki A et al.; Solitary non-parasitic cysts of the liver (NPHC) are rare . The incidence of NPHC on autopsy is 0.2% to 0.5% and on imaging from 2.5 to 4.6% of the population . They are more common in females than males . Congenital cysts can be solitary, multiple or involve the whole liver which is referred to as polycystic liver disease (PCLD) . Post-traumatic, neoplastic and echinococceal cysts are acquired lesions . Imaging procedures (USS, CT, MRI) are essential in diagnosis of hepatic cysts . Further diagnostic procedures include cytological, bacteriological and biochemical analysis of cystic fluid . Cystography can exclude communication of the cyst with the ductal system . Serologic tests are used in hydatid disease and serum tumour markers (CEA, CA 19-9) are measured to aid in differential diagnosis of suspected neoplastic cysts . Various therapeutic methods are used in the treatment of solitary non-parasitic hepatic cysts . The simplest is percutaneous obliteration with, for example ethyl alcohol . Fenestration (deroofing) with excision of the cyst wall is increasingly more often performed laparoscopically . Conventional open deroofing is used exceptionally, mainly in complicated cases.

Int J Syst Evol Microbiol, 2001 Nov, 51(Pt 6), 2221 - 5
Is characterization of a single isolate sufficient for valid publication of a new genus or species? Proposal to modify recommendation 30b of the Bacteriological Code (1990 Revision); Christensen H et al.; From 1990 to 2000, the number of published named taxa based upon new isolates at species and genus levels in International Journal of Systematic and Evolutionary Microbiology, formerly International Journal of Systematic Bacteriology, have increased by approximately four- and sevenfold, respectively . New taxa based upon characterization of only a single isolate remained at around 40% for both categories . The Bacteriological Code (1990 Revision) has no recommendations on the number of strains required for definition of new taxa . For a few groups, a minimum number of 5-10 strains has been suggested in minimal standards . Since an exponential increase in new taxa can be expected in the future, the authors discuss problems related to naming new species and genera based upon descriptions of a single isolate and suggest that this practice is re-evaluated . It is proposed that the following should be added to Recommendation 30b of the Bacteriological Code: 'Descriptions should be based on as many strains as possible (minimum five), representing different sources with respect to geography and ecology in order to be well characterized both phenotypically and genotypically, to establish the centre (from which the type strain could be chosen) and the extent of the cluster to be named . In addition, comparative studies should be performed, including reference strains that represent neighbouring species and/or genera, in order to give descriptions that are sufficiently detailed to allow differentiation from these neighbours.'

Hist Cienc Saude Manguinhos, 2001 Mar-Jun, 8(1), 133 - 71
{Rumors, fear or epidemy? The bubonic plague of 1913-1914 in the Atlantic coast of Columbia}; Valderrama JM; By the end of the 1800s, international trade and steam navigation made way for the third bubonic plague pandemy, which started in China in 1891 and reached America in 1898 . This calamity apparently arrived in Columbia's coast between 1913 and 1915, during the apex of Pasteur medicine . The deficiencies of Columbian public scientific and sanitary apparat, concerning the emerging bacteriology and epidemiology, prevented the government and the medical body from reacting against the fear and rumor of epidemy, which negatively affected the trade . The authorities were also unable to fight this problem with adequate diagnosis, enferms treatment, urban sanitation, and isolation of infected places . These difficulties led to a confrontation between the government and the medical body, inciting an argument about the existence of the plague . This discussion was settled by the North American official medicine that, in its verdict, gave preference to the commercial interests of the United States, ignoring the sanitary urgencies of the Columbian Atlantic coast.

Presse Med, 2001 Nov 17, 30(34), 1683 - 5
{Congenital syphilis still exists}; Tourneux P et al.; INTRODUCTION: Even today screening for congenital syphilis must be performed and confirmed by appropriate serological tests and bacteriological samples . OBSERVATION: A newborn presented with an apparently materno-fetal or viral fetal disease . It was in fact congenital syphilis . The mother exhibited no risk factors for syphilis . Systematic serological search for syphilis was negative in the mother at 11 weeks of amenorrhea . No signs of primary or secondary syphilis had been observed during pregnancy . At twenty-nine weeks of amenorrhea, the mother presented a menace of preterm delivery and no tocolysis at 31 weeks . Examination of the newborn revealed clinical signs of aterno-fetal infection, without specificorientation . Initial bacteriological and virological analyses were negative . Screening for specific Treponema pallidum M-type immunoglobulines (IgM) on the 9th day of life, confirmed the diagnosis of congenital syphilis . COMMENTS: Diagnosis of congenital syphilis must not be eliminated during early serological screening: clinical suspicion must lead to further anamnesis again and serological tests both in the newborn and the mother.

Pol Merkuriusz Lek, 2001 Aug, 11(62), 151 - 3
{Evaluation of efficacy of selected antiseptics for hands disinfection before surgical procedures}; Leksowski K et al.; The most important in surgical hands washing and disinfections is long-term and effective reduction of bacteria number . The aim of this study was to compare the efficiency of some antiseptic fluids used for surgical hands disinfection's (AHD 2000, Biotensid, Manopronto and Medi-Scrub PVP Iodine) . 62 doctors and surgical nurses were examined . The material for the bacteriological examination was collected before and after hands disinfection's . The bacterial flora reduction have been presented as a percent and a logarithmic reduction ratio . All estimated antiseptic fluids were very potent and provided prolonged efficiency when the operation team complied with orders of hands washing.

J Antimicrob Chemother, 2002 Jan, 49(1), 155 - 60
Once-daily versus twice-daily intravenous administration of vancomycin for infections in hospitalized patients; Cohen E et al.; The efficacy and toxicity of once-daily (od) versus twice-daily (bd) dosing of vancomycin was compared in 121 hospitalized patients . Eighteen patients were then withdrawn from the study . Clinical and bacteriological responses were evaluated in all patients (n = 103) . Nephrotoxicity was assessed in patients who did not receive nephrotoxic agents (n = 76) . Ototoxicity was assessed in patients who completed two audiograms and were not receiving ototoxic agents (n = 63) . No significant difference was found between the two groups for favourable clinical response: 47/51 (92.1%) and 49/52 (94.2%) in the od and bd groups, respectively . In 34 patients vancomycin was the only effective antibiotic . Fifteen of 18 (83.3%) evaluated episodes in the od and 12/16 (75.0%) evaluated episodes in the bd group showed a favourable bacteriological response . There were no significant differences between the od and bd groups for all adverse events . Nephrotoxicity developed in 4/37 (10.8%) and 3/39 (7.7%) patients, respectively . Hearing loss developed in 1/31 (3.2%) and 5/32 (15.6%) . Phlebitis occurred in 7/51 (13.7%) and 12/52 (23.0%) . Red man syndrome occurred in 7/51 (13.7%) and 5/52 (9.6%) in od and bd groups, respectively . The efficacy and safety profile of od administration of vancomycin is similar to that of the customary, but less convenient, bd administration.

J Antimicrob Chemother, 2002 Jan, 49(1), 31 - 40
Antibiotic therapy of community respiratory tract infections: strategies for optimal outcomes and minimized resistance emergence; Ball P et al.; Widespread, increasing antibiotic resistance amongst the major respiratory pathogens has compromised traditional therapy of the major infective respiratory syndromes, including bacterial pneumonia and acute exacerbations of chronic bronchitis . Guidelines for antibiotic prescribing dating from the 1980s to 1990s, which attempted to address such problems, were commonly too prescriptive and difficult to apply, and took little account of end-user practice or locally prevalent resistance levels . Further confusion was caused by conflicting recommendations emanating from differing specialty groups . The evidence that such guidelines benefited either clinical outcomes or treatment costs has been disputed . They have probably had little effect on resistance emergence . We report the recommendations of an independent, multi-national, inter-disciplinary group, which met to identify principles underlying prescribing and guideline formulation in an age of increasing bacterial resistance . Unnecessary prescribing was recognized as the major factor in influencing resistance and costs . Antibiotic therapy must be limited to syndromes in which bacterial infection is the predominant cause and should attempt maximal reduction in bacterial load, with the ultimate aim of bacterial eradication . It should be appropriate in type and context of local resistance prevalence, and optimal in dosage for the pathogen(s) involved . Prescribing should be based on pharmacodynamic principles that predict efficacy, bacterial eradication and prevention of resistance emergence . Pharmacoeconomic analyses confirm that bacteriologically more effective antibiotics can reduce overall management costs, particularly with respect to consequential morbidity and hospital admission . Application of these principles should positively benefit therapeutic outcomes, resistance avoidance and management costs and will more accurately guide antibiotic choices by both individuals and formulary/guideline committees.

Arch Surg, 2001 Dec, 136(12), 1386 - 90
Incidence and reversibility of organ failure in the course of sterile or infected necrotizing pancreatitis; Le Mee J et al.; BACKGROUND: Multiple organ failure (MOF) and infected necrosis are both considered severe adverse events during the course of necrotizing pancreatitis . HYPOTHESIS: The incidence of MOF and its reversibility in patients with necrotizing pancreatitis are influenced by the presence or absence of infected necrosis . DESIGN: Case series . SETTING: Intensive care, university teaching hospital . PATIENTS: Forty-three patients with necrotizing pancreatitis and failure of at least 1 organ were prospectively included . MAIN OUTCOME MEASURES: Organ failure defined according to the Goris classification; MOF defined by the simultaneous occurrence of 3 organ failures and graded with an MOF score . Microbial status of necrosis was assessed by percutaneous or intraoperative sampling . Surgical drainage was performed in patients with infected necrosis, whereas sterile necrosis was managed conservatively . RESULTS: Infected necrosis occurred in 27 patients (63%) . The mean (+/-SEM) number of organ failures was greater in cases of infection (3.6 +/- 1.1 vs 2.6 +/- 1.5; P =.02) . Multiple organ failure occurred more frequently in cases of infected necrosis (23/27 vs 7/16; P<.01) and was responsible for an increased mortality in this subgroup (33% vs 6%; P =.1) . The severity of MOF graded by the MOF score was related to the bacteriologic status of necrosis . CONCLUSIONS: The higher mortality commonly attributed to MOF in patients with infected necrosis appears to be due to a higher frequency and an increased severity of MOF . Conservative management in patients with severe necrotizing pancreatitis and sterile necrosis complicated by MOF is supported by the high reversibility rate of MOF and the low mortality rate observed in this series.

Neth J Med, 2001 Dec, 59(6), 280 - 5
Splenic abscess caused by Peptostreptococcus species, diagnosed with the aid of abdominal computerized tomography and treated with percutaneous drainage and antibiotics: a case report; Loualidi A et al.; We describe herein a 63-year-old patient with a splenic abscess due to Peptostreptococcus spp., diagnosed with the aid of abdominal computerised tomography and treated with ultra-sound guided percutaneous drainage and antibiotics . The bacteriological characteristics of splenic abscesses are discussed.

J Arthroplasty, 2001 Dec, 16(8 Suppl 1), 145 - 9
Primary arthroplasty of infected hips and knees in special cases using antibiotic-loaded bone-cement for fixation; Siegel A et al.; As a consequence of successful 1-stage exchange of infected joint prostheses, we decided to treat bacterial infection of the hip or knee by joint resection, synovectomy, and primary implantation of a hip or stabilized knee prosthesis . Since 1984, we have performed this procedure on 51 hips and 32 knees . All operations were preceded by identification of the causative organism and choice of appropriate antibiotics for addition to the bone-cement . The long-term rate of success corresponds to that of 1-stage exchange of infected prostheses . The different anatomic conditions at the hip and knee have to be taken into consideration . This treatment is restricted to special cases and should be performed only in specialized clinics with competent assistance from a bacteriologist.

Pediatr Infect Dis J, 2001 Dec, 20(12), 1161 - 4
Serologic response to a secreted and a cytosolic antigen of Mycobacterium tuberculosis in childhood tuberculosis; Raja A et al.; BACKGROUND AND AIM: Bacteriologic diagnosis of childhood tuberculosis is difficult, and alternate methods are needed . The utility of a serologic test for major secretory antigen (30 kDa) and a cytosolic antigen (16 kDa) of Mycobacterium tuberculosis was evaluated for the diagnosis of tuberculosis in children . METHODS: Enzyme-linked immunosorbent assay was used . Specific IgG, IgA and IgM antibodies were measured in the sera from 26 clinically and/or bacteriologically diagnosed cases of childhood tuberculosis and 61 normal children . RESULTS: Anti-IgG antibodies alone, against both 30- and 16-kDa antigens, were detected in 65.4% of patients . However, by combination of all three isotypes, increased sensitivities of 84.6 and 73%, with a specificity of 96.7% each, were obtained for 30- and 16-kDa antigens, respectively . CONCLUSIONS: We found good specificity and reasonably good sensitivity for detection of antibodies by enzyme-linked immunosorbent assay to 30-kDa antigen alone . The 16-kDa antigen did not perform as well.

Int J Antimicrob Agents, 2001 Dec, 18(6), 503 - 12
Randomized, double-blind study comparing 5- and 7-day regimens of oral levofloxacin in patients with acute exacerbation of chronic bronchitis; Masterton RG et al.; A randomized, double-blind, multicentre study was conducted in adult patients with acute exacerbation of chronic bronchitis (AECB), to compare the efficacy of a 5-day course of levofloxacin 500 mg once daily, with the standard 7-day regimen at the same dose . Five hundred and thirty-two patients from 48 centres in 10 countries were randomized to receive levofloxacin: 268 and 264 received the 5- and 7-day courses, respectively . The primary efficacy analysis was the clinical response at 7-10 days post-treatment in the per-protocol (PP) population . Clinical success rates in the primary PP analysis of 482 patients were 82.8% (197/238) for the 5-day group and 84.8% (207/244) for the 7-day group . The difference in success rates was -2.1% with a 95% CI of (-9.1 to 4.9%) . The bacteriological response showed eradication rates of 82.1% (92/112) and 83.2% (84/101) in the 5- and 7-day groups, respectively . Both treatments were well tolerated . These results show that for patients with AECB levofloxacin 500 mg once daily for 5 days provides equivalent clinical and bacteriological success to the same dose given for 7 days irrespective of the patient's age, the frequency of exacerbations or the presence of co-existing cardiopulmonary or chronic obstructive airways disease.

Arch Bronconeumol, 2001 Nov, 37(10), 417 - 23
{Tuberculosis notification from 1987 to 1999 for the public health area of the community of Valencia (Spain)}; Calpe JL et al.; OBJECTIVE: Under notification of tuberculosis (TB) is common worldwide but has hardly been studied in Spain . The objective of this study was to determine how many cases of TB are reported in our health care area . MATERIAL AND METHOD: Between 1987 and 1999 we carried out a direct study of the incidence and reporting of TB cases in our area (106,632 inhabitants on the census) . Cases were taken from mandatory notification, pathology and bacteriology files and were then reviewed . RESULTS: Of the 410 TB cases diagnosed, 378 were residents of the area (annual incidence: 27/100,000 inhabitants), 223 of whom were reported (54%) . Forty-eight patients were under 15 years of age . Sixty-seven percent of the pediatric cases and 53% of the adult cases were reported (n.s.) . Of the 78 cases with HIV co-infection, only 32% were reported, in contrast with 60% of HIV-negative cases (p < 0.001) . Of the 300 cases with pulmonary involvement, 56% were reported, versus 50% of those with exclusively extrapulmonary involvement (n.s.) . For the 149 with positive Ziehl-Neelsen stain, 61% were reported, in contrast with 51% of those who were smear negative (n.s.) . Diagnosis was based on clinical signs in 65 cases (16%), 51% of which were reported, versus 55% of those in which diagnosis was based on bacteriology or histology consistent with TB (n.s.) . Overall under notification tended to decrease during the study period (r = 0.73, p < 0.005) . Under notification also tended to decrease for patients with pulmonary involvement (r = 0.83, p < 0.0001) and for those with positive Ziehl-Neelsen staining of sputum (r = 0.79, p< 0.001) . Likewise, under notification also decreased for HIV negative patients (r = 0.74, p < 0.02) but not significantly so for HIV positive patients r = 0.44, n.s.) . CONCLUSIONS: Direct quantification of cases revealed a significant degree of under notification that is tending to decrease . Under notification is greatest for HIV-positive patients and is not changing . No differences were seen for smear positive and smear negative patients, by pulmonary or extra-pulmonary involvement, for clinical versus laboratory diagnosis, or for patients who were younger or older than 15 years of age . Reporting should be improved so that measures to decrease the incidence of TB can be taken.

Rev Sci Tech, 2001 Dec, 20(3), 769 - 75
Field investigations of brucellosis in cattle and small ruminants in Syria, 1990-1996; Darwish M et al.; The authors present the epidemiological status of brucellosis in cattle and small ruminants in Syria from 1990 to 1996, based on laboratory findings at the Brucellosis Centre, Damascus . Initial investigations using the Rose Bengal plate test, the complement fixation test and a miniaturised variant of the slow agglutination test were conducted throughout the country in 1990 and 1991, revealing an overall herd seroprevalence rate of 3.14% in cattle herds and 2.94% in small ruminant flocks . Although partially biased by previous vaccination of young female cattle with S19 vaccine, these figures indicate that brucellosis in cattle is widespread, particularly in the urban governorates (provinces) of Damascus, Aleppo and Suwaydah . Brucellosis seroprevalence in sheep and goats was relatively high in the governorates of Damascus, Aleppo and Dara'a . The results of a second series of investigations, performed between 1992 and 1996, show that herd seroprevalence in cattle decreased steadily from 17.48% in 1992, to 2.59% in 1996, in the Government-owned farms, while seroprevalence increased in the private sector during the same period . The difference may be explained by the restriction of brucellosis vaccination to public farms (although this was far from systematic), combined with partial application of a 'test-and-slaughter' policy . In sheep and goats, brucellosis seroprevalence fluctuated in the two sectors, but was higher in the private sector where husbandry is principally extensive . Bacteriological investigations led to the isolation of Brucella melitensis biovars 2 and 3 in sheep and B . abortus biovar 9 in cattle . Although no specific methodology was employed, particularly with regard to sampling, this study is significant as the first international report of the distribution of brucellosis in Syria . Further, well-structured studies are required, the results of which could be used to plan an appropriate national control programme for brucellosis.

Wien Klin Wochenschr, 2001 Oct 30, 113(20-21), 776 - 80
{Etiological research in medicine in Vienna circa 1900, at the time of Karl Landsteiner}; Groger H; By the end of the 19th century theoretical etiological research became more and more important in medical science . Anton Weichselbaum focused on bacteriology in the field of pathological anatomy and Rudolf Paltauf founded an Institute of Serotherapy, thus taking account of this new development . Progress made in laboratory medicine due to the work of a number of scientists in Vienna was of both fundamental and practical significance for the advancement of medicine.

CLAO J, 2001 Oct, 27(4), 231 - 3
Epithelial split associated with wear of a silicone hydrogel contact lens; Jalbert I et al.; PURPOSE: To describe the appearance and management of a superior epithelial arcuate lesion (SEAL) observed in association with the wear of a silicone hydrogel lens . METHODS: We present a case of a 30-year-old male who presented with a SEAL after 4 months of wear of a silicone hydrogel lens on a 30-day extended wear schedule . Bacteriological examination of the lenses and ocular adnexa was conducted at the time of the event . The clinical presentation and management are presented and compared to a review of cases associated with hydrogel lenses . RESULTS: The patient presented with symptoms of mild irritation . A linear splitwas noted in the superior peripheral cornea of the affected eye and was associated with limbal injection, stromal infiltrates, and fluorescein staining . Normal ocular biota was recovered from the lenses and eyelids of both eyes . Visual acuity remained unchanged and the lesion resolved following prophylactic treatment and discontinuation of lens wear for 8 days . CONCLUSIONS: The diagnosis and management of this SEAL case in a silicone hydrogel lens wearer mirrored that of previous events associated with hydrogel lenses . The possible etiologies of SEAL in this case are discussed and include mechanical irritation and dehydration of the lens surface.

No To Shinkei, 2001 Oct, 53(10), 957 - 60
{A case of craniopharyngioma with chemical meningitis as an initial symptom}; Nishio Y et al.; We reported a rare case of craniopharyngioma with chemical meningitis due to spontaneous rupture of the tumor . A 50-year-old woman was admitted with high fever, headache, and nausea . On physical examination, she had nuchal rigidity . The examination of her cerebral spinal fluid(CSF) revealed pleocytosis(mononuclear cell dominant), low value of glucose level and high content of protein . The feature of her CSF findings suggested tuberculosis or fungal meningitis, but bacteriologic culture of the CSF was negative . The CT scan showed an isodensity mass in the suprasellar region and a spotty calcification in the third ventricle . The MRI with gadolinium enhancement suggested that the tumor must be craniopharyngioma and that meningitis was a type of chemical meningitis due to spontaneous rupture of craniopharyngioma . The corticosteroid therapy was rather effective to the symptoms of fever and headache . Then the operation was performed by neurosurgeons, and the diagnosis of craniopharyngioma was pathologically confirmed . Spontaneous rupture of craniopharyngioma rarely occurred and was followed by chemical meningitis . This case was an extremely rare condition that presented with chemical meningitis as an initial symptom.

Pathologica, 2001 Oct, 93(5), 535 - 43
{Health anthropology and hospital archiving . The Museum of Pathological Anatomy of the City Hospital of Trieste}; Braulin F; The preparations found in the Trieste Hospital Museum of Pathological Anatomy fit into the context of a medical semiotics which has its origins in the anatomical clinical method . The study of the practices involved in the museum preparation leads back to its purely diagnostic function inasmuch as it convalidates or contradicts the suppositions that, from the symptomatological case history, made from the study of the lesions and the diseased organ . This whole investigative process corresponds to a break in the field of scientific knowledge which marks the birth of a new approach to diagnosis and a new form of nosology, made possible by the great number of sick people and deaths available in a modern hospital . The Museum is permeated with empiricism, morphologism and localisation, and its exhibits fluctuate between macroscopic and microscopic anatomy, between organic and cellular pathology . In the exhibits of infectious and contagious diseases, one can see traces of the revolution brought about by bacteriology and laboratory techniques; in the considerable collection of malignant tumours, one can detect an oncological awareness which relates explicitly to a nosology based on the work of Virchow . The preparations which refer to pathologies that cannot be reduced simply to localisation illustrate an increasing awareness of functional medicine and clinical biochemistry . The Museum has the task of showing and teaching in order to train the hospital doctor . The Museum--through pathological anatomy--directed the community towards a knowledge of healthcare methods destined to change the morbidity and mortality rates due to a certain disease, in relation to those diseases typical of the times.

Med Confl Surviv, 2001 Oct-Dec, 17(4), 355 - 68
The United States and biological warfare: secrets from the early cold war and Korea; Bruwer A; The United States and Biological Warfare is about accusations that the United States resorted to bacteriological warfare at a time of great military stress during the Korean War . In December 1951, the then US Secretary of Defense ordered early readiness for offensive use of biological weapons . Soon afterwards, the North Korean and Chinese armies accused the United States of starting a large-scale biological warfare experiment in Korea . The US State Department denied the accusation . Both parties to the dispute maintain their positions today . The authors spent 20 years researching the accusations in North America, Europe and Japan . They were the first foreigners to be given access to Chinese classified documents . The reader is also introduced to the concept of 'plausible denial', an official US policy which allowed responsible governmental representatives to deny knowledge of certain events . The authors hope that their work will contribute to the understanding of a time when modern war expanded into a new type of violence.

Int J Tuberc Lung Dis, 2001 Nov, 5(11), 1021 - 7
Patient and health care system delays in Queensland tuberculosis patients, 1985-1998; Ward J et al.; SETTING: Queensland tuberculosis (TB) control centre QTCC) . OBJECTIVE: To investigate patient and health care system delays in the diagnosis of active TB in Queensland . DESIGN: Analysis of data extracted from the QTCC database and review of charts . Symptomatic patients with bacteriologically or histologically proven TB were considered as a total group and a pulmonary smear-positive (PSP) group . RESULTS: The median patient delays were 29 days (total group) and 30 days (PSP group) . The median health care system delays were 22 days (total group) and 11 days (PSP group) . There were significant trends towards increasing health care system delays with increasing age and longer residency of migrants in Australia . Health care system delays were significantly longer for females and those aged over 45 . Migrants from countries of high TB incidence and indigenous Australians had shorter health care system delays compared to non-indigenous Australians . Common reasons for diagnostic delays of more than 90 days were failure to perform appropriate investigations and misdiagnosis of chest X-rays . CONCLUSION: Physicians need to consider including TB in the differential diagnosis in older age groups and migrants with longer residency in Australia . There should be a low threshold for obtaining chest X-rays and sputum samples in patients with persistent cough.

Ann Plast Surg, 2001 Nov, 47(5), 523 - 7
Fournier's gangrene: etiology, treatment, and complications; Kilic A et al.; Presented here are 23 patients with Fournier's gangrene who were treated between 1990 and 1999 in the departments of general surgery, urology, and plastic and reconstructive surgery . Patients were reviewed retrospectively and are discussed according to age, gender, bacteriology, etiology, treatment, and outcome in the light of the current literature.

Eur J Clin Microbiol Infect Dis, 2001 Sep, 20(9), 643 - 6
Piperacillin/Tazobactam versus cefotaxime plus metronidazole for treatment of children with intra-abdominal infections requiring surgery; Maltezou HC et al.; The efficacy of piperacillin/tazobactam at 100/12.5 mg/kg every 8 h (35 patients) was compared to cefotaxime plus metronidazole at 50/7.5 mg/kg every 8 h (35 patients) in 70 children with intra-abdominal infections requiring surgery . Diagnoses were gangrenous or perforated appendicitis (n =56), peritonitis (n =12), and abscess (n =2) . Clinical cure was observed in 35 of 35 evaluable patients treated with piperacilin/tazobactam and in 34 of 34 evaluable patients treated with cefotaxime plus metronidazole . Presumed bacteriological eradication was noted in 29 of 30 evaluable patients in the piperacillin/tazobactam group and in 31 of 31 evaluable patients in the cefotaxime plus metronidazole group . In this study, piperacillin/tazobactam was as effective as cefotaxime plus metronidazole for treating children with intra-abdominal infections requiring surgery.

Gastric Cancer, 2001, 4(2), 87 - 92
Prevalence of Helicobacter pylori infection in gastric remnant after distal gastrectomy for primary gastric cancer; Onoda N et al.; BACKGROUND: The development of a second primary cancer in the gastric remnant after gastrectomy for early gastric carcinoma is a problem, and eradication of Helicobacter pylori after the operation has been recommended . However, to date, practical indications for H . pylori eradication after gastric cancer surgery have not yet been reported . METHODS: We examined H . pylori infection in the gastric remnant after distal gastrectomy for primary gastric cancer . One hundred and nine patients who had had a gastrectomy were studied . Endoscopic findings and results from the urease test, bacteriologic assessment, serological test, and histopathological examination were analyzed . RESULTS: Seventy-one patients (65.1%) were judged to be positive for H . pylori infection . The prevalence of H . pylori infection was found to be significantly decreased in older patients, patients in whom the operation had been performed a long time before examination, patients with symptoms, and patients with severe reflux gastritis . On the other hand, histologically, chronic and acute gastritis correlated significantly with H . pylori infection . H . pylori prevalence was highest in mildly atrophic mucosa and decreased with more extensive atrophic changes of the mucosa . CONCLUSIONS: The persistence of H . pylori-related active gastritis in the gastric remnant after gastric cancer surgery was suggested in younger patients with mild atrophic gastritis and without reflux gastritis . These patients may be the best candidates for H . pylori eradication therapy.

Vet Parasitol, 2001 Dec 3, 102(1-2), 1 - 15
A Swiss case-control study to assess Neospora caninum-associated bovine abortions by PCR, histopathology and serology; Sager H et al.; Neospora caninum is one of the most frequent infectious organisms causing abortion in cattle worldwide . The present case-control study was designed to assess the importance of bovine neosporosis for causing abortion in Swiss cattle and to identify selected risk factors . Infection was primarily diagnosed by a N . caninum-specific PCR and serology, complemented with histopathology and immunohistochemistry . A total of 113 case and 113 corresponding control-farms were studied for 1.5 year . During this time period, 242 abortions were reported and referred for bacteriological, virological, parasitological and pathohistological examinations . N . caninum was detected by PCR in the brains of 21% of all aborted fetuses . Microscopic lesions indicative for cerebral protozoa infection were detected in 84% of PCR-positive fetal brains . Bovine viral diarrhea virus (BVDV) was demonstrated in 7% of the cases, and bacterial infections were detected in 4% of the abortions . One or more N . caninum-abortions occurred in 20% of the herds (41 case-farms and 3 control-farms) . Serological examination of aborting mother cows revealed a significantly higher percentage of N . caninum-seropositive animals (44%) in comparison to the prevalence in a randomly selected population (12%) . However, in eight cases (4% of all investigated abortions) seronegative cows aborted N . caninum PCR-positive fetuses, and in 50 cases the fetus remained negative although the respective mother cow was N . caninum-seropositive . Repetitive serological investigations (at a 3-12 months interval) of 3551 cows from case- and control-farms showed a decrease of the overall N . caninum-seroprevalence from 17 to 12% . Ninety out of 3008 seronegative animals were converted to N . caninum-seropositivity . Conversely, 212 out of 543 initially seropositive animals became seronegative for their second serum sample . The obtained data underlined the importance of N . caninum as a causative agent for abortion in Swiss cattle . Furthermore, PCR was confirmed to be a valuable diagnostic tool for the primary diagnosis of N . caninum in aborted fetuses . On the other hand, the value of serology appears to be hampered by the temporal instability of N . caninum antibody concentrations in adult cattle, including especially seronegativity of some individual animals . Thus, seronegativity in a mother cow or heifer does not exclude N . caninum-associated abortions.

Mikrobiol Z, 2001 Jul-Aug, 63(4), 91 - 5
{Resistance of Mycobacterium tuberculosis strains isolated from patients to antituberculosis drugs}; Sybirna RI et al.; Patients from focuses of tuberculosis infection in the Lviv Region for 1996-1999 were subjected to bacteriological examination . It has been established that the disseminated form occupies the first place in general structure among patients with bacterial excretions . The increase in the number of strains of tuberculosis mycobacteria resistant to the basic antituberculosis drugs and their polyresistance, especially, in patients living in towns has been revealed.

Int J Antimicrob Agents, 2001 Oct, 18(4), 383 - 6
Comparison of isepamicin with amikacin for the empirical treatment of febrile neutropenic children with malignancies; Maltezou HC et al.; The efficacy and safety of isepamicin at 7.5 mg/kg i.v . q 12 h was prospectively compared with that of amikacin at the same dose for the treatment of febrile neutropenic children with malignancies . Thirty-nine patients were enrolled in the study; 25 received isepamicin and 14 amikacin . Clinical and bacteriological response rates were 100% for both groups . No adverse events occurred . Median peak serum levels were 19.7 mg/l for isepamicin and 19.20 mg/l for amikacin . Median trough serum levels were 0.72 mg/l for isepamicin and 0.68 mg/l for amikacin . It was concluded that isepamicin was as effective and safe as amikacin for the treatment of febrile neutropenic children with malignancies, and might be used in areas where resistance to other aminoglycosides is a problem.

Infection, 2001 Oct, 29(5), 291 - 2
Unusual complication of breast implants: Brucella infection; Memish ZA et al.; Brucellosis is hyperendemic in Saudi Arabia . We report infection in a breast implant as an unusual complication of laboratory-acquired brucellosis . A 48-year-old female developed fever, rigors, headache, arthralgia and weight loss . A blood culture for Brucella was positive . A 6-week course of antibiotics effected a clinical and bacteriological cure but the resolution was short-lived . Six weeks later a relapse of her febrile symptoms occurred together with the appearance of a breast abscess . Cultures of the abscess and blood yielded brucella . A second course of antibiotics together with surgical drainage and subsequent reconstruction resulted in a cure.

Trends Parasitol, 2001 Aug, 17(8), 377 - 80
Bacteriological larvicides of dipteran disease vectors; Regis L et al.; The apparent success in vector control observed between 1950 and 1970 was followed by worldwide resistance to organosynthetic insecticides wherever they were used intensively . Insect resistance to one or more categories of insecticides has limited the effectiveness of these compounds, and their non-selective mode of action adversely affects non-target organisms . This scenario highlights the need for selective agents in integrated vector control programs . This article gives an overview of the main fundamental and applied research topics on entomopathogenic bacteria in relation to their role in vector control.

Rinsho Byori, 2001 Sep, 49(9), 864 - 7
{The control survey of Japanese Association of Medical Technologists (JAMT) and its possibility of the standardization for the survey}; Osawa S; External quality control survey of JAMT (Japanese Association of Medical Technologists) carries out 9 sections of clinical chemistry, hematology, bacteriology, serology, cytology, urology, physiology-pathology, blood transfusion and genetics . In two sections of biochemistry and urology, the control survey sample have been certified which was target value and allowance limits of error by the reference method . These standardized items are utilized in order to know the degree of the accuracy of the participation laboratories . We carried out the investigation for putting the focus at 2 sections of biochemistry and serology in order to execute the standardization of the external quality control . The multiple laboratories were carried out certified using both of common pooled serum and the reference serum for a proficiency test . On the standardization items, the result showed that the external quality survey assessment was possible by the accuracy . On items of biochemistry and serology test, there have compatibility which the results of same control survey of other group . It judged possible the standardization of the external quality control assessment by the integration of the research method.

J Antimicrob Chemother, 2001 Nov, 48(5), 677 - 89
Meta-analysis of randomized controlled trials on the comparative efficacy and safety of azithromycin against other antibiotics for upper respiratory tract infections; Ioannidis JP et al.; We carried out a meta-analysis of randomized controlled trials comparing 3-5 days of azithromycin with other antibiotics that are typically given in longer courses for the treatment of upper respiratory tract infections . For acute otitis media (19 comparisons including 3421 patients), acute sinusitis (11 comparisons including 1742 patients) and acute pharyngitis (16 comparisons including 2447 patients), azithromycin had similar clinical failure rates to the other antibiotics {random effects odds ratios 1.12, 95% confidence interval (CI) 0.81-1.54; 0.91, 95% CI 0.60-1.39; and 1.07, 95% CI 0.59-1.94, respectively} . The difference in clinical failures was <0.5%, and no 95% CIs exceeded 2.0% . There was no heterogeneity between studies . Subtle differences between comparators could have been due to chance . There were no significant differences in bacteriological outcomes . Azithromycin was discontinued because of adverse events in only 37 of 4870 (0.8%) patients . Short courses of azithromycin are as effective as longer courses of other antibiotics for upper respiratory tract infections . Convenience of dosing should be balanced against the increased cost of this regimen for the treatment of these common infections, where often no antibiotic may be indicated at all.

Trop Doct, 2001 Oct, 31(4), 237 - 40
Spinal tuberculosis; Bewes P; Spinal tuberculosis is an important and potentially crippling disease, but if recognized early and treated energetically it can be brought under control, often with very gratifying results . Knowledge of the exact bacteriology and sensitivity pattern of the organisms involved can be very helpful indeed, and should be sought where possible.

Gastroenterol Hepatol, 2001 Oct, 24(8), 375 - 80
{Fasciola hepatica . study of a series of 37 patients}; Cosme A et al.; BACKGROUND: To analyze the clinical, bacteriologic, diagnostic and therapeutic features of patients with Fasciola hepatica (FH) in our hospital . PATIENTS AND METHOD: We reviewed all the patients with a diagnosis of fascioliasis from 1975 to 1999 in the Aranzazu Hospital in San Sebastian (Guipuzcoa, Spain) . Diagnosis was made by direct vision of adult parasites during surgery and/or the presence of ova in stool examinations and/or positive serologic tests in patients with symptoms consistent with parasitosis . RESULTS: Thirty-seven patients were included (23 men and 14 women), aged 19 to 71 years . Ingestion of watercress was confirmed in 27 . Seven cases occurred as part of familiar outbreaks . Thirty-two were in the liver invasive stage and in 5 the biliary tree was invaded . The most common features were eosinophilia (91.8%), malaise and weight loss (75.6%), elevated alkaline phosphatase (74.2%), and abdominal pain (72.9%) . Adult worms in the biliary ducts were observed in 3 patients and ova in feces were observed in 6 . In 13 of 27 patients indirect hemagglutination test was ( 1/1,280 . Data significant to confirmation of liver involvement were provided by laparoscopy in 12 of 13 patients and by imaging techniques in 13 of 31 patients . Four patients had cholelithiasis and of these, 2 also showed adult parasites in the common bile duct . Three patients underwent surgery . Therapy with dehydroemetine and/or bithionol was followed by complete remission in 30 patients, although 6 required repeat treatment cycles . The remaining 4 patients were cured by praziquantel . CONCLUSIONS: Most of the patients in these series reported consumption of watercress and all patients showed the symptoms typical of parasite disease . Imaging techniques proved to be of great utility in confirming the diagnosis of hepato-biliary disease . In most of the patients therapy with dehydroemetine and/or bithionol (in one or several cycles) was followed by complete remission.

Biosens Bioelectron, 2001 Aug, 16(6), 399 - 408
Development of an evanescent-field fibre optic sensor for Escherichia coli O157:H7; Ferreira AP et al.; An intensity-modulated fibre optic sensor was developed for Escherichia coli O157:H7 . The interaction between the whole natural bacteria and the guided lightwave was carried out by means of evanescent-field coupling . A correlation between optical response and the current number of bacteria was achieved . The device sensitivity had been calibrated for initial number of bacteria (N(0)) from 10-800 . The sensor sensitivity was 0.016 (+/-0.001) dB/h/N(0) . The sensing mechanism starts together with the log phase leading the present sensor response to be five to ten times faster than conventional bacteriological techniques.

Scand J Infect Dis, 2001, 33(9), 667 - 72
Invasive pneumococcal infections in Southwestern Sweden: a second follow-up period of 15 years; Dahl MS et al.; In a retrospective study, the incidence, clinical manifestations, concomitant conditions and case fatality rate were studied in patients with invasive pneumococcal infections in the Goteborg area of Sweden during 1981-95, when the pneumococcal polysaccharide vaccine was available but little used . Patients were identified from the records of the Departments of Clinical Bacteriology and from the computer-based hospital discharge registers of the relevant departments . Individual case records were found for 876 patients with invasive pneumococcal infections verified by cultures from blood, cerebrospinal fluid or other sterile body fluids . A study from the same area with the same design covering the years 1964-80 has previously been published . There was an increase in total incidence from 5.3 to 10.3 cases/100,000/y from the previous to the present study . This increase was due to an increase in patients with non-meningitic infections aged > or = 60 y . The incidence of meningitis was virtually unchanged (1.4/100,000/y), as was the incidence of non-meningitic infections in individuals < 60 y . There were no other important changes between the 2 studies, which confirm that invasive pneumococcal infections have the highest incidence rates in children < 2 y and in the elderly, that a wide variety of underlying conditions are seen in the patients and that the case fatality rate, 15% in the present study, is still high.

J Vet Med B Infect Dis Vet Public Health, 2001 Sep, 48(7), 529 - 36
Endometritis in she donkeys in Egypt; Sokkar SM et al.; The endometrial necropsies of 165 she donkeys were examined and the endometria were classified into four grades according to histological features (I, IIa, IIb, III) . Category I was observed in 86 cases (52.12%) and diagnosed as normal endometria . Category IIa was observed in 18 cases (10.91%) and diagnosed as slight endometritis . Category IIb was observed in 28 cases (16.97%) and diagnosed as moderate endometritis (two to four nests/field), while category III was observed in 33 cases (20%) and diagnosed as severe endometritis (eight nests/field) . A bacteriological examination was carried out and oestrogen and progesterone were estimated . Our results indicate that endometritis and the prognosis of fertility in she donkeys were more or less parallel to mares.

Hist Sci Med, 2000 Jul-Sep, 34(3), 289 - 94
{The Constantinople Imperial Bacteriology Institute}; Huet M; The Constantinople Imperial Bacteriology Institute (CIBI) allowed the development of a common medical effort between France and Turkey at a time when the main European powers were competing to have an influence on the Ottoman Empire . In 1887, Turkey sent Zoreos Pacha, a medical doctor, to Paris to learn anti-rabies immunization techniques, and he started a rabies control institute after his coming back . In 1893, a cholera epidemic in Constantinople was vanquished by A . Chantemesse, sent by Pasteur, and France was allowed to start another microbiologic Institute . The first director of this Constantinople Imperial Bacteriology Institute was Maurice Nicolle . A brillant man, but suffering from a lack of diplomacy; he encountered numerous difficulties and regularly threatened to turn in his resignation . His successor, Paul Remlinger, arrived in 1900 . His main research topic was rabies, and he became later a world-class expert on the subject . His position was taken over in 1911 by Paul-Louis Simond, unjustly forgotten nowadays despite his major discovery in 1898 showing that the plague was transmitted by ratfleas . The next director was a veterinary doctor, P . Forgeot, but his tenure was cut short by World War I, and he was the last French director of the CIBI . Since that time, Turkey has felt some gratitude towards France for its medical efforts . It organized in 1957 in Istambul a very congenial celebration for the 70th anniversary of the Rabies Control Institute, which numerous Pasteur Institute alumni attended . There is a clear contrast between the CIBI, the target of many intrigues and hostile maneuvers, and the North African Pasteur Institutes, which were making crucial discoveries during the same period . This contrast was mostly due to the absolute power of the Sultan, who would arbitrarily oppose some directors decisions, whereas the French government allowed the balanced growth of the Pasteur Institutes in territories under his control.

Rev Hist Pharm (Paris), 1994, 41(303), 452 - 9
{Professor A.-C . Hollande at the School of Pharmacy of Nancy, 1912-1922}; Labrude P; Andre-Charles Hollande, born in Chambery in 1881, obtained his pharmacy degree and science doctorate in Lyon and Grenoble . He came to the School of Pharmacy in Nancy in 1912 as director of studies in micrography and lecturer in natural history . During the war, while he was mobilized (1914-1917), he was head of the chemical and bacteriological laboratory of Chambery and worked on clinical chemistry and bacteriology . Professor of natural history in Nancy in January 1920, professor of bacteriology some months after, he left Nancy for Montpellier in 1922 . His research in Nancy was devoted to zoology (cytology of insects), parasitology, bacteriology (discovery of 5 bacterial species), clinical chemistry and technics (determination of simulations, histology), and finally cytology and colorations . He was also pharmacist inspector for the towns of Chaumont (Haute-Marne) and Epinal (Vosges).

Nippon Ishigaku Zasshi, 1992 Sep, 38(3), 401 - 31
{Career and work of Dr . Jiro Tsuboi, a hygienist}; Izumi H; The author recorded the career and work of Dr . Jiro Tsuboi, a hygienist and the first dean of the medical school, Kyoto Imperial University . He was born in 1862 as a son of Dr . Tameharu Tsuboi, a famous medical educator . After graduation from Tokyo University Medical School, he entered the Department of Hygienics of his mother school . In 1890, he went to Germany, and studied under Dr . Max von Pettenkofer at Ludwig Maximillians University in Munich . He also learned tuberculin therapy for tuberculosis from Dr . Robert Koch in Berlin . After he returned to Japan, he worked as a hygienist for various social needs, including serving as a committee member for mineral pollution at Ashio copper mine . In 1899, he was appointed Dean of the medical school, Kyoto Imperial University . Though he exerted himself for the school, he died at the age of 41 in 1903 . His scientific contribution comprises both hygienics and bacteriology . Because of his early death, his attainment remained limited.

Soc Hist Med, 1995 Apr, 8(1), 55 - 73
The Russian influenza in the United Kingdom, 1889-1894; Smith FB; The pandemic of severe influenza known in western Europe as the Russian flu, with its associated infections, caused extensive morbidity and high general mortality . In the United Kingdom, as elsewhere, sufferers and their doctors were hard put to explain the visitatiion and resorted to analogies with physical or bacteriological phenomena, or recalled older beliefs in extra-terrestrial forces . The outcomes were more disturbing than was appreciated at the time, or since . The Russian influenza and its sequelae might well have had a crucial part in creating the 'spirit of the 1890s'.

Rev Soc Venez Hist Med, 1992 Dec, 41(62), 17 - 42
Not Available
Velez Boza F.
In remembrance of the First Centennial of the Normal and Pathological Histology, Experimental Physiology and Bacteriology courses foundation, a quantitative analysis of the Dr . Jose Gregorio Hernandez career between 1891 and 1919 is made . He was its Founder Professor and, with that, the Pasteurian and Experimental era initiator in our medicine . His elevated pedagogic quality, as well as his excellent condition as searcher and in the practice of medicine is highlighted.

Hist Cienc Saude Manguinhos, 1997 Nov-1998 Feb, 4(3), 411 - 59
{The dawning of a new science: Bahian tropicalist medicine}; de Barros PM; Medicine in 19th-century Brazil was a scientific field where traditional knowledge, academic teaching, and clinical care found themselves clashing with new theories of illness and medical care underpinned by pioneer disciplines like parasitology, bacteriology, and anatomopathology and an experimental clinical practice focused on tropical diseases which afflict the poor . This new set of theoretical and social references which affected public health-care policy saw its decadence when it was appropriated by an ideology that argued that the Afro-Brazilian population was racially and culturally inferior . Two new disciplines--criminal physical anthropology and legal medicine--contributed to the development of specialized knowledge within intellectual circles . At the same time, they were placed at the service of the ruling order, reinforcing principles and devices that the elite utilized to keep itself in power . This hybrid structure constitutes the legacy of barbarianism which is sundering today's civilization.

Arch Hist Filoz Med, 1997, 60(4), 327 - 44
{Hygiene issues in polish academic centres of the period of twenty years of Poland's independence after World War I}; Jeszke M et al.; Within the discipline as such, among Polish scientists of the period of twenty years of independence after the World War I, there was no agreement as to the understanding of the area of hygiene interests and as to the role of it . On one poend it was placed a concept of hygiene as the remedy towards the basic sanitary inadvertences, covering only narrow segments of relationship between the organism condition and individual environment elements of positive or negative importance for health . This depiction was bringing a hygienist closer to such disciplines as physiology, pathophysiology, toxicology, bacteriology etc., it imposed typically natural point of view and research workshop . On the second end the issue of health has been considered within the broad social and cultural context . In such a meaning hygiene goes beyond the narrow concept of medicine, since the latter has not been able to replace the shortages of civilisation and it has not been interested in issues of cultural adaptation of desired sanitary behaviour . As a matter of fact, both views have been excluding each other, adopting different and "incommensurate" visions of the "world and human being" as well as methodological depictions . In the time under discussion, within Polish territories, a thesis, that individual health has a social dimension, makes a considerable economic value, decides on the defence abilities of state, so it is in the interest of the whole society the care for health of all members of society - was still having virtues of uniqueness . It was going like that despite earlier activity of many outstanding Polish hygienists, giving fruits both in information campaigns planned on a wide scale and civilisation experiments . ...

Hippokrates (Helsinki) . 1997;:62-73.
{Fifty years of dental nurse education in Finland}; Meurman JH et al.; The first training-course for dental nurses was arranged by the Finnish Dental Association in 1947-1948 . Professional help was needed in dental offices in assisting the dentists, taking care of the patients, particularly children, and in cleaning the equipment . As early as 1922 the Scandinavian Dental Association had pointed out that "clinic sisters" would be needed in dental training centers, but the suggestion was not put into effect . The first nine-month curriculum for dental nurses already included all disciplines of dentistry . Lectures in pharmacology, bacteriology and first-aid were also given . Practical training was arranged at the Institute of Dentistry, University of Helsinki . The students further trained for three-week periods both at dental clinics and at privat dental offices . Nine students completed the course and received their diplomas at the end of May, 1948.

Hist Sci Med, 1997 Apr-Jun, 31(1), 87 - 95
{A challenged Nobel Prize: Johannes Fibiger, 1926}; Petithory JC et al.; Johannes Fibiger born in Denmark in 1867 died in 1928 from a cancer of the colon . First interested in bacteriology he became later (1900) professor of pathological anatomy . His chief work on the alleged cancerigenous role of a nematode Gonglyonema neoplasticum in some species of rats allowed him to receive the Nobel Prize in medicine in 1926 . The difficulties met later (species of Gongylonema spp . from rats, dietary, lack of vitamin A) and even the impossibility to reproduce his results have brought a contestation of his work . However the cancerigenous action of some parasitic heminths such as Schistosoma is now recognized.

Hist Cienc Saude Manguinhos, 1994, 1(1), 7 - 18
{Ludwik Fleck and the history of sciences today}; Lowy I; In the 1920's and 30's the physician and epistemologist Ludwik Fleck developed a highly original ideas on science . These ideas were rooted in Fleck's own experience as bacteriologist and immunologist and, on the other hand, in the practice-based thought of the Polish School of Philosophy of Medicine . Fleck affirmed that 'scientific facts' are constructed by groups of scientists, in his terms, by "thought collectives" . Each thought collective elaborates a "thought style" which contains norms, concepts and practices of that collective . Newcomers to a professional community are socialized into its specific thought style and develop an unique way of viewing the world . Scientific facts produced by a given thought collective are therefore shaped by that collective's thought style, and are incommensurable with facts produced by other thought collectives . The incommensurability of scientific facts and its consequence, the need to 'translate' these facts into the style of different thought collectives in an inter-community use are, Fleck proposed, an important source of innovations in science and in society . Fleck ideas were rediscovered in the 1960's and 70's, first by Thomas Kuhn, who in the introduction to his book, The structure of scientific revolutions, acknowledges his ties with Fleck's thought, then by sociologists of science . Beyond their direct influence, Fleck's epistemology has many affinities with new trends in science studies, focused on the scientists' practices, and interested in their material, discursive and social techniques.

J Hist Biol, 2000 Spring, 33(1), 141 - 80
From bacteriology to biochemistry: Albert Jan Kluyver and Chester Werkman at Iowa State; Singleton R; This essay explores connections between bacteriology and disciplinary evolution of biochemistry in this country during the 1930s . Many features of intermediary metabolism, a central component of biochemistry, originated as attempts to answer fundamental bacteriological questions . Thus, many bacteriologists altered their research programs to answer these questions . In doing so they changed their disciplinary focus from bacteriology to biochemistry . Chester Hamlin Werkman's (1893-1962) Iowa State career illustrates the research perspective that many bacteriologists adopted . As a junior faculty member in the Bacteriology Department in the late 1920s, Werkman faced a powerful professional dilemma: establishing a research identity that distinguished him from his colleagues with flourishing national and international reputations . His solution was to radically alter his research program from traditional bacteriology to a biochemistry program, which reflected the influence of the Dutch microbiologist/biochemist, Albert Jan Kluyver (1888-1956) . Werkman was extremely successful in this career change . His laboratory made significant contributions to biochemistry, and Werkman achieved a notable degree of personal success . His career began in the shadow of his departmental bacteriological colleagues; within a decade he became the department's dominant research figure, as a biochemist . Werkman's personal success, however, had profound consequences for the disciplinary future of bacteriology at Iowa State.

J Hist Biol, 2000 Spring, 33(1), 113 - 39
Sex cells: gender and the language of bacterial genetics; Bivins R; Between 1946 and 1960, a new phenomenon emerged in the field of bacteriology . "Bacterial sex," as it was called, revolutionized the study of genetics, largely by making available a whole new class of cheap, fast-growing, and easily manipulated organisms . But what was "bacterial sex?" How could single-celled organisms have "sex" or even be sexually differentiated? The technical language used in the scientific press - the public and inalienable face of 20th century science - to describe this apparently neuter organism was explicit" the cells "copulated," had "intimate contact," "conjugal unions," and engaged in "menage a trois" relationships . And yet, to describe bacteria as sexually reproducing organisms, the definition of sex itself had to change . Despite manifold contradictions and the availability of alternative language, the notion of sexually active (even promiscuous) single-celled organisms has persisted, even into contemporary textbooks on cell biology and genetics . In this paper I examine the ways in which bacteria were brought into the genetic fold, sexualized, and given gender; I also consider the issues underlying the durability of "bacterial sex."

Yeni Tip Tarihi Arastirmalari, 1998, 4, 55 - 8
{The influence of Mustafa Zeki Pasha on the progress of the Turkish veterinary medicine}; Unat EK; Good results of the administration of Mustafa Zeki Pasha, as the General Minister of Military Schools and Field Marshal of the Imperial Arsenal of Ordanance and Artillery, on the progress of Turkish veterinary medicine is unforgettable . Above all, he accepted that veterinary art was very important for the country and tried to make it a respectable and attractive profession . He improved the education in the veterinary classes . He secured the rank of captain for the new graduates instead of lieutenancy . He sent the most capable students to France for veterinary medical education for the purpose of training new instructors . Veterinary bacteriology started in Turkey under the auspices of his administration.

Med Ges Gesch, 1997, 16, 9 - 32
{Defense, attack, and street fighting . The role of medicine and military illustrated the example of the cholera epidemics in Prussia}; Briese O; This article intends to illustrate the introduction of military rhetoric into medical discourse during the cholera epidemic of 1831/32 in Europe . Even before the era of bacteriology, illness and epidemics were considered to be the military enemies of mankind . Beginning with the rise of the military in early modern times, the language of medical discourses oriented itself on the influential military institutions . Sickness appeared as a warring aggressor . Since the time of the plague at the very latest, military connotations were commonplace in Europe, and this tendency became stronger during the conflicts of the 19th century . In this vein, during the inner crises of Germany at the end of this century, cholera was, at least in the descriptive rhetoric, understood as an inner, destructive, and anarchic enemy.

Dynamis, 1998, 18, 81 - 105
{The antecedents and creation of the Alfonso XIII Institute of Serotherapy, Inoculation and Bacteriology}; Porras Gallo I; This article studies the establishment of the Alfonso XIII Institute of Serotherapy, Inoculation and Bacteriology in 1899, using the general press and the professional-scientific, medical and pharmaceutical press as its prime source, It aims to highlight the principal factors which led to its gestation and later development, as well as the circumstances which led to its creation, by analyzing the antecedents and orgins of the aforementioned institution.

Arch Hist Filoz Med, 1996, 59(1), 85 - 90
{Little known activity of the Czestochowa typhus Institute in 1943 and 1944}; Aramowicz P et al.; In 1921 Prof . Rudolf Weigl started manufacturing on an industrial scale a typhus vaccine . Until the beginning of World War Two he organised five companies called Weigl Institute . During the Soviet occupation the Lvov plant became the Lvov Sanitary and Bacteriological Institute and after the town was taken over by the German Army on 1st July 1941, Prof . Weigl became a head of research of the Military Typhus Institute . It consisted of four sections for manufacturing the vaccine . All the produce was mainly despatched to the Russian front and only very little reached the civilians . In November and December 1943 the plant was moved to Czestochowa into a main building in Wilsona str . and two four storey others in Jasnogorska str . Its head became a German doctor Mozer (witness test) . It is difficult to state numbers the plant employed there being no data left but according to employees still alive there must have been about a hundred lab . staff and two hundred feeders . The plant was divided into "breeding", "preparatory" and "liofilisation" sections . "The breeding" was for feeders and breeding lice . Cages containing about 30,000 lice were fastened to voluntary feeders for each feeding . Next "loaders" covered a so-called key board with 20 insects and infectors introduced and pressurised solution containing live rickets into a louse intestine . After a six or seven day passage, lice ware dried and their intestines prepared to produce liofilizeate all the staff and their families were inoculated . ...

Arch Hist Filoz Med, 1996, 59(1), 41 - 8
{Paul Ehrlich (1854-1915) and his contacts with East European physicians at the time of testing the first chemioterapeutics}; Schneck P; Among numerous scientific contacts which Paul Ehrlich had with foreign scientists information about his contacts with East European scientists is very limited . The communique will deal with some of the particulars concerning Ehrlich's co-operation with physicians from East Europe directly before the practical application of the chemioterapeutics among others he was in touch with the Russians: Georgi N . Gabryczewski, Alexander A . Wladimirow and a Finn Julius Iversen . The contacts originated during Robert Koch bacteriological courses at the Institute of Hygiene in Berlin . Only between 1885-1988 at least 11% of participants came from the countries of Eastern Europe . Ehrlich and Gabryczewski correspondence indicates that such a co-operation had already existed in the 90-ties, at the time of the research of a therapeutic influence of aniline dyes like diacetylparaaminophenol and triasid at spirillioza (recurrens) . Iversen, a chief physician of Obuchow Hospital in St . Petersburg, was one of the first who after initial tests (Atoxyl, Arsazetin), at Ehrlich's request successfully used 606 preparation in case of spirochaeta infections.

Arch Hist Filoz Med, 1996, 59(1), 103 - 6
{Development of infectious diseases treatment in Szczecin following the World War Two through the prism of infectious diseases ward}; Noiszewska H et al.; The epidemiological situation of Szczecin following the liberation was both difficult and dangerous . Numerous cases of typhus, diphteria ague, venereal diseases, typhoid and dysentery were noted and an urgent need of dealing with them was necessary . Thus an infectious diseases ward was opened in 1945 at 4 Arkonska Str . Its organiser was dr Elzbieta Buk . Despite of lack of both medical staff and equipment as well as medicines in its first month of operation the ward had 160 patients . Mostly they suffered from typhus, diphtheria, dysentery and typhoid . Mortality was high: 37 patients died . Till the end of 1945 674 patients were treated, most in September . The patients were mostly Germans, Poles, Russians, Ukranians, Belorussians and occasionally French . The most frequent was typhus though there were cases of malaria and rabies . Typhoid TB, dysentery and diphtheria were also observed . In 1946/47 more wards were opened dealing with lung, skin, venereal and children's diseases . The last one directed by Dr Krystyna Stawiarska hod its scarlet fever and diphtheria sections and simultaneously an analytical and a bacteriological labs were set up and due to Dr Stanislae Swierczysski determination they enabled basic diagnostics . Slowly post-war epidemics were contained and both infections mortality and admissions grew smaller.

Nuncius, 1994, 9(1), 265 - 94
Not Available
Pogliano C.
A review of the inaugural addresses held during half a century in Italy makes clear the image that the University professors of medicine wanted to present about themselves and their activities . They sang a hymn to science, the only admittable authority, by which useful and astonishing prodigies were performed . The annual addresses deliberately stressed those particular themes which would better illustrate past and present progress: surgical improvements, achievements in hygiene and dictates of preventive medicine, bacteriological 'revolution' etc . More and more the medical professors were claiming competences which should enlarge their field; they promised the just unified Italian nation that they would bring about a gradual but whole physical, moral and social "redemption".

Zhonghua Yi Shi Za Zhi, 1995, 25(3), 129 - 33
{Modern history of gynecology in China}; Xiao W; Dealing with the modern history (1850-1949) of the establishment and development of Gynecology in China, this paper claims that the sprouting period covers the time prior to 1899 . After 1991 Gynecology developed steadily due to the advancement of surgery, pathology, bacteriology and anesthesiology . During this period, there were definite improvements in Gynecology diagnosis, treatment of pelvic inflammation and gynecological endocrinology.

Yakushigaku Zasshi, 1995, 30(1), 1 - 10
{Historical sketch of modern pharmaceutical science and technology (Part 3) . From the second half of the 19th century to World War II}; Yamakawa K; The history of modern pharmaceutical science and technology, from the second half of the 19th century to the end of World War II, is divided into nine sections for the purpose of discussion . 1 . The European medical and pharmaceutical science and technology at the end of the 19th century is reviewed . Pharmacology, bacteriology and biochemistry were built in this period . 2 . The Meiji Government accepted Western medicine and medical law and regulations in 1883 . Consequently, the Japanese physician changed from Eastern (Kanpooi) to Western (Seiyooi) . 3 . Modern scientific and engineering education had been accepted in America, England, Germany, and France etc . Foreign scientists and engineers (Oyatoi-gai-kokujin) were educated by practice and theory . The Faculty of Engineering was established in the universities in Japan . This fact is one of the differences in the history of universities in Europe and America . 4 . Pharmaceutical education in the Meiji period (1873-1911) . Twenty-nine schools of pharmacy were built in this period . However, 20 schools of pharmacy had been closed . Pharmacy and pharmaceutical industry was not established in the Meiji era . 5 . The profession of pharmacist in 1873-1944 . The policy of medicine was changed by the Meiji Government in 1889, when Western physicians were allowed to prepare medicines for patients, and this practice continues today . Political and technological power of Japanese pharmacists was weak, so their role was not estimated . 6 . Consequences of world War I, and the establishment of the pharmaceutical industry . The Sino-Japanese War (1894-95) and Russo-Japanese War (1904-05) were won fortunately . The first pharmaceutical company was established in 1885 . At this times, many pharmaceutical manufacturing companies, which were converted from whole sale merchants, were built . Then started the manufacturing of commercial drugs . 7 . Hygienic chemistry and some problems of public hygiene . The causes of diseses unique to Japan, such as beriberi (Katuke), were searched for in medical and agricultural laboratories . Dr . Suzuki discovered olizanine from rice bran, which was effective for deficiency of vitamin B1 disease . However, pharmaceutical scientists did not participate in this research . Hygienic and forensic chemistry were included in pharmaceutical departments . 8 . Pharmaceutical scientific studies in Europe and Japan in the first half of the 20th century . The discovery of a drug for the treatment of syphilis by Ehrlich-Hata (1889), then chemotherapeutics were started . Adrenalin, the first isolated hormone, by Takamine (1900), after this time many hormones were discovered . The first Japanese pharmacists who studied abroad studied in Germany and came back to Japan . Then, they built the pharmaceutical sciences . Studies on natural products by chemistry and organic chemistry were started . 9 . Pharmaceutical scientific and technology during 15 Years of War (1931-45) . Since 1930, theoretical organic chemistry was developed in England and America . The discovery of chemotherapeutics and antibiotics (sulfonamides and penicillin) and studies on some vitamins and hormones proceeded during the 15 years of war (1931-45) at Tokyo and Kyoto Universities, and some institutes in China and Manchuria . Studies on anti-maralia, sulfonamides and penicillins were carried out.

Yakushigaku Zasshi, 1994, 29(3), 446 - 62
{A history of a hundred years of pharmaceutical education in Japan}; Yamakawa K; The history of a hundred years of pharmaceutical education in Japan is divided into six periods for the purposes of discussion . 1 . Founding period of the pharmaceutical education in the Meiji era (1873-1879) The Department of Manufacturing Pharmacy, Faculty of Medicine, University of Tokyo was established in 1873 (now, Faculty of Pharmaceutical Sciences, the University of Tokyo) . The purpose of this school was for professional training to accommodate growing imported Western drugs . 2 . Building period of the pharmaceutical education in the Meiji era . (1880-1911) The Pharmaceutical society of Japan (academic) was established in 1880, and then 13 years later (1893) the Japan Pharmaceutical Association (professional) was established . The order of establishments, first academic and then professional, was opposite of the history in European countries . Twenty-nine schools of pharmacy were built in the Meiji era, however 20 schools of pharmacy have been closed . 3.Developing period the pharmaceutical education in the Taisho era and half of the Showa era (1912-1944) Seventeen pharmaceutical colleges were built in these periods . Pharmaceutical chemistry, pharmacognosy, hygenic chemistry, and manufacturing chemistry were mainly taught in these schools of pharmacy, however pharmacology, bacteriology, and biochemistry were not taught in these schools . 4 . Reform of pharmaceutical education system after the World War II (1945-1960) In 1949, the Japanese education system was reformed, and then 46 colleges and universities of pharmacy were built . Then, the number of students doubled to 8,000 . Graduates from pharmaceutical colleges and universities, pharmaceutical departments were eligible to take the national pharmacists licence examination which was conducted by the Ministry of Health and Welfare . The standard of the pharmaceutical education system was revised in 1656, recommending that the single pharmaceutical departments at the colleges of pharmacy by replaced by three departments, pharmacy, manufacturing pharmacy and biological pharmacy . 5 . Improvement and developement of pharmaceutical education (1961-1985) Many universities and colleges were founded, and there are currently 46 universities and colleges . Every year, some 8,000 people who study pharmacy at 14 national, 3 public and 29 private universities enter the profession on graduation . About 60 percent found jobs in the pharmaceutical industry, and the remainder work as pharmacists in hospitals and pharmacies . 6 . Recent movements toward reform in pharmaceutical education (1986-present) Two amendments to the Medical Services Law in 1986 and 1992 have specified clearly the role to be played by pharmacists and pharmacies within their local medical service and has sharpened the distinction between medicine and pharmacy . Thus, in 1994, the period required for graduation is proposed by a committee of the Ministry of Health and Welfare, supplementing of the current 4-year undergraduate pharmacy course with a 2-year postgraduate master's degree course or a 6-year new pharmaceutical education system including practical training in a medical institution for a period of at least 6 months.

Arch Hist Filoz Med, 1994, 57(3), 313 - 24
{Scottish professors in the Polish School of Medicine in Edinburgh}; Tomaszewski W; In 1941, on the initiative of the University of Edinburgh, a Polish School of Medicine was founded at that University for soldier-students in the Polish Forces in Gr . Britain . It was a joint Scottish-Polish academic enterprise, unique in the history of universities . The Polish school of Medicine became an integral part of the University . As only 7 Polish professors were available (apart from associate professors and senior lecturers), a number insufficient to start a Medical School, a similar number of Scottish professors filled the vacant Polish chairs . Such an arrangement had been agreed by the organisers of the School and was included in the Agreement, negotiated between the University of Edinburgh and the Polish Government in London . According to the agreement the Scottish professors were proposed by the University authorities . A special invitation was sent to them by the Polish Government in London . The Scottish professors of the Polish School of Medicine were: Lt col . F.A.E . Crew honorary professor of the Polish School . L.S.P . Davidson (medicine), A.M . Drennan (pathology), D.M . Dunlop (co-examiner to prof . L.S.P . Davidson), R . W . Johnstone (obstetrics/gynaecology), T.J . Mackie (bacteriology), G.F . Marrion (chemistry/biochemistry), C . McNeil (paediatrics) and Sydney Smith (forensic medicine) . Replacement due to retirement: R.J . Kellar, R.W.B . Ellis, Sir James Learmonth . Polish lecturers were attached to all the Scottish professors who held the Polish chairs . Thus the instruction in the above-mentioned subjects was given in Polish but the examination was conducted in English by the Scottish professors . But in some subject, both the instruction and the examination, were in English . The students had to learn English quickly as the language was essential for their reading of English textbooks and dealing with Scottish patients in the wards . A typical picture at that time in the wards of the Royal Infirmary was of a group of Scottish students being instructed by their professor at patient's bedside, and at another bed, a group of Polish soldier-students in battledress, being taught in Polish by their lecturer . The co-operation worked very well indeed . Seemingly impossible things can be successfully accomplished in exceptional circumstances for instance in warfare . A total of 227 students obtained the diploma M.B., Ch.B . It was valid only in Poland . By an Act of Parliament the diploma was made valid also in Gr . Britain . The diploma was in two versions: a Latin text of the diploma of the University of Edinburgh, and a Polish text of the Polish universities . In recognition of the invaluable help extended by the University of Edinburgh to Polish science and learning, a bronze plaque was unveiled in 1949 in the Quadrangle of the Medical Faculty.

Gesnerus, 1998, 55(3-4), 249 - 69
{Interpreting cellular inclusions: a contribution to the history of virology}; Diosi P; In the middle of the 19th century cell inclusions were observed with increasing frequency in more and more diseases and were closely scrutinized by researchers working in different fields . Because of their distinct viewpoints, however, the various authors came inevitably to different conclusions . The morphologists interpreted the inclusions as artefacts or degenerative changes, the etiologists, on the other hand, took them for pathogenic protozoa, for cellular lesions inflicted by invisible agents or, conversely - for aggregated products of the cellular defense . Various morphological, parasitological and bacteriological methods have been used to clear up the pros and cons of these hypotheses . It was the rapid progress realized in virology at the middle of the 20th century that finally brought to light their real significance.

Int J Tuberc Lung Dis, 2001 Oct, 5(10), 912 - 9
Tuberculosis treatment in nepal: a rapid assessment of government centers using different types of patient supervision; Mathema B et al.; SETTING: Urban and periurban government tuberculosis (TB) treatment clinics in Nepal . OBJECTIVE: To assess TB treatment supervision strategies and outcomes . DESIGN: Three types of treatment centers were selected according to intensity of treatment supervision: Group A-all patients supervised by directly observed therapy (DOT) at the treatment center during the intensive phase; Group B-flexible DOT where patient-nominated treatment supervisors include community or family members; Group C-drugs dispensed monthly and no supervised treatment . The cohort studied comprised all new patients starting treatment during a 5-month period in 1996 (n = 759) . RESULTS: At group A treatment centers, 100% of patients had daily DOT supervised by treatment center staff during the intensive phase . At group B sites, 75% of nominated supervisors were family or community members and 13% of patients had no supervisor . At group C sites 93% of patients were unsupervised . Bacteriologically confirmed cure rates for smear-positive patients were 91% (95%CI 80.3-97.2) for A sites, 57% (95%CI 48.8-64.0) for B, and 34% (95%CI 25.1-40.4) for C . Treatment centers with the best results had good access to laboratory facilities, uninterrupted drug supply, longer clinic hours, standardized TB case management, and support from a non-governmental organization . CONCLUSION: At government facilities in Nepal, only group A treatment centers achieved World Health Organization global targets for cure . Group B treatment centers showed better outcomes than unsupervised therapy but did not achieve cure targets . Rapid low-cost assessments to collect data that are not routinely reported can improve the evaluation of program aspects such as supervision strategies.

Eur J Epidemiol, 2001, 17(2), 111 - 21
Role of the coypu (Myocastor coypus) in the epidemiology of leptospirosis in domestic animals and humans in France; Michel V et al.; The coypu (Myocastor coypus), a rodent whose natural habitat is stagnant freshwater, has become a widespread pest in France within the last decade . This study investigated the prevalence of seropositivity and the renal carriage of leptospires in coypus in order to evaluate their role in terms of the risk of infection by Leptospira interrogans in domestic animals and humans . The study involved the application of serological and bacteriological methods to identify leptospires infection and/or carriage in 738 coypus trapped from 1996 to 1999 in six areas of France . Seroprevalence in samples ranged from 16.5 to 66%, and three field strains were isolated (two L . interrogans Icterohaemorrhagiae and one L . interrogans Sejroe) . This first report on the isolation of leptospires from coypus in France emphasises the role of this animal in the epidemiology of leptospirosis.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2001 Oct, 92(4), 440 - 5
Endodontic infection caused by localized aggressive periodontitis: a case report and bacteriologic evaluation; Zehnder M; A rare case of a periodontally induced endodontic lesion in a systemically healthy subject of 28 years is described . The patient, having presented with severe attachment loss on the palatal and distal aspects of his maxillary right second premolar, was diagnosed with localized aggressive periodontitis . He had never received periodontal treatment . The tooth was nonvital and showed all signs of symptomatic apical periodontitis . It was also free of any restoration . All clinical findings clearly suggested that the endodontic problem was caused by the aggressive periodontal disease . Bacteriologic screening of the pocket and the root canal, by using "checkerboard" DNA-DNA hybridization analysis, revealed diverse flora in the periodontal lesion . The sample obtained from the root canal exhibited DNA from a limited number of species, including black-pigmented anaerobic rods . No bacterial DNA was found in the root canal that was not also recovered from the periodontal pocket.

Clin Infect Dis, 2001 Nov 15, 33(10), E119 - 21 Epub 2001 Oct 05.
Detection of Mycoplasma pneumoniae DNA in cerebrospinal fluid of a patient with M . pneumoniae infection-"associated" stroke; Padovan CS et al.; A 36-year-old woman presented with an acute ischemic stroke and a concomitant Mycoplasma pneumoniae infection that had been proven clinically, bacteriologically, and serologically . M . pneumoniae DNA was demonstrated in cerebrospinal fluid by positive nested polymerase chain reaction, and intrathecal antibody production was also detected . Contrary to previous reports about M . pneumoniae-associated stroke, most thrombostatic abnormalities in this patient occurred after stroke onset . Although the cause of stroke remains unclear in this patient, central nervous system invasion of M . pneumoniae DNA has to be considered a possible cause in rare cases of cerebral ischemia.

Int J Syst Evol Microbiol, 2001 Sep, 51(Pt 5), 1939 - 41
Nomenclature of the subgenera Moraxella and Branhamella and of the nine species included in these subgenera and proposal to modify rule 34a of the Bacteriological Code (1990 Revision) . Request for an opinion; Euzeby JP; The subgenera Moraxella and Branhamella and the nine species included in these subgenera were inadvertently omitted from the Approved Lists of Bacterial Names and have never been revived according to Rule 28a of the Bacteriological Code (1990 Revision) . The author requests that these names be revived and considered to be validly published in the 'Index of the bacterial and yeast nomenclatural changes published in the International Journal of Systematic Bacteriology since the 1980 Approved Lists of Bacterial Names (1 January 1980 to 1 January 1985)', which appears in the July 1985 issue of the International Journal of Systematic Bacteriology . Another problem is the status of the species included in the subgenera Moraxella and Branhamella because the Bacteriological Code (1990 Revision) does not envisage the status of a species transferred into a subgenus . The same is true for a species transferred into a subspecies . The author requests that such species be considered as new combinations and, according to this, proposes to modify Rule 34a of the Bacteriological Code (1990 Revision).

Int J Syst Evol Microbiol, 2001 Sep, 51(Pt 5), 1933 - 8
Corrigenda to the validation lists; Euzeby JP et al.; Some repetitions, omissions or errors have been made in the Validation Lists published in the International Journal of Systematic Bacteriology and they are corrected in this paper.

Probl Tuberk, 2001, (5), 41 - 2
{Detection of antigen-binding lymphocytes in the diagnosis of tuberculosis}; Gnusareva NA et al.; The efficiency of diagnosis of active tuberculosis was evaluated from detection of tuberculin-receptor lymphocytes {antigen-binding lymphocytes (ABL)} by the indirect rossette-formation test with the red blood cell reagent designed . Sixty two patients with tuberculosis (of them 10 patients with extrapulmonary tuberculosis), 10 with lobular pneumonia, and 27 healthy individuals cal were examined . Positive results of fluography, smear microscopy, bacteriological study, leukocytic migration inhibition test, and test for ABL were obtained in 84, 40, 50, 39, and 100%, respectively . The controls had negative tests . Thus, ABL detection was the method of choice in tuberculosis diagnosis.

Arq Gastroenterol, 2001 Jan-Mar, 38(1), 40 - 7
{Experimental cirrhosis induced by carbon tetrachloride inhalation: adaptation of the technique and evaluation of lipid peroxidation}; Cremonese RV et al.; BACKGROUND: Long-term administration of carbon tetrachloride is an accepted experimental model to produce hepatic fibrosis . Oxidative stress has been postulated as a major molecular mechanism involved in carbon tetrachloride hepatotoxicity, where the reactive oxygen species play an important role in the pathogenesis of liver fibrosis . AIMS: This study was conducted to evaluate the effectiveness of an experimental model of hepatic cirrhosis induced by carbon tetrachloride inhalation as well as the importance of lipid peroxidation and the characteristics of the ascitic fluid in this model . METHODS: At first the hepatic histologic findings were assessed using the hematoxilineosin technique in different moments of carbon tetrachloride inhalation (5th, 7th, 9th, 12th weeks) . Later, at the end of 15 weeks of the study the rats were divided in three groups (control; control + phenobarbital; and carbon tetrachloride + phenobarbital) for lipid peroxidation, ascitic fluid and histologic characteristics evaluation . For the lipid peroxidation analysis, thiobarbituric acid and QL techniques were used . Cytologic and bacteriologic parameters were analysed in the ascitic fluid . RESULTS: Cirrhosis was established in 100% of carbon tetrachloride rats between the 12th and 15th weeks with an elevation in the lipid peroxidation carbon tetrachloride rats' livers . Ascitic fluid infection was observed in one of seven rats who has developed ascites . CONCLUSIONS: The carbon tetrachloride inhalation method developed in this study is effective in cirrhosis induction and ascites formation, and the carbon tetrachloride cirrhosis physiopathogenesis is probably related to the oxidative stress installation.

Dermatology, 2001, 203(2), 171 - 3
Acute genitocrural intertrigo: a sign of primary human immunodeficiency virus type 1 infection; Calikoglu E et al.; We describe a 49-year-old male patient who presented with an acute illness associated with a widespread maculopapular eruption and eroded lesions in the inguinal folds consistent with an acute intertrigo, for which search of mycological and bacteriological causes remained negative . Serological tests disclosed a high viral HIV-1 load and p24 antigenemia, while anti-HIV-1 antibodies were absent, a profile typical of acute HIV-1 infection . Since the maculopapular eruption regressed concomitantly with the orogenital lesions as well as the eroded inguinal lesions prior to specific therapy, our observation indicates that intertriginous lesions may constitute one of the early cutaneous markers of primary HIV-1 infection .

Pneumologia, 2001 Apr-Jun, 50(2), 79 - 84
{Tuberculosis - HIV/AIDS associated cases registered in Department of Mures between 1994- 1999 }; Jimborean G et al.; Tuberculosis--HIV/AIDS associated cases registered in the Department of Mures between 1994-1999 are under a low rate--24 patients, meaning 0.69% of all tuberculosis cases . 79% of these were children (7.1% of the tuberculosis in children) . There was a dominance of the pulmonary location (22-91.5%) . The bacteriologic confirmation among these cases is low: 37.5% vs . 66.5% in HIV negative patients; this imposes the improvement of the diagnosis using methods as bronchoscopy, hemocultures, biopsies and modern bacteriological methods as Bactec and molecular biology in these cases . In 62.5% of the cases the tuberculosis diagnosis was established by combining epidemiological, clinical, radiological and biological data . Skin test was positive in 12.5% of the cases . The clinical and radiological data showed aspects near to the common pulmonary tuberculosis, but with a high rate of the complicated forms in children (66.6%) . 14 patients (58%) originated from a positive-contact environment . The standard treatment was well tolerated in 91.6% of the cases; there were 2 side effects to PZM and EMB . The evolution under treatment was generally favorable; there were 2 deaths with AIDS during active tuberculosis . The early diagnosis of HIV infection in high-risk patients and of the latent tuberculous infections would allow the decrease of the rate of this high-gravity associated illness.

Pneumologia, 2001 Apr-Jun, 50(2), 71 - 4
{Evolution of tuberculosis in the District of Dolj.}; Didilescu C et al.; The 742,500 inhabitants of Dolj District face a high risk of TB since over 10 years . In 1992 the TB incidence was 93.7@100,000 and 155.7@100,000 in 2000 (66% increase) . A number of 1156 TB patients were registered in year 2000, 84% new cases and 16% relapses . 82% of the patients had lung lesions, 11.9% had pleurisy and 6.1% had various extra-thoracic lesions . Bacteriologic confirmation was 67.7% . The periodic prevalence of smear positive patients, with a high level of 139@100,000 in 1999, determined a high risk for disease among children, also, the TB incidence in this category being 46.8@100,000 . The evaluation of treatment results in a cohort of smear positive patients registered in 1999 showed a success rate of only 75.5% . The decrease of the TB endemy level in Dolj district depends on improvement of life status in the district, complete use of DOTS and a good financement of all parts of the National TB Control Program in 2001-2005.

Klin Padiatr, 2001 Sep-Oct, 213(5), 266 - 70
{Leprosy - An overview from a pediatric perspective}; Magdorf K et al.; Worldwide tourism is an increasing industry . One result of this phenomenon is the occurrence of imported infectious diseases, as recently observed even in Germany . Leprosy ranks high among dreaded infectious diseases from tropical and subtropical countries . It remains a major health threat despite marked improvements in diagnosis and therapy . This was achieved by a better understanding of bacteriological and immunological mechanisms over the past decades, resulting in a decline of Leprosy's incidence.

BMC Public Health . 2001;1(1):8 . Epub 2001 Aug 29.
A prospective study of rural drinking water quality and acute gastrointestinal illness; Strauss B et al.; BACKGROUND: This study examined the relationship between the bacteriological contamination of drinking water from private wells and acute gastrointestinal illness (AGII), using current government standards for safe drinking water . METHODS: A prospective cohort study was conducted using 235 households (647 individuals) randomly selected from four rural hamlets . Data were collected by means of a self-administered questionnaire, a self-report diary of symptoms and two drinking water samples . RESULTS: Twenty percent of households sampled, had indicator bacteria (total coliform or Escherichia coli (E . coli)) above the current Canadian and United States standards for safe drinking water . No statistically significant associations between indicator bacteria and AGII were observed . The odds ratio (OR) for individuals exposed to E . coli above the current standards was 1.52 (95% confidence interval (CI), 0.33-6.92), compared to individuals with levels below current standards . The odds ratio estimate for individuals exposed to total coliforms above the current standards was 0.39 (95% CI, 0.10-1.50) . CONCLUSIONS: This study observed a high prevalence of bacteriological contamination of private wells in the rural hamlets studied . Individual exposure to contaminated water defined by current standards may be associated with an increased risk of AGII.

Blood Purif, 2001, 19(4), 401 - 7
Long-term outcome of permanent hemodialysis catheters: a controlled study; Jean G et al.; AIMS: Hemodialysis tunneled catheters are widely used nowadays . However, their complications, infection and dysfunction, remain much too frequent . Different types of tunneled silicone hemodialysis catheters are available . We prospectively compared the long-term outcome of the two most popular devices, Permcath cuffed double catheter and TwinCath uncuffed twin catheter, both inserted percutaneously . METHODS: From January 1994 to April 1998, 125 tunneled catheters were inserted in the internal jugular vein of 86 chronic hemodialysis patients, 63 TwinCath MedComp (TC) and 62 Permcath Quinton (PC) . They were prospectively followed looking for technical patency, infection and dysfunction rate . RESULTS: TC were used more often for iterative access (52 vs . 25%, p = 0.01) and were inserted more frequently in the left internal jugular vein (59 vs . 16% p < 0.001) . Their median technical survival rate was longer (869 vs . 433 days for PC, p < 0.01) with a 1-year patency rate of 80 vs . 53% (p = 0.002) . Total catheter extrusion was also slightly less frequent with TC (4.7 vs . 9.6%), but partial extrusion happened more frequently (43 vs . 16%, p = 0.02) . No significant difference in infection rate was observed, 0.77 for TC vs . 1.3 local infection/1,000 catheter days; 1.08 vs . 1.30 bacteremia/1,000 catheter days . A persistent catheter thrombosis was observed in 7.9 vs . 20.9% in PC (p = 0.04), the number of dysfunction was 10.5 vs . 24/1,000 days in use (p = 0.0001) and the number of urokinase infusion was 4.4 vs . 12/1,000 days (p = 0.001) . PC needed more radiological interventions for dysfunction with endolumenal brushes (4 vs . 0) or fibrin sleeve removal (4 vs . 0) . The vena cava thrombosis incidence was not different (2 vs . 3) . CONCLUSION: Although the study was not randomized, TC appears more efficient allowing for a longer patency with a lower dysfunction rate than PC . This was reinforced by less favorable conditions of TC including more left jugular side and more iterative catheters . The cuff does not offer a better bacteriological barrier or protection against extrusion, and the TC seems at a less risk of fibrin sleeves . However, a large randomized study is needed to definitively conclude .

Int J Tuberc Lung Dis, 2001 Sep, 5(9), 847 - 54
'Smear-negative' pulmonary tuberculosis in a DOTS programme: poor outcomes in an area of high HIV seroprevalence; Hargreaves NJ et al.; SETTING: Lilongwe Central Hospital, Malawi . OBJECTIVES: To investigate 1) treatment outcome of a cohort of smear-negative pulmonary TB (snPTB) patients in an area of high human immunodeficiency virus (HIV) seroprevalence, and 2) whether poor treatment outcomes are due to non-TB patients being mistakenly treated for TB due to lack of diagnostic facilities . DESIGN: Patients about to be registered for snPTB treatment by the National TB Programme underwent further assessment including TB culture, bronchoscopy and bronchoalveolar lavage . All patients were followed up for 8 months . Standard TB control treatment outcomes were recorded . RESULTS: Of 352 snPTB patients assessed, 137 patients had bacteriologically confirmed TB, 136 had possible TB, and 79 had other non-TB diagnoses . The HIV seroprevalence rate was 89% . Outcomes were known for 325 (92%) patients: 129 (40%) died within 8 months . Death rates on TB treatment were 31% for bacteriologically confirmed TB patients and 35% for patients with possible TB but no bacteriological diagnosis . The death rate among patients with non-TB diagnoses was 53% . HIV infection significantly increased the risk of death (OR 3.9; P = 0.01) . CONCLUSION: SnPTB is strongly associated with HIV infection in Malawi, where patients treated for snPTB have a poor prognosis . The high mortality is not fully explained by non-TB patients being mistakenly treated for TB.

Ugeskr Laeger, 2001 Sep 10, 163(37), 5038 - 9
{Isolated purulent arthritis of lumbar facet joint}; Marinovskij E et al.; We present the case of a 51-year-old woman suffering from septic arthritis of a lumbar facet joint, which was probably caused by an infected central venous catheter . Increased uptake on the bone scintigraphy was an early finding . Magnetic resonance imaging (MRI) of the spine contributed to the diagnosis by showing lesions of the facet joint and involvement of the surrounding soft tissues . Percutaneous needle aspiration guided by computed tomography established a bacteriological diagnosis . The positive response to antibiotic therapy was confirmed by MRI.

Vestn Oftalmol, 2001 Jul-Aug, 117(4), 40 - 2
{Azelastine in the treatment of allergic conjunctivitis}; Vakhabova NT et al.; The efficiency of azelastin (eye drops) in allergic conjunctivitis was evaluated . Ophthalmological, specific allergological, bacteriological, and cytological studies were carried out in 3 groups of patients . Group 1 was treated with claritin (orally), group 2 with azelastin (eye drops), and group 3 with both . The treatment was effective in all 3 groups . Regression of the clinical symptoms started earlier in groups 2 and 3 and was observed throughout the entire period of observation.

Am J Vet Res, 2001 Sep, 62(9), 1461 - 6
Attenuation of a Brucella abortus mutant lacking a major 25 kDa outer membrane protein in cattle; Edmonds MD et al.; OBJECTIVE: To determine the virulence of a Brucella abortus mutant, BA25, lacking a major 25 kd outer membrane protein (Omp25) in cattle . ANIMALS: 20 mixed-breed heifers in late gestation . PROCEDURE: 10 heifers were inoculated with 1 x 10(7) colony-forming units of the Omp25 mutant via the conjunctival sac, and an equal number were infected with the virulent parental strain B . abortus 2308 . The delivery status of the dams was recorded, and colonization was assessed following necropsy . The ability of BA25 to replicate inside bovine phagocytes and chorionic trophoblasts was also evaluated in vitro because of the propensity of virulent brucellae to replicate inside these cells in vivo . RESULTS: The parental strain induced abortions in 5 of 10 inoculated cattle, whereas only 1 of 10 dams exposed to BA25 aborted . Brucella abortus strain 2308 colonized all of the cow-calf pairs and induced Brucella-specific antibodies in 100% of the dams . In contrast, BA25 was isolated by bacteriologic cultural technique from 30% of the calves and 50% of the inoculated dams (n = 10) . Of the 10 heifers inoculated with BA25, 4 did not develop Brucella-specific antibodies nor were they colonized by the mutant strain . In bovine macrophages and chorionic trophoblasts, BA25 replicated in significantly lower numbers than the virulent parental strain (n = 3) . CONCLUSIONS AND CLINICAL RELEVANCE: The 25 kd outer membrane protein may be an important virulence factor for B . abortus in cattle . The attenuation of the Omp25 mutant in cattle may involve the inability of BA25 to replicate efficiently in bovine phagocytes and chorionic trophoblasts.

Ann Ital Chir, 2001 Mar-Apr, 72(2), 125 - 8
{Banks of vascular homografts}; Polvani GL et al.; We define as Banking of the tissues all the procedures that include the finding, preparation, conservation and distribution of the homograft . The vascular homografts are taken and put into a solution of transportation at +4 degrees C and kept at this temperature till their arrival at the Bank . The following step is the dissection of the homograft which will have to be performed as quickly as possible at most 24 hours after the taking in conditions of maximum sterility . At the Italian Homograft Bank at Centro Cardiologico, the vascular homografts are kept at +4 degrees C for 96 hours on average with antibiotics . After a phase of sterilization at +4 degrees C the tissue is frozen according to a homogeneous and controlled thermic decrease and stored at -150 degrees C/-180 degrees C in fumes of liquid nitrogen till the moment of their employment allowing a long term conservation . The aim of all these procedures of cryopreservation is to keep the structural and functional integrity of cells and tissues . The thermic decrease of the tissues must occur so that to avoid all the damages of the cellular vitality and functionality and especially of the tissue structure in toto . In order to limitate these events some cryoprotector agents are employed because they reduce the concentration of the solutes, the cellular dehydration, the formation of micro-macro crystals . Another step to establish if the homograft is proper is the study of bacteriological and viral aspects . The viral screenings are performed on the donor's blood and the bacteriological tests are performed on the tissue and on the liquids . For each phase of the banking a series of information about the donor and about the tissues are recorded and filed both on paper and database so that to grant always a right conduct of the material.

Lancet, 2001 Sep 1, 358(9283), 747 - 51
Mycobacterium xenopi spinal infections after discovertebral surgery: investigation and screening of a large outbreak; Astagneau P et al.; BACKGROUND: Mycobacterium xenopi spinal infections were diagnosed in 1993 in patients who had undergone surgical microdiscectomy for disc hernia, by nucleotomy or microsurgery, in a private hospital . Contaminated tap water, used for rinsing surgical devices after disinfection, was identified as the source of the outbreak . Several cases were recorded in the 4 years after implementation of effective control measures because of the long time between discectomy and case detection . The national health authorities decided to launch a retrospective investigation in patients who were exposed to M xenopi contamination in that hospital . METHODS: Mailing and media campaigns were undertaken concurrently to trace exposed patients for spinal infections . Patients were screened by magnetic resonance imaging (MRI), and the scans were reviewed by a radiologist who was unaware of the diagnosis . Suspected cases had discovertebral biopsy for histopathological and bacteriological examination . FINDINGS: Of 3244 exposed patients, 2971 (92%) were informed about the risk of infection and 2454 (76%) had MRI . Overall, 58 cases of M xenopi spinal infection were identified (overall cumulative frequency 1.8%), including 26 by the campaign (mean delay in detection 5.2 years, SD 2.4, range 1-10 years) . Multivariate analysis showed that the risk of M xenopi spinal infection was related to nucleotomy and high number of patients per operating session . INTERPRETATION: Failures in hygiene practices could result in an uncontrolled outbreak of nosocomial infection . Patients who have been exposed to an iatrogenic infectious hazard should be screened promptly and receive effective information.

Antibiot Khimioter, 2001, 46(3), 16 - 20
{Comparative efficacy and safety of ciprofloxacin, ofloxacin, and pefloxacin in treatment of respiratory infections in children with cystic fibrosis}; Postnikov SS; Data on comparative investigation of the clinical and bacteriological efficacy and tolerability of monofluoroquinolones ciprofloxacin, ofloxacin and pefloxacin are given . The results confirm good clinical efficacy of all three monofluoroquinolones and high antistaphylococcal activity of pefloxacin . Efficacy of monofluoroquinolones against P . aeruginosa and S . maltophilia was moderate--only isolation of bacteria from spetrum became lower . Tolerability of monofluoroquinolones was good . Only at 5 patients the drugs use was stopped (4 in the ciprofloxacin group and 1--in the pefloxacin group) . At 2 patients it was caused by arthropathy which was drug- and age-dependent . Quinolone-arthropathy was more often in the pefloxacin group and was registered only at the children elder than 10 years old with arthrological anamnesis . This arthropathy differed from experimental one by positive outcome and full recovery in the period from 7 days to 3 months . Results of morphological investigation confirmed clinical data--no invalidizing cartilage damage was revealed.

Symbiosis, 1990, 8, 95 - 116
Endospore-forming filamentous bacteria symbiotic in termites: ultrastructure and growth in culture of Arthromitus; Margulis L et al.; Many morphologically distinguishable filamentous spore-forming bacteria symbiotic in the paunch (hypertrophied hindguts) of wood-eating insects have been seen since Arthromitus was first described and named as a plant by Leidy in 1850 . Previous descriptions were inadequate for acceptance of the group in modern bacteriological literature . Twenty-two distinguishable arthromitids in nine different arthropod hosts are recorded on the basis of microscopic studies . Five are named, including two whose ultrastructure are detailed: Arthromitus chasei sp . nov . that lives in the damp wood-eating termite Zootermopsis angusticollis (from the west coast of North America) and Arthromitus reticulitermitidis sp . nov . from the subterranean west coast termite Reticulitermes tibialis . A pterotermiditis from the desert termite Pterotermitidis occidentis; A . zootermopsidis, also from Z . angusticollis; and A . cristatus (Leidy, 1881) from Reticulitermes flavipes of eastern North America are also named here . Characterized by trichomes that show a morphogenetic sequence from no spores through immature spores to mature spores with spore filaments, Arthromitus symbionts can be identified as members of the genus by light microscopy and habitat . Electron microscopy reveals their remarkable complexity . They attach by spore filaments to various objects including the host gut wall; their maturation extends distally toward the termite lumen . By surface sterilization of the termite, maceration of the paunch, exposure to boiling temperatures and plating on soft acetate agar, the heat resistant nature of the spores and facultatively aerobic nature of Arthromitus sp . (from Zootermopsis) was demonstrated.

Cell Death Differ, 2001 Aug, 8(8), 808 - 16
Escherichia coli induces apoptosis and proliferation of mammary cells; Long E et al.; Mammary cell apoptosis and proliferation were assessed after injection of Escherichia coli into the left mammary quarters of six cows . Bacteriological analysis of foremilk samples revealed coliform infection in the injected quarters of four cows . Milk somatic cell counts increased in these quarters and peaked at 24 h after bacterial injection . Body temperature also increased, peaking at 12 h postinjection . The number of apoptotic cells was significantly higher in the mastitic tissue than in the uninfected control . Expression of Bax and interleukin-1beta converting enzyme increased in the mastitic tissue at 24 h and 72 h postinfection, whereas Bcl-2 expression decreased at 24 h but did not differ significantly from the control at 72 h postinfection . Induction of matrix metalloproteinase-9, stromelysin-1 and urokinase-type plasminogen activator was also observed in the mastitic tissue . Moreover, cell proliferation increased in the infected tissue . These results demonstrate that Escherichia coli-induced mastitis promotes apoptosis and cell proliferation.

Vet Microbiol, 2001 Oct 22, 83(1), 11 - 22
Mycoplasma conjunctivae infection is self-maintained in the Swiss domestic sheep population; Janovsky M et al.; Bacteriological and serological investigations were performed to assess whether the domestic sheep population is a reservoir of Mycoplasma conjunctivae in Switzerland . Among a sample of 69 sheep showing clinical signs of infectious keratoconjunctivitis (IKC) in three Swiss cantons, M . conjunctivae was identified 53 times (76.8%) . A commercially prepared indirect ELISA was used to detect M . conjunctivae antibodies in 674 sera of adult sheep . We analysed a stratified random sample of 123 sheep herds from 25 out of the 26 Swiss cantons . At least one positive animal was detected in 89.4% of the herds . In positive herds (n=110), 57.1% of the individual animals tested positive . To assess the importance of sheep's age in the spread of M . conjunctivae, 209 sera of adult sheep and 93 lamb sera among eight sheep herds were analysed using the indirect ELISA . Seroprevalence in 2-6-month-old lambs was 50.5%, indicating that the IKC agent is spread in sheep flocks during raising . Lambs experimentally infected with M . conjunctivae carried the agent for 8 and 23 weeks, respectively, depending on the strain used for challenge . We conclude that the M . conjunctivae-infection is endemic and self-maintained in the domestic sheep population in Switzerland.

Can Vet J, 2001 Aug, 42(8), 623 - 6
{Comparison of direct smear observations and bacteriologic culture results carried out on equine tracheal secretions}; Labonville M et al.; The aim of the study was to assess the relation between the direct smear observations and bacteriological results carried out on equine tracheal secretions . A total of 304 cases comprising both the direct smear (Gram stain) and the bacteriological culture, over a period of 8 years, were submitted to this retrospective study . Most of the specimens (78%) were obtained using tracheal washings while the rest (22%) originated from tracheal brushings . A total of 96 specimens (32%) were negative for both direct smear and culture . The positive predictive value of direct smears appeared high (81-96%) while the negative predictive value was lower (48-79%) . Sensitivity of direct smear was considered as low and varied from 24 to 46% for tracheal brushings and from 41 to 46% for tracheal washings . Specificity of direct smear was high for both types of specimens . Results of this study indicate that the use of Gram-stained smear examination, carried out on tracheal secretions, is a technique which is specific but not very sensitive for the prediction of bacteriological culture results . Moreover, the use of tracheal washing, more than tracheal brushing, seems to increase the sensitivity of the test.

Kekkaku, 2001 Jul, 76(7), 533 - 43
{Tuberculosis of the elderly (above the age of 75) in national hospitals}; Mori M et al.; In Japan tuberculosis is becoming rapidly the disease of the elderly . We studied the background, the type and level of hospital cares needed, and the outcome of patients with pulmonary tuberculosis (sputum smear and/or culture positive) above the age of 75 who were admitted to 8 national hospitals during the period from January 1 to December 31, 1997 . The study included 150 patients (male: 109, female: 41, mean age: 81.6), of whom 25% needed care in a single-bed room, 84.3% had underlying diseases (cardiovascular diseases: 43.3%, malignant diseases: 20.9%, neuro-psychiatric diseases: 13.4%), and 47.6% needed cares mainly in feeding and excretions . 92 patients (62.6%) improved and 45 patients (30.6%) died, of whom the cause of death was directly related to tuberculosis in 42 . The mean hospital stay was 4.7 months . However, in 42 patients whose cause of death was related to tuberculosis, 66% died within 3 months, while in 102 patients who were discharged 71% stayed more than 3 months . The same comparison was done in 508 patients with bacteriologically proven tuberculosis above the age of 75 admitted to National Tokyo Hospital during the period from 1990 to 1999 . The result was almost the same, among 133 patients died in the hospital 60% died within 3 months, while in 375 patients who were discharged hospital stay was more than 3 months in 70% . In the near future, the elderly will occupy more than 25% of the beds of the tuberculosis ward in Japan and most of them have underlying diseases other than tuberculosis . Because tuberculosis, once the disease of the young, is becoming rapidly the disease of the elderly, it is imperative for us to make necessary adjustments to meet this inevitable trend.

Theriogenology, 2001 Aug 1, 56(3), 415 - 24
Retrospective study on an unusual form of ovario-bursal pathology in the camel (Camelus dromedarius); Tibary A et al.; A peculiar form of ovarian bursa pathology, called hydrobursitis, is described in the dromedary camel . This malformation is characterized by a collection of fluid within the ovarian bursa with encapsulation of the ovary . Retrospective study of all diagnosed cases in our laboratory shows that this malformation is responsible for reduced reproductive performance due to abortion, infertility and embryonic death . Hydrobursitis was diagnosed in 33 of 355 animals examined . The incidence of this lesion was higher in animals that aborted (9/24) or were barren for more than 2 years (13/37) . Diagnosis by palpation per rectum and ultrasonography, is described . Gross pathological and biochemical studies on specimens collected at surgery or in the slaughterhouse showed that the fluid is hemorrhagic and that it could be a mixture of blood and follicular fluid . Bacteriological and cytological studies were inconclusive . The origin of this lesion is discussed in light of genetic, pathological and management factors . Loss of embryos in affected animals could be due to the effect of increased tension on the uterus caused by the accumulation of fluid which ranged in volume from 250 mL to 4240 mL . The condition was treated in several females by surgical ablation . Embryo transfer was used in females that were bilaterally affected and underwent a bilateral ovariectomy . Pregnancy and calving rates were 52.5% and 38.1% for unilaterally ovariectomized females bred after surgery and 33.3% and 22.2% for bilaterally ovariectomized females used as embryo recipients after surgery . These results show that involvement of the uterus in this malformation is very limited and that surgery can be considered for valuable animals if they are unilaterally affected.

Adv Ther, 2001 Jan-Feb, 18(1), 1 - 11
A comparative study of clarithromycin modified release and amoxicillin/clavulanic acid in the treatment of acute exacerbation of chronic bronchitis; Martinot JB et al.; This phase III, investigator-blind, randomized, parallel-group study compared the efficacy and tolerability of clarithromycin modified release (MR) with those of amoxicillin/clavulanic acid in 250 adult outpatients with acute exacerbationof chronic bronchitis (AECB) . Patients received either clarithromycin MR 500 mg once daily or amoxicillin/clavulanic acid 500 mg/125 mg three times daily for 7 days . Primary endpoints were sponsor-defined clinical response and pathogen outcome at the end of treatment . Secondary endpoints were sponsor-defined clinical response and pathogen outcome at study end, investigator-defined clinical response at end of treatment and end of study, resolution or improvement of signs and symptoms, eradication of baseline pathogens, serologic outcome for atypical pathogens, and occurrence of reinfection and superinfection . Adverse events and compliance were also evaluated . Clinical and bacteriologic outcomes with both treatments for all endpoints were statistically equivalent, as were total adverse events, although the incidences of digestive disturbances (13% vs 4%) and discontinuations due to adverse events (8 vs 2 patients; P < or =.05) were significantly higher with amoxicillin/clavulanic acid . Ninety-five percent of patients receiving clarithromycin MR and 80% receiving amoxicillin/clavulanic acid were 100% compliant with medication (P < or =.05) . Clarithromycin MR and amoxicillin/clavulanic acid are both well tolerated and effective as therapy for AECB; however, clarithromycin produced fewer side effects and discontinuations and higher compliance rates.

Probl Tuberk, 2001, (3), 58 - 60
{Role of PCR analysis in complex bacteriological studies in phthisiology}; Chernousova LN et al.; The study was undertaken to assess the role of polymerase chain reaction (PCR) analysis in complex bacteriological studies in diagnosing pulmonary tuberculosis in 197 patients by bacterioscopy, inoculation, and PCR . It was shown that in addition to conventional bacteriological methods, PCR might be used as an additional laboratory study in making a diagnosis in patients with restrictive pulmonary tuberculosis . A combination of cultural inoculation and PCR analysis enhances the sensitivity of bacteriological diagnosis and reduces its duration in oligo- and abacillary patients with tuberculosis . PCR analysis enhances the efficiency of laboratory control over antituberculous chemotherapy.

ANZ J Surg, 2001 Aug, 71(8), 467 - 71
Human bites of the hand: the Tasmanian experience; Tonta K et al.; INTRODUCTION: The purpose of the present paper is to provide geographically representative information on the presentation, treatment and complications of human bites of the hand in Australia . METHODS: A 5-year retrospective study was undertaken of patients treated at Royal Hobart Hospital for human bites of the hand . The variables evaluated included age, sex, hand involvement, anatomical distribution, presentation, operative findings, bacteriology, antibiotic use, X-ray findings, complications and compliance . RESULTS: Thirty-five patients had human bites to the hand . All were male with a median age of 24 years . Most were clenched fist injuries with the middle metacarpophalyngeal joint being the most prone to injury . Patients presenting early had a high incidence of open joints and fractures but spent less time in hospital than late presenters, almost all who had infection complications . Compliance with treatment was found to be a major problem . Serious hand infections were not observed . CONCLUSION: The treatment of human bites must be early, correct and comprehensive . The appropriate treatment is surgical exploration with debridement and lavage, appropriate antibiotic administration, hand elevation and initial immobilization . Poor compliance of patients in the present study was demonstrated by a high incidence of late presentation, self-discharge from hospital and loss to follow up, making assessment of outcomes difficult . Despite this there is an absence of serious hand infections reported in the literature and this may be due to the administration of antibiotics prior to referral.

J Wildl Dis, 2001 Jul, 37(3), 532 - 7
Experimental infection of nontarget species of rodents and birds with Brucella abortus strain RB51 vaccine; Januszewski MC et al.; The Brucella abortus vaccine strain RB51 (SRB51) is being considered for use in the management of bnucellosis in wild bison (Bison bison) and elk (Cervus elaphus) populations in the Greater Yellowstone Area (USA) . Evaluation of the vaccines safety in non-target species was considered necessary prior to field use . Between June 1998 and December 1999, ground squirrels (Spermophilus richardsonii, n = 21), deer mice (Peromyscus maniculatus, n = 14), prairie voles (Microtus ochrogaster, n = 21), and ravens (Corvus corax, n = 13) were orally inoculated with SRB51 or physiologic saline . Oral and rectal swabs and blood samples were collected for bacteriologic evaluation . Rodents were necropsied at 8 to 10 wk and 12 to 21 wk post inoculation (PI), and ravens at 7 and 11 wk PI . Spleen, liver and reproductive tissues were collected for bacteriologic and histopathologic evaluation . No differences in clinical signs, appetite, weight loss or gain, or activity were observed between saline- and SRB51-inoculated animals in all four species . Oral and rectal swabs from all species were negative throughout the study . In tissues obtained from SRB51-inoculated animals, the organism was isolated from six of seven (86%) ground squirrels, one of six (17%) deer mice, none of seven voles, and one of five (20%) ravens necropsied at 8, 8, 10, and 7 wk PI, respectively . Tissues from four of seven (57%) SRB51-inoculated ground squirrels were culture positive for the organism 12 wk PI; SRB51 was not recovered from deer mice, voles . or ravens necropsied 12, 21, or 11 wk, respectively, PI . SRB51 was not recovered from saline-inoculated ground squirrels, deer mice, or voles at any time but was recovered from one saline-inoculated raven at necropsy, 7 wk PI, likely attributable to contact with SRB51-inoculated ravens in an adjacent aviary room . Spleen was time primary tissue site of colonization in ground squirrels, followed by the liver and reproductive organs . The results indicate oral exposure to SRB51 does not produce morbidity or mortality in ravens, ground squirrels, deer mice, or prairie voles.

New Microbiol, 2001 Jul, 24(3), 249 - 57
Leptospira strains kept at the National Centre for Leptospirosis in Rome, Italy; Ciceroni L et al.; Since the National Centre for Leptospirosis (Department of Bacteriology and Medical Mycology, Istituto Superiore di Sanita, Rome) was established in 1956 by B . Babudieri, efforts have been devoted to identifying new Leptospira isolates and maintaining a collection of strains that today comprises 670 strains, 550 of which have been totally or partially classified, and 120 are still under study . This collection includes 23 serogroups and 156 serovars of pathogenic leptospires, and 32 serogroups and 54 serovars of saprophytic leptospires . The conventional serogroup and serovar identification, mainly based on antigenic relatedness, is tedious and time-consuming, requiring the maintenance of a comprehensive collection of serovar reference strains and the preparation of the corresponding rabbit antisera . Although considerable difficulties are encountered in the classification of leptospires at the serogroup and serovar level, this classification system is essential to obtain information on the epidemiology of leptospirosis in the different geographical areas . Serovar identification has become faster with the introduction of pulsed-field gel electrophoresis (PFGE) of large DNA fragments obtained after digestion of leptospiral DNAs with rare-cutting restriction enzymes . This technique has been successfully utilized to discriminate between closely related serovars of the Leptospira interrogans complex . We have recently used PFGE to characterize several Italian leptospiral isolates, confirming that PFGE analysis combined with microscopic agglutination test (MAT) with monoclonal and polyclonal antibodies can be used as an accurate and reliable method to compare and classify leptospires.

Clin Neuropathol, 2001 Jul-Aug, 20(4), 176 - 80
Diagnostic utility of polymerase chain reaction and immunohistochemical techniques for the laboratory diagnosis of intracranial tuberculoma; Sumi MG et al.; In an attempt to establish a tuberculous etiology, polymerase chain reaction (PCR) and immunohistochemical (IHC) methods were undertaken in formalin-fixed paraffin sections of ten surgical specimens of intracranial tuberculoma . The control group included an equal number of intracranial fungal granuloma . Both PCR and IHC methods did not yield false-positive results in fungal granuloma . PCR was found to be less sensitive (60%) than IHC method (80%) in this study . IHC method definitely possesses several operational advantages over PCR and is more suited to laboratories in developing countries for establishing a tuberculous etiology particularly in those patients in whom the conventional bacteriological methods did not confirm the diagnosis of tuberculoma.

Anesteziol Reanimatol, 2001 Mar-Apr, (2), 16 - 9
{Principles of prevention of pneumonia associated with the use of artificial ventilation of the lungs in resuscitation and intensive care units}; Eremenko AA et al.; Pneumonia ranks among the most incident complications associated with forced ventilation of the lungs (FVL) . Its incidence depends on FVL duration and according to published reports varies from 9 to 70% . Pneumonia deteriorates the prognosis and essentially increases the mortality in intensive care wards . Based on published reports and their own experience, the authors formulate the fundamentals of prevention of pneumonia in patients on FVL: use of intubation tubes with low-pressure cuffs; minimum duration or no procedures involving the intubation tube cuff blowing off; regular sanitization of the tracheobronchial tree and oropharynx; use of devices for removal of tracheobronchial secretion in the closed contour and of disposable catheters; inhalation of bronchomucolytics and antibiotics through a nebulizer; patient's position in bed with elevated head part; rigid approach to prescription of antacide drugs and H2-receptor blockers; decontamination and regulation of intestinal function; antibiotic therapy with consideration for the results of bacteriological studies; no or minimum exposure to procedures involving the respiratory contour seal opening; use of sterile gloves; use of disposable respiratory contours and hydrophobic bacterial filters instead of humidifiers.

Gig Sanit, 2001 Mar-Apr, (2), 30 - 1
{Sanitary assessment of water quality in the city of Khiva}; Niiazmetov M; The paper deals with the 1994-1999 studies and hygienic assessments of the quality of water of the basis superficial water objects, point and shaft wells, tap water used by the population of the city of Khiva and its region . Sanitary features of the population's water use were found . The quality of tap water does not comply with the sanitary standards in the total hardness and sanitary and bacteriological indices.

Neurochirurgie, 2001 Sep, 47(4), 413 - 22
{Diagnostic problems in brain abscess: 45 cases}; Fichten A et al.; BACKGROUND AND PURPOSE: We analysed the difficulties encountered in the differential diagnosis between brain abscess and brain tumor and their influence on treatment and outcome . METHODS: - Forty-five adults with brain abscess operated on between 1993 and 1999 were retrospectively reviewed . We studied preoperative diagnosis, clinical, radiological, bacteriological findings, surgical procedure, primary sources of infection and outcome . RESULTS: Preoperative diagnosis was right in 55.6% (25/45), wrong in 22.2% (10/45) and doubtful in 22.2% (10/45) . Diffusion-weighted MR imaging was successfully used in 4 doubtful cases to make the differential diagnosis between abscess and tumor . When the preoperative diagnosis was right, the surgical procedure was a burr-hole aspiration in 73.3% (22/25) whereas when it was wrong, an excision was performed in 60% (6/10) of the cases . Aspiration was the last diagnostic investigation in 80% (8/10) of doubtful cases . Microbacterial organisms were identified in 75.5% (34/45) of the cases and primary cause of infection in 62.2% (28/45) . The outcome depended on clinical status on admission, preoperative diagnosis and surgical procedure . In four cases, diffusion-weighted MRI allowed differential diagnosis between brain abscess and tumor through calculation of the Apparent Diffusion Coefficient which is low in abscess and high in cystic tumor . CONCLUSION: The diagnosis of brain abscess remains difficult in certain patients . Correct preoperative diagnosis influences the decision on the appropriate surgical procedure and helps improve outcome.

Eur Respir J, 2001 Jun, 17(6), 1112 - 9
Changes in bronchial inflammation during acute exacerbations of chronic bronchitis; Gompertz S et al.; There are little data describing noncellular changes in bronchial inflammation during exacerbations of chronic bronchitis . The relationship between sputum colour and airway inflammation at presentation has been assessed during an exacerbation in patients with chronic bronchitis and a primary care diagnosis of chronic obstructive pulmonary disease . Sputum myeloperoxidase, neutrophil elastase, leukotriene B4 (LTB4), interleukin-8 (IL-8), sol:serum albumin ratio and serum C-reactive protein were measured in patients presenting with an exacerbation and mucoid (n = 27) or purulent sputum (n = 42) . Mucoid exacerbations were associated with little bronchial or systemic inflammation at presentation, and sputum bacteriology was similar to that obtained in the stable state . Purulent exacerbations were associated with marked bronchial and systemic inflammation (p < 0.025 for all features) and positive sputum cultures (90%) . Resolution was related to a significant reduction in LTB4 (p < 0.01), but no change in IL-8, suggesting that LTB4 may be more important in neutrophil recruitment in these mild, purulent exacerbations . In the stable state, IL-8 remained higher in patients who had experienced a purulent exacerbation (2p < 0.02) . The presented results indicate that exacerbations of chronic bronchitis, defined by sputum colour, differ in the degree of bronchial and systemic inflammation . Purulent exacerbations are related to bacterial infection, and are associated with increased neutrophilic inflammation and increased leukotriene B4 concentrations.

Probl Tuberk, 2001, (2), 31 - 3
{Features of hysterosalpingogram in verified genital tuberculosis}; Kochorova MN et al.; Two hundred and fifty one women were examined . Of them, 93 patients with active tuberculosis made up Group 1, 38 with inactive tuberculosis Group 2, and 120 with nonspecific gynecological diseases Group 3 . In All tuberculosis was verified by morphological and bacteriological studies . Analyzing the X-ray pattern demonstrated that their leading X-ray signs were rigidity and clavity deformity of the uterine tubes and contrast shadows in the projection of uterine adnexa, and obliteration of the uterus . These signs were observed in 63.2% of the patients with inactive or long-lasting tuberculosis . At the same time young women with active tuberculosis firstly detected had no pronounced anatomic changes, which makes it possible to be initiate treatment timely and preserve reproductive function.

Eur Respir J, 2001 May, 17(5), 995 - 1007
Bacteria, antibiotics and COPD; Wilson R; Bacterial infection is one of several important causes of exacerbations of chronic obstructive pulmonary disease (COPD) that may coexist . COPD is a heterogeneous condition and the incidence of bacterial infection is not uniform; mucus hypersecretion may be an important risk factor . The bacteriology of infections varies depending on the severity of the underlying airway disease . There is now a much better understanding of the pathogenesis of bacterial infections of the respiratory mucosa . Lower airway bacterial colonization may be a stimulus for chronic inflammation and may influence the interval between exacerbations . Antibiotic resistance has increased in all the major pathogens . Antibiotics are an important part of the treatment of acute exacerbations of COPD and the decision about whether to give an antibiotic can be made on clinical grounds . It is more difficult to decide, on the available evidence, whether patient characteristics and the risk of antibiotic resistance should influence choice of empiric antibiotic treatment . Most new antibiotics are modifications of existing structures, suggesting that every effort should be made to conserve the sensitivity of current antibiotics by using them appropriately.

Niger Postgrad Med J, 2001 Jun, 8(2), 74 - 7
Effect of HIV infection on the clinical spectrum of leprosy in Maiduguri; Moses AE et al.; The clinical features associated with different classes of leprosy patients co-infected with HIV in Maiduguri was studied and the classification of leprosy was done clinically and bacteriologically using Ridley-Jopling classification and bacteriological index respectively . The cases were classified as paucibacillary (Tuberculoid--TT and Borderline Tuberculoid--BTT) and multibacillary (Borderline Borderline--BB, Borderline Lepromatous BL and Lepromatous Leprosy--LL) leprosy . Eleven (10.5%) of 105 leprosy cases were HIV-seropositive comprising of 7 males and 4 females . Age range was 15 and 62 years . Among the HIV seropositive patients, those with paucibacillary (PB) leprosy were 6 (TT-1, BT-5) while multibacillary (MB) leprosy 5 (BB-1, BL-2, LL-2) . The predominant clinical features were clawing of fingers (64%), ulcerations (64%), hand muscle atrophy (55%) and clawing of toes (45%) . Some clinical features of paucibacillary leprosy such as sensory and hair losses (as is also seen in HIV negative patients) occurred in increased frequency in HIV positive patients belonging to the multibacillary class . The HIV infected leprosy patients are more likely to manifest advanced stages of the disease than the HIV seronegative patients.

Eur J Epidemiol, 2000, 16(12), 1151 - 7
Rodents and Leptospira transmission risk in Terceira island (Azores); Collares-Pereira M et al.; The role of rodents as Leptospira renal carriers in Terceira island was evaluated (1993-1995) through kidney culture and serology {microscopic aglutination test (MAT)} of 94 mice and rats . Fifty-nine animals were positive (n = 41 by serology + culturing; n = 11 serology; n = 7 culturing), presenting a wide distribution in man-made and natural areas . House mice had the highest bacteriological (82.9%) and serological (90.9%) rates, being strictly related to serovar arborea . Black rats were involved in the dispersion of all isolated L . interrogans sensu lato serovars (arborea, copenhageni and icterohaemorrhagiae) . Logistic regression analysis and non-metric multi-dimensional scaling, relating Leptospira infection with biological and environmental variables, expressed that adult males Mus domesticus, sexually active and living in humid biotopes, mainly above 500 m, are the most likely reservoirs . This study emphasizes the role of house-mice in the epidemiology of leptospirosis in Terceira and the need of reducing the risk of Leptospira transmission through integrated control programmes, primarily focusing on adult house-mice in peri-domestic environments, before the breeding season.

Klin Khir, 2001 Apr, (4), 24 - 6
{Inflammation response syndrome, sepsis and multi-organ insufficiency in patients operated for destructive pancreatitis}; Desiateryk VI et al.; In 128 patients, operated on for destructive pancreatitis (DP), the systemic inflammatory response syndrome (SIRS), sepsis and polyorganic insufficiency (POI) was investigated . SIRS was revealed in 56.3% of observations, the severe one--in 31%, sepsis--in 39.8%, including in 79.4% reoperated patients . According to bacteriological investigation data the diagnosis of sepsis was confirmed in 26.3% of patients only . POI was revealed in 25% of patients, including in 59.4% of those, who were reoperated.

J Pediatr Gastroenterol Nutr, 2001 Jul, 33(1), 58 - 63
Familial and community environmental risk factors for Helicobacter pylori infection in children and adolescents; Wizla-Derambure N et al.; BACKGROUND: The aim of the study was to identify familial and community environmental risk factors associated with Helicobacter pylori infection in a pediatric population . METHODS: Children requiring diagnostic upper endoscopy were included in the study during a 2-year period . During endoscopy, five gastric biopsies were performed for the histologic or bacteriologic diagnosis, or both, of H . pylori infection . Epidemiologic data collected by a questionnaire were analyzed using the chi-square test or Fisher test and stepwise logistic regression . RESULTS: The authors included 436 patients (242 boys), aged 2 days to 17.9 years (median, 2.7 years) . H . pylori prevalence was 7.3% . Univariate analysis found H . pylori was more common in older patients (P < 0.00001), in children who had at least one parent born in a developing country (P < 0.02) or with a low socioeconomic status (P < 0.02), and in those living in crowded conditions (P < 0.02) . Children whose mother worked at home were more frequently infected than children whose mother worked outside the home (P < 0.02) . Attendance at nursery or school before the age of 6 years was not associated with infection . Logistic regression showed a strong association with H . pylori only for age and number of persons at home . CONCLUSIONS: The source of H . pylori is intrafamilial rather than from a community, such as nursery and school attended at a young age . The number of persons in the home influences the infection status of children but not by the presence of the mother in home . These data suggest that H . pylori infection transmission occurs from siblings or the father rather than from mother.

Zhonghua Jie He He Hu Xi Za Zhi, 1998 Oct, 21(10), 620 - 2
{Clinical features, diagnosis and treatment of solitary vertebral arch tuberculosis}; Lin Y et al.; OBJECTIVE: To explore clinical features of vertebral arch tuberculosis, and to discuss the diagnosis and treatment of this illness . METHOD: Seventeen of 3,825 cases of spinal tuberculosis who were hospitalized and treated from 1956 to 1996 were reviewed, and their clinical features, diagnosis and treatment were analyzed and reported . RESULT: Sixteen cases of vertebral arch tuberculosis were in adolescence and prime of life, and another one was a 2-year-old child . Their symptoms in early stages were untypical, including local fixed pain and tenderness, and later, abscess, fistula and symptoms of nerve system appeared . All the cases were diagnosed through summarizing of their history, signs, imaging examination and bacteriology tests, and only one case was misdiagnosed . In one of 17 cases, antituberculosis chemotherapy was conducted alone and non-operation was performed . In the other 16 cases, focal debridement of vertebral arch was performed on the basis of antituberculous chemotherapy, and in 4 cases of them with symptoms of nerve system, laminectomy and spinal decompression was performed homochronously . All the cases were healed and no relapse occurred during follow-up . CONCLUSION: It is difficult to diagnose vertebral arch tuberculosis in early stages due to its occult symptoms, but the symptom of confined pain and manifestation in X-ray, CT and MRI are much useful for early diagnosis . Abscess puncture and acid-fast staining smear microscopy can usually be used to confirm diagnosis . And surgical intervention is an important measure for its treatment.

Rev Panam Salud Publica, 2001 May, 9(5), 302 - 5
{Aluminum hydroxide hydrogel to remove arsenic from water}; Lujan JC; OBJECTIVE: To describe the making of and the preliminary results from an aluminum hydroxide hydrogel that, when added directly to water, can totally eliminate arsenic, regardless of the nature of the water and the oxidation state of the metalloid . METHODS: The raw materials used to make the aluminum hydroxide hydrogel were: hydrated aluminum sulfate (which is used to make water safe for drinking), calcium hypochlorite in powder form, ammonium hydroxide, and distilled water (when done at the laboratory scale), and water from inverse osmosis of the same or better quality than the distilled water (when done at a pilot scale) . Quality control for the finished product consisted of determining its ability to adsorb arsenic and performing bacteriological tests to demonstrate its sterility . The product was used with water samples to which arsenic had been added in the laboratory and with water samples from the province of Tucuman, Argentina, with naturally occurring arsenic . To analyze the arsenic in the water the colorimetric silver diethyldithiocarbamate method was used . RESULTS: Using the hydrogel greatly reduced the amount of arsenic . Treating both the natural and laboratory-produced arsenical waters yielded arsenic concentrations under the limit (0.01 parts per million) that was detectable with the analytical method used . The bacteriological tests of the finished product indicated there were no viable bacteria . CONCLUSIONS: Using the aluminum hydroxide hydrogel produced the desired reduction in the arsenic concentration in the water . This method for removing arsenic is inexpensive and easy to use in scattered rural populations in areas having high arsenic levels and lacking drinkable water, as well as an adequate sanitary and electric-power infrastructure.

Eur Radiol, 2001, 11(7), 1263 - 6
Intra-abdominal tuberculous peritonitis; Schneider G et al.; We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion . Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy . This type of disease is a rare manifestation of extrapulmonary tuberculosis . The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented . Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed . This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies.

Ann Fr Anesth Reanim, 2001 Jun, 20(6), 520 - 36
{Catheter-related infection in intensive care . Physiopathology, diagnosis, treatment and prevention}; Mimoz O et al.; PURPOSE: To review the mechanisms, diagnosis, treatment and prophylaxis of catheter-related sepsis in intensive care unit patients . DATA SOURCES: A Medline research of the English- or French-language reports published between 1966 and 2000 and a manual research of references of relevant papers . STUDY SELECTION: Experimental, clinical and basic research studies related to catheter-related sepsis . DATA EXTRACTION: Data in selected articles were reviewed, and relevant clinical information was extracted . DATA SYNTHESIS: Infection remains the major complication related to catheter insertion . No bacteriological exam or systematic catheter change is required in the absence of infection suspicion . In the intensive care unit, and without septic shock, the surveillance of skin cultures at the catheter insertion site or the time to positivity of hub-blood versus peripheral-blood culture determination may reduce the number of unnecessary removed catheters . Catheter change over a guidewire is not recommended because of the risk of dissemination of infection . When the catheter is removed, a quantitative culture is warranted . The treatment of catheter-related sepsis is based on catheter removal . The use of antibiotics is limited to some organisms or when the infection is complicated . The persistence of fever and positive blood cultures 72 h after catheter removal require to look for dissemination of infection or septic thrombophlebitis, especially if S . aureus or Candida are incriminated . The treatment of infection without catheter removal is not recommended in the intensive care unit because of a high risk of treatment failure . Compliance with catheter care guidelines and continuing quality improvement programs are the two major procedures in reducing catheter infection . CONCLUSIONS: Improved understanding of the pathophysiology of catheter-related sepsis has led to improved prevention . Compliance with catheter care guidelines and continuing quality improvement programs are majors procedures to reduce the risk of catheter infection.

J Am Vet Med Assoc, 2001 Jul 15, 219(2), 203 - 8
Dermatologic disorders in dogs with diabetes mellitus: 45 cases (1986-2000); Peikes H et al.; OBJECTIVE: To characterize skin lesions and causative infections in diabetic dogs and evaluate other potential causes of dermatologic disorders, including concurrent endocrinopathies, allergic skin disease, and long-term corticosteroid administration . DESIGN: Retrospective study . ANIMALS: 45 dogs with diabetes mellitus (DM) that were examined by dermatologists . PROCEDURE: Medical records were reviewed for signalment; allergic conditions prior to development of DM; prior corticosteroid administration; and results of dermatologic examinations, ear and skin cytologic examinations, skin scrapings for parasites, bacteriologic and fungal culturing of ear and skin specimens, histologic examinations, and endocrine testing . RESULTS: Bacterial skin infection was the most common dermatologic disorder (n = 38 {84%}), followed by otitis (26 {58%}) and Malassezia-induced dermatitis (19 {42%}) . Twenty-two (49%) dogs had pruritic skin disease consistent with allergic dermatitis, which preceded diagnosis of DM . Prior corticosteroid administration was reported in 21 (47%) dogs . Concurrent hyperadrenocorticism was diagnosed in 13 (29%) dogs, and concurrent hypothyroidism was diagnosed in 5 (11%) dogs . Iatrogenic hyperadrenocorticism was diagnosed in 1 additional dog . Only 10 (22%) dogs did not have a documented concurrent endocrinopathy or allergic disease that could have caused the dermatitis . CONCLUSIONS AND CLINICAL RELEVANCE: Bacterial and yeast-induced dermatitis and otitis develop in dogs with DM . Many diabetic dogs with dermatologic problems have a preexisting allergic condition, history of prior corticosteroid administration, or concurrent endocrinopathy that may be a more likely cause of dermatologic problems than DM alone.

Rev Mal Respir, 2001 Jun, 18(3), 297 - 300
{Contribution of bronchial fibroscopy in pneumonology services in developing countries}; Ouedraogo M et al.; Bronchial fibroscopy is a recent investigation method that requires equipment and facilities difficult to implement in respiratory diseases units in developing countries . In Burkina Faso, this technique was introduced for the first time in February 1997 . The purpose of this study was to determine the contribution of bronchial fibroscopy for the diagnosis of respiratory disease in countries with limited resources . This study was conducted between February 1997 and October 1998 at the respiratory diseases unit of the Yalgado Ouedraogo National Hospital Center in Ouagadougou, Burkina Faso . Thirty-five cases of tuberculosis were diagnosed, including 29 cases with bronchial node involvement, where bronchial fibroscopy is an essential diagnostic examination, and 6 cases of bacteriologically proven pulmonary tuberculosis . Ten cases of lung cancer were diagnosed (40% squamous cell carcinoma) . Malignant disease is a reality in developing countries despite low rates of diagnosis due to insufficient diagnostic facilities . For tuberculosis, the importance of specific treatment is certainly well established and should always be initiated, even if fibroscopy cannot be performed . This contrasts with the situation for malignant disease, where the high prevalence of lung cancer (9.9% of the bronchial fibroscopies performed) is associated with total lack of treatment due to the absence of a thoracic surgery unit or a radiotherapy unit, and the impossibility of providing satisfactory surveillance of anti-cancer chemotherapy.

Int J Tuberc Lung Dis, 2001 Jul, 5(7), 628 - 32
Treatment outcome among Rwandan and Burundian refugees with sputum smear-positive tuberculosis in Ngara, Tanzania; Rutta E et al.; SETTING: Tuberculosis programme in six camps (Benaco, Musuhura, Lumasi, Lukole, Keza and Kitali) for Rwandan and Burundian refugees in Ngara district, Tanzania, where treatment was directly observed throughout . OBJECTIVES: To evaluate the treatment outcome of sputum smear-positive tuberculosis cases recruited in refugee camps in Ngara, and to determine the cumulative frequency of conversion of sputum smears by direct microscopy . DESIGN: Retrospective review of tuberculosis registers from January 1995 to December 1999 . RESULTS: Of 546 patients with smear-positive tuberculosis who were notified in the programme, 363 (66.5%) had completed treatment and were bacteriologically cured after 7 months, 10.9% had died, 7.1% had defaulted and 14.5% had transferred out . Sputum conversion after the 2-month intensive phase was 88%, and increased to 99% after 7 months of chemotherapy . CONCLUSION: The involvement of the Tanzania NTLP in collaboration with health NGOs has led to a satisfactory outcome . These data suggest that it is possible for tuberculosis control programmes to perform successfully in refugee settings.

Int J Antimicrob Agents, 2001 Jul, 18(1), 19 - 27
Efficacy and safety of gemifloxacin 320 mg once-daily for 7 days in the treatment of adult lower respiratory tract infections; Ball P et al.; An open-label, non-comparative study assessed the clinical and bacteriological efficacy of gemifloxacin (320 mg, once-daily for 7 days) in lower respiratory tract infections (LRTI) . Patients with acute exacerbation of chronic bronchitis (AECB, n=261) or community-acquired pneumonia (CAP, n=216) were enrolled into the study . Clinical success rates at follow-up (days 21-28) in the intent-to-treat (ITT) population were high, 83.1% in AECB patients (95% CI: 77.9, 87.4) and 82.9% in CAP patients (95% CI: 77.0, 87.5) . High bacteriological success rates were achieved (bacteriological ITT population), 91.2% (52/57) in AECB patients (95% CI: 80.0, 96.7) and 77.9% (60/77) in CAP patients (95% CI: 66.8, 86.3) . Gemifloxacin was well tolerated with a low incidence of adverse events . Gemifloxacin treatment resulted in high clinical and bacteriological success rates and is a well-tolerated therapy for the treatment of LRTIs.

Clin Infect Dis, 2001 Aug 15, 33(4), 421 - 7 Epub 2001 Jul 11.
A decade (1989-1998) of pediatric invasive pneumococcal disease in 2 populations residing in 1 geographic location: implications for vaccine choice; Fraser D et al.; During 1 decade (1989-1998), data on invasive pneumococcal disease were collected prospectively to assess the burden of disease among Jewish and Bedouin children in southern Israel and the potential reduction in illness that can be achieved by using conjugate vaccines . Data on 513 children <15 years old with bacteriologically proven invasive pneumococcal disease were obtained . Among Jewish and Bedouin children <5 years old, incidence rates were 45 and 139 cases per 100,000 child-years of observation, respectively . Jewish and Bedouin children differed in clinical manifestations, seasonal patterns of disease, serotype distribution, and antibiotic susceptibility rates . The potential coverage by 7-, 9-, and 11-valent conjugate vaccines is 41%, 67%, and 71%, respectively, for Jewish children and 22%, 63%, and 65%, respectively, for Bedouin children . The 9- and 11-valent pneumococcal conjugate vaccines have the potential to substantially decrease invasive pneumococcal disease in southern Israel.

J Med Assoc Thai, 2001 Mar, 84(3), 323 - 31
Necrotizing enterocolitis: a comparison between full-term and pre-term neonates; Ruangtrakool R et al.; A retrospective study comparing 16 full-term and 18 pre-term neonates with NEC operated on at Siriraj Hospital between 1987 and 1999 is presented . Major risk factors leading to NEC in full-term neonates included sepsis, SGA, birth asphyxia, severe jaundice requiring exchange transfusion and chorioamnionitis . Although full-term neonates developed NEC earlier than pre-term neonates (8.56 days vs 12.78 days), the average ages of operation in both groups were the same . There was no difference in CBC and bacteriological culture's results between term and pre-term patients . The decision to conduct operative treatments for full-term neonates with NEC was mostly based on only clinical signs of peritonitis (56.25%) before the pneumoperitoneum developed (31.25%) . Ileo-caecal region was the most common site of bowel necrosis in both premature and full-term infants . Although term infants had a better 3-month survival rate than pre-term neonates (75% and 61% respectively), both groups had the same surgical complication rates.

J Environ Health, 2001 Jul-Aug, 64(1), 9 - 14
Rapid determination of bacteria in pools; Lee J et al.; If a method for rapid determination of bacterial levels in swimming pools and whirlpools were available, bacterial health risks could be avoided before exposure occurred . Such a method would enable public-health authorities to make timely decisions about closing or reopening pools and to adjust disinfectant doses . The purpose of this study was to determine if a rapid adenosine triphosphate (ATP) bioluminescence method would serve this purpose . Bacteriological analyses were completed on samples from swimming pools and whirlpools in Washtenaw County, Michigan . The results from the ATP assay were compared with those from the conventional plate count method and were found to be highly correlated (r = .92) . To assess whether a prefiltration step was necessary to delete nonbacterial ATP--which might originate from bathers' skin cells or other debris--two procedures were tested: one with prefiltration and one without prefiltration . The results for prefiltered samples were not statistically different from the results for non-prefiltered samples (p > .05), for both the heterotrophic plate counts and the ATP bioluminescence method . This study indicates that the ATP assay can estimate bacterial levels in pools within minutes and without prefiltration.

Zhonghua Yi Xue Za Zhi (Taipei), 2001 Apr, 64(4), 239 - 43
Fournier's gangrene--Taiwan experience; Yang SC et al.; BACKGROUND: Synergistic necrotizing fascitis of the scrotum, penis and perianal region was first described by Fournier in 1883 . If not recognized early, this infectious process will extend along the fascia plane to the lower abdominal and back regions, causing severe morbidity and even mortality . METHODS: The records of 8 patients diagnosed of Fournier's gangrene were reviewed between 1988 and 2000 . The sex, age, etiology, associated diseases, bacteriological studies and treatments were analyzed . RESULTS: The 8 patients were all males, age ranging from 42 to 78 years old, with average 55.1 years . Six patients were due to perianal abscess, one patient was a complication of hemorroidectomy, and one patient had traumatic injury of scrotum . Six patients had poor controlled diabetes mellitus, and there were two patients with cirrhosis of the liver and hepatoma, respectively . Even with aggressive treatments, two patients died; the other 6 recovered completely . The mortality rate was 25% . CONCLUSIONS: Fournier's gangrene is a not common but life-threatening disease which needs radical debridement and effective antibiotics to control the infection and early reconstruction with skin graft and myocutaneous flaps . Mortality is usually due to delayed diagnosis.

Rev Prat, 2001 May 15, 51(9), 964 - 8
{Chronic bacterial overgrowth in the small intestine}; Bouhnik Y; The small intestinal bacterial overgrowth (SIBO) is defined by the presence in the proximal part of the intestine of a bacterial population and qualitatively abnormal . It is necessary to distinguish the "non-symptomatic" SIBO and the "symptomatic" SIBO responsible for a chronic diarrhoea and/or of a malabsorption syndrome . The main factor encouraging the intervening of a SIBO is the stasis of the intestinal juice . The gold standard test to confirm the diagnosis of SIBO is the jejunal bacteriological intubation, but it is about a trying and expensive method . It is currently supplanted by the respiratory test to hydrogen after ingestion of glucose that is simple, no invasive and little expensive . The treatment usually consists on the repeated administration of antibiotics and nutritional support.

Aust N Z J Obstet Gynaecol, 2001 May, 41(2), 177 - 81
Is there an interaction between cervical length and cervical microbiology in the pathogenesis of preterm labour?
Dowd J, Permezel M, Garland S, de Crespigny L.
Transvaginal ultrasound of the cervix is increasingly used to estimate cervical length during pregnancy . Initially used to determine a possible need for cervical suture, the technique has been shown to be of value in the prediction of preterm delivery In addition, bacterial vaginosis has been shown to be associated with an increased risk of preterm delivery . We hypothesised that shortening of the cervix and potential cervical pathogens, in particular the presence of bacterial vaginosis, act synergistically in the pathogenesis of premature labour . Three hundred and sixteen women were recruited for prospective longitudinal follow-up, with both transvaginal ultrasound and cervical bacteriology performed at approximately 18 and 28 weeks gestation . A strong correlation was found between a shortened cervix and preterm delivery (p<0.02 at 18 weeks; p<0.001 at 28 weeks) . Women with both a short cervix and cervical pathogens had the highest risk of preterm delivery (43%), although not significantly greater than a short cervix with normal cervical flora (31% preterm delivery) . In the presence of a normal cervical length, preterm delivery rates in the presence of normal flora and potential cervical pathogens were much lower (9% and 5% respectively).

J Chemother, 2001 Jun, 13(3), 288 - 98
Efficacy of gemifloxacin in acute exacerbations of chronic bronchitis: a randomised, double-blind comparison with trovafloxacin; Ball P et al.; This randomised, double-blind, double-dummy, multinational study compared the efficacy and safety of gemifloxacin with trovafloxacin in the treatment of acute exacerbations of chronic bronchitis . There were 617 patients randomised: 303 to gemifloxacin and 314 to trovafloxacin . Clinical success rates at follow-up (clinical per-protocol population) were 91.5% for gemifloxacin and 87.6% for trovafloxacin . For the intent-to-treat population, the clinical efficacy of gemifloxacin was statistically significantly superior to that of trovafloxacin . In general, the in vitro activity of gemifloxacin against the major respiratory bacterial pathogens was superior to that of other antibiotics tested . Per-patient bacteriological success rates at follow-up (bacteriology per-protocol population) were 86.8% for gemifloxacin and 82.4% for trovafloxacin . Both agents were well tolerated . The clinical and bacteriological efficacy of a once-daily 5-day course of gemifloxacin is at least as good as that of a similar regimen of trovafloxacin in the treatment of acute exacerbations of chronic bronchitis.

Ann Chir Plast Esthet, 2001 Jun, 46(3), 196 - 209
{Systemic complications of extended burns}; Wassermann D; Burns covering more than 10% of the total body surface area (TBSA) are responsible for systemic perturbations which, in very severe cases, can represent a vital risk and, in all cases, affect the wound evolution . Among these general perturbations, fluid volume and electrolyte changes, leading eventually to burn shock, have the most dramatic consequences . Burn shock is, still to day, a vital risk and can also, in case of inadequate early fluid resuscitation, results in secondary morbidity and mortality . Fluid replacement during the very first hours after injury represents certainly a key point of the management of severe burn cases . Estimation of resuscitation fluid needs during this period is frequently underestimated . For adult, we recommend, during the first hour, a minimum of one liter for all severe injuries and two liters if the injury exceeds 50% of TBSA . Pulmonary injuries due to smoke inhalation are frequent, about 25% of patients hospitalized in burn units, and responsible for numerous death at site of house fires . In burn units, about 25% of hospitalized patients have pulmonary injuries in relation with smoke inhalation . This population has a high mortality rate increasing with the area of the skin injury and with age . Patients with inhalation injury need more resuscitation fluids, are subject to pneumonia and necessitate frequently mechanical ventilation . Parameters of the mechanical ventilation have to be choice to avoid barotrauma . Severe burn patients are submitted to a very high metabolic level . This can leads to a deep nutritional deficit responsible for an immunological suppression . It is then of major importance to provide an adequate nutritional support . It is also necessary to fight against the stress and to put the patient in a warm environment . Finally, infection is the most frequent and the most severe complication of burn injuries . Everything have to be done to avoid bacteriological contamination including architecture, equipment's, care procedure, nutritional support, types of wound dressing and most importantly surgery . Surgical procedures have to be done as earliest as possible to excise necrosis and cover the wound.

Vet Rec, 2001 Jun 16, 148(24), 743 - 6
Confirmation of the presence of Mycoplasma bovis in Hungarian cattle with pneumonia resembling pleuropneumonia; Bashiruddin JB et al.; Cattle from several farms in Hungary were investigated for the presence of mycoplasmal infections after the discovery of pulmonary lesions in some animals at slaughter . The pneumonic lesions, which resembled those of contagious bovine pleuropneumonia (CBPP) macroscopically and histologically were found to be caused by Mycoplasma bovis and not Mycoplasma mycoides subspecies mycoides (MmmSC) which is the causative agent of CBPP . No other bacterial pathogens were isolated . Negative results in complement fixation tests also showed that there was no serological evidence of CBPP . PCR tests for the detection of the M mycoides cluster and specifically for MmmSC were also negative . However, PCR and bacteriological culture detected cases of M bovis and the pneumonias may therefore be attributed to this mycoplasma.

Vet Rec, 2001 Jun 9, 148(23), 711 - 4
Relationships between infection with caprine arthritis encephalitis virus, intramammary bacterial infection and somatic cell counts in dairy goats; Sanchez A et al.; Somatic cell counts, the bacteriological condition of the milk and antibodies against caprine arthritis encephalitis virus (CAEV) were measured monthly throughout lactation in 121 lactating goats of the Murcia-Granada breed in four commercial dairy goat herds . The prevalence of bacterial intramammary infection was 5.6 per cent and the prevalence of CAEV infection was 20.6 per cent . An analysis of variance revealed a significant effect of herd, intramammary infection and the interaction between intramammary infection and CAEV on the somatic cell count . In udder halves free of intramammary infection, the somatic cell counts were significantly lower in seronegative goats than in seropositive goats (P<0.05), but the difference was not significant in udder halves persistently infected by bacteria . There was a significant increase in somatic cell counts due to bacterial intramammary infection (P<0.01) in the seronegative goats, but this effect was not present in the seropositive animals.

Ann Dermatol Venereol, 2001 May, 128(5), 641 - 3
{Cutaneous aseptic abscesses, manifestations of neutrophilic diseases}; Carvalho P et al.; BACKGROUND: Neutrophilic skin disease includes several entities: Sweet syndrome, pyoderma gangrenosum, erythema elevatum diutium, Sneddon-Wilkinson sub-keratous pustulosis, and neutrophilic eccrine hidradenitis . We report two cases of aseptic abscesses which correspond to the deepest anatomoclinical form of neutrophilic dermatosis . CASE REPORTS: A 28-year-old man was hospitalized for fever and abdominal pain with bloody diarrhea in relation with Crohn's disease . The patient also presented two skin abscesses on the lower limbs . Bacteriology specimens were negative . The histology specimen of a skin lesion revealed neutrophil infiltration of the hypodermis without granulomatosis . Systemic corticosteroid therapy was given and rapidly led to resolution of the inflammatory bowel disease and the skin lesions . The patient developed inflammatory spondylarthropathy several months later . The second patient was a 36-year-old woman with a history of splenomegaly with asceptic abscesses . She was admitted for abdominal pain with non-bloody diarrhea, fever and multiple joint pain related to spondylarthropathy . She developed several simultaneous abscessed nodules on the legs . Biopsy revealed neutrophil infiltration of the hypodermis . The diagnosis of neutrophilic disease with aseptic cutaneous and visceral abscesses was retained . Nonsteroidal antiinflammatory drugs and dapsone were given leading to regression of the skin lesions and the abdominal and joint pain . DISCUSSION: Aseptic skin abscesses result from a deep localization of neutrophilic disease . They suggest the presence of inflammatory bowel disease, spondylarthropathy or other aseptic visceral localizations.

J Clin Microbiol, 2001 Jul, 39(7), 2717 - 8
Pneumocystis carinii carriage among cystic fibrosis patients, as detected by nested PCR; Sing A et al.; A total of 137 sputa from 95 consecutive cystic fibrosis (CF) patients undergoing routine bacteriological surveillance were analyzed for Pneumocystis carinii colonization using nested PCR . Seven of 95 patients (7.4%) were PCR positive, suggesting that P . carinii carriage may exist among CF patients due to their underlying pulmonary disease.

J Clin Microbiol, 2001 Jul, 39(7), 2531 - 40
Identification of rifampin-resistant Mycobacterium tuberculosis strains by hybridization, PCR, and ligase detection reaction on oligonucleotide microchips; Mikhailovich V et al.; Three new molecular approaches were developed to identify drug-resistant strains of Mycobacterium tuberculosis using biochips with oligonucleotides immobilized in polyacrylamide gel pads . These approaches are significantly faster than traditional bacteriological methods . All three approaches-hybridization, PCR, and ligase detection reaction--were designed to analyze an 81-bp fragment of the gene rpoB encoding the beta-subunit of RNA polymerase, where most known mutations of rifampin resistance are located . The call set for hybridization analysis consisted of 42 immobilized oligonucleotides and enabled us to identify 30 mutant variants of the rpoB gene within 24 h . These variants are found in 95% of all mutants whose rifampin resistance is caused by mutations in the 81-bp fragment . Using the second approach, allele-specific on-chip PCR, it was possible to directly identify mutations in clinical samples within 1.5 h . The third approach, on-chip ligase detection reaction, was sensitive enough to reveal rifampin-resistant strains in a model mixture containing 1% of resistant and 99% of susceptible bacteria . This level of sensitivity is comparable to that from the determination of M . tuberculosis drug resistance by using standard bacteriological tests.

Clin Diagn Lab Immunol, 2001 Jul, 8(4), 772 - 5
Use of recombinant BP26 protein in serological diagnosis of Brucella melitensis infection in sheep; Cloeckaert A et al.; Previously a Brucella protein named CP28, BP26, or Omp28 has been identified as an immunodominant antigen in infected cattle, sheep, goats, and humans . In the present study we evaluated antibody responses of infected and B . melitensis Rev.1-vaccinated sheep to the BP26 protein using purified recombinant BP26 protein produced in Escherichia coli in an indirect enzyme-linked immunosorbent assay (I-ELISA) . The specificity of the I-ELISA determined with sera from healthy sheep (n = 106) was 93% . The sensitivity of the I-ELISA assessed with sera from naturally infected and suspected sheep found positive in the current conventional diagnostic tests was as follows: 100% for bacteriologically and serologically positive sheep (n = 50), 88% for bacteriologically negative but serologically and delayed-type hypersensitivity-positive sheep (n = 50), and 84% for bacteriologically and serologically negative but delayed-type hypersensitivity-positive sheep (n = 19) . However, the absorbance values observed did not reach those observed in an I-ELISA using purified O-polysaccharide (O-PS) as an antigen . In sheep experimentally infected with B . melitensis H38 the antibody response to BP26 was delayed and much weaker than that to O-PS . Nevertheless, the BP26 protein appears to be a good diagnostic antigen to be used in confirmatory tests and for serological differentiation between infected and B . melitensis Rev.1-vaccinated sheep . Weak antibody responses to BP26 in some of the latter sheep suggest that a B . melitensis Rev.1 bp26 gene deletion mutant should be constructed to ensure this differentiation.

J Anim Sci, 2001 Jun, 79(6), 1457 - 65
Behavioral, adrenal, immune, and productive responses of lactating ewes to regrouping and relocation; Sevi A et al.; The experiment involved 40 mid-lactating Comisana ewes . The animals were housed in straw-bedded pens and assigned to a control group (n = 10) and two test groups of 15 subjects each . Control ewes were never moved from their pen and peers throughout the experiment period, whereas test animals were subjected to either regrouping (RG) or regrouping and relocation (RGRL) three times at weekly intervals (d 7, 14, and 21 of the trial) . Three behavioral recordings were conducted after each social and pen exchange over a 6-h period (1000 to 1600) . Animals from groups RG and RGRL were bled immediately before each regrouping and relocation and 15 and 60 min afterward . The phytohemagglutinin skin test was performed at d 9, 16, and 23 . Milk yield was recorded when the ewes were mixed and moved, and before and after each mixing and moving procedure . Individual milk samples were analyzed for composition, renneting parameters, and bacteriological characteristics; samples with more than 10(6) somatic cells/mL were cultured for mastitis-related pathogens . Control ewes spent more time lying than groups RG (P < 0.001) and RGRL (P < 0.01) and less time in ambulatory activities than RGRL sheep (P < 0.05) . Moved and remaining ewes showed a higher number of aggressive interactions than control subjects (P < 0.001 and P < 0.01, respectively) . Control sheep showed the highest cell-mediated immune response compared with both moved and mixed ewes (P < 0.001 and P < 0.01, respectively) . The RGRL ewes gave lower yields of milk than did the control ewes on the days after the first (P < 0.05) and the second (P < 0.01) change of pen and peers . The RGRL ewes also had a lower fat content (P < 0.05) than control ewes in the milk yielded on the day of the first regrouping and relocation and a lower milk protein content (P < 0.05) on the following day . The RG treatment resulted in the ewes yielding milk with a lower fat content (P < 0.01) on the day of each mixing procedure as compared with controls and in a decreased milk protein content on the days after the first (P < 0.05) and the second regrouping (P < 0.01) . One case of subclinical mastitis was recorded in both the RG and RGRL groups, whereas no cases were detected in control group . These findings suggest that regrouping and relocation may cause increased aggression, altered immune responses, and short-term effects on the production performance of lactating ewes . These practices should be performed by attempting to minimize their impact on animal welfare.

Eur J Cardiothorac Surg, 2001 Jul, 20(1), 203 - 4
Sternal dehiscence after cardiac surgery and ACE inhibitors {correction of ACE type 1 inhibition}; Abid Q et al.; We report two cases, which underwent surgery through Median sternotomy . They were on ACE inhibitors {corrected} pre-operatively . Both of these patients developed persistent dry cough post-operatively, which resulted in sternal wound dehiscence . They had no clinical or bacteriological evidence of sternal wound infection . Although one patient was overweight and had moderately impaired left ventricular function, there were no other associated risk factors . Both patients underwent rewiring of the sternum . Type II receptors inhibitor were introduced post-rewiring, which cured the persistent dry cough . Both the patients are enjoying a good quality of life at 2 year 6 months and 2 years post-rewiring of the sternum.

Trop Med Int Health, 2001 Jun, 6(6), 484 - 90
Poor food hygiene and housing as risk factors for typhoid fever in Semarang, Indonesia; Gasem MH et al.; To identify risk factors for typhoid fever in Semarang city and its surroundings, 75 culture-proven typhoid fever patients discharged 2 weeks earlier from hospital and 75 controls were studied . Control subjects were neighbours of cases with no history of typhoid fever, not family members, randomly selected and matched for gender and age . Both cases and controls were interviewed at home by the same trained interviewer using a standardized questionnaire . A structured observation of their living environment inside and outside the house was performed during the visit and home drinking water samples were tested bacteriologically . Univariate analysis showed the following risk factors for typhoid fever: never or rarely washing hands before eating (OR = 3.28; 95% CI = 1.41-7.65); eating outdoors at least once a week (OR = 3.00; 95% CI = 1.09-8.25); eating outdoors at a street food stall or mobile food vendor (OR = 3.86; 95% CI = 1.30-11.48); consuming ice cubes in beverage in the 2-week period before getting ill (OR = 3.00, 95% CI = 1.09-8.25) and buying ice cubes from a street vendor (OR = 5.82; 95% CI = 1.69-20.12) . Water quality and living environment of cases were worse than that of controls, e.g . cases less often used clean water for taking a bath (OR = 6.50; 95% CI = 1.47-28.80), for brushing teeth (OR = 4.33; 95% CI = 1.25-15.20) and for drinking (OR = 3.67; 95% CI = 1.02-13.14) . Cases tended to live in houses without water supply from the municipal network (OR=11.00; 95% CI = 1.42-85.2), with open sewers (OR = 2.80; 95% CI = 1.0-7.77) and without tiles in the kitchen (OR = 2.67; 95% CI = 1.04-6.81) . Multivariate analysis showed that living in a house without water supply from the municipal network (OR = 29.18; 95% CI = 2.12-400.8) and with open sewers (OR = 7.19; 95% CI = 1.33-38.82) was associated with typhoid fever . Never or rarely washing hands before eating (OR = 3.97; 95% CI = 1.22-12.93) and being unemployed or having a part-time job (OR = 31.3; 95% CI = 3.08-317.4) also were risk factors . In this population typhoid fever was associated with poor housing and inadequate food and personal hygiene.

Spinal Cord, 2001 Apr, 39(4), 223 - 7
Management of spinal brucellosis and outcome of rehabilitation; Nas K et al.; STUDY DESIGN: Review of cases . OBJECTIVE: To review cases of brucellosis in order to clarify diagnostic guidelines, treatment regimes and prognosis . SETTING: University Hospital, Turkey . METHODS: Study of 11 patients (9 male, 2 female) with either brucellar spondylitis or epidural brucellar abscess . Diagnosis made on clinical presentation, laboratory findings, radiographic evidence and a minimum brucellar anti body of 1 : 160, a positive bacteriological culture and/or histological finding of inflammation of granulomatous tissue . All patients were treated with a combination of oral antibiotics . Surgery was performed in 8 patients . RESULTS: At least 6 months antibiotic therapy using Rifampicin and Doxycycline is recommended . Surgery is indicated in the presence of spinal instability, cord compression or radiculopathy . In our series eight patients required surgery . CONCLUSION: The patients complaining of back pain, particularly in endemic areas should be investigated as possible cases of brucellosis.

J AOAC Int, 2001 May-Jun, 84(3), 737 - 51
Comparison of the Reveal 20-hour method and the BAM culture method for the detection of Escherichia coli O157:H7 in selected foods and environmental swabs: collaborative study; Bird CB et al.; Four different food types along with environmental swabs were analyzed by the Reveal for E . coli O157:H7 test (Reveal) and the Bacteriological Analytical Manual (BAM) culture method for the presence of Escherichia coli O157:H7 . Twenty-seven laboratories representing academia and private industry in the United States and Canada participated . Sample types were inoculated with E . coli O157:H7 at 2 different levels . Of the 1,095 samples and controls analyzed and confirmed, 459 were positive and 557 were negative by both methods . No statistical differences (p <0.05) were observed between the Reveal and BAM methods.

J AOAC Int, 2001 May-Jun, 84(3), 719 - 36
Reveal 8-Hour Test System for detection of Escherichia coli O157:H7 in raw ground beef, raw beef cubes, and iceberg lettuce rinse: collaborative study; Bird CB et al.; Five different food types were analyzed by the Reveal for E . coli O157:H7 8-Hour Test System (Reveal 8) and either the U.S . Food and Drug Administration's Bacteriological Analytical Manual (BAM) culture method or the U.S . Department of Agriculture Food Safety Inspection Service (FSIS) culture method for the presence of E . coli O157:H7 . A total of 27 laboratories representing academia and private industry in the United States and Canada participated . Food types 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 . During this study, 1,110 samples and controls were analyzed by both the Reveal 8 and by BAM or FSIS by each of the collaborators (2,220 samples in total) . For each set of samples, 740 were artificially inoculated with E . coli O157:H7, and 370 were uninoculated controls . The Reveal 8 detected 528 presumptive positives of which 487 were confirmed positive by the BAM culture method . In comparison, BAM and FSIS detected 489 of the 740 artificially contaminated samples as positive . In an additional in-house study performed only on chilled and frozen raw ground beef, 240 artificially inoculated samples were analyzed by both the Reveal 8 and by FSIS . The Reveal 8 detected and confirmed 104 samples as positive compared to 79 confirmed positive by FSIS.

Presse Med, 2001 May 19, 30(18), 897 - 9
{Infection of a pneumonectomy site 16 years after intervention}; Hocqueloux L et al.; BACKGROUND: Infection of the residual cavity after pneumonectomy generally occurs early after surgery . CASE REPORT: A 67-year old patient was hospitalized with fever 16 years after pneumonectomy for lung cancer . Investigations led to the diagnosis of infection of the pneumonectomy cavity . DISCUSSION: Late infection several years after pneumonectomy is exceptional and usually occurs in a setting of bacteriemia . Diagnosis is difficult due to modifications of the thoracic signs but should be entertained whenever unexplained fever or an inflammatory syndrome occurs in a pneumonectomized patient . The thoracic CT scan shows an abnormally enlarged cavity . Bacteriological examination of evacuated fluid provides the key to diagnosis . Drainage-lavage is indicated . Surgery may be needed exceptionally.

Int J Syst Evol Microbiol, 2001 May, 51(Pt 3), 873 - 9
A proposal for the unification of five species of the cyanobacterial genus Microcystis Kützing ex Lemmermann 1907 under the rules of the Bacteriological Code; Otsuka S et al.; Genomic DNA homologies were examined from six Microcystis (cyanobacteria) strains, including five different species, Microcystis aeruginosa, Microcystis ichthyoblabe, Microcystis novacekii, Microcystis viridis and Microcystis wesenbergii . All DNA-DNA reassociation values between two strains of M . aeruginosa and the other four species exceeded 70%, which is considered high enough for them to be classified within the same bacterial species . It is proposed to unify these five species into M . aeruginosa under the Rules of the Bacteriological Code and NIES843T (= IAM M-247T) is proposed as the type strain . Two other species, Microcystis flos-aquae and Microcystis pseudofilamentosa, should be regarded as morphological variations of this unified M . aeruginosa . The current taxonomy of cyanobacteria depends too much upon morphological characteristics and must be reviewed by means of bacteriological methods as well as traditional botanical methods.

Cochrane Database Syst Rev . 2001;(2):CD001090.
Intravenous immunoglobulin for treating sepsis and septic shock; Alejandria MM et al.; OBJECTIVES: Death from severe sepsis and septic shock is common, and researchers have explored whether antibodies to the endotoxins in some bacteria reduces mortality . This review summarises 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 Controlled Trials Register, MEDLINE 1966 to 2000, EMBASE 1988 to February 1999; 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 to 0.96) . Overall mortality was reduced in patients who received polyclonal IVIG (n=492; RR=0.64; 95% CI 0.51 to 0.80) . 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 in 4 good quality studies; 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: In our opinion, polyclonal IVIG significantly reduces mortality and can be used as an adjuvant treatment for sepsis and septic shock . Adjunctive therapy with monoclonal IVIGs remains experimental.

Kekkaku, 2001 Apr, 76(4), 371 - 7
{Analysis of factors related to the high incidence of tuberculosis in the city of Wakayama--analysis according to age groups, and sputum test results}; Kasamatsu M et al.; Over the last 20 years, the decrease in the incidence of Tuberculosis (TB) in Japan has slowed down . As of 1999, the incidence rate was 34.6 per 100,000 population in Japan, which was higher than that of the other developed countries, and the incidence rate in the city of Wakayama, one of the prefectural capital cities in Japan, during the same period was 42.9 per 100,000 population . We investigated the causes of this high incidence rate of TB in Wakayama City according to the analysis by age groups and sputum test results when patients are newly registered . Comparing our data during the period from 1.1.1998 to 12.31.1999 with data during the same period in the whole country and the rest of Wakayama Pref., the following results were obtained . Observing by age-groups, the incidence of TB in Wakayama City as well as in the rest of Wakayama Pref . and in the whole country was highest in the age-group above 70 years of age, though the rate of Wakayama City was significantly higher (146.2 per 100,000 population) than that in the rest of Wakayama Pref . (98.5 per 100,000 population) and that in the whole country (90.3 per 100,000 population) . Furthermore, the incidence rate of cases diagnosed as TB without bacteriological proof in Wakayama City (57.1 per 100,000 population) was significantly higher than that of the whole country (33.7 per 100,000 population) . Therefore, we concluded that one of the causes of high incidence of TB in Wakayama City was due to inappropriate method of diagnosing TB . More extensive use of sputum examination and strict evaluation of cases without bacteriological proof are desirable to increase the accuracy of TB diagnosis in Wakayama City.

J Vet Med B Infect Dis Vet Public Health, 2001 Apr, 48(3), 185 - 95
Immune reactions in cattle after immunization with a Mycobacterium paratuberculosis vaccine and implications for the diagnosis of M . paratuberculosis and M . bovis infections; Kohler H et al.; After immunization of four calves with a live modified Mycobacterium paratuberculosis vaccine the course of the humoral and cell mediated immune reactions was studied during a 2-year clinical investigation . Furthermore, the possibility of shedding of the vaccine strain and the influence of the vaccination on the tuberculin skin test was determined . In addition to standard procedures recently developed diagnostic methods (antibody enzyme-linked immunosorbent assay, interferon-gamma test, polymerase chain reaction) were used . A cell-mediated immune reaction, reflected in an increased, specifically induced, interferon-gamma production developed much earlier (1-2 weeks post-immunization) than humoral immunity (8-16 weeks post-gamma immunization) . While the increase in antibody titres was transient, declining to extremely low levels 48-60 weeks post-immunization, cell-mediated immunity remained detectable until the end of the investigation . Spread of the vaccine strain into the body and shedding were never detected during the whole course of the study except for one colon site in one calf . As late as 2 years after vaccine application positive or doubtful skin reactions against M . bovis purified protein derivative were measured, reflecting possible interference of the immunization with the diagnosis of bovine tuberculosis . At the end of the investigation, a positive cell-mediated immune reaction was detected the control animal although clinical, pathological and bacteriological examinations gave no indication for a mycobacterial infection.

Surg Clin North Am, 2001 Apr, 81(2), 359 - 61, xi
Angiography and interventional radiology: percutaneous approaches to benign pancreatic disorders; Neff R; Interventional radiology contributes several avenues for the diagnosis and treatment of benign pancreatic disorders . Biopsy can provide supporting evidence for benign or equivocal lesions . Aspiration of collections suspected of infection can yield specific bacteriologic diagnosis . Bleeding complications of pancreatitis can be treated directly by transcatheter embolization.

Clin Infect Dis, 2001 Jul 1, 33(1), 29 - 34 Epub 2001 May 23.
Randomized, double-blind, controlled study of cefoperazone-sulbactam plus cotrimoxazole versus ceftazidime plus cotrimoxazole for the treatment of severe melioidosis; Chetchotisakd P et al.; We conducted a prospective randomized, double-blind, controlled study of cefoperazone-sulbactam (ratio, 1:1; cefoperazone 25 mg/kg/day) plus cotrimoxazole (trimethoprim-sulfamethoxazole {TMP-SMZ} at a ratio of 80:400; TMP, 8 mg/kg/day) versus ceftazidime (100 mg/kg/day) plus cotrimoxazole (TMP, 8 mg/kg/day) for the treatment of severe melioidosis . Of 219 patients enrolled in the study, 102 (47%) had culture-proven melioidosis . These patients were assigned randomly to 2 treatment groups, each with 50 patients (2 patients were excluded) . Mortality rates were not significantly different between the 2 groups: 18% in the cefoperazone-sulbactam group versus 14% in the ceftazidime group . The crude difference in the mortality rate was 4%, but when adjusted for type of infection the difference was 0.9% (95% confidence interval, -3.6% to 5.4%; P = .696) . The duration of defervescence and the bacteriological response of successfully treated patients were similar in both groups, and both treatment regimens were well tolerated . Cefoperazone-sulbactam plus cotrimoxazole might be used as an alternative to ceftazidime plus cotrimoxazole as treatment for severe melioidosis.

Vet Rec, 2001 May 12, 148(19), 587 - 91
Morbillivirus in common seals stranded on the coasts of Belgium and northern France during summer 1998; Jauniaux T et al.; Sixteen common seals (Phoca vitulina) were stranded on the Belgian and northern French coasts during the summer of 1998 . Eleven (10 pups and one adult) were sampled for histopathological, immunohistochemical, serological, bacteriological, parasitological and virological investigations . The main gross findings were severe emaciation, acute haemorrhagic enteritis, acute pneumonia, interstitial pulmonary emphysema and oedema, and chronic ulcerative stomatitis . Microscopical lung findings were acute to subacute pneumonia with interstitial oedema and emphysema . Severe lymphocytic depletion was observed in lymph nodes . Severe acute to subacute meningoencephalitis was observed in one animal . Specific staining with two monoclonal antibodies directed against canine distemper virus (CDV) and phocine distemper virus was observed in a few lymphocytes in the spleen and lymph nodes of three seals . Anti-CDV neutralising antibodies were detected in sera from six animals . Seven of the seals were positive by reverse transcriptase-PCR for the morbillivirus phosphoprotein gene . The lesions observed were consistent with those in animals infected by a morbillivirus, and demonstrated that distemper has recently recurred in North Sea seals.

J Pediatr Surg, 2001 Jun, 36(6), 851 - 4
Usefulness of cord-blood harvesting for autologous transfusion in surgical newborns with antenatal diagnosis of congenital anomalies; Imura K et al.; BACKGROUND/PURPOSE: The risks of homologous transfusion and the effectiveness of predeposit autologous transfusion have been described . The authors examined the clinical usefulness of cord-blood harvesting for autologous transfusion in newborns who had congenital anomalies antenatally diagnosed that would require surgical intervention at or near the time of delivery . METHODS: Of 112 cases of antenatal diagnosis of congenital anomalies, 50 mothers gave informed consent and enrolled in this study . Cord-blood was withdrawn immediately after clamping of the umbilical cord and was used for autologous transfusion in newborns within the first 3 days postpartum . RESULTS: A mean of 72 +/- 54 mL of cord-blood was harvested (27 +/- 18 mL/kg) . While preserving cord-blood for 3 days at 4 degrees C, no signs of clot formation or hemolysis were observed . The harvested cord-blood included plasma-free Hb ranging from 1 to 68 (13 +/- 18) mg/dL and thrombin-antithrombin III complex ranging from 2 to 273 (18 +/- 50) ng/mL . Bacteriologic examination of the stored cord-blood showed negative cultures, except for samples from 3 newborns after vaginal delivery . A mean of 46 +/- 34 mL of cord-blood was used in 26 patients for autologous transfusion . No significant complications related to cord-blood transfusion were recognized clinically . CONCLUSIONS: Autologous cord-blood transfusion has the potential to be a useful alternative to homologous transfusion in newborns requiring surgery . Adequate collection and storage techniques for cord-blood must be developed . J Pediatr Surg 36:851-854 .

Afr J Med Med Sci, 2000 Mar, 29(1), 51 - 3
Modified short-course chemotherapy of pulmonary tuberculosis in Ibadan, Nigeria--a preliminary report; Ige OM et al.; Over a 3 year period 3rd of April 1995 and 6th of April 1998 a controlled clinical trial of the modified short-course chemotherapy (SSC) in newly diagnosed cases of pulmonary tuberculosis in Nigeria was carried out . Between The SCC used was the one adopted from World Health Organisation/International Union Against Tuberculosis and Lung Diseases for developing countries by the Nigerian National Tuberculosis and Leprosy Control Programme (NTLCP) . The regimen used consisted of streptomycin (S), isoniazid (H), Rifampicin (R) and pyrazinamide (Z) in the initial or intensive phase of 2 months . Ethambutol (E) was sometimes substituted for streptomycin . The continuation phase was 6 months of thiacetazone, (T) and isoniazid (H), i.e., 2SHRZ/6TH or 2EHRZ/6TH . Sputum conversion was 90% at the second month of treatment and there was no bacteriological relapse after 18 months of follow-up . Side effects were few and consisted mainly of acne vulgaris which occurred in twenty (20.6%) of 97 patients during the continuation phase . It is concluded that the 8-month chemotherapy regimen adopted by NTLCP is efficacious in treatment of smearpositive pulmonary tuberculosis (PTB).

Gastrointest Endosc, 2001 Jun, 53(7), 789 - 93
Endoscopic diagnosis of colonic tuberculosis; Naga MI et al.; BACKGROUND: GI tuberculosis is a diagnostic challenge, particularly in the absence of evidence of pulmonary infection . It may mimic many other abdominal diseases such as other infectious processes, tumors, and Crohn's disease . In the absence of positive laboratory and radiologic tests, the diagnosis is often established definitively by obtaining a surgical specimen . Colonoscopy, however, has been used successfully to diagnose the disease and thus avoid the morbidity and mortality associated with exploratory laparotomy . METHODS: An evaluation was conducted of colonoscopic features in 10 patients with colonic tuberculosis . OBSERVATIONS: In all cases there was ileocecal involvement; total colonic involvement was found in only 1 case . The colonoscopic appearance included the following: ulcerated lesions, sessile firm polyps, masses, and small diverticula, ranging from 3 to 5 mm in diameter . In 5 of our patients the diagnosis was confirmed bacteriologically, in 3 with endoscopic biopsy material, and in 2 by sputum examination . In all cases antituberculous therapy produced remarkable symptom and endoscopic improvement . CONCLUSION: This report highlights the importance of colonoscopy in the diagnosis of tuberculous involvement of the GI tract.

Odontostomatol Trop, 2000 Jun, 23(90), 19 - 23
{Clinical and bacteriologic response to irrigation with a chlorhexidine solution in the treatment of periodontal pockets}; Diallo AS et al.; Most of parodontal diseases have a bacterial aetiology . Their episodic and asynchronic evolution differs from site to site . The "in situs" antimicrobian used in the parodontal bags reduces the systemic administration . Various antibiotics or antiseptics slow liberation systems were experimented . Two patients suffering from advanced parodontitis were treated after radicular scraping by subgingival irrigation with a syringe filled with chlorhexidine . Each patient presented at last four parodontal bags more or less six millimetres (6 mm) deep . The following clinical parameters were noted: Patch index, bleeding index, bag depth . A bacteriological analysis was realized at the beginning and of the treatment . Controls were made at D60 . Results showed a significant improvement of clinical parameters . It seems that the chlorhexidine irrigation improves the parodontal treatment efficiency.

Gesundheitswesen, 2001 Apr, 63(4), 191 - 9
{Bacteriology and constitutional health--genomics and proteomics: concepts in medicine and concepts in health insurance in the past and future}; Labisch A; Future discussions on health issues on the individual or society level will be fundamentally linked to genetic dispositions . This genetic world will become reality in the same way the world of hygiene and bacteriology has become real for everyone . Approaches of molecular medicine for public health issues have not yet been created so far . The secret dreams of molecular eugenics must be made public and critically discussed . Up to now only a few monogenetically recessive hereditary diseases can be detected by screening . This kind of screening should be carefully considered . However, for the sciences, for medicine and thus for the physicians in practice, for health care sciences as well as for public health care, new tasks will emerge from genetics and molecular medicine . In individual as well as public health these new tasks will at first mainly turn in on the sphere of diagnosis and specific screening as well as health education and consultation . With regard to the considerable social implications the public health care sector should be aware of the coming issues of molecular medicine in time.

Rozhl Chir, 2001 Mar, 80(3), 110 - 3
{Bacteriologic study of secretions of the lower respiratory tract after pulmonary resection}; Siller J et al.; Bacteriological monitoring of the low respiratory tract secretion was examined in 43 patients with lung resections . Three groups of cultivation results were evaluated: before operation, during operation and after operation in selected patients . There are two main reasons: 1 . To prevent early infectious complications after operation, 2 . To attempt treatment of the known bacteriological agent in time.

Zhonghua Jie He He Hu Xi Za Zhi, 1998 Sep, 21(9), 528 - 31
{Multicentre, randomized, prospective and comparative study of ceftriaxone, cefotaxime and cefuroxime in treating mild to moderate respiratory tract infection}; Gao B et al.; OBJECTIVE: The objective of this multicentre, randomized, prospective and comparative study was to evaluate and compare the efficacy and safety of 1 g intravenous ceftriaxone (active ingredient of Rocephin), 3 g intravenous cefoiaxime (active ingredient of clafron), and 2.25 g intavenous cefuroxime (active ingredient of Zinacef) . METHOD: In this multicentre, randomized, prospective and comparative study, patients received 1 g of ceftriaxone intravenously once a day (group A), or 1 g of cefotaxime intravenously three times a day (group B), or 0.75 g of cefuroxime intravenously three time a day (group C) . 197 patients were enrolled in the study, and in 142 (48 in group A, 46 in group B and 48 in group C) we were able to make an evaluation . RESULT: The overall efficacy (bacteriological eradication plus clinical cure or clear improvement) of ceftriaxone, cefotaxime and cefuroxime were 81%, 83%, 79% respectively (P > 0.05) . The eradication rate for three groups were 80%, 78%, 75% (P > 0.05) . No adverse events occured . CONCLUSION: Data obtained in our study indicate that for the majority of patients with lower respiratory tract infections, 1 g ceftriaxone, 3 g cefotaxime and 2.25 g cefuroxime are effective and safe, and 7 days therapy is enough, but the use of 1 g ceftriaxone is more convenient.

Clin Ther, 2001 Apr, 23(4), 585 - 95
Comparative efficacy of clarithromycin modified-release and clarithromycin immediate-release formulations in the treatment of lower respiratory tract infection; Adam D et al.; BACKGROUND: A modified-release (MR) formulation of clarithromycin, distinct from the extended-release formulation, has recently been developed and has efficacy and tolerability similar to standard immediate-release (IR) clarithromycin, with the advantage of once-daily dosing . OBJECTIVE: The purpose of this study was to compare the efficacy (as measured by relief of clinical symptoms and eradication of specific pathogens) and tolerability of clarithromycin MR 500 mg administered once daily versus clarithromycin IR 250 mg administered twice daily for 5 days . METHODS: In this randomized, double-blind (with matching placebo), parallel-group . multicenter, controlled trial, patients with lower respiratory tract infection were randomized to 1 of 2 treatment regimens: clarithromycin MR 500 mg once daily plus clarithromycin IR 250 mg placebo twice daily or clarithromycin IR 250 mg BID plus clarithromycin MR 500 mg placebo once daily . RESULTS: Statistically equivalent clinical cure and success rates, overall symptomatic improvement, and bacteriologic responses were achieved with both treatments . In the clarithromycin MR group, the clinical cure rate was 72.5% (87/120), and the clinical success rate (cure plus symptomatic improvement) was 97.5% (117/120) . Of the 124 patients treated with clarithromycin IR 250 mg BID, 98 (79.0%) achieved a clinical cure, and 120 (96.8%) achieved clinical success . There were no statistically significant between-group differences in clinical cure or success rates . More than 85% of patients in both study groups experienced improvement in dyspnea, cough, wheezing, chest discomfort, fatigue, and fever, and the visual appearance of sputum: these symptoms resolved completely in the majority of patients . Bacteriologic response (efficacy against specific pathogens), which was assessed as an objective efficacy criterion, was assessable for 40 patients treated with clarithromycin MR and 49 patients treated with clarithromycin IR . Bacteriologic eradication of the pretreatment target pathogen was achieved in 95.0% (38/40) of assessable patients treated with clarithromycin MR 500 mg once daily and 91.8% (45/49) of patients treated with clarithromycin IR 250 mg BID . Treatment-related adverse events were mild to moderate in all cases . Nausea (n = 9), diarrhea (n = 6), abdominal pain (n = 5), and gastric pain (n = 3) were the only study drug-related adverse events reported by > or = 1 patient in each treatment arm . Diarrhea was reported only in the clarithromycin IR group (n = 6) (P = 0.029 vs clarithromycin MR) . CONCLUSIONS: Clarithromycin MR 500 mg administered once daily for 5 days is as effective and well tolerated as the IR formulation, with the advantage of once-daily dosing and fewer episodes of diarrhea.

Rev Pneumol Clin, 2001 Apr, 57(2), 124 - 31
{Diagnosis and treatment of nosocomial pneumonia: bronchial fibroscopy, protected brushing and/or bronchial lavage is not indispensable}; Marquette CH; Nosocomial pneumonia in ventilated patients is a frequent and serious complication of ventilatory assistance . The causal role of these lung infections in the overmortality observed in ventilated patients remains a question of debate, but the therapeutic cost (antibiotics and longer stay in intensive care) is considerable . Unlike the spontaneously ventilating patient, fever and new radiologic opacities in ventilated patients can be caused by many non-infectious conditions often concomitant with bacterial pneumonia . The association of clinical signs (fever, purulent tracheal secretions) and laboratory (leukocytosis, leukopenia, hypoxia) or radiographic (recent persistent alveoloar opacities) findings are suggestive of bacterial pneumonia but do not provide bacteriological proof . In order to avoid unjustified treatments (in patients without bacterial pneumonia) or poorly adapted treatments (broad spectrum empiric antibiotics) that can generate high costs in terms of therapy and epidemiology (emergence of resistance), a certain number of fibroscopic techniques have been proposed to improve the diagnosis of nosocomial pneumonia in ventilated patients . These sophisticated and attractive techniques have however provided rather disappointing results and do not allow sufficiently sure positive diagnosis nor bacteriological proof . Moreover, despite their cost and the difficulty of implementing fibroscopic techniques, no reduction in the mortality of nosocomial pneumonia in ventilated patients has been achieved.

Rev Pneumol Clin, 2001 Apr, 57(2), 101 - 12
{Prevention of infections transmitted by intravascular devices (catheters, implanted sites)}; Nitenberg G et al.; Infection remains a major complication of central veinous catheters . A clinically or bacteriologically proven infection is identified in 5 to 10% of the cases although the actual risk varies from less than 1 to more than 30 episodes of infection per 1000 catheter-days . Systemic spread follows colonization of the catheter tip via the skin or the connectors, less frequently via hematogenous seeding from a distant focus of infection . Excepting emergency situations, search for proof of catheter-related infection or noninfection without removing the catheter now appears to be acceptable for selected intensive care patients if appropriate safety measures are taken; the reasonable choice is between maintaining the catheter while performing tests susceptible of determining the reality of catheter-related infection (in this case there remains a certain doubt concerning the respective performance of the different methods proposed for early diagnosis) and catheter exchange on a metal or plastic guide-wire . Rigorous application of the rules of hygiene, asepsis, and local care is crucial: systematic and repeated hand washing is by far the best antiinfectious prophylaxis . Three types of future developments susceptible of improving the current situation can be identified: better knowledge of host defense mechanisms against foreign bodies, reduction of hand-transmitted contamination by wider use of hydro-alcohol solutions for decontamination of the hands, and elaboration of new connectors, and most importantly, biomaterials capable of inhibiting colonization by the growing number of increasingly virulent strains . Discussions concerning the real clinical efficiency, ecological risk and the cost-effectiveness of catheters impregnated with antiseptics and/or antibiotics is a perfect illustration of the current debate.

Aust Vet J, 2001 Apr, 79(4), 267 - 78
Progress towards understanding the spread, detection and control of Mycobacterium avium subsp paratuberculosis in animal populations; Whittington RJ et al.; OBJECTIVE: To review and interpret aspects of the pathogenesis and epidemiology of paratuberculosis (Johne's disease) for veterinarians involved in current Johne's disease control programs . PROCEDURE: An electronic and manual search was undertaken to identify published information which, together with limited unpublished data, was interpreted and summarised . CONCLUSIONS: Paratuberculosis, a chronic enteropathy of ruminants, is caused by Mycobacterium avium subsp paratuberculosis and is transmitted mainly in faeces to young animals by infected adults, some of which may not have clinical signs . The incubation period is inversely related to the size of the challenge dose but can be extremely prolonged . Clinical cases may not be seen within the economic lifespan of farm animals, particularly when stocking rates are low, pasture is spelled, or when animals are culled at a relatively young age . Other as yet unknown influences may determine the rate of progression or recovery from infection . Paratuberculosis appears in a range of forms from a disease with high prevalence and significant mortality through to one with very low prevalence and little obvious morbidity or mortality . Detection of infected flocks and herds relies on use of laboratory tests . Bacteriological culture of faeces is the most sensitive herd-level test . The passage of time and repeated testing are the greatest allies in detecting paratuberculosis because infected animals progress in the disease process and most tests are more effective in the later stages of the disease . These factors generally cause the prevalence of paratuberculosis to be underestimated at both herd or flock and regional level . Greater understanding of the epidemiology and pathogenesis of M a paratuberculosis infection is critical in order to design improved diagnostic strategies, assess the feasibility of eradication and develop control options, particularly in small ruminants.

Int J Surg Investig, 2000, 1(5), 441 - 6
Ultrathin cutting needle biopsy histology in the tissue diagnosis of acute pancreatitis--experimental study and application in a human case; He ZJ et al.; BACKGROUND AND AIMS: This study was to assess whether the tissue obtained with an ultrathin cutting needle, that is as thin as used for aspiration cytology and bacteriology, can give enough material to diagnose acute pancreatitis in rat model and in a human case . METHODS: Wistar rats were randomly allocated into control group (n = 6), cerulein group (n = 6), ligation group (n = 6) and bile salt group (n = 6) . In the cerulein, ligation and bile salt groups acute pancreatitis was induced by cerulein intraperitoneal injections, low ligation of common biliopancreatic duct and sodium taurodeoxycholate intraductal injection, respectively . Serum amylase activity was measured and a large cut specimen and two ultrathin needle biopsy specimens were obtained from the pancreas for light microscopic histology . Oedema, acinar cell necrosis, haemorrhage or fat necrosis, and leukocyte infiltration were evaluated semiquantitatively and compared with large cut specimens . RESULTS: The pancreatitis groups revealed different severity in oedema, acinar cell necrosis, haemorrhage or fat necrosis, and leukocyte infiltration . The needle biopsy showed 100% sensitivity and 100% specificity in the diagnosis of acute pancreatitis . The histopathologic scores showed a good and significant correlation between ultrathin biopsy and large cut specimens in all the four histologic parameters, especially in oedema and acinar cell necrosis . A human case is presented, whose percutaneous ultrathin needle biopsy histology was successfully applied for diagnosing acute pancreatitis . CONCLUSIONS: The ultrathin needle biopsy histology can give enough material for the diagnosis of acute pancreatitis . Further studies with ultrasonography guided percutanous or endosonography guided transduodenal technique will be needed to assess the role of tissue sampling in acute pancreatitis.

Anesteziol Reanimatol, 2001 Jan-Feb, (1), 53 - 5
{Complex approach to selection of antibiotics in the treatment of children with peritonitis}; Mukhtarov EG; The author discusses rational antibiotic therapy of pyoseptic diseases in children as exemplified by peritonitis . An approach to selection of the optimal drug is developed, consisting in a rapid bacteriological and immunological analysis of the minimal volume of blood, which helps choose the most effective antibiotic, evaluate individual drug tolerance and dose with consideration for the immunotropic effect of the drug in patients with changed immune status so that no further correction is needed.

Rev Esc Enferm USP, 2000 Mar, 34(1), 9 - 15
{The historicity of the interpretative theories about health and disease}; Oliveira MA et al.; The interpretative theories of the health-illness process that can be identified through History have as consequence intervention projects upon the reality, in response to social needs . Until the 19 century, they could be synthesized in two main streams: ontologic and dynamic . In the ontologic conception, illness assumes the character of a natural or supernatural entity, external to the human body, that shows itself when invading it . The dynamic conception sees illness as a product of the disharmony among vital forces, and the re-establishment of the health comes of the restoration of this balance . At the end of the 18 century, the social-environmental paradigms prevailed in Europe as forms of explanation for human illness, linked to the dynamic conception, and the first evidences of the social determination of the health-illness process were formulated . The onset of the Bacteriologic Era made the ontologic conception victorious and its conquests led to the abandon of the social approaches to face the populations health problems . At the present time, one can identify the prevalence of the multicausal theory, with emphasis in the individual conditionings . This paper proposes the articulation of the individual and collective dimensions of the health-illness process, in consonance with the Theory of Nursing Praxical Intervention in Collective Health.

Trends Microbiol, 2001 May, 9(5), 196 - 8
A marriage of bacteriology with cell biology results in twin arginines; Sargent F; The Tat apparatus is a remarkable molecular machine required for the transmembrane translocation of folded proteins . Recent studies have identified jellyfish green fluorescent protein as an excellent reporter protein for the bacterial Tat pathway . Although the genetics of the Tat system are reasonably well-defined in Escherichia coli, the utilization of heterologous proteins as transport substrates promises to facilitate further mechanistic and structural characterization of this system.

Int J Tuberc Lung Dis, 2001 May, 5(5), 419 - 25
Screening for pulmonary tuberculosis among immigrants: estimated effect on severity of disease and duration of infectiousness; Verver S et al.; OBJECTIVE: To estimate the effect of tuberculosis screening among recent immigrants on the severity of disease at diagnosis and on the duration of the infectious period . DESIGN: Comparison of pulmonary tuberculosis cases among immigrants detected through screening with those detected passively, using information from the Netherlands Tuberculosis Register . PARTICIPANTS: Immigrants from highly endemic countries diagnosed with culture-positive pulmonary tuberculosis within 30 months after arrival in The Netherlands, 1993 through 1998 . OUTCOME MEASURES: Severity of disease (smear-positive disease, hospitalisation, case fatality) and duration of symptomatic period . RESULTS: A total of 882 bacteriologically confirmed tuberculosis patients from highly endemic countries had been in The Netherlands less than 30 months, and were detected through screening (454), or passively (368) . Compared with patients detected passively, patients found through screening were less often sputum smear-positive (OR 0.5, 95%CI 0.3-0.8) and less often hospitalised (OR 0.2, 95%CI 0.1-0.2) . Those detected through screening had a shorter symptomatic period . Screening is estimated to have reduced the infectious period by approximately 33% . CONCLUSION: The screening programme detected cases earlier, resulting in fewer hospital admissions, shorter duration of symptoms and therefore probably reduced tuberculosis transmission.

Diagn Cytopathol, 2001 May, 24(5), 317 - 21
Utility of fine-needle aspiration cytology in the classification of leprosy; Rao IS et al.; The role of fine-needle aspiration cytology (FNAC) in the diagnosis of benign skin lesions has been restricted primarily to the evaluation of bacteriologic and morphologic indices in leprosy . This study was undertaken to evaluate the efficacy of FNAC in the diagnosis and classification of lepromatous lesions . Aspirates of 94 newly diagnosed cases of leprosy were studied, and the bacterial load was determined by modified Ziehl-Neelsen (ZN) stain . A skin biopsy was taken from the same site at the same sitting . Frozen and paraffin sections stained with hematoxylin-eosin (H&E) and ZN stains were examined from the biopsy specimen . In 61 of 94 cases (64.9%), the aspirates were satisfactory . Both diagnosis and classification of leprosy were possible in 40 of these 61 cases; the rest of the aspirates showed nonspecific chronic inflammation . The 39 cases of leprosy where a biopsy was available from the same site were classified on FNAC into tuberculoid (TT and BT), lepromatous (LL and BL), and midborderline (BB) subtypes . Taking the histologic diagnosis and Ridley-Jopling classification to be the gold standard, a strong concordance in tuberculoid leprosy cases (18 of 20 cases, 90%) and in lepromatous cases (15 of 16 cases, 93.7%) was observed . Midborderline cases of leprosy posed a problem, and a correct cytohistological correlation was observed in only one of the three cases .

Int J Tuberc Lung Dis, 2001 Apr, 5(4), 346 - 53
Incidence of pulmonary tuberculosis in Korean civil servants: second study, 1992-1994; Bai GH et al.; SETTING: A survey based on biennial medical examinations for civil servants, including school teachers . OBJECTIVE: To estimate the incidence of pulmonary tuberculosis (PTB) for the general population from a sample survey, and to compare it with the previous results from 1988-1990 . DESIGN: A retrospective follow-up study which started in April 1996 and ended in December 1997 . Development of PTB among all South Korean civil servants who were tuberculosis-free in the 1992 biennial medical examination was followed up to the 1994 medical examination . The survey was based on newly-developed cases by 1) the findings of the biennial medical examination, 2) scrutiny of the medical records of all those claiming health insurance for tuberculosis, and 3) checking of the TB registers in all health centres during the period . Civil servants constituted 2.6% of the Korean population aged 20 to 64 . RESULTS: Of 958137 subjects who were found to be TB-free in the 1992 medical examination, 957216 were eligible for the study . Radiologically active PTB was found in 4146 cases over the 2-year period of the study . Bacteriological examinations were performed in 3306 patients: there were 1551 bacteriologically proven cases (46.9%), including 1049 smear-positives (31.7%) and 502 smear-negative culture-positives (15.2%) . The age-sex adjusted incidence rate for the general population was 202/100000 in radiologically active PTB, 81/100000 in bacteriologically proven PTB, and 54/100000 in smear-positive PTB . Overall PTB incidence rates were higher in males (240/100000) than in females (163/100000), and in the age group 20-24 years (280/ 100 000) than in the other age groups . CONCLUSION: Comparing the 1992-1994 PTB incidence with that observed in the 1988-1990 survey, the highest incidence was observed among young adults in both surveys, and it had not changed over time.

Tidsskr Nor Laegeforen, 2001 Mar 20, 121(8), 946 - 7
{Konrad Birkhaug and the BCG vaccine}; Laerum OD; Konrad Elias Birkhaug (1892-1980) was born in Bergen to Elisa Marie Skorge and Karl Anders Birkhaug, a policeman, as the sixth of their ten children . After a period as a laboratory assistant at Bergen Municipal Hospital, he emigrated to USA in 1911 . He graduated from the medical school of Johns Hopkins University in 1924 . After residency in bacteriology, he became professor at Rochester University in 1927 and head of its laboratory of bacteriology . From 1932 to 1935 he worked as a senior scientist at the Institute Pasteur in Paris and from 1935 to 1945 as a fellow of the Chr . Michelsen Institute in Bergen . From 1937 he also headed the National Laboratory for production of BCG vaccine . After active involvement in the resistance movement against the Nazis during the Second World War, he returned to the USA in 1946 as head of the BCG laboratory of the State of New York in Albany . He retired in 1953 and settled in Bergen, where he died in 1980 . Birkhaug is one of the pioneers in the research on immunity reactions to tuberculosis infection and BCG vaccination . He is also known for producing the first antiserum against erysipelas, which was used from 1927 until sulphonamides were discovered . In addition to his international scientific publications, he wrote two books in Norwegian, his autobiography and a book about the German eradication of a small fishermen's village in Western Norway during the Second World War.

Allergy Asthma Proc, 2001 Mar-Apr, 22(2), 87 - 91
Atopic status of an adult population with active and inactive tuberculosis; Mungan D et al.; The rise in allergic disorders over the past three decades has been suggested to be related to the decrease in infectious diseases . Recently, a negative association between tuberculin responses and atopic disorders has also been reported . We planned to investigate the effect of natural exposure to Mycobacterium tuberculosis on atopic status in patients with active tuberculosis and to compare the findings with the data of patients with inactive disease . A total of 97 subjects were divided into two groups . Group 1, patients with proven active pulmonary tuberculosis (n = 66); group 2, subjects who had a history of previous tuberculous disease, with negative bacteriologic studies and no clinical and/or roentgenographic evidence of current disease (n = 31) . Current history of allergic diseases was recorded by a physician with the use of a questionnaire adapted from the European Community Respiratory Health Survey (ECRHS), and skin-prick tests (SPTs) were performed using a standardized panel . Total IgE and Phadiatop were measured by the Pharmacia uniCAP system . The rate of one or more positive SPTs was significantly lower in the patients with active tuberculosis than the inactive group (15% versus 48.4%, p < 0.001) . The current history of atopic diseases was 7.6% and 29% in the active and inactive tuberculosis groups, respectively (p = 0.002) . The rate of positive skin tests to inhalant allergens in patients with inactive disease was higher than the rate of healthy adult Turkish people (48.4% versus 25%, p = 0.001) . Geometric mean of total IgE levels were lower in patients with inactive disease than patients with active pulmonary tuberculosis (74.97 kU/L versus 106.3 kU/L, p = 0.05) . The ratios of Phadiatop positivity were 21% and 38.7% in the active and inactive tuberculosis groups, respectively (p = 0.008) . We found lower atopy rates in patients with active pulmonary tuberculosis than subjects with inactive disease . Although our data support the hypothesis that M . tuberculosis may prevent the development of atopic disorders by inducing the production of cytokines antagonistic to Th2 development, we believe prospective and experimental studies are needed before attributing a direct cause-effect link to this association.

J Chemother, 2001 Apr, 13(2), 176 - 81
Duration of clinical symptoms in female patients with acute urethral syndrome caused by Chlamydia trachomatis treated with azithromycin or doxycycline; Skerk V et al.; One hundred fifty-one female patients with acute urethral syndrome caused by Chlamydia trachomatis were examined . First, patients were divided into two groups, those with clinical symptoms present < 3 weeks before the start of treatment, and those with clinical symptoms > or = 3 weeks prior to the beginning of therapy . Then patients were further divided into groups and randomized to receive azithromycin once daily in a single dose of 1.0 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 (8 study groups in all) . Clinical and bacteriological efficacy was evaluated 3 weeks after the end of therapy . In the group of patients with disease symptoms lasting for 3 weeks or longer, the eradication and clinical cure rates were significantly higher after administration of azithromycin in a dose of 1x500 mg/6 days than after a single dose of 1.0 g (p<0.01), and after administration of doxycycline 2x100 mg/14 days than by using doxycycline 2x100 mg/7 days (p<0.05).

J Periodontol, 2001 Mar, 72(3), 275 - 83
A 2-step non-surgical procedure and systemic antibiotics in the treatment of rapidly progressive periodontitis; Sigusch B et al.; BACKGROUND: In the last few years knowledge about periodontal infections has increased enormously, nevertheless practitioners are still seeking guidelines for suitable treatment concepts . METHODS: The aim of this study was to examine the effect of doxycycline, metronidazole, and clindamycin used adjunctively in a 2-step nonsurgical procedure in patients with rapidly progressive periodontitis (RPP) . The first step included scaling, root planing, and polishing (SRP) in each quadrant using 4 to 5 visits . The second step included full-mouth enhanced root planing (RP) and wound dressing in 1 or 2 visits after SRP and the beginning of antibiotic therapy . Forty-eight patients (mean age 32.4 years) with generalized RPP, with an average of 16 sites with probing depths (PD) deeper than 8 mm, and high counts of Porphyromonas gingivalis were randomly assigned to 4 different groups: group 1 (doxycycline) n = 12, group 2 (metronidazole) n = 15, group 3 (clindamycin) n = 11, and group 4 (control group; no antibiotic treatment) n = 10 . Clinical evaluations, including plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), clinical attachment level (CAL), and bacteriological and crevicular cell sampling, were done at baseline (BL), 3 weeks after SRP, and 6 and 24 months after RP . RESULTS: After the first step (SRP), we observed an improvement of PI and SBI in all 4 groups, but did not see any statistically significant PD reduction 3 weeks after SRP compared to baseline . However, 6 and 24 months after the second step (RP) we observed a significantly greater reduction of PD in groups 2 and 3 and a significantly greater CAL gain in comparison to groups 1 and 4 . After 24 months, the attachment level gain in group 1 and group 4 was less than 1.5 mm, and less than 1.0 mm in PD site categories 6 to 9 mm and >9 mm . PI showed no significant difference between the groups throughout the period after SRP until 24 months, compared to 3 weeks after SRP . SBI decreased most in the metronidazole and clindamycin groups . P . gingivalis and Actinobacillus actinomycetemcomitans were almost completely eradicated in these 2 groups 24 months after RP . In addition, the phagocytotic capacity of crevicular polymorphonuclear neutrophils was increased in groups 2 and 3 after the second step . CONCLUSIONS: The present results show that metronidazole and clindamycin are effective antibiotics when used adjunctively in a 2-step nonsurgical procedure of scaling and root planing in RPP patients.

Zhonghua Jie He He Hu Xi Za Zhi, 1998 Jul, 21(7), 388 - 91
{Controlled clinical trial on efficacy of 5-month regimens and whole course intermittent 6-month regimens in treating bacillary pulmonary tuberculosis}; Chu N et al.; OBJECTIVE: To assess the therapeutic efficacy of rifapentine (L), to reduce the duration of treatment and the frequency of drug administration, and to observe the influence on efficacy and adverse reactions of using pyrazinamide (Z) through whole-course . METHOD: Two 5-month regimens respectively including rifampin (R) and L and two whole course intermittent regimens were designed as following: I: 2SHRZ/3R2H2Z2; II: 2SHRZ/3L1H2Z2; III: 2S3H3R3Z3/4L1H2Z2; IV: 2S3H3R3Z3/4L1H2E2 . A total of 366 newly-diagnosed bacillary pulmonary tuberculosis patients were admitted and randomly allocated . RESULTS: 339 cases completed the prescribed short course chemotherapy . The sputum conversion rates at the end of the treatment of groups I, II, III and IV were 97.0%, 94.1%, 100.0% and 97.2% respectively . X-ray resolution rates were 96.0%, 97.6%, 100.0% and 94.4% respectively . Cavity-close rates of the 5-month regimens and the 6-month regimens were 77% and 76% . Comparing the results among groups, there were no statistically significant differences (P > 0.05), and no obvious side-effect was found . 305 patients have been followed up for 3 years since completion of the chemotherapy . The bacteriological relapse and bacteriological relapse with deterioration on chest X-ray in groups I, II, III and IV were seen in 2,3,6 and 3 cases respectively . CONCLUSION: Domestic-made rifapentine is a long-acting, highly effective antituberculosis drug . It is unnecessary to use Z in continuation phase, and it is possible to shorten the duration to 5 months with the appropriate combination of essential drugs, which is worthwhile for further study.

Int J Tuberc Lung Dis, 2001 Mar, 5(3), 250 - 6
Is quarterly cohort analysis useful for assessing treatment outcomes in a low incidence country?
Trnka L, Dankova D, Krejbich F.
SETTING: In the Czech Republic, a country regarded as having a low incidence of tuberculosis (TB), short-course chemotherapy (SCC) of TB has been implemented in routine practice country-wide . OBJECTIVE: To assess the outcome of SCC by quarterly cohort analysis of patients using the methodology recommended by the World Health Organization (WHO) . DESIGN: Patients with newly detected bacteriologically confirmed pulmonary TB notified in 1998 were treated according to local recommendations (SCC) or with the WHO-recommended DOTS strategy . The type of chemotherapy and its outcome were evaluated 12 months later by quarterly cohort analysis . RESULTS: A total of 731 patients with bacteriologically confirmed pulmonary TB, 403 of them smear-positive, were assessed . The proportion of those treated under the DOTS strategy increased from 56.2% to 75.1% . Favourable treatment outcomes (cure or treatment completed) were achieved in 69.0% of patients in the first quarter and 74.0% in the fourth quarter . Only four treatment failures and 21 defaulters were recorded . A total of 129 patients (15-21% in different cohorts) died before or during treatment, mostly from causes not connected with TB . If this proportion were not taken into account, treatment efficacy would have attained 85% . CONCLUSIONS: Analysis of SCC based on quarterly cohorts proved feasible in routine conditions in a country with a low incidence of TB and ongoing TB control, and provided more information than once yearly analysis.

Indian J Lepr, 2001 Jan-Mar, 73(1), 11 - 5
Role of paucibacillary leprosy in the transmission of disease; Halder A et al.; The objective of this study was to establish that paucibacillary leprosy also carried increased risk of infection to the community . All members of 100 families with an index paucibacillary case were clinically, bacteriologically and immunologically examined . The "comparison" group was sampled from suspect register . Fifty-six cases occurred among 944 contacts of index paucibacillary cases; of these, four were multibacillary and 52 were paucibacillary . In the "comparison" group, two contacts out of 760 developed paucibacillary leprosy . This difference, between the two groups, was statistically significant . All the 56 cases in the index case families were under 20 years of age; and 50 of them were aged under 15 years . Male/female ratio was 2.1:1 . Of the 56 cases, 28 shared the same bed with the index patient, 20 shared the same room and eight lived in the same house . Lepromin positivity rate was higher in "comparison" families (92.2%) than in index case families (74.6%), the difference being statistically significant (x = 6.09, P < 0.001) . Contacts of index case families, therefore, were immunologically at higher risk than contacts of "comparison" families.

Small Rumin, Res. . 2001 Jun, 40(3), 245 - 254
Relationships among somatic cell count, California mastitis test, impedance and bacteriological status of milk in goats and sheep in early lactation; McDougall S et al.; The objectives of this trial were to evaluate and compare the test characteristics of a number of indirect tests of bacteriological status of the milk from goats and sheep and to assess the affect of varying levels of prevalence of infection on the performance of those tests.The somatic cell count, California mastitis test (CMT) score, electrical impedance and the bacteriological status of 220 and 262 milk samples from the glands of lactating dairy goats and sheep, respectively, were determined . The sensitivity and specificity of indirect tests in predicting the bacteriological status were compared by analyzing the areas under the receiver operating characteristic curve and calculating the likelihood ratio at various cut-off values.Bacteria were isolated from 17.7 and 4.6% of glands from goats and sheep, respectively . Somatic cell count was a better predictor of bacteriological status than either the CMT score or impedance in both goats and sheep . However, knowledge of the CMT score in both sheep and goats and the impedance in goats increases the likelihood of predicting the presence of a bacterial pathogen compared to no testing at all (P<0.05) . Knowledge of the age and days postpartum of the animals at the time of testing did not increase the probability that infection status could be predicted . Variation in cut-off levels to predict infection status reported in the literature may be due to variation in the prevalence of infection in the populations studied . Use of likelihood ratio allows comparison of tests over a range of prevalence's as likelihood ratios are independent of prevalence . The prevalence of infection within a herd should be considered when selecting a cut-off value for indirect testing for the presence of bacteria in milk of small ruminants.

Int J Syst Evol Microbiol, 2001 Mar, 51(Pt 2), 725 - 7
Nomenclatural type of orders: corrections necessary according to Rules 15 and 21a of the Bacteriological Code (1990 Revision), and designation of appropriate nomenclatural types of classes and subclasses . Request for an opinion; Euzeby JP et al.; An important aspect of the Bacteriological Code (1990 Revision) is the designation of nomenclatural types to the various taxonomic ranks to provide a suitable reference point for the unambiguous identification of the taxon . Although the nomenclatural type of the species is the designated strain, and the nomenclatural type of the genus is the type species, the nomenclatural type of both the family and the order is the 'genus on whose name the name of the relevant taxon is based' . However, in some cases a genus has not been designated as the nomenclatural type of an order . Twelve cases that are contrary to the Rules listed and appropriate corrections are proposed . In addition, several classes have been named for which no nomenclatural type has been designated; this brings into question whether they can be considered to have been validly published, as well as highlighting the fact that they would be/are illegitimate.

Cent Afr J Med, 2000 Sep, 46(9), 247 - 51
Storage of breast milk: effect of temperature and storage duration on microbial growth; Igumbor EO et al.; OBJECTIVE: To study the effect of storage duration at varying temperature ranges, the pattern of microbial isolates and the quantity of colony-forming units (CFU) on expressed breast milk . DESIGN: Cross sectional study . SETTING: Bacteriology laboratory, University of Zimbabwe in Parirenyatwa Hospital, Harare . MAIN OUTCOME MEASURES: The temperature, storage duration and types of micro-organisms in freshly expressed breast milk . RESULTS: Freshly expressed human breast milk contained microbial non-pathogens of skin flora . There was no growth of organisms in stored breast milk after four hours, eight hours, 24 hours and 72 hours storage duration at temperature ranges 0 to 4 degrees C (freezing temperature), 4 to 10 degrees C (refrigerator temperature), 15 to 27 degrees C (room temperature) and 30 to 38 degrees C (high temperature) respectively . Growth was detected after the storage durations and organisms isolated were both pathogens and non-pathogens with low counts . Average colony counts was (CFU < 200) . CONCLUSION: The study revealed that storage duration for expressed breast milk should not exceed 24 hours in refrigerator temperature (4 to 10 degrees C), eight hours at room temperature (15 to 27 degrees C) and four hours at high temperature (30 to 38 degrees C) . Although freezing temperature (0 to 4 degrees C) seemed safest for breast milk storage, short-term storage in a freezer is not recommended due to likely the hazards of the thawing process.

Rev Chir Orthop Reparatrice Appar Mot, 2001 Apr, 87(2), 176 - 9
{Rare localizations of bone tuberculosis . Three case reports}; Rachid K et al.; Bone and joint involvement is observed in 3 to 5 p . 100 of all cases of tuberculosis and in 15 p . 100 of extrapulmonary tuberculosis . Spinal and weight-bearing joints are most frequently involved . We report three cases of bone tuberculosis with rare localizations that raised difficult diagnostic problems . Our patients had tuberculosis of the sternum, the iliac bone and in the third case, the spine but solely in the posterior arch of the fourth cervical vertebra . X-ray evidenced bone lysis and invasion of adjacent tissues . The cold abscesses were evacuated surgically allowing bacteriological and histological diagnosis . The patients were successfully treated with anti-tuberculosis regimens . An infectious etiology should be considered in patients with bone lesions in order to obtain the samples necessary for positive diagnosis.

Ann Dermatol Venereol, 2001 Mar, 128(3 Pt 1), 250 - 2
{Mycobacterium kansasii skin infection at insulin injection sites}; Domergue Than Trong E et al.; BACKGROUND: Insulin injection sites rarely become infected . We report a case of Mycobacterium kansasii infection at the sites of insulin injection.CASE REPORT: An 84-year-old woman with insulin-dependent diabetes consulted for lesions on the anterior aspect of the thighs . She had papulonodules at the sites of insulin injection . These lesions progressed to hard fibrinonecrotic ulcerations with a raised erythematous border . There were no enlarged nodes locally . Laboratory tests were normal . Bacteriological samples were negative at direct examination . Histology was not specific . The biopsy cultures finally found an atypical mycobacteria, Mycobacterium kansasii . The clinical course was favorable with clarithromycin alone.DISCUSSION: Only 35 cases of Mycobacterium kansasii skin infections have been reported in the literature . This is the first case observed in a diabetic subject and the first treated with clarithromycin alone . This case illustrates the potential, though exceptional, risk of insulin bottle contamination by an environmental germ.

Ann Dermatol Venereol, 2001 Mar, 128(3 Pt 1), 217 - 9
{New cases of leprosy at the Marchoux Institute: a comparative study 1988-1997}; Keita S et al.; BACKGROUND: The prevalence of leprosy had declined greatly over the last decade . The purpose of this work was to determine whether changes in the epidemiology, clinical and bacteriological patterns occurred among patients with leprosy treated at the Marchoux Institute in 1988 and in 1997.PATIENTS AND METHODS: We conducted a descriptive cross-sectional study, reviewing retrospectively all files of patients with leprosy seen in 1988 in comparison with a prospective series of leprosy patients seen in 1997 . Only new cases of leprosy, prior to treatment and with skin and/or nervous lesions irrespective of the bacilloscopy results, were included in the two series.RESULTS: We included 93 patients among 246 patient files in 1988 . There were 119 new cases in 1997 . The following variables showed changes: mean delay to consultation (41.2 months in 1988 versus 26.1 months in 1997; patient's suspicion of having leprosy (93 patients in 1988 versus 22 in 1997); notion of contact (35 cases in 1988 versus 45 in 1997) . Multibacilli leprosy predominated over paucibacilli leprosy in 1988 (51 versus 42 cases) . This trend was inverted in 1997 (44 versus 75) (p<0.009) . Patients with grade 2 handicap were more numerous in 1988 (20 cases versus 2 cases, p<0.001).CONCLUSION: These findings demonstrate a change in the epidemiology, clinical and bacilloscopic pattern of patients with leprosy from 1988 to 1997.

Cent Afr J Med, 2000 Jul, 46(7), 194 - 200
An update on human bartonelloses; Pretorius AM et al.; The data available on Bartonella species has increased rapidly in the last decade with 12 new species and subspecies being described and bartonellas being found to be associated with an increasing spectrum of clinical syndromes in immunocompetent and immunocompromised patients . In addition B . weissii is found in cats . This rapid expansion of knowledge has come about with the development of new culture and molecular biology techniques to isolate and identify the organisms . Much of the information on the bartonellas and the emerging infectious diseases they cause has been derived from the USA and Europe although there is growing evidence that the organisms may be important pathogens in other regions including southern Africa . In this review we describe the bacteriology, epidemiology, clinical and laboratory signs, diagnosis and treatment of bartonella infections and the most recent data on bartonellas in southern Africa.

J Microbiol Methods, 2001 Jun, 45(2), 135 - 41
Specificity for field enumeration of Escherichia coli in tropical surface waters; Jensen PK et al.; In remote rural areas in developing countries, bacteriological monitoring often depends on the use of commercial field media . This paper evaluates a commercial field medium used for the enumeration of Escherichia coli in different surface waters under primitive field conditions in rural Pakistan . In order to verify the field kit, 117 presumptive E . coli isolates have been tested, finding a specificity of only 40% . By excluding some strains based on colony colours, the calculated specificity could be increased to 65% . Thus, it is suggested that prior to use in a tropical environment, the specificity of any commercial medium used should be tested with representative tropical isolates, in order to increase the specificity.

Acta Clin Belg, 2001 Jan-Feb, 56(1), 38 - 45
Usefulness of bacteriological surveillance cultures for monitoring infection in hospitalized patients: a critical reappraisal; Glupczynski Y; Untargeted bacteriological surveillance of superficial and deep body sites is frequently performed routinely in various clinical settings . This practice is based on the assumption that early identification of surface microbial flora might be predictive of organisms that will later cause invasive disease and that it may consequently assist in guiding empirical antibiotic therapy . A comprehensive review of the literature however indicates that the clinical value and cost-effectiveness of such practices still remain debated and appear largely unproven in most conditions and situations where they are routinely advocated . The present article reviews and critically discusses the available body of evidence supporting or disproving the use of bacteriological surveillance cultures . It is also aimed to issue general recommendations, strategies and methodologies that could be applied in different hospital care settings including the neonatal or adult intensive care as well as the hematology-oncology units.

Intensive Care Med, 2001, 27 Suppl 1, S49 - 62
Source control in the management of sepsis; Jimenez MF et al.; The process of surgical decision making is based on both general principles that are amenable to evaluation using rigorous techniques of clinical research and the intangible element of surgical judgment that seeks to apply those principles to the care of an individual patient . The role of surgical judgment is inescapable, even though it is intrinsically subjective and recalcitrant to objective evaluation, for a host of factors modify the application of principle in each patient, and render the circumstances of a given problem sufficiently distinctive, that evidence must be tempered with common sense . We have tried to provide, through an evidence-based approach to a series of questions, the rationale for the basic principles that should guide the clinician in initiating or modifying source control, recognizing that sound clinical judgement demands, at times, that these be set aside . In the individual patient, evidence of clinical improvement is the most important marker of the approach selected . Evaluation of the adequacy of source control in the critically ill patient can be difficult . As with other modes of anti-infective therapy, effective source control measures are expected to result in clinical improvement, reflected in: Resolution of clinical signs of sepsis or systemic inflammation . Bacteriological resolution . Evidence of reversal of the metabolic sequelae of infection, with normal progression of wound healing, reflected in the formation of granulation tissue, and epithelialization . Radiographic evidence of control of an infectious focus . Prevention of further organ dysfunction, and resolution of existing organ dysfunction . Survival . Evaluation of the adequacy of source control may necessitate planned reoperation . The adequacy of debridement of necrotizing soft-tissue infections can be assessed by repeat exploration under general anesthesia, continuing the process until there is evidence of healthy granulation tissue throughout the wound . Planned reexploration is also indicated for patients with diffuse intestinal ischemia to ensure bowel viability . The appropriate interventions to determine the adequacy of source control are dictated by the clinical circumstances . A residual or recurrent abscess can usually be demonstrated by CT or ultrasound examination, while resolution of an abscess cavity can be monitored using sinograms . The diagnosis of persistent or evolving tissue necrosis is guided by the clinical setting . Retroperitoneal necrosis can be detected by CT, while sigmoid ischemia following aortic aneurysmectomy can be evaluated by sigmoidoscopy . Occasionally diagnostic peritoneal lavage assists in establishing a diagnosis of gut ischemia; the lavage fluid appears bloody with established ischemia . The diagnosis of an infected foreign body requires an appropriate history and is supported by recurrent bacteremia or by positive cultures drawn retrograde through an indwelling vascular or peritoneal dialysis catheter . Finally, ongoing contamination from a breach of the gastrointestinal tract can be documented by appropriate contrast studies . The general principles that guide the use of source control techniques in the management of the patient with severe sepsis or septic shock are readily articulated . Their implementation in practice, however, is more complex, and does not, as a rule, lend itself to simple algorithms that are applicable in all cases . Moreover evidence-based support for these principles is weak . In the final analysis, the elusive process of experienced surgical judgement is invaluable for all but the most straightforward problems.

Tidsskr Nor Laegeforen, 2001 Mar 10, 121(7), 832 - 3
{Magnus Haaland--a pioneer in international cancer research}; Laerum OD; Pathologist and bacteriologist Magnus Haaland (1876-1935) was a pioneer in European experimental cancer research . For eight years he worked in some of the most prominent research institutions in France, Germany and England . He worked with Elie Metschnikow and Amedee Borrel at Institut Pasteur in Paris, with Paul Ehrlich in Frankfurt am Main and with Erwin Bashford at the Imperial Cancer Research Fund in London . From 1911 to his death in 1935, he was the head of the Gade Institute in Bergen . He became a pioneer in Norwegian bacteriology research and made particular contributions to the eradication of typhoid fever in Norway . His main scientific work was on the progression of experimental transplantable tumours in mice, patterns of metastasis, and experimental hyperthermia treatment . He gave the first description of neoplastic reticuloses in mice.

Magy Seb, 2000 Aug, 53(4), 151 - 4
{Local antibiotic treatment of chronic thoracic empyema}; Balogh G et al.; The authors present their indications, aims and method for the local antibiotic treatment of chronic empyema thoracis . They analyse the sensitivity and resistant conditions of the most often occurring bacteria, Pseudomonas spp., in an open window treatment of empyema thoracis . 338 patients were treated for intrathoracic suppuration between January 1, 1987 and December 31, 1998 . The youngest patient was 13, the oldest one was 90 (the average age was 53.2 . Of these 11 died, representing a mortality rate of 3.2% . Of these 11 patients, 7 suffered from chronic intrathoracal suppuration . 82 patients had chronic empyema . 44 patients (13%) were treated by the open window procedure, 6 females and 38 males . The average age was 62.1 . Of them 7 died, the mortality rate of chronic empyema thoracis was 8.5% in our department . Of 164 pus samples taken from suppurative pleura cavity bacteria, Pseudomonas spp., were bred in 148 cases during bacteriological examinations . Their bacteriological examinations confirm that local and aimed treatment by Polimyxin, Amikacin, Meronpenem, Ceftadizim, Imipenem, Tobramycin, Ciprofloxacin and Piperacillin proved to be the better medicine against Pseudomonas infection.

Lett Appl Microbiol, 2001 Apr, 32(4), 268 - 72
Detection and characterization of filterable heterotrophic bacteria from rural groundwater supplies; Lillis TO et al.; AIMS: The chemical/physical environment of groundwater may contribute to the existence of a subpopulation of small-sized bacteria (filterable bacteria) that fails to be trapped on conventional 0.45 microm-pore-size membrane filters during routine bacteriological water quality analyses . Efforts were directed to determining an efficient recovery method for detection of such cells . METHODS AND RESULTS: Individual groundwater supplies in a rural setting were examined by a double membrane filtration procedure to determine the presence of heterotrophic plate count (HPC) bacteria capable of escaping detection on conventional pore size (0.45 microm) membrane filters but retained on 0.22 microm-pore-size filters . Since optimum cultural conditions for recovery of filterable bacteria are not well defined, initial efforts focused on evaluation of various media (R2A, m-HPC and NWRI) and incubation temperatures (15, 20, 28 and 35 degrees C) for specific recovery of filterable bacteria . Maximum recovery of small-sized HPC bacteria occurred on low-nutrient concentration R2A agar incubated for 7 d at 28 degrees C . Similarly, identical cultural conditions gave enhanced detection of the general HPC population on 0.45 microm-pore-size filters . A 17-month survey of 10 well water supplies conducted with the cultural conditions described above resulted in detection of filterable bacteria (ranging in density from 9 to 175 cfu ml-1) in six of the groundwater sources . The proportion of filterable bacteria in any single sample never exceeded 10% of the total HPC population . A majority of the colonies appearing on the 0.22 microm membrane filters was pigmented (50-90%), whereas the proportion of colonies demonstrating pigmentation on the larger porosity filters failed to exceed 50% for any of the samples (19-49%) . CONCLUSION: A reliable recovery method was developed for the detection of filterable bacteria from groundwater . During a subsequent survey study using this procedure, filterable bacteria were detected in a majority of the groundwater supplies examined; however, the density of filterable bacteria in any single sample never exceeded 10% of the total HPC population . Identification of randomly selected isolates obtained on the 0.22 microm filters indicated that some of these filterable bacteria have been implicated as opportunistic pathogens . SIGNIFICANCE AND IMPACT OF THE STUDY: We have determined the presence of small-sized HPC bacteria in ground water that may go undetected when using standard porosity membrane filters for water quality analyses . Further study is needed to assess the significance and possible health risk associated with presence of filterable bacteria in drinking water supplies from groundwater sources.

Prog Urol, 2001 Feb, 11(1), 62 - 7
{Urogenital tuberculosis . Experience in 10 years}; el Khader K et al.; OBJECTIVE: To review the clinical, imaging and therapeutic aspects of urogenital tuberculosis . MATERIAL AND METHODS: From April 1989 to April 1999, 57 patients with urogenital tuberculosis were reviewed in our department . This series consisted of 32 males and 25 females with a mean age of 40 years (range: 18 to 72 years) . RESULTS: The most frequent clinical symptoms were irritative symptoms (47.3%) . Fever, anorexia and weight loss were rare (11%) . 16% of patients had an isolated genital lesion . 14% presented with renal failure (mean serum creatinine: 18 mg/l) . Only 3 cases (5.2%) presented with bacilluria . Urography showed abnormalities in 80% of cases . The most frequent abnormality was a non-functioning silent kidney in 23 cases (40.3%) . The positive diagnosis was based on bacteriological (5 cases) and histological data (52 cases) . Treatment consisted of antituberculous chemotherapy in all patients, in combination with surgery (75%), and/or endourological procedures (26.3%) . Nephrectomy is still indicated for non-functioning tuberculous kidneys in order to prevent the development of hypertension, abscess and fistulas . CONCLUSION: The diagnosis of urogenital tuberculosis is difficult and often late . A surgical or endourological procedure is often necessary to preserve renal function and to improve quality of life.

Prog Urol, 2001 Feb, 11(1), 34 - 9
{Long-term results of interferential current stimulation in the treatment of bladder instability}; Mauroy B et al.; OBJECTIVE: To study the late results of interferential current stimulation in the treatment of detrusor instability . MATERIAL AND METHODS: 62 patients with detrusor instability refractory to medical treatment by anticholinergic drugs were treated by interferential current stimulation . This technique combines the advantages of retraining stimulation with external application . This retrospective study was based on 62 patients (43 children, 11 men and 8 women) presenting with detrusor instability between January 1990 and December 1997 . All patients were assessed clinically and by a radiological, bacteriological and urodynamic work-up prior to treatment . The mean follow-up was 5 years (range: 18 months to 10 years) . RESULTS: The results of this technique were excellent, with 80.9% of cures at one year, but they tended to fade over time to 40% of cures at 5 years . However, results which deteriorate after one year can generally be maintained by performing 5 maintenance sessions every 12 or 18 months . CONCLUSION: Treatment of detrusor instability by interferential current is a reliable technique which constitutes an alternative to the other methods of retraining stimulation and can be performed in cases of instability refractory to anticholinergic drugs, before considering neuromodulation or surgery . Five to 10 maintenance sessions every 12 or 18 months ensure stable long-term results in the majority of cases.

Vet Microbiol, 2001 May 21, 80(2), 163 - 70
Fluorescence polarization assay for the diagnosis of bovine brucellosis: adaptation to field use; Nielsen K et al.; A fluorescence polarization assay (FPA) was used to test whole blood samples prepared by mixing blood cells from cattle without exposure to Brucella abortus (B . abortus) with sera from animals with confirmed (bacteriologically) infection . A cut-off value between negative and positive values was initially established to be 87.2mP . This value was changed to 95mP to increase assay specificity without loss of sensitivity when testing blood samples from negative animals . The FPA technology was applied to whole blood samples in the field and to stored whole blood samples using two diluent buffers . Relative sensitivity and specificity values for the FPA performed in the field, based on buffered antigen plate agglutination test and competitive enzyme immunoassay results were 95.3 and 97.3%, respectively . However, to obtain maximum sensitivity and specificity, a cut-off value of 105mP was determined for fresh whole blood samples . The relative sensitivity and specificity values of the FPA when testing stored whole blood samples were 100% each using a 95mP cut-off.The usefulness of the FPA for testing whole blood samples in the field was demonstrated.

Ceylon Med J, 2000 Dec, 45(4), 171 - 2
First isolation of Legionella pneumophila in Sri Lanka; Wahala WM et al.; OBJECTIVES: To determine the presence of legionellae and species composition of the genus Legionella in Sri Lankan hotel cooling towers, and to determine the previous exposure of hotel workers to Legionella pneumophila . DESIGN: Collection of water samples from 16 cooling towers of air conditioning plants from 7 representative hotels, and blood samples from hotel workers . SETTING: Department of Bacteriology, Medical Research Institute, Colombo 8 . RESULTS: Water samples from 4 (57.4%) hotels selected were positive for legionellae . Five (38.4%) selected cooling towers yielded legionellae with viable counts ranging from 1 to 5 colony forming units (CFU)/ml . 93.7% of the isolates were Legionella pneumophila . Only one hotel worker had significant antibody levels denoting past infection to Legionella pneumophila . CONCLUSION: Legionella does occur in the Sri Lankan hotel environment and Legionella pneumophila appears to be the most common species.

Rev Sci Tech, 2001 Apr, 20(1), 304 - 24
In vivo and in vitro diagnosis of Mycobacterium bovis infection; Adams LG; The intradermal delayed type hypersensitivity (DTH) skin test, using purified protein derivative from culture of M . bovis or M . avium, is the most frequently used test for diagnosis of tuberculosis or detection of M . bovis infection in cattle . Many improvements have been made to the original tuberculin test, and molecular approaches to identify and clone antigens may lead to improved specificity and sensitivity of DTH skin tests . Recent advances in technology have allowed the development of new in vitro techniques, such as antibody-based, cell-mediated immunity-based and nucleic acid-based diagnostics, which allow more rapid diagnosis than bacteriological culture . The choice of diagnostic technique should consider both the population being investigated (e.g . apparently healthy animals or a herd with a high prevalence of clinical infection) and the aim of the testing (e.g . the screening of healthy animals or confirmation of infection in animals strongly suspected to be infected) . Moreover, any evaluation of a diagnostic test must use a carefully selected control population which is representative of the population to be tested in terms of relative proportions of infected and non-infected animals.

Rev Sci Tech, 2001 Apr, 20(1), 265 - 90
Mycobacterial infections in domestic and wild animals due to Mycobacterium marinum, M . fortuitum, M . chelonae, M . porcinum, M . farcinogenes, M . smegmatis, M . scrofulaceum, M . xenopi, M . kansasii, M . simiae and M . genavense; Bercovier H et al.; The epidemiology and the natural distribution of Mycobacterium marinum, M . fortuitum, M . chelonae, M . porcinum, M . farcinogenes, M . smegmatis, M . scrofulaceum, M . xenopi, M . kansasii, M . simiae and M . genavense are described . In addition to the bacteriological, biochemical and genetic characteristics, the authors review the pathology of these species, including the natural and experimental diseases and the accompanying lesions, diagnosis, antibiotic sensitivities and treatment of animal infections caused by these mycobacteria.

Rev Sci Tech, 2001 Apr, 20(1), 204 - 18
Mycobacterium avium and Mycobacterium intracellulare infection in mammals; Thorel MF et al.; Mycobacterium avium subsp . avium and M . intracellulare are ubiquitous organisms in the environment . The reservoir of M . avium subsp . avium is generally accepted to be environmental, in particular, water and soil are sources of the organism . In contrast to M . avium infection in wild and domestic birds, M . avium infection in mammals occurs only sporadically and is rarely transmissible . Generalised disease is usually uncommon, owing to the non-progressive, chronic character of the infection . However, some cases of disseminated disease have been reported, e.g . in captive non-domestic hoofed animals as well as in immunosuppressed dogs and cats . The majority of M . avium and M . intracellulare infections in livestock are detected at slaughter and the diagnosis is confirmed by bacteriological procedures . Condemnation of affected portions of the carcass can result in significant economic losses, although gross lesions are mostly restricted to lymph nodes close to the alimentary tract . Successful treatment with antibiotics in combination with surgery has been reported in some affected domestic cats, but is not considered to be effective or economical in other species . In the past, differentiation of M . avium bacteria from the closely related M . avium subsp . paratuberculosis was based on the mycobactin dependence and prolonged incubation period of the latter . More recently, amplification of the genomic insertion sequence IS900 has proved to be a powerful tool for identification of M . avium subsp . paratuberculosis . The potential zoonotic importance of M . avium infections has been indicated, but requires clarification.

J Neuroradiol, 2001 Mar, 28(1), 7 - 16
{Diagnostic accuracy of the percutaneous spinal biopsy . Optimization of the technique}; Brenac F et al.; Between 1992 and 1999, 210 percutaneous biopsies of the spine were performed in our department of neuroradiology . The purpose of this retrospective study was to determinate the diagnostic accuracy of the procedure and to discuss the technical points that might improve its accuracy . An accurate diagnosis was obtained in 72% of the spondylodiscitis and in 80% of the tumoral lesions (88% of metastatic lesions and 68% of primary tumors) . These results have been compared with the other results of the literature . There was no significant difference of accuracy between CT and fluoroscopic guided biopsies . On the other hand, the type of needle and the multiplicity of samples for bacteriological and histologic studies improve the diagnostic accuracy.

Respiration, 2001, 68(2), 160 - 4
A case-controlled study with dornase alfa to evaluate impact on disease progression over a 4-year period; Shah PL et al.; BACKGROUND: Chronic endobronchial sepsis and profuse airway secretions dominate pulmonary disease in cystic fibrosis . Recombinant human DNase I (dornase alfa) reduces the viscoelasticity of airway secretions and hence may improve clearance of airway secretions . OBJECTIVES: To evaluate the long-term influence of dornase alfa on disease progression by performing a case-controlled study with dornase alfa over a period of 4 years . METHODS: A cohort of patients with cystic fibrosis who have been treated with dornase alfa were matched with a control group of patients with cystic fibrosis who had not received treatment with dornase alfa . The patients were matched by pulmonary function, age, and then sex . All available measurements of forced expiratory volume in one second (FEV1), height, weight and sputum bacteriology were collected for periods when the patients were free from respiratory exacerbations . RESULTS: Thirty-eight patients were matched . Slopes of median changes in FEV1 were -2.19 (-3.32, -1.06) in the control group and -0.75 (-1.87, 0.36) in the dornase alfa-treated group (p = 0.076) . There were more infective exacerbations per patient year in the control group {3.13 (1.25-4.25)} in comparison to the dornase alfa group {1.25 (0.63-3.0), p = 0.035} over the 4-year treatment period . Antibiotic requirements were also greater with a median 43.75 (17.5-60.0) days of intravenous antibiotic use per patient year in the control group and 16.25 (8.5-44.0) days in the dornase alfa group (p = 0.034) . CONCLUSIONS: The trends suggest that dornase alfa may have some influence on disease progression but in view of the limitations of the current study the need for further long-term studies in larger cohorts of patients is emphasised .

Tijdschr Diergeneeskd, 2001 Mar 15, 126(6), 211 - 7
{The effect of a high dose bovine herpes virus 1 marker vaccine in pregnant heifers: virological, bacteriological, immunological, and pathological findings.}; Bruschke CJ et al.; To determine a possible relationship between the compulsory vaccination against bovine herpesvirus 1 (BHV1) and cattle wasting disease, the effects of BHV1 vaccination on heifers were investigated . Twenty heifers in the third trimester of pregnancy were randomly allotted to a vaccine and a control group . The vaccine group was vaccinated twice with a 50-fold dose of BHV1 vaccine and the control group was inoculated with the diluent . The experiment was performed double blind . After vaccination, the cows were examined daily and condition scores were determined weekly . Blood, milk, and faeces samples were collected weekly for virological, bacteriological, and immunological investigation . The heifers were euthanized either 9 or 13 weeks after the first inoculation and pathological, virological, and bacteriological examination was performed . No differences were detected between the vaccine group and the control group . No concurrent infections were detected and there were no indications of immunosuppression after vaccination . No relationship between the BHV1 vaccination and wasting disease in cattle was detected.

Rev Saude Publica, 2001 Feb, 35(1), 81 - 7
Age transition of tuberculosis incidence and mortality in Brazil; Chaimowicz F; OBJECTIVE: Before the Aids pandemic, demographic transition and control programs prompted a shift in the age of incidence of tuberculosis from adults to older people in many countries . The objective of the study is to evaluate this transition in Brazil . METHODS: Tuberculosis incidence and mortality data from the Ministry of Health and population data from the Brazilian Bureau of Statistics were used to calculate age-specific incidence and mortality rates and medians . RESULTS: Among reported cases, the proportion of older people increased from 10.5% to 12% and the median age from 38 to 41 years between the period of 1986 and 1996 . The smallest decrease in the incidence rate occurred in the 30 - 49 and 60+ age groups . The median age of death increased from 53 to 55 years between 1980 and 1996 . The general decline in mortality rates from 1986 to 1991 became less evident in the 30+ age group during the period of 1991 to 1996 . A direct correlation between age and mortality rates was observed . The largest proportion of bacteriologically unconfirmed cases occurred in older individuals . CONCLUSIONS: The incidence of tuberculosis has begun to shift to the older population . This shift results from the decline in the annual risk of infection as well as the demographic transition . An increase in reactivation tuberculosis in older people is expected, since this population will grow from 5% to 14% of the Brazilian population over the next 50 years . A progressive reduction in HIV-related cases in adults will most likely occur . The difficulty in diagnosing tuberculosis in old age leads to increased mortality.

Am J Respir Crit Care Med, 2001 Mar, 163(4), 824 - 8
Rapid detection of Mycobacterium tuberculosis infection by enumeration of antigen-specific T cells; Lalvani A et al.; There is no reliable means of detecting latent M . tuberculosis infection, and even in patients with active tuberculosis, infection is often unconfirmed . We hypothesized that M . tuberculosis antigen-specific T cells might reliably indicate infection . We enumerated peripheral blood-derived interferon gamma (IFN-gamma)-secreting T cells responding to epitopes from ESAT-6, an antigen that is highly specific for M . tuberculosis complex but absent from BCG, in four groups of individuals . Forty-five of 47 patients with bacteriologically confirmed tuberculosis had ESAT-6-specific IFN-gamma-secreting T cells, compared with four of 47 patients with nontuberculous illnesses, indicating that these T cells are an accurate marker of M . tuberculosis infection . This assay thus has a sensitivity of 96% (95% confidence interval {CI} 92-100) for detecting M . tuberculosis infection in this patient population . By comparison, of the 26 patients with tuberculosis who had a diagnostic tuberculin skin test (TST), only 18 (69%) were positive (p = 0.003) . In addition, 22 of 26 (85%) TST-positive exposed household contacts had ESAT-6-specific T cells, whereas zero of 26 unexposed BCG-vaccinated subjects responded . This approach enables rapid detection of M . tuberculosis infection in patients with active tuberculosis and in exposed asymptomatic individuals at high risk of latent infection; it also successfully distinguishes between M . tuberculosis infection and BCG vaccination . This capability may facilitate tuberculosis control in nonendemic regions.

Ann Biol Clin (Paris), 2001 Mar-Apr, 59(2), 123 - 30
{Mycobacterium xenopi: epidemiological and bacteriological features}; Dauendorffer JN et al.; Mycobacterium xenopi is a scotochromogenic slow-growing atypical mycobacteria, with a thermostable catalase, no production of niacin and whose cell wall contains types I and VI long-chain fatty acids . Cosmopolitan, it is mainly recovered in tap-warm water . The contamination occurs through aerosol inhalation, water ingestion or use of contaminated medical or surgical equipment . M . xenopi is an opportunistic pathogen; the infection is facilitated by the incidental introduction of the bacteria in the body, pre-existing pulmonary lesions and an immunodepression . M . xenopi is mainly involved in infections of lungs, bones and joints . The treatment consists in the combination of three or four antibiotics, among rifampicin, rifabutin, ethambutol, macrolides, amikacin and fluoroquinolones.

Int J Antimicrob Agents, 2001 Mar, 17(3), 177 - 88
An open, randomised, multi-centre study comparing the safety and efficacy of sitafloxacin and imipenem/cilastatin in the intravenous treatment of hospitalised patients with pneumonia; Feldman C et al.; This was a phase II, randomised, open-label, multi-centre study to assess the safety, tolerability, and efficacy of sitafloxacin (DU-6859a, 400 mg once daily) compared with imipenem (imipenem/cilastatin, 500 mg three times daily) in the treatment of hospitalised patients with pneumonia . Patients (n=69) were entered into the study in the intent-to-treat group, 35 in the sitafloxacin and 34 in the imipenem group . Patients (n=65) were included in the clinically evaluable population and 42 in the bacteriologically evaluable population . Baseline demographic data and clinical characteristics were similar for both treatment groups and across all patient populations . The incidence, severity and type of adverse events were similar in both treatment groups . The frequency of adverse events, which were considered to be related to the study of drugs was low and generally similar between the two groups . Mild transient increases in alanine aminotransferase and alkaline phosphatase occurred in the sitafloxacin treatment group, but there were no apparent trends in the other serum enzyme levels . The clinical response at the first and second follow-up assessments indicated that 94-97% of patients in the clinically evaluable population and 91% of patients in the intent-to-treat population were classified as cured in both treatment groups . The bacteriological response was classified as satisfactory for all patients (100%) in the bacteriologically evaluable population in the imipenem treatment group and satisfactory for 90 and 95% of cases at the first and second follow-up assessments in the bacteriologically evaluable population in the sitafloxacin treatment group, respectively . In conclusion, for the treatment of pneumonia, sitafloxacin was considered as safe and as tolerable as imipenem and preliminary data from this study suggest that it may have similar efficacy.

J La State Med Soc, 1999 Jan, 151(1), 11 - 8
HIV sinusitis: rationale for a treatment algorithm; Belafsky P et al.; Over 12 million individuals worldwide are infected with the human immunodeficiency virus (HIV) . Up to 60% of these persons may suffer from disease of the paranasal sinuses . Numerous differences exist between sinusitis in HIV and non-HIV infected patients . Some of the differences include HIV sinusitis pathogenesis, bacteriology, and management . This paper addresses these issues so that physicians may adequately prevent, diagnose, and treat persons suffering from HIV sinus infection.

Am J Vet Res, 2001 Mar, 62(3), 398 - 405
Bacteriologic and histologic features in mice after intranasal inoculation of Brucella melitensis; Mense MG et al.; OBJECTIVE: To characterize effects of intranasal inoculation of virulent Brucella melitensis strain 16M in mice . ANIMALS: Female Balb/c mice, 6 to 8 weeks old . PROCEDURE: Studies were designed to elucidate gross morphologic lesions, bacterial burden in target organs, and histologic changes in tissues following experimental intranasal inoculation of mice with B melitensis 16M, which could be used to characterize a model for testing vaccine efficacy . RESULTS: Measurable splenomegaly was evident at 3 and 7 weeks after inoculation . A demonstrable increase in splenic colony-forming units (CFU) from infected mice increased over time with increasing dose when comparing inocula of 10(3), 10(4), and 10(5) CFU . Recovery of brucellae from the lungs was possible early in infection with 10(1), 10(3), and 10(5) CFU, but only the group inoculated with 10(5) CFU consistently yielded quantifiable bacteria . At a dose of 10 CFU, few organisms were located in the spleen . Bacteria were recovered up to 140 days after inoculation in mice given 10(3) CFU . At an inoculum of 10(5) CFU, bacterial counts were highest early in infection . Histologic examination of tissues revealed an increase in white pulp and marginal zone in the spleen and lymphohistiocytic hepatitis . CONCLUSION AND CLINICAL RELEVANCE: Changes in the spleen and liver increased with increases in dose and with increased time following intranasal inoculation with B melitensis 16M . Surprisingly, histologic changes were not observed in the lungs of inoculated mice.

J Assoc Physicians India, 2000 Jul, 48(7), 708 - 10
Colonic tuberculosis: colonoscopic appearance and clinico-pathologic analysis; Das HS et al.; BACKGROUND: There has been a resurgence of interest in intestinal tuberculosis because of acquired immunodeficiency syndrome (AIDS) epidemic sweeping our country . Role of colonoscopy and colonoscopy directed histology for diagnosing the disease have been emphasised since last few years . AIMS AND OBJECTIVES: To know the colonoscopic features in patients with intestinal tuberculosis and to study the clinicopathological findings in the same . METHODS: We studied twenty-one patients with intestinal tuberculosis referred to us between 1993-1997 . Colonoscopy was done in all patients and biopsy specimens were collected from the site of lesion during the procedure . RESULTS: Ileocaecal disease was found in 9 patients, ileocaecal with contiguous ascending colon involvement in eight and segmental colonic tuberculosis in four cases . The colonoscopic findings included nodules in seven patients, nodules with ulcerations in three, ulcerations alone in seven, nodules with strictures in three and polypoidal mass in one patient . Eight cases revealed granuloma on histopathology . CONCLUSIONS: Though bacteriological and histological assessment of tissue is essential to differentiate tuberculosis from other disorders, we stress the importance of colonoscopic appearances in diagnosing tuberculosis . We also recommend antituberculous chemotherapy in patients with high clinical suspicion of tuberculosis on the basis of colonoscopic appearance alone after ruling other causes on histopathological examination.

J Wildl Dis, 2001 Jan, 37(1), 101 - 9
Pathology of brucellosis in bison from Yellowstone National Park; Rhyan JC et al.; Between February 1995 and June 1999, specimens from seven aborted bison (Bison bison) fetuses or stillborn calves and their placentas, two additional placentas, three dead neonates, one 2-wk-old calf, and 35 juvenile and adult female bison from Yellowstone National Park (USA) were submitted for bacteriologic and histopathologic examination . One adult animal with a retained placenta had recently aborted . Serum samples from the 35 juvenile and adult bison were tested for Brucella spp . antibodies . Twenty-six bison, including the cow with the retained placenta, were seropositive, one was suspect, and eight were seronegative . Brucella abortus biovar 1 was isolated from three aborted fetuses and associated placentas, an additional placenta, the 2-wk-old calf, and 11 of the seropositive female bison including the animal that had recently aborted . Brucella abortus biovar 2 was isolated from one additional seropositive adult female bison . Brucella abortus was recovered from numerous tissue sites from the aborted fetuses, placentas and 2-wk-old calf . In the juvenile and adult bison, the organism was more frequently isolated from supramammary (83%), retropharyngeal (67%), and iliac (58%) lymph nodes than from other tissues cultured . Cultures from the seronegative and suspect bison were negative for B . abortus . Lesions in the B . abortus-infected, aborted placentas and fetuses consisted of necropurulent placentitis and mild bronchointerstitial pneumonia . The infected 2-wk-old calf had bronchointerstitial pneumonia, focal splenic infarction, and purulent nephritis . The recently-aborting bison cow had purulent endometritis and necropurulent placentitis . Immunohistochemical staining of tissues from the culture-positive aborted fetuses, placentas, 2-wk-old calf, and recently-aborting cow disclosed large numbers of B . abortus in placental trophoblasts and exudate, and fetal and calf lung . A similar study with the same tissue collection and culture protocol was done using six seropositive cattle from a B . abortus-infected herd in July and August, 1997 . Results of the bison and cattle studies were similar.

J Food Prot, 2001 Feb, 64(2), 208 - 12
Rapid assessment of the bacteriological quality of raw milk using ATP bioluminescence; Samkutty PJ et al.; Research was conducted to assess the practical use of an ATP bioluminescence assay to evaluate the bacteriological quality of raw milk . Filtration was used to precondition samples before ATP determination, which was measured in relative light units (RLUs) . The Lumac ATP bioluminescence assay results were compared with standard plate counts (SPCs) of samples to estimate the microbial load for 246 raw milk samples that were split and either tested immediately or subjected to two preliminary incubation temperatures, 12.8 and 15.6 degrees C, for 18 h . Linear regression analysis procedures were used to analyze the data . Preincubation treatments were analyzed separately . For all treatments, linear regression coefficients were significantly different from zero (P < 0.01) . The R2 values calculated using log10-transformed SPC and log10-transformed RLUs for samples tested immediately and samples preliminarily incubated at 12.8 and 15.6 degrees C were 0.58, 0.78, and 0.80, respectively . The R2 for all samples combined was 0.78 . Differences in regressions among treatments were tested using a multiple slope and intercept model . Treatment intercepts and slopes were significantly different (P < 0.01) . A linear regression equation was used to predict SPC from ATP values . Comparison of predicted values with actual SPCs indicated that ATP could be useful in predicting SPC in raw milk.

J Food Prot, 2001 Feb, 64(2), 164 - 7
Polymerase chain reaction for the direct detection of Brucella spp . in milk and cheese; Tantillo G et al.; A polymerase chain reaction test was developed to detect Brucella spp . directly in milk and cheese and optimized using primers for the BSCP-31 gene . A total of 46 cheese samples produced with sheep and goats milk were assayed, and Brucella spp . was detected in 46% of them, especially in cheese made from sheep milk . This method is of remarkable epidemiologic interest because it is an indirect test indicating the sanitary quality of milk used in dairy industries . The method showed good sensitivity and specificity . It is faster and less expensive than the conventional bacteriological assays.

Otolaryngol Pol, 2000, 54(6), 697 - 701
Speech rehabilitation using a voice prostheses following laryngectomy; Kramp B et al.; The most serious consequence for patients following laryngectomy is the restriction of verbal communication . Since the introduction of laryngectomy significant concerns have already been focused on the field of speech rehabilitation . The operational procedures for the speech rehabilitation include training of the oesophageal voice speech and the voice prostheses . Speech prostheses are available in our hospital since 1983 . The speech quality of the speech prostheses is compared with the classical oesophageal voice or to the voice by means of a Provox speech help . Bacteriological and mycological colonisation as a function of the length of implantation are defined . Our approach to the voice rehabilitation after a laryngectomy by use of a spacer during the laryngectomy has proven successful . As a result patients do not fall into a "hole" of non verbal communication . The aim of our efforts is always to create a functioning oesophageal voice after leaving the care of the hospital.

Ann Vasc Surg, 2001 Mar, 15(2), 197 - 205 Epub 2001 Mar 01.
Infected aneurysms of neck and limb arteries: a retrospective multicenter study; Patra P et al.; Infected aneurysms (IA) of neck and limb arteries are uncommon . This report describes the results of a retrospective study undertaken by the University Association for Surgical Research (AURC) to evaluate etiology, bacteriology, location, diagnostic features, and therapeutic methods associated with IA . A total of 58 IA in 52 patients were reviewed . The lesion was located in a lower extremity artery in 47 patients (81%), internal carotid artery in 7 (12%), and upper extremity artery in 4 (6%) . Eleven patients had multilocular aneurysm (21%) . Symptoms of local infection were observed in 43 patients (82.6%) . Rupture or splitting was the presenting manifestation in 13 patients (25%) . Primary IA following bacteremia or septicemia without endocarditis was the most common type of IA observed in 34 patients (65.3%) . Twelve patients (23%) presented mycotic IA secondary to bacterial endocarditis . In the remaining six patients (11.5%), IA resulted from direct contamination or spreading from a contiguous infection site . Surgical treatment included ligation of the artery without reconstruction in 19 patients and exclusion bypass in 33 patients . The duration of antibiotic treatment ranged from 15 days to 3 months . No recurrence of aneurysm was observed but three patients developed bypass infection . Primary IA was associated with high mortality due to severe septicemia.

J Health Popul Nutr, 2000 Dec, 18(3), 157 - 62
Bacteriological quality of weaning food and drinking water given to children of market women in Nigeria: implications for control of diarrhoea; Iroegbu CU et al.; Bacteriological quality of weaning food and drinking water given to 2 groups of children aged < or = years was evaluated by estimating bacterial cell count . One group consisted of those taken to market and the other of those left at home in the care of older siblings or house-helps . Bacterial counts (geometric mean) ranged from 5.02 +/- 1.82 to 8.70 +/- 1.0 log10 cfu per g or mL of food, and from 1.15 +/- 1.67 to 6.53 +/- 0.81 log10 cfu per g or 100 mL of water . Analysis of variance showed no significant difference in counts between types of food and between meals (breakfast and lunch) . Bacterial contamination increased significantly with storage time, and was, in all circumstances except the water samples, significantly higher in foods given to children left at home . Reheated leftover foods also had significantly higher bacterial load than the freshly-cooked food . Coliform count varied significantly with source of drinking water . Poor hygiene standard (inferred from bacterial contamination) was generally observed among mothers weaning < or = 2-year-old children, while they were engaged in trading activities in the market, thus exposing their children to high risk of diarrhoea . Hygiene was significantly poorer in weaning of children left at home in the care of older siblings or house-helps . This implies that, in spite of their trading activities in the market, mothers still take better care of their babies than the older siblings or house-helps who may be inexperienced . These mothers may need education on childcare and food hygiene to suit to their trading activities, for example, during their monthly meetings . There is also a need to establish ORT (oral rehydration therapy) corners in the markets as part of the municipal services . This can be used not only for efficient and quick management of diarrhoea in the market but also for reinforcing hygiene education.

Kekkaku, 2001 Feb, 76(2), 59 - 69
{Problems and their transition of long-term hospitalized patients with tuberculosis}; Tuberculosis Research Committee (Ryoken).; In 1975, the Tuberculosis Research Committee (Ryoken) conducted its first study on long-term hospitalized TB patients who had been staying in a hospital for more than five years . Similar studies were repeated in 1981 (hospitalized for more than three years), 1988 (hospitalized for more than two years), 1993 and 1998 (hospitalized for more than one year) . The same patient cohorts in each study were followed up, each after a different time period, i.e., after 68 months for the 1975 study cohort, 36 months for the 1981 study cohort, 26 months for the 1988 study cohort, and 74 months for the 1993 study cohort . Based on the results of these series of studies, changes in the patients' characteristics and factors related to long-term hospitalization during the last 23 years were analyzed . The main findings are summarized below . 1) The proportion of patients who stayed in a hospital for more than one year in the study decreased from 41.6% in 1975 to 9.5% in 1998 . 2) The long-term hospitalized patients have become older, are more likely to be previously untreated cases, and initially bacillary cases . 3) The major cause of the treatment failure among the long-term hospitalized cases as reported by the attending doctors was "too chronic disease" in the earlier years, but the causes have changed to adverse reactions to anti-TB drugs, initial drug-resistance, and patient's poor compliance or non-adherence to treatment in recent years . 4) The cause of the long-term hospital stay after bacteriological negative conversion was chronic respiratory failure in more than one third of the patients in every study . Among these patients, an increasing proportion of cases has non-medical problems, such as poor family acceptance and reluctance to be discharged . 5) The mortality of the long-term hospitalized cases was generally high . Among bacteriologically positive cases in the study, it was 14% to 19% annually, and tuberculosis deaths occupied 60% to 80% of all the deaths . 6) The outcomes of those patients who were eventually discharged has become less favorable . Only 3% of them were returned to light work in the 2000 study, while 15% did in the 1981 study.

Int J Environ Health Res, 2001 Mar, 11(1), 29 - 40
Skin irritation in users of brominated pools; Kelsall HL et al.; This study investigated adverse skin and eye effects in swimmers using pools with three different disinfection systems (chlorine, chlorine/ozone and bromine/ozone) and monitored water quality parameters that may be related to adverse health effects . A cross-sectional study of 770 children swimming in three school pools was carried out over a 4 week period in November 1994 using a postal questionnaire . Physico-chemical and bacteriological parameters of water quality were monitored on a weekly basis . Responses were obtained for 385 swimmers . Skin rashes with an onset less than 24 h after swimming in the school pool were reported by 4-8% of swimmers . Compared with the bromine/ozone pool, the odds ratio (OR) of having a rash that started less than 24 h after pool use was 1.91 (CI 0.71-5.10) for the chlorine pool and 1.88 (CI 0.61-5.81) for the chlorine/ozone pool . Adjustment for possible confounders made no significant differences to these results . Eye redness, itch or irritation was reported by 23-33% of swimmers and 24% of non-swimmers, and wearing swimming goggles had a protective effect (OR 0.40; CI 0.24, 0.65) . Disinfectant levels were more consistently maintained in the pools with automatically controlled systems . The bromine disinfection system was not associated with a greater risk of the development of skin rashes than other disinfection systems, but the numbers were small, and need to be interpreted with caution.

Int J Tuberc Lung Dis, 2001 Feb, 5(2), 197 - 9
Multicenter study of incidence of Mycobacterium marinum in humans in Spain; Casal M et al.; A retrospective survey was carried out on the epidemiological monitoring of the isolation incidence of Mycobacterium marinum in 21 laboratories, in an attempt to gain an insight into the frequency of its isolation in Spain . From 1991 to 1998, 39 cases (22 male and 17 female) of bacteriologically confirmed M . marinum infection were accumulated . The majority of the cases (35) were fish related . The clinical presentation usually suggested sporotrichosis, with the majority of skin eruptions appearing on the hand (32 cases) . For treatment, minocycline was recommended as the drug of choice in 12 cases, rifampicin in eight cases and clarithromycin and ethambutol in seven cases.

Int J Tuberc Lung Dis, 2001 Feb, 5(2), 185 - 90
Serial evaluation of serum neopterin in HIV seronegative patients treated for tuberculosis; Immanuel C et al.; OBJECTIVE: To delineate the course of serum neopterin (s-neo) concentrations in patients with pulmonary tuberculosis who are on anti-tuberculosis therapy . DESIGN: S-neo concentrations were measured by high performance liquid chromatography (HPLC) in 39 patients treated for pulmonary tuberculosis at pretreatment, at one month and at end of treatment . It was also measured in 11 relapse cases and their matched controls at the above time points and at the time of relapse . The results were correlated with bacteriological and radiological findings . RESULTS: All patients had elevated levels of s-neo at pretreatment which had declined at 1 month and were near normal at the end of treatment . The decline was more significant in patients with moderate lesions, suggesting that immune activation is maximum in this group of patients . The mean decrease was 37% at one month and 66% at the end of treatment . The corresponding decreases were 11% and 56% in patients with limited lesions and 11% and 45% in those with extensive lesions . It continued to fall after completion of therapy in patients who did not relapse, whereas an increase after completion of therapy was associated with bacteriologically proven relapse . CONCLUSIONS: The measurement of s-neo concentration could be of help in evaluating response to therapy . This study provides a rational basis for the association between s-neo concentration and relapse.

Hist Philos Life Sci, 2000, 22(1), 81 - 100
Pasteur, Koch and American bacteriology; Gossel PP; This study traces American awareness of the work of Louis Pasteur and Robert Koch from the 1860s to the 1890s . In the years before the Civil War, American interest in germ theories had appeared at times of epidemics and persisted to a limited extent among physician-microscopists . Discussions of Pasteur's work occurred primarily in the context of spontaneous generation and antisepsis . Few Americans imitated his work on immunology or studied with Pasteur, but his work on immunity influenced their faith in the potential of bacteriology as a solution to problems of infectious disease . Koch's discoveries of the bacterial agents of tuberculosis and cholera stimulated American medical and public health interest in bacteriology in a more practical way . Americans learned Koch's methods by taking his courses and imported them directly into their own laboratories . A context of enthusiasm for science, educational reform, and problems of infectious disease associated with urbanization and changes in agriculture aided the growth of bacteriology in the American context.

Med Trop (Mars), 2000, 60(3), 273 - 4
{First confirmed case of laryngeal diphtheria in Djibouti}; Koeck JL et al.; The first bacteriologically confirmed case of laryngeal diphtheria in Djibouti was reported in 1998 . It involved a three-year-old native-born infant who had been vaccinated during the first year of life with three doses of a combined vaccine against diphtheria, tetanus, poliomyelitis, and pertussis . A rapid clinical improvement was observed under erythromycin treatment . Other cases of laryngeal diphtheria have been observed . It is important to reverse decreasing vaccinal coverage in Djibouti and to warn incoming travelers of the need to be adequate immunized against diphtheria . Enhanced epidemiologic surveillance of this disease is also needed.

Med Trop (Mars), 2000, 60(3), 262 - 6
{Buruli ulcer: risk of bone involvement! Apropos of 33 cases observed in Benin}; Lagarrigue V et al.; Skin lesions are the best known manifestations of Mycobacterium ulcerans infection . However osteomyelitis is not uncommon with incidences as high as 14 p . 100 having been reported . The literature contains little specific data on bone lesions . This report describes a series of 33 patients presenting bacteriologically and/or histologically confirmed osteomyelitis induced by Mycobacterium ulcerans . In 64 p . 100 of cases, bone involvement occurred within the first year of the disease . In 70 p . 100 of cases, the site of involvement was on extremities . The median number of sites per patient was two (range, 1 to 5) and the number of bones was not correlated with the duration of disease . Overall, 41 p . 100 of bone sites occurred locally beneath skin lesions and 59 p . 100 were distant metastases . Osteomyelitis was associated with other germs in only 16 p . 100 of cases and superinfection was not a prerequisite for development of bone involvement . Clinical manifestations were usually low-grade with non-inflammatory, slightly painful local mass . The patient's general health status was unaffected in 79 p . 100 . Histological examination allowed identification of the type of bone lesions induced by Mycobacterium ulcerans . For the first time, bone biopsy specimens were cultured . Based on bacteriological and histological findings, several postulations can be made about underlying pathophysiological mechanisms . The role of Buruli toxin is dealt with in the discussion.

Thorax, 2001 Apr, 56(4), 306 - 11
Sputum induction as a research tool for sampling the airways of subjects with cystic fibrosis; Henig NR et al.; BACKGROUND: Sputum induction (SI) has proved to be a reliable non-invasive tool for sampling inflammatory airway contents in asthma, with distinct advantages over collection of expectorated sputum (ES) and bronchoalveolar lavage (BAL) . A study was undertaken to evaluate the safety of SI and to assess if it might be an equally valuable outcome tool in patients with cystic fibrosis (CF) . METHODS: The safety of the procedure was examined and sample volume, cell counts, cytokine concentrations, and bacterial culture results obtained by SI, spontaneous ES, and fibreoptic bronchoscopy were compared in 10 adults with CF . RESULTS: SI was well tolerated and was preferred to BAL by all subjects . The mean (SE) sample volume obtained by SI was significantly greater than ES (6.74 (1.46) ml v 1.85 (0.33) ml, p = 0.005) . There was no significant difference in the number of cells per ml of sample collected . There was a difference in the mean (SD) percentage of non-epithelial, non-squamous cells collected (67 (28)%, 86 (21)%, and 99 (1)% for ES, SI, and BAL, respectively) . These percentage counts were different between ES and both SI and BAL (p=0.03 and p=0.006, respectively) . Cell differential counts (excluding squamous cells) from all collection methods were similar (mean (SD) 84 (9)%, 87 (7)%, and 88 (11)% polymorphonuclear cells for ES, SI, and BAL, respectively) . The concentrations of interleukin (IL)-8 and tumour necrosis factor (TNF)-alpha were the same in all three samples when corrected for dilution using urea concentration . The test specific detection rate for recovery of bacteriological pathogens was 79% for SI, 76% for ES, and 73% for BAL . CONCLUSION: SI offers safety advantages over BAL and may be a more representative airway outcome measurement in patients with CF.

Plast Reconstr Surg, 2001 Apr 1, 107(4), 1025 - 35
Massive infectious soft-tissue injury: diagnosis and management of necrotizing fasciitis and purpura fulminans; Andreasen TJ et al.; Learning Objectives: After studying the article, the participant should be able to: 1 . Describe the most common bacteriology of necrotizing fasciitis and purpura fulminans . 2 . Describe the "finger test" in the diagnosis of necrotizing fasciitis . 3 . Discuss the three presentation patterns of necrotizing fasciitis . 4 . Discuss the pathophysiology of acute infectious purpura fulminans . 5 . Discuss the treatment strategies for necrotizing fasciitis and purpura fulminans, including the use of artificial skin substitutes.Necrotizing fasciitis and purpura fulminans are two destructive processes that involve skin and soft tissues . The plastic and reconstructive surgeon may frequently be called on for assistance in the diagnosis, treatment, and/or reconstruction of patients with these conditions . Understanding the natural history and unique characteristics of these processes is essential for effective surgical management and favorable patient outcome . A comprehensive review of the literature pertaining to these two conditions is presented, outlining the different pathophysiologies, the patterns of presentation, and the treatment strategies necessary for successful management of these massive infectious soft-tissue diseases.

Diabetes Metab, 2001 Feb, 27(1), 66 - 8
Rare side-effects of fenofibrate; Rabasa-Lhoret R et al.; Fibrates are widely prescribed as hypolipidemic drugs and are considered as safe . We report the case of a 69 year-old woman who probably developed a major allergic reaction following a Fenofibrate prescription (generic form) of 300 mg per day . Clinical features included asthenia, hyperthermia (40.5 degrees C) and slight muscular pain . Biological abnormalities were mildly elevated muscular enzymes and pancytopenia rapidly developed . All bacteriologic, virologic, immune and radiologic investigations were normal . Evolution was spontaneously favorable with Fenofibrate withdrawal . This is the first reported case of major fever and pancytopenia following a Fenofibrate prescription . Adverse effects of Fenofibrate are briefly reviewed and their usual favorable outcomes following drug removal are outlined.

Can J Physiol Pharmacol, 2001 Feb, 79(2), 95 - 102
{Intervention by nitric oxide, NO, and its oxide derivatives particularly in mammals}; Ducrocq C et al.; Nitric oxide (NO) is a natural and stable free radical produced in soil and water by the bacteriological reduction of nitrites and nitrates and in animals by the enzyme oxidation of L-arginine . NO is biosynthesised by finely regulated enzymatic systems called NO-synthases and readily diffuses through tissues . It reacts rapidly with hemoproteins and iron-sulphur centers to form nitrosylated compounds . It oxidises more slowly to form nitrogen oxides that nitrosate thiols into thionitrite . NO is transported in these various forms and released spontaneously or through yet unclear mechanisms into most cells; it also regulates oxygen consumption at the mitochondrial respiratory chain level through interaction with cytochrome oxidase . In the cardiovascular system, NO lowers blood pressure by activating a hemoprotein, the guanylate cyclase present in muscle cells; through such interaction it acts also as a neuromediator and neuromodulator in the nervous system . However, many of NO's roles result from rapid coupling to other radicals; for example, it reacts with the superoxide anion (O2-) to form oxoperoxinitrate (ONOO-, also known as peroxynitrite) . This strong oxidant of metallic centers, thiols, and antioxidants is also able to convert tyrosine to 3-nitrotyrosine and to act upon tyrosine residues contained in proteins . The biological aspects of the roles of NO are presented with particular respect to the rapid interactions of NO with hemoproteins' iron and other radicals . Concurrently, NO oxidation enables nitrosation reactions primarily of thiols but ultimately of nucleic bases . The thionitrite function (R-S-NO) thus formed and the dimerisation and nitration of tyrosine residues are protein post-translational modifications that are being investigated in animals.

Scand J Infect Dis, 2001, 33(2), 155 - 6
A case of Moraxella canis-associated wound infection; Christensen JJ et al.; Moraxella canis was isolated from an infected foot ulcer in a patient suffering from diabetes mellitus with neuropathy . Bacteriological findings and 16S rDNA data are presented.

Scand J Infect Dis, 2001, 33(2), 132 - 6
Demonstration of Chlamydia pneumoniae in the adenoid from children with and without secretory otitis media using immunohistochemistry and PCR; Engstrand I et al.; Chlamydia pneumoniae has been found in patients with middle ear inflammation . The adenoid, which has a central role in the development of secretory otitis media (SOM), may act as a reservoir for bacteria causing ear infection . Adenoid tissue was examined for the presence of C . pneumoniae . Twenty children undergoing adenoidectomy because of hyperplastic adenoids, 10 with SOM and 10 without SOM, were examined with nasopharyngeal swabs for routine bacteriological culture, serology for C . pneumoniae and throat swabs for C . pneumoniae PCR . The removed tissues were analyzed for C . pneumoniae using immunohistochemical (IHC) analysis and PCR . In the group of children with SOM samples were also taken from the middle ear fluid for routine bacteriological culture and PCR for C . pneumoniae . C . pneumoniae was found in the adenoid by PCR in 3 cases from each group and from all 20 children by IHC . Four children in each group had increased levels of specific antibodies to C . pneumoniae . Two children with SOM had high antibody titers and a positive PCR from a throat swab . Two children were PCR-positive for C . pneumoniae in fluid from the middle ear . The significance of these findings is not yet clear.

Vet Microbiol, 2001 Mar 2, 79(1), 31 - 45
Pilus ELISA and an anamnestic test for the diagnosis of virulent ovine footrot and its application in a disease control program in Nepal; Dhungyel OP et al.; The immunological memory (anamnestic) responses in sheep recovered from virulent footrot (VFR) can be aroused by subcutaneous injection of outer membrane protein (OMP) antigens of Dichelobacter nodosus . The magnitude of this response is directly correlated to the highest antibody response attained during infection and memory lasts at least a year after recovery from VFR . However, some older animals show non-specific responses to OMP antigens . In this study an evaluation of D . nodosus pilus antigen for the anamnestic diagnosis of footrot in sheep was undertaken . The results indicated that the primary and anamnestic responses to pilus were similar in character to OMP antigen but were highly specific . The sensitivity of the procedure for detection of sheep with a history of VFR was approximately 80% . A low proportion of sheep with mild lesions due to virulent strains of D . nodosus reacted to anamnestic challenge . Anamnestic challenge with 10 microg pilus was used in a VFR surveillance program in migratory sheep flocks in Nepal . Conventional diagnostic methods could not be applied during the disease transmission periods in these flocks because of their migration to alpine pastures far away from human habitation . The results supported clinical and bacteriological findings suggesting that virulent strains of D . nodosus have apparently been eliminated from these flocks in Nepal.

Int J Lepr Other Mycobact Dis, 2000 Sep, 68(3), 283 - 90
Efficacy of single-dose ROM therapy plus low-dose convit vaccine as an adjuvant for treatment of paucibacillary leprosy patients with a single skin lesion; Majumder V et al.; The recent World Health Organization multicentric field study on the treatment of paucibacillary (PB) leprosy patients with single skin lesion (SSL) and a single dose of rifampin-ofloxacin-minocycline (ROM) brought new hope to those who are engaged in the eradication of leprosy from India . Being encouraged by the WHO report, we undertook the present hospital-based study and found that PB leprosy patients with SSL were morphologically and histopathologically heterogeneous . The histological spectrum of SSL ranged from indeterminate through tuberculoid (TT) to borderline tuberculoid (BT) leprosy, and most patients had active BT leprosy . Ninety new, untreated PB leprosy patients with SSL were included in the present study for comparative assessment of the efficacies of ROM and ROM plus Convit vaccine therapies . Children, pregnant women, lactating mothers and patients with any thickening of nerves were excluded . All patients were bacteriologically negative (skin-smear test) but lepromin reactive . The patients were divided into two groups after proper matching for morphological and histological status of SSL: a) The test group included 60 patients and the control group included 30 patients . The test group was given a single dose of ROM initially and two injections of low-dose Convit vaccine, one initially and the other at the end of 3 months . b) The control group was given only a single dose of ROM initially . Both groups were followed clinically every 2 weeks for 6 months and retested for histological, bacteriological and lepromin status at the end of 6 months . Thereafter, they were followed clinically every month for another 6 months . In the test group, the SSL resolved in 33.3%, regressed in 48.3%, and remained active in 18.3% of the patients, while the granuloma disappeared in 70% of the cases . Only one patient developed neuritis, and in another patient the disease relapsed on the eighth month . On the other hand, the SSL in the control patients resolved, regressed and remained active in 13.3%, 63.3% and 23.3% of the cases, respectively, while the granuloma disappeared in 53.3% of the cases . In the seven patients who remained active, the disease course was progressive, and two of them developed neuritis . The clinical outcome of the patients treated with ROM plus low-dose Convit vaccine was statistically superior to those treated with single-dose ROM therapy alone.

Int J Pediatr Otorhinolaryngol, 2001 Mar, 57(3), 213 - 8
Peritonsillar abscess in children: a 10-year review of diagnosis and management; Schraff S et al.; OBJECTIVE: peritonsillar abscess is the most common deep neck infection in adults and children . However, pediatric patients with their smaller anatomy and often inability to cooperate with exam and treatment, provide a challenge . This study reviews the experience over the last 10 years at a children's hospital in the diagnosis and treatment of pediatric peritonsillar abscess . METHODS: a retrospective chart review of 83 children diagnosed with a peritonsillar abscess by the Otolaryngology service over a 10-year period (March 1989-February 1999) were reviewed . Presenting signs and symptoms, physical findings, age, season of presentation, prior pharyngitis history, and prior treatment was collected from the charts . Additionally, diagnostic studies (if any), treatment performed, bacteriology, and outcome/complications were noted . RESULTS: due to either an inability to cooperate fully for examination and treatment, or because of an earlier history of significant recurrent pharyngitis or obstructive tonsillar hypertrophy, half of the children required treatment in the operating room . Twenty-six out of 83 (31%) underwent a quinsy tonsillectomy . Length of stay was relatively short (0.9 days) . There were no recurrent PTAs in our series, although four children initially treated with incision and drainage required tonsillectomy for persistent symptoms or residual abscess . Ten of those not treated with tonsillectomy (19%) required interval tonsillectomy for recurrent pharyngitis . CONCLUSION: limited by the ability to cooperate with treatment, children often require different treatment plans . We offer a treatment algorithm for managing children with PTAs that takes into account their age, level of cooperativeness, co-morbidities and prior history of pharyngitis, PTA or obstructive sleep disorder.

J Antimicrob Chemother, 2001 Mar, 47(3), 323 - 31
Effects of cationic liposome-encapsulated doxycycline on experimental Chlamydia trachomatis genital infection in mice; Sangare L et al.; In a previous study, we demonstrated that cationic liposome-encapsulated doxycycline (CaL-Dox) was two-fold more effective than free doxycycline against Chlamydia trachomatis in vitro . Here, we evaluated the effects of two CaL-Dox regimens in comparison with unencapsulated doxycycline on the course of chlamydial genital infection in mice . Progesterone-treated, female CF-1 mice were challenged intravaginally with 1.2 x 10(5) inclusion-forming units (ifu) of C . trachomatis . Two days post-infection, the animals were divided into four treatment groups for im injection of doxycycline at 10 mg/kg body weight bd for 3 (3 Dox) or 7 days (7 Dox), or of CaL-Dox at the same dose level for 3 (3 CaL-Dox) or 7 days (7 CaL-Dox) consecutively . An infected fifth group served as a control and was given an empty CaL preparation . C . trachomatis were isolated after five blind passages from 82% of infected control mice, 61.4% of 3 Dox, 52.2% of 3 CaL-Dox, 29% of 7 Dox and 20% of 7 CaL-Dox animals . Histopathological reactions were found in various tissues of the genital tract in 79.5% of infected control mice, 80.9% of 3 Dox, 65.2% of 3 CaL-Dox, 47.1% of 7 Dox and 25.7% of 7 CaL-Dox animals . Total antichlamydial antibody titres were lower in 7 CaL-Dox mice than in all the other groups (P < 0.005) . The results showed that progesterone-treated CF-1 mice are suitable for investigation of both lower and upper genital tract infection with a lymphogranuloma venereum biovar strain of C . trachomatis . Neither 7 CaL-Dox nor 3 CaL-Dox treatment was more effective than unencapsulated 7 Dox doses in the bacteriological cure of chlamydial genital infection in mice . However, 7 CaL-Dox prevented tissue damage in the genital tract significantly more than all the other regimens (P < 0.05) . These results suggest that liposome-encapsulated doxycycline, particularly CaL-Dox, may have potential for the clinical treatment of chlamydial infections.

J Comp Pathol, 2001 Feb-Apr, 124(2-3), 95 - 101
Pathological, immunohistochemical and bacteriological findings in kidneys of cattle with contagious bovine pleuropneumonia (CBPP); Grieco V et al.; Between 1990 and 1993, 61 outbreaks of contagious bovine pleuropneumonia (CBPP) were reported in Lombardy, Northern Italy . In this study, gross pathological examination was carried out on 3129 slaughtered cattle, 716 of which (22.9%) showed typical CBPP pulmonary lesions . Single or multiple renal infarcts at different stages of development were observed in 88 (12.2%) of these 716 cattle . The kidneys of 77 cattle whose lungs showed typical CBPP lesions and were bacteriologically and immunohistochemically positive for the small colony type of Mycoplasma mycoides subspecies mycoides (M . m . mycoides SC) were selected and submitted to histological, immunohistochemical and bacteriological examination . Histologically, in chronic CBPP cases, infarcts were characterized by fibrosis, calcification of cortical tubules and tubular atrophy, accompanied by the presence of interstitial inflammatory infiltrates composed of lymphocytes, plasma cells and histiocytes . M . m . mycoides SC antigen was detected immunohistochemically in 65 (84.4%) of the 77 kidneys examined . The antigen was detected in the lumen of blood vessels and in glomerular cells . Immunolabelled interstitial cells and tubular epithelial cells were seen in chronic cases only . M . m . mycoides SC was isolated from the kidneys of 12 animals (15.6%) and more frequently in cases with renal infarcts . This study confirms previous observations that demonstrated a renal involvement in cases of CBPP . Moreover, the immunohistochemical results indicated that M . m . mycoides SC antigen was frequently detectable in different renal structures and cells in spontaneous cases of CBPP . Copyright Harcourt Publishers Ltd.

Clin Ther, 2001 Jan, 23(1), 72 - 86
Comparison of the efficacy of extended-release clarithromycin tablets and amoxicillin/clavulanate tablets in the treatment of acute exacerbation of chronic bronchitis; Anzueto A et al.; BACKGROUND: Clarithromycin has established efficacy and safety in the treatment of respiratory infections . OBJECTIVE: This study examined the efficacy and safety of a new extended-release formulation of clarithromycin compared with amoxicillin/clavulanate in the treatment of acute exacerbation of chronic bronchitis (AECB) . METHODS: This phase IIIB, multicenter, randomized, parallel-group, investigator-blinded study in patients with AECB and productive cough with purulent sputum compared treatment with extended-release clarithromycin (two 500-mg tablets once daily for 7 days) and amoxicillin/clavulanate (one 875-mg tablet twice daily for 10 days) . Assessments were performed before treatment, between study days 10 and 12 (or within 48 hours after premature discontinuation), and between study days 17 and 21 (test of cure) . RESULTS: Of 287 patients randomized and treated, 270 were clinically evaluable (137 clarithromycin, 133 amoxicillin/clavulanate) . Treatment groups were well matched in terms of demographic characteristics, medical condition, and history . Among clinically evaluable patients at test of cure, 85% and 87% of clarithromycin- and amoxicillin/clavulanate-treated patients, respectively, demonstrated clinical cure (as defined in 1998 draft US Food and Drug Administration guidelines); among clinically and bacteriologically evaluable patients, 92% versus 89%, respectively, demonstrated bacteriologic cure . Overall pathogen eradication rates were similar in the 2 groups (88% clarithromycin, 89% amoxicillin/clavulanate) . Rates of premature discontinuation of study drug for any reason differed between treatments: 3% (4/142) of clarithromycin-treated patients versus 12% (17/145) of amoxicillin/clavulanate-treated patients (P = 0.005) . One percent (2/142) and 6% (8/145) of the respective treatment groups discontinued study drug because of adverse events . Adverse events generally occurred with a similar frequency in the 2 groups; however, taste alteration was more common with clarithromycin (9/142 {6%}) than with amoxicillin/clavulanate (1/145 {1%}; P = 0.01) . Mean severity scores for gastrointestinal adverse events showed a significant difference between groups (1.16 for clarithromycin-treated patients and 1.58 for amoxicillin/clavulanate-treated patients: P = 0.016) . CONCLUSIONS: The results of this study demonstrate the clinical and bacteriologic equivalence and improved gastrointestinal tolerability of a 7-day course of once-daily extended-release clarithromycin relative to a 10-day course of twice-daily amoxicillin/clavulanate in the treatment of AECB.

Nippon Rinsho, 2001 Feb, 59(2), 221 - 6
{Progress of molecular bacteriological studies on Helicobacter pylori}; Nakazawa T; To understand pathogenesis of H . pylori in stomach diseases including gastric cancer, molecular bacteriological studies are important . The studies are greatly advanced by information of the whole genome sequence of this bacterium in 1997 . Various methods of gene manipulation to identify the genes involved in pathogenesis are now available such as transformation followed by construction of knockout mutants, complementation using H . pylori-E . coli shuttle vectors, random insertion mutagenesis, and RT-PCR or proteome analysis of in vivo-expressed genes . The molecular mechanism of persistent infection of H . pylori is discussed in light of recent findings on molecular mechanisms of bacterial attachment and colonization as well as on gastric physiology.

South Med J, 2001 Jan, 94(1), 2 - 5
Psoas abscess: a primer for the internist; Taiwo B; Psoas abscess is a rare condition with vague clinical presentation . In this article, its epidemiology, etiology, bacteriology, diagnosis, and treatment are discussed . Common diseases that may be erroneously diagnosed in patients with psoas abscess are presented.

Antibiot Khimioter, 2000, 45(12), 37 - 40
{Clinical and laboratory efficacy of the novel difluoroquinolone Sparflo (sparfloxacin) in therapy of skin and soft tissue infections}; Iakovlev VP et al.; Results of clinical trial of new difluoroquinolone--Sparflo (sparfloxacin, Dr . Reddy's Laboratories Ltd) are presented . Sparfloxacin was used in the treatment of 24 patients at the Department of Wounds and Wounds infections (11 patients) and at the Department of burn wounds (13 patients) of the A.V . Vishnevsky Institute of Surgery . After the treatment with sparfloxacin pathogen eradication was stated in 18 patients, eradication with superinfection--in 13 patients, persistence--in 3 patients . Thus bacteriological efficacy amounted to 87.5 per cent . Pharmacokinetic data demonstrates long-term sparfloxacin circulation in the organism of patients with burns--elimination half-life amounted to 20 hours . Overall after the sparfloxacin use the favourable clinical effect was stated in 100 per cent patients--18 patients (75%) had clinical cure and 6 (25%)--clinical improvement . The drug tolerance was good . It is concluded that clinical and laboratory investigation demonstrated high efficacy of sparfloxacin (Sparflo, Dr . Reddy's Laboratories Ltd) in the treatment of patients with skin and tissue wounds of different localization and genesis, complicated with infections.

Indian J Lepr, 2000 Oct-Dec, 72(4), 469 - 75
Status of long absentees among multibacillary leprosy patients admitted to a controlled clinical study; Jaggarajamma K et al.; Of 210 multibacillary leprosy patients who were admitted to a trial of two drug regimens, fifty-seven were excluded from efficacy analysis at 120 months for various reasons . Thirty-three of these patients were identified as long absentees . Efforts were made to contact these patients through letters and home visits to assess their clinical and bacteriological status and to find out the reasons for default . Twenty-one patients were thus retrieved . Only one patient was found to be having active disease requiring treatment; the rest were clinically inactive and bacteriologically negative.

Kekkaku, 2001 Jan, 76(1), 33 - 43
{Effectiveness and problems of PZA-containing 6-month regimen for the treatment of new pulmonary tuberculosis patients}; Wada M; One third of the world population has been infected with Mycobacterium tuberculosis, and the number of tuberculosis will increase worldwide without more effective programs of tuberculosis control . Despite of the presence of very potent anti-tuberculosis drugs the global tuberculosis situation is still very serious, and such gloomy feature are caused, at least partly, by the failures in the treatment of tuberculosis . The most important factor for the failure in chemotherapy is incompliance of the patients to the regimens . History of the chemotherapy of tuberculosis can be said as the history of the efforts to reduce such defaulters . Modern chemotherapy of tuberculosis has started from the discovery of streptomycin . Streptomycin monotherapy could improve temporally symptoms and bacteriological status, but could not cure the patients with moderately advanced pulmonary tuberculosis because of the emerge of drug-resistant tuberculosis . This problem was overcome by combining use of para-aminosalicylate and/or isoniazid developed later on . About 97% of patients with pulmonary tuberculosis became bacteriologically quiescent by the 12 months of streptomycin, para-aminosalicylate and isoniazid . Since 1950s through 1970s three drug combination of streptomycin, para-aminosalicylate and isoniazid had been the standard regimen for the treatment of tuberculosis . By the introduction of rifampicin, the duration of chemotherapy could be shortened to 9 months . Subsequent to the successful animal experiments carried out by Grosset which demonstrated that the addition of pyrazinamide for initial 2 months to the standard two-drug combination (isoniazid and rifampicin) could remarkably shorten the duration of chemotherapy, many clinical trials have been done all over the world to compare the efficacy and safety of pyrazinamide-containing intensified short-course regimen with those of standard regimen without pyrazinamide . Sputum negative conversion rates after 2 months of treatment with PZA-regimen was 70-95%, and the relapse rates after the completion of the treatment course were less than 4% . The incidence of adverse events was less than 4% . The pyrazinamide-containing 6 months short-course regimens has been established as a new standard regimen for the initial treatment of pulmonary tuberculosis worldwide . But, in Japan, this regimen had not been adapted as the standard until April 1996 because of undue fear for high incidence of liver toxicity induced by pyrazinamide . However, in many clinical trials carried out in various parts of the world did not show any causative relationship between the higher incidence of liver toxicity and pyrazinamide . According to our own experience in Fukujuji Hospital, Japan Anti-tuberculosis Association, the frequency of drug induced hepatitis among 632 patients with normal liver function at the onset of chemotherapy was 7.9 percent (50/632) when treated with pyrazinamide-containing regimens, and was similar to that among 412 patients treated with other regimens without pyrazinamide (7.3 percent 30/412) . These figures were higher than those reported in the literatures . The risk factors of drug-induced hepatitis so far reported included elderly, positive hepatitis C virus antibody, low serum albumin and so on . Such known risk factors could not wholly explain the higher rate of liver dysfunction observed among our Japanese patients . We have examined additional factors affecting the frequency of drug-induced hepatitis in our hospital, and noticed that the past history of gastrectomy and over-dosing of isoniazid (> or = 7.5 mg/kg) and/or pyrazinamide (> or = 30 mg) were relating to the higher incidence of drug-induced hepatitis . Another important finding is that the relapse rate among patients complicated with diabetes mellitus is significantly higher than that of the patients without diabetes mellitus (6.31/100 person-years vs 0.90/100 person-years, P < 0.001) . Further research will need whether the patients complicated with diabetes mellitus have any immunological deficient to kill Mycobacterium tuberculosis . WHO, CDC and ATS recommended that 4-drug regimen including pyrazinamide for the initial treatment of all cases of tuberculosis . Considering that the incidence of initial resistance to isoniazid is 4.4% in Japan, we should start to treat all cases of newly diagnosed tuberculosis with pyrazinamide-containing regimen (isoniazid, rifampicin, pyrazinamide, plus streptomycin or ethambutol) . To do this, further studies on the risk factors of drug-induced hepatitis are urgently needed.

Jpn J Antibiot, 2000 Nov, 53(11), 637 - 41
{Clinical effects of cefoselis (CFSL) on infections in obstetric and gynecologic field and prevention of postoperative infections}; Chimura T et al.; Clinical effects of cefoselis (CFSL) on various infections and prevention of postoperative infections in the field of obstetrics and gynecology were investigated with a total of 100 patients of 8 facilities in Yamagata and the following results were obtained: 1 . For the patients (n = 70) who received the treatment with CFSL at 2 g/day for 5 days to prevent postoperative infections, the treatment was effective for such infections in 68 of 69 (98.6%) except one to whom the treatment was discontinued during the course . 2 . For the patients with infections (n = 30) who were treated with CFSL at 2-4 g/day for 5-7 days, the treatment was markedly effective in 8/30 (26.7%), effective in 21/30 (70%) and not effective in 1/30 (3.3%) . The overall rate of efficacy was 29/30 (96.7%) . Based on the clinical effects for each isolate, the bacteriological efficacy was evaluated as 29/29 and the rate of bacterial eradication for each isolate was 23/29 (79.3%) . 3 . Laboratory test revealed liver functional abnormalities in one patient and eruption, a subjective/objective symptom caused by CFSL was noted in two patients . These results suggest that CFSL is effective for various infections in obstetric and gynecologic field and also the prevention of postoperative infections.

Gesundheitswesen, 2000 Dec, 62(12), 619 - 26
{Health, public health, society--results from the past, responsibilities for the future}; Labisch A; Communication is the basic precondition of a global society . At the same time, however, communication is a basic cause for today's health hazards and diseases . This is an experience of our time, it is a historical experience of social change as well . If a global society wants to survive, the existing hazards to life and health have to be understood and treated on a global scale . Apart from a "new morbidity" and chronic diseases also infectious diseases again require more and more attention even in industrialised countries . The history of public health offers an overwhelming expertise of well-established concepts for every imaginable risk, to handle infectious diseases which are either not yet or no longer controllable on an individual therapeutical level . History of medicine also shows, that the effectiveness of hygienic concepts is based on their scientific validity and the resulting predictability of their interventions . This implies, that modern hygiene has to incorporate actively the concept of molecular medicine . Every single discipline involved, i.e . hygiene/sanitation, toxicology, microbiology, bacteriology, immunology, and infectiology, has to join in interdisciplinary scientific and interventional efforts.

Intern Med, 2000 Dec, 39(12), 1044 - 8
Oral administration of fluoroquinolones in the treatment of typhoid fever and paratyphoid fever in Japan; Ohnishi K et al.; OBJECTIVE: To study the adverse reactions and therapeutic effects of fluoroquinolones to investigate whether they can be used for the treatment of patients with typhoid fever and paratyphoid fever . METHODS: The adverse reactions and therapeutic effects of fluoroquinolones were studied retrospectively in patients with typhoid fever and paratyphoid fever . PATIENTS: 58 patients (54 Japanese) with typhoid fever, 42 patients (41 Japanese) with paratyphoid fever, and 1 Japanese patient with both typhoid fever and paratyphoid fever, who were admitted in hospitals in Tokyo, Kawasaki, Yokohama, Kyoto, and Osaka from 1995 to 1998 and treated with fluoroquinolones . RESULTS: Almost 80% of the patients were treated with tosufloxacin (TFLX) and the remaining 20 % were treated with norfloxacin, ciprofloxacin, levofloxacin, or sparofloxacin . Side effects (nausea, urticaria, aphthous stomatitis) and elevation of serum amylase were found in 3.6% and 8.3 % of patients treated with TFLX, respectively, but these adverse reactions disappeared in all of these cases either with or without a change in the drug used . No adverse reactions were found in patients treated with the other fluoroquinolones . The clinical and bacteriological effects of these drugs were adequate . CONCLUSION: Though further studies still need to be performed on the fluoroquinolones other than TFLX, we can preliminarily conclude that fluoroquinolones are safe drugs and they can be recommended for the initial therapy of patients with typhoid fever and paratyphoid fever.

Am J Rhinol, 2000 Nov-Dec, 14(6), 387 - 91
Acanthamoeba rhinosinusitis: characterization, diagnosis, and treatment; Teknos TN et al.; Nasal and paranasal sinus manifestations are among the most common presentations of the acquired immunodeficiency syndrome (AIDS) . Several studies cite that as many as 70% of patients with this disease have symptoms referable to the head and neck, including a 30% prevalence of sinusitis . Although the bacteriology of sinusitis in this population is largely considered comparable to that of immunocompetent patients, several opportunistic pathogens have been identified, particularly when T-cell counts are low . This report identifies Acanthamoeba as a potentially fatal cause of rhinosinusitis in immunosuppressed patients . The pathogenesis, diagnosis, and treatment of this rare entity will be discussed and the literature reviewed.

Rev Clin Esp, 2000 Nov, 200(11), 590 - 6
{Respiratory complications in hematopoietic stem cell transplantation . What does radiology contribute?}; Rossello Llerena JA et al.; OBJECTIVE: To determine the incidence of respiratory complications and their manifestations in both conventional radiology and high-resolution computerized tomography (HRCT) in a series of patients who had undergone blood progenitor cell transplantation (BPCT) . The objective was to evaluate whether the radiological findings associated with post-transplantation time can be useful for establishing the differential diagnosis . PATIENTS AND METHODS: A study was undertaken of a total of 108 consecutive patients who had undergone BPCT and were alive one year after; from these patients a selection was made of those who had some respiratory complications during the first year after transplantation . Complications were classified in three different groups on the basis of time elapsed since transplantation (early, intermediate, and late stages) . Chest X-ray films of each patient were examined and in 17 cases the study was completed with HRCT . These findings were correlated with both definitive diagnosis and time elapsed since BPCT . The following procedures were useful for diagnostic confirmation: blood culture, sputum culture, fibrobronchoscopy with bronchoalveolar lavage or lung biopsy, biopsy by other methods, necropsy, or clinical course after empirical therapy . RESULTS: Thirty-three out of the 108 patients undergoing BPCT had some form of respiratory complication during the first year after transplantation . The most common radiological pattern both in the chest X-ray and in HRCT was alveolar consolidation . Other findings included ground-glass appearance, interstitial pattern, pulmonary nodules, and pleural effusion . The diagnoses in relation to the different stages of transplantation were: a) early stage: three cases of heart failure, two cases of alveolar hemorrhage, two cases of pulmonary aspergillosis and three cases of undocumented complications; b) intermediate stage: four cases of cytomegalovirus pneumonia, one case of pulmonary aspergillosis, two cases of bacterial pneumonia, and two cases of undocumented pneumonitis; c) late stage: four cases of bacteriologically documented pneumonia, two cases of pneumonitis with an unidentified agent, two cases of graft-versus-host disease, one case of pulmonary aspergillosis and two complications without established diagnosis . CONCLUSIONS: The relationship between radiological findings and time elapsed since transplantation of blood precursor cells is very useful for establishing the diagnosis of pulmonary complications . High resolution computerized tomography is useful for detecting unnoticed lesions in conventional X-ray, and for diagnosing bronchiolitis obliterans and some fungal lesions.

Clin Ther, 2000 Dec, 22(12), 1421 - 32
Phase III, randomized, double-blind study of clarithromycin extended-release and immediate-release formulations in the treatment of adult patients with acute maxillary sinusitis; Murray JJ et al.; BACKGROUND: Clarithromycin has an established bacteriologic efficacy and safety profile in the treatment of respiratory tract infections . OBJECTIVE: This study compares the efficacy and tolerability of extended-release and immediate-release formulations of clarithromycin in patients with acute maxillary sinusitis . METHODS: Fourteen days' treatment with once-daily clarithromycin was compared with the immediate-release, twice-daily formulation in a phase III, randomized, double-blind, parallel-group, multicenter study . Patients aged > or =12 years with signs, symptoms, and a radiologically confirmed diagnosis of acute maxillary sinusitis were eligible . Patients were assessed before treatment, within 48 hours after treatment, on study days 16 to 18, and at the test-of-cure visit on study days 24 to 31 . Patients who received > or =1 dose of study drug were included in the safety analysis . RESULTS: Of 283 patients treated, 245 were included in the efficacy analysis (122 in the extended-release group, 123 in the immediate-release group) . Treatment groups were well matched with respect to demographic characteristics and medical condition and history . At the test-of-cure visit, 85% of patients in the clarithromycin extended-release group and 79% in the immediate-release group were deemed clinical cures; 89% and 91% in the extended-release and immediate-release groups, respectively, demonstrated radiographic success . Overall incidences of study drug-related adverse events were similar in the 2 treatment groups (32% in the extended-release group and 28% in the immediate-release group); however, significantly fewer patients receiving extended-release clarithromycin (2/142 11%}), compared with those receiving the immediate-release formulation (10/141 {7%}: P = 0.02) discontinued therapy because of drug-related gastrointestinal symptoms or abnormal taste . No clinically meaningful changes in laboratory values or vital signs were observed during the study . CONCLUSION: Although the efficacy of the 2 formulations was comparable, once-daily clarithromycin extended-release was better tolerated than the twice-daily immediate-release formulation by patients with acute maxillary sinusitis.

Clin Ther, 2000 Dec, 22(12), 1410 - 20
Phase III, randomized, double-blind study of clarithromycin extended-release and immediate-release formulations in the treatment of patients with acute exacerbation of chronic bronchitis; Adler JL et al.; BACKGROUND: Clarithromycin has an established efficacy and safety profile in the treatment of respiratory tract infections . OBJECTIVE: The purpose of this study was to compare the clinical and bacteriologic efficacy and tolerability of clarithromycin extended-release and immediate-release formulations in patients with acute exacerbation of chronic bronchitis (AECB) . METHODS: In a phase III, randomized, double-blind, parallel-group, multicenter study . patients aged > or =12 years with signs and symptoms of AECB and a productive cough with purulent sputum received treatment with extended-release (two 500-mg tablets once daily) or immediate-release (one 500-mg tablet twice daily) clarithromycin for 7 days . Assessments were performed before treatment, within 48 hours after treatment, and at the test-of-cure visit (study days 19-21) . Patients who took > or =1 dose of study drug were included in the safety analysis . RESULTS: Of 620 patients randomized and treated, 182 were clinically and bacteriologically assessable (100 in the extended-release group and 82 in the immediate-release group) . Treatment groups were well matched with respect to demographic characteristics and medical and social history . At the test-of-cure visit, 83% (83/100) of patients in the extended-release and 82% (67/82) of patients in the immediate-release group achieved clinical cure; 86% (85/99) and 85% (70/82), respectively, demonstrated bacteriologic cure . Overall pathogen eradication rates were 86% (100/116) in the extended-release group and 88% (86/98) in the immediate-release group . The most frequently reported adverse events were diarrhea (6% in extended-release group vs 4% in immediate-release group; no significant difference), taste alterations (4% in each group), and nausea (3% in each group); no clinically meaningful changes in laboratory values or vital signs, as assessed by the investigator, were observed . CONCLUSION: This study suggests that clarithromycin extended-release and immediate-release formulations have equivalent clinical and bacteriologic efficacy and tolerability in patients with AECB.

Cas Lek Cesk, 2000 Nov 8, 139(22), 679 - 84
{Tuberculosis in the Czech Republic in 1999}; Trnka L et al.; Report is given on the tuberculosis (TB) prevalence and the new diseases monitoring in Czech Republic (CR) in 1999 using the register of notifiable TB diseases . 1631 new TB cases and relapse were notified (15.9/100,000 citizens) . Majority TB cases, 1369 (13.3/100,000 citizens) were of the respiratory system and 262 TB cases were in other locations . 63% of the respiratory system diseases were bacteriologically verified . In comparison with the year 1998, the number of newly notified TB patients was 9.6% lower, number of TB cases of the respiratory system which were bacteriologically verified was 12.3% lower, cases of microscopically positive TB were 17.4% less frequent . Among the notified TB patients there were 91 foreigners . TB relapse was identified in 61 patients . Among the notified TB cases, 987 (60.5%) were males and 644 (39.5%) were females . In both sexes patients over 65 predominated . Prevalence of TB cases higher than the average for the whole state was found in Prague, northern and western Bohemia . Groups with TB prevalence higher than 50/100,000 citizens were identified (the risk groups) . They include homeless people, drug addicts, asylum applicants, and prisoners . Due to subjective troubles of patients TB was diagnosed in 70.2% cases, by active investigation in 13.9% patients . Late TB diagnosis at autopsy came in 6.8% cases . Decease due to TB was notified in 79 patients . In 77 of them TB had not been diagnosed premortally . 106 new cases and relapses of non-TB mycobacterial disease were notified in 1999 . The case of tuberculosis in CR was in 1999 restrainable . In comparison with 1998 significant decrease of TB prevalence in individual subgroups of TB disease was described (10 to 17%) . Also the decrease of the long-term trend (10 years) of newly notified TB patients and TB of the respiratory system was depicted . It is necessary to maintain the quality and extend of the TB control program in order to prevent the new outbreak of TB disease.

Gastroenterol Clin North Am, 2000 Dec, 29(4), 879 - 84
Accurate diagnosis of Helicobacter pylori . Culture, including transport; Perez-Perez GI; Bacteriology laboratories are interested in culturing H . pylori for several reasons: (1) to investigate its growth requirements and metabolism; (2) for diagnostic purposes; (3) to establish the antibiotic susceptibility of isolates; (4) to identify potential virulence factors; and (5) to investigate microbial host-cell interactions . Despite the reasons listed, culture of H . pylori from gastric biopsy specimens is becoming less popular among clinical laboratories and physicians . The main reason is that it has become generally accepted that culture techniques are too demanding with many factors that must be controlled, in addition to simple and less expensive methods now available . Some of the disadvantages of culture include (1) special conditions for specimen transportation, (2) speed in processing of the sample to increase the probability of recovering the organism, (3) the use of expensive and complicated media with special conditions for maintenance, (4) the need for special incubation conditions, and (5) the length of time necessary to obtain a result for establishing treatment options in the patient . This article reviews aspects of H . pylori culture that could explain use being relegated to only a few clinical laboratories, some regional laboratories, and reference centers . There are several misconceptions in relation to culture techniques, such as transport and the processing of biopsy specimens . This article has mentioned simple and clear points that optimize the recovery rates of H . pylori by culture.

Rev Fac Cien Med Univ Nac Cordoba, 2000, 57(1), 109 - 14
{Analysis of a proposal for changing the educational paradigm in bacteriology and virology . Facultad de Ciencias Médicas, Universidad Nacional de Córdoba}; Marquez E et al.; The productive character of the scientific thought points out a methodological means that include the demand of the students' job about the information and not his mere reception and reproduction . It is essential to give the students the opportunity of discovering the cognitive processes used in the production of the scientific knowledge . In this work, we present the result of the starting of a workshop dynamic in a basic subject, the students' answers, and the analysis of the subject . In the Chair of Medical Bacteriology and Virology of the School of Medical Sciences, the National University of Cordoba, 1700 students attended classes in 1997 . The subject was developed with the activities that worked the same contents from two different learning conceptions: (I) workshop activity, non obligatory, constructive, and (II) theorico-practical activity, obligatory and traditional . Two voluntary and anonymous interviews were done about the valuation that the student gave to these two activities and their basis, one in the middle and the other at the end of the course . 90.55% classified the traditional activity as positive, and 9.45% as negative . Regarding the workshop activity, the 60.5% classified it as positive and the 39.5% as negative . The same developed content with two activities made possible the analysis of the impact that the two different methodologies produced on the students . The student's answer to the traditional activity was better than the workshop activity (p < 0.001) . The differences in the student's acceptance between the two option revealed the major difficulty of an alternative methodological strategy in the current educational model.

Lakartidningen, 2000 Nov 29, 97(48), 5622 - 6
{Extrapulmonary tuberculosis--an infection of concern in most clinical settings}; Adamsson K et al.; In a retrospective study at the Department for Infectious Diseases at Huddinge Hospital, 57 patients with extrapulmonary tuberculosis were identified from 1992 to 1997 . Two categories of patients were found: young persons born abroad (the largest group) and elderly persons born in Sweden . Most patients showed a positive PPD, and the diagnosis was verified through bacteriological culture in 42/51 (82 per cent) . Patients had sought help in a number of different clinical settings . Only four patients were shown to have resistant strains . This study demonstrates the difficulties inherent in the diagnostic process, with a long interval between appearance of symptoms to start of treatment: median 8 weeks but with a wide range . For one quarter of the patients, data sufficient to warrant conclusions regarding completed treatments are lacking . Efforts to increase knowledge on the part of medical personnel, compliance on the part of patients, and improvements in follow-up are essential in order to halt the spread of tuberculosis, to reduce morbidity and to prevent the development of resistance.

Rev Panam Salud Publica, 2000 Oct, 8(4), 272 - 9
{Evaluation of the tuberculin reaction in health occupation students} ; Arbelaez MP et al.; A cross-sectional study was done at the University of Antioquia, MedellIn, Colombia, to evaluate the response to a tuberculin skin test among students in undergraduate health programs (medicine, odontology, nursing, and bacteriology) as compared to undergraduate students in nonhealth programs . The study included students from the beginning, middle, and end of the university's academic programs . The sample of 490 students included 273 from health programs and 217 from nonhealth programs . Participants were randomly selected using lists provided by the university registrar, for the second semester of 1998 . The presence of a BCG vaccination scar was determined, and all the participants were also questioned about TB-related risk factors . Tuberculin skin test reactivity was evaluated by the size of induration 72 hours after intradermal injection of two tuberculin units of purified protein derivative RT 23 . There were no differences in tuberculin reactivity between students from the health programs and from the nonhealth programs, irrespective of the academic level . However, there was a significantly higher proportion of positive skin tests among students with a BCG scar . These results suggest that undergraduate health students do not have extensive contact with TB patients or with clinical samples from such patients . Nevertheless, the results do not rule out TB as an occupational risk for health personnel.

Am J Respir Crit Care Med, 2001 Jan, 163(1), 234 - 43
Septic shock and acute lung injury in rabbits with peritonitis: failure of the neutrophil response to localized infection; Matute-Bello G et al.; The major goal of this study was to investigate the mechanisms that link the host response to a local infection in the peritoneal cavity with the development of sepsis and lung injury . Rabbits were infected by intraperitoneal inoculation of fibrin clots containing Escherichia coli at 10(8), 10(9), or 10(10) cfu/clot . Physiologic, bacteriologic, and inflammatory responses were monitored, and the lungs were examined postmortem . At a dose of 10(8) cfu/clot the animals had resolving infection, and a dose of 10(9) cfu/clot resulted in persistent infection at 24 h, with minimal systemic manifestations . In contrast, inoculation of 10(10) cfu/clot resulted in rapidly lethal local infection, with septic shock and lung injury . The onset of septic shock was associated with a paradoxical lack of identifiable polymorphonuclear leukocytes (PMN; neutrophils) in the peritoneal cavity . The absence of PMN in the peritoneum was due in part to lysis of intraperitoneal PMN, because the peritoneal fluids contained free myeloperoxidase and induced rapid death of normal rabbit PMN in vitro . Although most animals became bacteremic, only those with a severe systemic inflammation response developed lung injury . These data show that control of an infection in the first compartment in which bacteria enter the host is a critical determinant of the systemic response . Above a threshold dose of bacteria, failure of the local neutrophil response is a key mechanism associated with deleterious systemic responses . Bacteremia alone is not sufficient to cause lung injury . Lung injury occurs only in the setting of a severe systemic inflammatory response and an inadequate leukocyte response at the primary site of infection.

Aliment Pharmacol Ther, 2001 Mar, 15(3), 379 - 88
Non-Helicobacter pylori bacterial flora during acid-suppressive therapy: differential findings in gastric juice and gastric mucosa; Sanduleanu S et al.; BACKGROUND: Intragastric growth of non-Helicobacter pylori bacteria commonly occurs during acid-suppressive therapy . The long-term clinical consequences are still unclear . AIM: To investigate the luminal and mucosal bacterial growth during gastric acid inhibition, in relation to the type and duration of acid-inhibitory treatment, as well as to concomitant H . pylori infection . METHODS: A total of 145 patients on continuous acid inhibition with either proton pump inhibitors (n=109) or histamine2-receptor antagonists (H(2)RAs, n=36) for gastro-oesophageal reflux disease, and 75 dyspeptic patients without acid inhibition (control group) were included . At endoscopy, fasting gastric juice was obtained for pH measurement and bacteriological culture . Gastric biopsy specimens were examined for detection of H . pylori (immunohistochemistry) and of non-H . pylori bacteria (modified Giemsa stain-positive and immunohistochemistry-negative at the same location) . RESULTS: Non-H . pylori flora was detected in the gastric juice of 92 (41.8%) patients and in the gastric mucosa of 109 (49.6%) patients . In gastric juice, prevalence rate for non-H . pylori bacteria was higher in patients taking proton pump inhibitors than controls and those taking H(2)RAs (58.7% vs . 22.6% and vs . 30.6%, P < 0.0001 and P < 0.003, respectively), but did not differ statistically between H(2)RAs and controls . In gastric mucosa, prevalence rates for non-H . pylori bacteria were higher in patients taking proton pump inhibitors and H(2)RAs than in the controls (antrum: 46.9% and 48.6% vs . 25%, P < 0.05 for both; corpus: 52.2% and 56.8% vs . 23.7%, P < 0.001 for both), but did not differ between proton pump inhibitors and H(2)RAs . Both luminal and mucosal growth of non-H . pylori bacteria were significantly greater in H . pylori-positive than -negative patients taking proton pump inhibitors (P < 0.05 for both) . Luminal growth of non-H . pylori flora increased with the intragastric pH level, whilst mucosal bacterial growth increased with the duration of acid inhibition . CONCLUSIONS: Non-H . pylori flora not only contaminates the gastric juice but also colonizes the gastric mucosa of a large proportion of patients treated long-term with acid inhibition . The relationship between H . pylori and non-H . pylori bacteria in the pathogenesis of atrophic gastritis and gastric cancer needs further elucidation.

Thorax, 2001 Mar, 56(3), 167 - 72
First randomised trial of treatments for pulmonary disease caused by M avium intracellulare, M malmoense, and M xenopi in HIV negative patients: rifampicin, ethambutol and isoniazid versus rifampicin and ethambutol; Research Committee of the British Thoracic Society; BACKGROUND: The treatment of pulmonary disease caused by opportunist mycobacteria is controversial . It is uncertain whether in vitro sensitivity testing predicts clinical response in the way it does for Mycobacterium tuberculosis . The literature suggests that the combination of rifampicin (R) and ethambutol (E) is important whereas isoniazid (H) may not be, but to date there have been no published reports of randomised controlled trials in the treatment of these conditions . The British Thoracic Society has conducted the first such trial, a randomised study of two regimens in HIV negative patients with pulmonary disease caused by M avium intracellulare (MAC), M malmoense, and M xenopi . METHODS: When two positive cultures were confirmed by the Mycobacterium Reference Laboratories for England, Wales and Scotland, the coordinating physician invited the patient's physician to enrol the patient . Patients were also recruited from Scandinavia . Randomisation to 2 years of treatment with RE or REH was performed from lists held in the coordinator's office . Clinical, bacteriological, and radiological progress was monitored at set intervals up to 5 years . RESULTS: From October 1987 to December 1992, 141 physicians entered 223 patients (106 with M malmoense, 75 with MAC, 42 with M xenopi) . At entry the RE and REH groups were comparable over a range of demographic and clinical features . For each species there was no significant difference between RE and REH in the number of deaths, but when the three species were combined there were fewer deaths from the mycobacterial disease with RE (1% v 8%, p=0.018, odds ratio 0.10, exact 95% CI 0.00 to 0.76) . For M malmoense the failure of treatment/relapse rates did not differ appreciably between the regimens, but for MAC there were fewer failures of treatment/relapses with REH (16% v 41%, p=0.033) With M xenopi there was a non-significant trend in the same direction (5% v 18%, p=0.41) and when all three species were combined there was a significant difference in favour of REH (11% v 22%, p=0.033) . There was no correlation between failure of treatment/relapse and in vitro resistance . M xenopi was associated with the greatest mortality (57% at 5 years), MAC was the most difficult to eradicate, and M malmoense had the most favourable outlook (42% known to be alive and cured at 5 years) . CONCLUSIONS: The results of susceptibility tests performed by the modal resistance method do not correlate with the patient's response to chemotherapy . RE and REH are tolerated better than previous regimens containing second or third line anti-mycobacterial drugs . Treatment of M malmoense with RE for 2 years is preferable to REH . The addition of H reduces the failure of treatment/relapse rates for MAC and has a tendency to do so also for M xenopi, but there is a suggestion that REH is associated with higher death rates overall . Better regimens are required.

Int J Infect Dis, 2000, 4(3), 134 - 9
Significance of respiratory isolates of Mycobacterium avium complex in HIV-positive and HIV-negative patients; Raju B et al.; OBJECTIVE: Mycobacterium avium complex (MAC) is isolated with increasing frequency from respiratory specimens . This study was an attempt to determine the significance of this in human immunodeficiency virus (HIV)-positive and HIV-negative patients . METHODS: A retrospective cohort study was conducted at Bellevue Hospital, a large municipal hospital in New York City, including all patients with two or more respiratory tract specimens positive for MAC during the period January 1996 to October 1996 . RESULTS: Eighty patients met inclusion criteria . Forty-six were HIV-positive, and 34 were HIV-negative . Age, gender distribution, and race were comparable . Cough was a common complaint in all patients, whereas HIV-positive patients were significantly more likely to have fever (19 vs . 2, P < 0.0001) . Abnormal chest radiographs were common in both groups (P > 0.8), although HIV-positive patients were more likely to have diffuse abnormalities (P < 0.0001) . Focal radiographic findings were similar for both groups; however, there was a trend toward more lymphadenopathy in the HIV-positive group, though this did not reach statistical significance (P = 0.17) . Notably, patients in both groups frequently had an established concurrent pulmonary diagnosis or evidence of disseminated MAC infection . Patients who were HIV-positive had Pneumocystis carinii pneumonia (n = 10), pneumonia (n = 10), and disseminated MAC disease (n = 12); whereas the concurrent disease in HIV-negative patients predominantly was active tuberculosis (n = 13) . According to the recent American Thoracic Society-recommended criteria for the diagnosis of pulmonary disease caused by nontuberculous mycobacteria only 7 of 46 HIV-positive patients and 1 of 34 HIV-negative patients met clinical, bacteriologic, and radiographic criteria for pulmonary disease caused by MAC (P = 0.052) . CONCLUSIONS: Mycobacterium avium complex often is cultured from patients with other lung diseases, and its presence in sputum infrequently signifies true disease, though it is more likely to do so in HIV-positive patients.

Bull Exp Biol Med, 2000 Aug, 130(8), 780 - 2
Modern methods for diagnosis of Gardnerella infection; Makarova LN et al.; Comparison of morphological, bacteriological, serological, and genetic methods for diagnosis of Gardnerella infection in vaginosis showed that the first three methods are preferable, while the genetic method (polymerase chain reaction) is more efficient for identification of Gardnerella vaginalis in culture.

Am J Infect Control, 2001 Feb, 29(1), 48 - 52
Brucellosis in laboratory workers at a Saudi Arabian hospital; Memish ZA et al.; BACKGROUND: Saudi Arabia is hyperendemic for brucellosis, with more than 8000 cases reported each year to public health authorities . During 1998, brucellosis ranked as the No . 1 reportable communicable disease (22.5%) in Saudi Arabian National Guard communities . King Fahad Hospital is the major referral center for National Guard personnel in the nation's central region.Methods And Results: From 1991 to 2000, brucellosis developed in 7 expatriate hospital employees . Six employees were bacteriology technologists, and one was a pathologist . Each had a clinical syndrome compatible with brucellosis (headache, fever, rigors, sweats, and myalgias) plus elevated Brucella sp serum agglutinin titers > or = 1:1280; one patient also had positive blood cultures . All patients responded to anti-Brucella therapy . Two patients had relapses, and complications occurred in four patients (septic endophlebitis of the leg, infected prosthesis, epididymoorchitis, and lumbar spondylitis) . In all these employees except the pathologist, the infection was associated with processing Brucella sp cultures . CONCLUSION: Despite the enforcement of stringent infection control measures including the use of a class II biosafety hood in the laboratory, the problem of nosocomial brucellosis persists because of the large number of infected specimens handled by the laboratory (17,500 specimens per year) . Ultimately, risk reduction depends on efforts to reduce disease endemicity in the country . In the meantime, conversion of the laboratory to biosafety level 3 is under wayPublication Types:

Case Reports

What Is Prokaryote?, What Is Botulism?, What Is Biotechnology?, What Is Pcr?, What Is Fermentation?, i, Bacterium, i, Microorganism, e, Microbiology, r, Microbe, n, Microorganisms, r, Antibiotics, e, Bacteria, r, Streptococcal, i, Functional genomics, r, Microorganisms, a, Escherichia coli, a, Clostridia, o, Growth media, s, Pseudomonas aeruginosa, n, Antibiotics, s, Bacillus subtilis, e, Antibiotics, c, Escherichia coli, i, Campylobacter, c, O157, e, Thermophile, a, Enterococci, c, Vibriosis, a, Clostridia, r, E coli O157, o, Antibiotics

Scientific Publications - Work Done by Microbiology Reader Bioscreen C
Agricultural Microbiology Anaerobic Microbiology Antimicrobial Susceptibility Artificial Atmosphere Bioassay of Antibiotics Biofilm Microbiology Bioreactor Technology Biotechnology Cell Biology Clinical Microbiology Environmental Microbiology Experiments with Yeast	Fermentation Food Microbiology Functional Genomics Gene Technology Growth Media Development Growth Rate and Lag Time Industrial Microbiology Medical/Pharmaceutical Field Microbiological Assay Microbiological Research Microbiology of Cosmetics go to a specific theme...	Military Microbiology Molecular Microbiology Mutagenicity and Genotoxicity Oral Microbiology Patents Postantibiotic Studies Soil Microbiology Spore Microbiology Veterinary Microbiology Waste/Wastewater Treatment Water Microbiology Wine Microbiology

� 2005 Transgalactic Ltd (manufacturer of Bioscreen C software) | Privacy Statement | P.O. Box 1393, 00101 Helsinki, Finland, phone: +358 9 85172920, fax: +358 9 8749481, e-mail: microbiology@bionewsonline.com

Last modified: May 25, 2005