Vaccine, 1995 Feb, 13(3), 301 - 4 The Brucella abortus RB51 vaccine does not confer protection against Brucella ovis in rams; Jimenez de Bagues MP et al.; The protective efficacy against Brucella ovis of the live vaccine Brucella abortus strain RB51 has been evaluated in rams using the attenuated B . melitensis strain Rev 1 as a reference vaccine . Sixteen Brucella-free rams, 6 months of age, were vaccinated subcutaneously with 4.18 x 10(10) c.f.u . RB51 . Sixteen rams of the same condition and age were vaccinated subcutaneously the same day with 1.1 x 10(9) c.f.u . Rev 1 . Fifteen similar rams were kept unvaccinated as controls . Six months after vaccination all rams were challenged with 3 x 10(9) c.f.u . B . ovis and slaughtered 8 weeks thereafter for bacteriological and pathological studies . The percentage of rams that were found infected was 68% (Rev 1), 100% (RB51) and 100% (controls) . At necropsy, the percentage of organs found to be infected was significantly lower (p < 0.0005) in Rev 1-vaccinated (34%) than in RB51-vaccinated rams (74%) or controls (69%) . In conclusion, the RB51 vaccine did not confer protective immunity against B . ovis in rams. Vaccine, 1995 Feb, 13(2), 191 - 6 Comparison of the efficacy of Brucella suis strain 2 and Brucella melitensis Rev . 1 live vaccines against a Brucella melitensis experimental infection in pregnant ewes; Verger JM et al.; The comparative efficacy of Brucella suis strain 2 (S2) and Brucella melitensis strain Rev . 1 (Rev . 1) live vaccines in protecting sheep against B . melitensis infection was evaluated by clinical and bacteriological examination of ewes vaccinated conjunctivally with a dose of 1 x 10(9) c.f.u . when 4 months old and then challenged with 5 x 10(7) c.f.u . of the B . melitensis virulent strain 53H38 (H38) at the middle of the first or second pregnancy following vaccination . Animals were considered to be protected when no abortion, no excretion of the challenge strain and no infection at slaughter occurred . The percentages of protection in Rev . 1-vaccinated groups challenged during either first (80%) or second (62%) pregnancy were significantly different (p < 0.001 and p < 0.05, respectively) compared with those of the relevant unvaccinated control groups . In contrast no significant difference in protection was found between the S2-vaccinated and control groups. Indian J Med Sci, 1995 Feb, 49(2), 28 - 31 Myocarditis in enteric fever; Prabha A et al.; 1 . Myocarditis in the course of enteric fever is a common occurrence . In a series of 100 bacteriologically or serologically proved enteric fever, we found 7 cases with clinical evidence of myocarditis and 46 cases with ECG evidence of myocarditis . 2 . Commonest ECG abnormality was Q-Tc prolongation (29%) followed by ST-T changes (20%) bundle branch block (7%) first degree A-V Block (%) and arrhythmia (2%) . 3 . All the ECG changes were transient except bundle branch block which persisted in 3 cases . 4 . Those with other systemic complications had a higher chance of having myocarditis (P < 0.01) . 5 . Autopsy evidence of myocarditis was found in 2 cases . With our results, it is obvious that ECT must be recorded in all cases of enteric fever . Those with ECG changes must be observed carefully for clinical evidence of myocarditis . All these patients must have absolute bed rest . Judicious use of corticosteroids is indicated in selected cases of selected cases of severe myocarditis . Diuretics are indicated in cases with evidence of congestive cardiac failure. Med Dosw Mikrobiol, 1995, 47(3-4), 119 - 25 {Characterization of bacteriophage nontypable patterns of S . aureus strains}; Cybulski Z et al.; Out of 195 strains of S . aureus isolated from in and outpatients . 43 were proven not to be lysed by the chosen set of bacteriophages . Of these nontypeable strains 14 were isolated from blood cultures and septic wounds of patients from Poznan University Hospital . 29 strains were derived from the anterior nares or throat swabs of outpatients, who were treated for chronic pharyngitis in the children's clinic in Poznan . S . aureus was identified using standard bacteriological method . Sensitivity tests to antibiotics were performed using the ATB computer system (bioMerieux) . Beta lactamase production was examined using the iodometric method . The intracellular esterases of S . aureus were separated by polyacrylamid gel electrophoresis and stained with Fast Blue using alpha-naphtyhl acetate, beta-naphthyl propionate and indoxyl acetate as substrates . A much higher percentage of S . aureus strains isolated from specimens obtained from the hospital patients showed the ability to produce beta-lactamase than the strains cultured from outpatients . The esterase patterns of S . aureus are helpful in differentiating bacteriophage nontypeable strains. Med Trop (Mars), 1995, 55(4), 363 - 73 {Mycobacterium ulcerans cutaneous infections: Buruli ulcers}; Josse R et al.; Mycobacterium ulcerans skin infection or Buruli ulcers are common in children in many rural tropical areas . The usual clinical appearance is a deep, rapidly developing chronic ulcer associated with necrosis of subcutaneous fat . Patients are usually seen at an advanced stage . Bacteriologic identification is not always possible because the pathogen, Mycobacterium ulcerans, is an atypical mycobacteria that is difficult to isolate and grows slowly in culture . Medium although of little assistance in tropical regions, the histological features are highly characteristic and can allow diagnosis in areas in which the disease is rare and unsuspected . The pathogenic effects of Mycobacterium ulcerans are due to the production of a necrotizing exotoxin with an immunosuppressive action . Treatment using antituberculosis and antileprosy drugs has been disappointing . Surgery is usually required and causes extensive sequels in many cases, the best technique being an excision/graft procedure . Many epidemiologic characteristics of Buruli ulcers which are andemic in regions with and aquatic ecosystem are still unclear including the mode of infection, transmission and reservoir . Recent outbreaks, particularly in west Africa, may be related to changes in the natural environment. Ann Med Interne (Paris), 1995, 146(7), 496 - 9 {Value of the stool bacteriological test in Mycobacterium avium complex infections in AIDS}; Bevilacqua S et al.; Incidence of Mycobacterium avium complex (MAC) infection has increased in HIV infected patients . We report a retrospective study of 25 cases of MAC infection occurring in HIV patients . Stools examination was performed in 5 (31%) of the patients without digestive symptoms and in the 9 (100%) patients presenting with diarrhoea . The stools culture are positive in 79% of cases (11/14) . In all the patients with diarrhoea, direct examination of the stools gave the diagnosis of MAC infection . All the patients had profound immunodepression with CD4+ cell count < 5/mm3 . The mean survival time from mycobacteriosis diagnosis was 122 +/- 90 days despite antimycobacteriosis therapy. Folia Parasitol (Praha), 1995, 42(2), 91 - 6 Amoebic gill infection of turbot, Scophthalmus maximus; Dykova I et al.; Amoebae were found to cause severe gill tissue damage in turbot, Scophthalmus maximus L, from a grow-out facility in northwestern Galicia (Spain) . The nature and extent of lesions along with negative results of bacteriological and virological examination made this agent responsible for mortalities in four turbot stocks supplied with water from a single source . We present our findings, although we failed to isolate amoebae, since there was a clear evidence of their primary role in the development of disease condition and occurrence of mortalities . In addition, this is a record both of a new host endangered by amoebae in intensive cultures and pathogenesis of the gill lesions. Ann Radiol (Paris), 1995, 38(7-8), 408 - 17 {Primary tuberculous infection . Current aspects in imaging . Apropos of 14 cases}; Ouzidane L et al.; Active pulmonary tuberculosis, a source of contamination, is currently undergoing a recrudescence in developed countries, particularly in clinical contexts of immunodepression . The authors report a retrospective series of 14 cases of primary tuberculosis in a paediatric population (7 girls and 7 boys) with a mean age of 3.5 years (range: 4 months-16 years) observed over a 3-year period . After reviewing the current radiological features of patent primary tuberculosis, the authors emphasize the contribution of chest CT scan in latent forms with a normal chest x-ray and a difficult bacteriological diagnosis . Imaging remains an essential tool in early diagnosis, therapeutic management and active surveillance of this form . The authors propose a decisional flow-chart in the case of suspected primary tuberculosis in children. Vestn Khir Im I I Grek, 1995, 154(3), 17 - 21 {The interpretation of the data from the ultrasonic examination of patients with acute and chronic suppurative lung and pleural diseases}; Tsurupa DI et al.; Observations were made in 104 patients with acute and chronic lung abscesses and pleural empyema . The endoscopic, bacteriological and ultrasonic methods were used to make full diagnosis and to begin treatment . This article describes the part of the work devoted to the ultrasonic diagnostics . Different forms of lung abscesses were revealed and explained . The method was used to differentiate the collection of pus in the lung and pleural cavity, to reveal the structure of pathologic processes and its development, to learn the character of changes in the lungs and pleural space . The method is rather simple and gives the doctor much information about the condition of the pathologic tissue. Ann Otolaryngol Chir Cervicofac, 1995, 112(8), 393 - 8 {Peritonsillar abscess . Emergency tonsillectomy?}; Marchal F et al.; The treatment of peritonsillar abcess is still controversial: quincy tonsillectomy, also called tonsillectomy "a chaud" (TC) or interval tonsillectomy, also known as tonsillectomy "a froid" (TF), several weeks after incision and drainage . Of 105 patients presenting with peritonsilar abscess, 53 had tonsillectomy: 27 TC and 26 TF . For each group the following variables were analyzed: age, location of abscess, bacteriology, duration of surgery, amount of per-operative bleeding, post-operative hemorrhage and complications, and length of hospital stay . The location of the abscess was posterior in 33%, and therefore difficult to drain without tonsillectomy . Significant differences in favor of TC were found for: 1) the amount of per-operative bleeding; 2) the occurrence of post-operative hemorrhage; and 3) the duration of hospital stay . We conclude that TC is a safe procedure without increased risks, with less complications, and with a reduced cost . When surgery is indicated in the treatment of peritonsillar abcess, we advocate TC . From our results and the litterature a decision tree for the management of peritonsillar abcess is presented. Arch Inst Pasteur Madagascar, 1995, 62(1), 45 - 51 {National Laboratory for Mycobacterias . Evolution, missions and activities from 1991 to 1994}; Ramarokoto H et al.; The setting up of a new nationwide tuberculosis control programme allowed the creation of a National Mycobacteria Reference Laboratory . This latter originated from the small bacteriology laboratory of the antitubercular dispensary of the Institut d'Hygiene Sociale (IHS) and its activities increased tenfold within three years . Extension of rooms, a more numerous staff and the acquisition of a modern equipment explained those results . However, to carry out the tasks of such a laboratory a rapid modification of structures and a new job distribution facilitated by a cooperation with the Institut Pasteur de Madagascar are necessary. Arch Inst Pasteur Madagascar, 1995, 62(1), 18 - 23 {Tuberculosis in the prison milieu at Antananarivo from 1990 to 1993}; Auregan G et al.; Within 42 months, from June 1990 to December 1993, 454 cases of tuberculosis have been recorded in the central remand home of Antananarivo . The tubercular prevalence observed was there eight times superior to that of the global population of Madagascar . Among the 360 pulmonary tuberculosis, only one did not have any bacteriological proof; among the 94 extrapulmonary tuberculosis, 37 have been proved by histology or bacteriology . Among the extrapulmonary tuberculosis, pleurisies were obviously preeminent (79/94) . Association of tubercular localizations could be observed with 21% of the patients . New cases of smear-positive pulmonary tuberculosis (PMT+) represented 81% of all the PMT+, recurrences were 9% and revivals 10% . Since February 1991, the 8 months short course regimen was the standard applied; before, the lack of stock did not allowed any standardization . The PMT+ new cases recovery rate increased from 42.5% in 1990 to 74% in 1993, whereas lethality decreased from 23% in 1990 to 8% in 1993 . Patient dropouts were noted only with released or escaped individuals . Treatment failure rate was 4% . The diminution of cases despite the constancy of prisoners number and the carrying out of activities by the same health team make questionable the explanatory factors of the burst of tuberculosis-diseases in a prison milieu . Because of the importance of prison tubercular foci in terms of public health and the satisfactory results obtained, the Programme proposes to apply the model of partnership developed between the Tonga soa NGO and the prison administration to other prisons in Madagascar. Acta Gastroenterol Latinoam, 1995, 25(3), 153 - 61 {Colonic ulcer in HIV (+) patients}; Varsky C et al.; A characteristic rectocolonic endoscopic finding is the presence of ulcers, which may correspond to different diagnosis . Between January, 1989 and May, 1993, we performed 28 colonoscopies and 12 rectoscopies in patients with HIV (+) . In all cases, histologic, parasitologic, bacteriologic, virologic, and micrologic studies were practised on tissue biopsies . Eighteen of them presented rectocolonic ulcers (we are not including anal and terminal ileum ulcers) . The studies involved 16 males and 2 females, with an average age of 31, 21 years old (20-47), 14 of which were male homosexuals, 2 intravenous drug abusers, 1 hemophilic and an heterosexual female . Symptoms were as follows: 15 with hematochezia, 7 with proctorrhagia, 6 with enterorrhagia and 2 with both manifestations . All the rest, presented chronic diarrhea, loss of weight, anal secretion, asthenia, fever, constipation and anemia in isolated cases . Diagnosis were 6 rectocolonic cytomegalovirus (all occurred during the current year) . Other related opportunistic pathogens included an intestinal TBC, a rectal Herpes and a Burkitt's lymphoma . Related etiological agents were not found in 9 patients, in spite of systematic quest . Opportunistics found in three of the cases revealed AIDS in those patients . COMMENTS: 1-The indexes of male homosexuals are strikingly higher than the rest of our HIV endoscopy statistics . 2-We observed prevailing idiopathic lesions . 3-The relationship between "CU like" pictures, already described, and the immunocomponents of the idiopathic CU is unknown . 4-All our CMV cases are recent . 5-Hematochezia was the most frequent symptom . 6- Herpetic ulcers correspond to HSV type 1 . 7-Diffuse ulcers may correspond to lymphoma. Scand J Infect Dis, 1995, 27(5), 463 - 8 Ampicillin plus mecillinam vs . cefotaxime/cefadroxil treatment of patients with severe pneumonia or pyelonephritis: a double-blind multicentre study evaluated by intention-to-treat analysis; Cronberg S et al.; In this double-blind multicentre study, using the intention-to-treat approach, a total of 293 patients with fever (> or = 38.5 degrees C), symptoms of sepsis and signs of pneumonia or pyelonephritis were randomly assigned to treatment with ampicillin and mecillinam (A+M) or cefotaxime followed by cefadroxil . In the febrile phase, treatment was given intravenously twice daily, either with 1,200 mg ampicillin together with 600 mg mecillinam or with 2 g cefotaxime alone . When the patients stayed afebrile, the intravenous administration was replaced by oral treatment twice daily for 14 days, either with 500 mg pivampicillin and 400 mg pivmecillinam or 1 g cefadroxil . In the A+M group, 33% (48/144) of the patients did not complete the full course of treatment as compared with 32% (47/149) in the cephalosporin group, the reasons being treatment failure in 27 and 29, respectively, or adverse effects (n = 16 in both groups) . The median duration of fever was 47 h in the A + M group and 50 h in the cephalosporin group . Of 135 patients with pneumonia, 68% were completely cured in the A + M group, and 65% in the cephalosporin group, the main reasons for treatment failure being Mycoplasma pneumonia or ornithosis . Of 136 patients with pyelonephritis, 63% were cured in each group . The main reason for failure was bacteriological relapse . Side-effects were reported by 32 patients (22%) of the A+M group, as compared with 41 (28%) of the cephalosporin group . Epigastric complaints were equally frequent in both groups, but there was a tendency for a higher frequency of exanthema in the A+M group, and for antibiotic-associated diarrhoea and fungal superinfections in the cephalosporin group. Ann Fr Anesth Reanim, 1995, 14(4), 320 - 5 {Aseptic meningitis . Demonstration of bacterial DNA in cerebrospinal fluid by gene amplification}; Salord F et al.; OBJECTIVE: To develop a diagnostic tool to recognize whether a postoperative meningitis occurring in neurosurgical patients is of bacteriological origin or not, in detecting in CSF bacterial DNA with the polymerase chain reaction (PCR) technique . STUDY DESIGN: Laboratory study . PATIENTS: Twenty-seven neurosurgical ICU patients associating, in the postoperative period, the CDC criteria of meningitis and a neutrophil polymorphonuclear count over 100 cells.mm-3 were allocated either into the MB+ group (n = 7) when their CSF culture was positive or in the MB- group (n = 20) when the culture was sterile . The CSF of 43 neurosurgical ICU patients without postoperative clinical and biological features of meningitis acted as controls . Sixteen specimens out of the 43 were inoculated with bacteria at a known concentration . METHODS: The CSF specimens of all patients were tested for the presence of eurcaryote DNA using the PCR technique . Beforehand its sensitivity had been assessed using the inoculated CSF of control group: a positive amplification at 20 cycles was equivalent to 10(5) CFU.mL-1 and a positive amplification at 25 cycles to 10(3) CFU.mL-1 . RESULTS: In the 43 sterile control CSF specimens the amplification was negative in all at 20 cycles and in 42 at 25 cycles . In the 16 previously sterile control specimens supplemented with bacteria, as well as in the CSF of all 7 patients of MB+ group the amplification was positive at 20 and 25 cycles . In those of MB- group the amplification was negative in all at 20 cycles, but was positive in 19 out of 20 at 25 cycles . Southern blot with specific procaryote probes was positive with amplification products from CSF of MB+ and MB- groups and negative with control CSFs and human DNA . DISCUSSION: The presence of bacteria in CSF of patients sustaining a meningitis can be accurately detected through their DNA . Postoperative aseptic meningitides may have a bacterial origin . PCR can be used as a routine technique to provide a diagnosis of bacterial meningitis in less than 6 hours . Additionally specific oligonucleotides allow to identify the bacteria in less than 12 hours. Acta Orthop Belg, 1995, 61(4), 331 - 6 Skin closure in hip surgery: subcuticular versus transdermal . A prospective randomized study; Sakka SA et al.; A randomized parallel-group clinical trial was conducted between March 1991 and December 1993 to compare the effectiveness of subcuticular suture using absorbable material (Dexon) and continuous transdermal blanket suture using nonabsorbable material (silk) in hip surgery . Eighty patients (48 females and 32 males) aged between 19 and 94 years (average 71.4 years) who underwent 97 hip operations were studied . Patients were followed up between 2 and 20 months . The two groups were evaluated with respect to infection rate, patient satisfaction with the scar, extra time and cost in removal of suture and the cosmetic appearance assessed by a plastic surgeon evaluating photos of patients' wounds using a specific scoring method without knowledge of the suturing method used . Five patients died during the study . There was no significant difference in superficial infection rate between the two groups (5% with positive bacteriological swab and 16% requiring extra antibiotics on clinical grounds) . No deep infection was suspected in either group . The average score of patient satisfaction with the scar was 9.6/10 in the subcuticular group and 8.68/10 in the continuous mattress with a significant difference between the two groups (p < 0.05) . Cosmetic evaluation by the plastic surgeon using a 6-category scoring system showed a better cosmetic result in the subcuticular group with a significant difference (p < 0.01) . An average of 17 minutes of extra nursing time was needed for removal of suture material in the nonabsorbable group in addition to the cost of the suture removal set . We conclude that absorbable subcuticular skin closure is an effective method and offers some advantages over the traditional transdermal suturing method in hip surgery. Med Trop (Mars), 1995, 55(3), 252 - 4 {Autopsy findings in 70 AIDS patients who died in a department of pneumology in Ivory Coast: impact of tuberculosis}; Domoua K et al.; Based on autopsy findings in 70 patients infected by human immunodeficiency virus (HIV) who died in the Pulmonology Department of the Treichville University Hospital Center in Abidjan, Ivory Coast . the authors assess the incidence of tuberculosis as the cause of death and analyze the clinical, bacteriologic, and histologic features of the disease . in this population . Pulmonary tuberculosis was the first cause of death in this series accounting for 31 cases (44.2%) . In 12 cases (38.7%), microscopic identification failed during hospitalization and the disease had been misdiagnosed as common bacterial pneumonia . In 29 cases (93.5%) pulmonary tuberculosis was associated with abdominal involvement . In 17 cases (54.8%) involvement of more than two organs was observed . Of the 60 abdominal sites detected during the autopsy of the 31 patients with pulmonary tuberculosis, there were 19 (31.3%) in lymph nodes, 18 (30%) in the liver, 14 (23.3%) in the spleen, and 9 (14.9%) in the kidneys . Histologic features were remarkable by the absence of typical tuberculous granulomas . The findings of this study confirm the high incidence of disseminated tuberculosis in patient infected by HIV as noted in a number of previous studies. Hist Philos Life Sci, 1995, 17(1), 81 - 90 Between bacteriology and virology: the development of typhus vaccines between the First and Second World Wars; Weindling P; This paper provides an overview of the development of typhus vaccines between the first and second world wars . It is shown that there was a shift in the classification of the causal Rickettsiae from being classed as bacteria to being conceptualised as a type of virus . This 'paradigm switch' stimulated interest in the possibility of producing an effective medicine. Gynecol Obstet Invest, 1995, 40(3), 183 - 9 Low birth weight and genital infections . An incident case-referent study; Bique Osman N et al.; In an attempt to elucidate the potential association between genital infections and low birth weight (LBW) births, 51 women with LBW neonates were identified and compared to 51 women with normal birthweight (NBW) neonates . Both groups were matched according to age and parity . All women were subjected to interviews regarding socioeconomic background and obstetric history . The were examined clinical and tested regarding serum haemoglobin, malaria parasitaemia, syphilis and HIV serology . Cultures were taken from the vagina, endocervix, amniotic fluid and from various sites of newborn, including the conjunctivae and the stomach and from the interior of the placenta . Whilst socioeconomic background factors did not differ among cases and referents, previous neonatal death did . Significant differences were also found in mid-upper-arm circumference (OR 3.08) and body mass index (OR 6.00) . The prevalence of alleged risk factors according to the antenatal card was similar among cases and referents . Birthweight < 2,000 g was significantly more often associated with chorioamnionitis than birthweight between 2,000 and 2,499 g (OR 5.46) . Bacteriological findings did not show significant differences in cases and referents . Haemoglobin values and prevalence of malaria parasitaemia were similar as was the neonatal mortality . It is concluded that LBW births is difficult to predict by use of alleged risk factors in existing antenatal cards. Ann Dermatol Venereol, 1995, 122(4), 206 - 12 {Value of molecular biology methods for diagnosis in bacteriology}; Piemont Y et al.; Progress in molecular biology has led to the development of new tools for bacteriological diagnosis . Sporadic genes coding for virulence factors can be detected with highly specific genetic probes applied to cultured bacteria . Such genetic probes can also be used to specifically identified cultured bacteria whose general taxonomic classification is known . Another advantage of molecular genetics is the possibility that the cell culture step may not be needed, bacteria being identified directly in the sample specimen . Such techniques are particularly interesting to identify bacteria which are difficult to culture (for example: Borrelia burgdorferi, Chlamydia trachomatis) or which grow slowly (mycobacteria) . The bacterial DNA must be isolated and amplified with an enzyme reaction . This is a critical step in the method: several positive and negative controls are required . When performed under optimal conditions, amplification techniques are excellent methods which can offer results similar to culture methods in culturable bacteria . Finally, molecular biology can be used to identify previously cultured bacteria for which there is no taxonomic orientation . Here the ribosome 165 DNA must be amplified and sequenced . The sequence is then compared with a data bank allowing classification . One could image future techniques applied to certain pathology samples for the detection and identification of bacteria without need for a culture step . However, direct microscope examination and bacterial culture remain the basic methods for bacteriologic diagnosis, the advantages and disadvantages of molecular biology leading to its use a complementary method for improving the quality of the diagnosis. Rev Med Interne, 1995, 16(10), 771 - 4 {Adrenal histoplasmosis in a non-insulin-dependent diabetic patient}; Sert C et al.; Adrenal histoplasmosis is a rare infection that can be misdiagnosed as tuberculosis . We present here a case of adrenal histoplasmosis in a 65 year-old male diabetic with marked weight loss . Laboratory investigations noticed an inflammatory syndrome and the abdominal computed tomography scanner reported an heterogenous left adrenal mass of 6 cm in diameter . Hormonal as well as bacteriological studies were negative . The patient was operated and the histopathological examination proved that the mass was a tuberculoma and an anti-tuberculous treatment was started . Four months later, the patient suffered from recurrence of symptoms and laboratory investigations confirmed the inflammatory syndrome and the abdominal computed tomography scanner showed a right adrenal mass . A surgical biopsy was performed and specific fungal researches proved that the lesion was due to Histoplasma capsulatum . The patient experienced a remarkable improvement under anti-fungal treatment. Przegl Lek, 1995, 52(7), 338 - 43 {Interpretation of diagnostic data exemplified by tests for identification of Helicobacter pylori in gastric mucosa}; Dabrowiecki S et al.; Seven diagnostic tests were employed to detect the infection of gastric mucosa with the H . pylori bacteria, among patients with epigastric pain and dyspeptic complains . The tests' results were compared to the bacteriologic culture . For each test the following criteria were taken into consideration: sensitivity, specificity, positive and negative predictive values . The tests' accuracy was compared with the agreement expected by chance and beyond chance (kappa) . For each test the likelihood ratio was calculated for its positive and negative results . The construction of so called diagnostic decision tree was presented, which allows on the evaluation of the diagnostic test and its utility . The best result were obtained from the test, in which the identification of bacteria took place in the histopathologic specimen after its Gram staining . The interpretation of clinical significance of diagnostic data is simplified with the use of likelihood ratio calculated for a positive test result. Med Dosw Mikrobiol, 1995, 47(1-2), 11 - 6 {Diagnostic value of the latex test (Pyloriset) for detection of Helicobacter pylori antibodies in adult patients with upper digestive tract diseases}; Zaremba M et al.; The biopsy specimens and sera from 269 adult patients referred for gastroscopy were examined for Helicobacter pylori infections . The bacteriologic studies included: Gram smears, urease test and culture methods of biopsy specimens, biochemical tests for identification of isolates and their sensitivity testing to 17 chemotherapeutics . The biopsy specimens were examined histopathologically also . For demonstration of specific antibodies the latex test (Pyloriset, Orion Diagnostica, Finland) was used . Biopsy--cultures were positive for H . pylori in 171 (63.6%) cases, biopsy--urease test in 149 (55.4%) and Gram smears in 163 (62.8%) . A total of 193 (71.7%) positive sera with latex were found . The sensitivity and specificity of the latex test as compared with the culture method, biopsy--urease test and Gram smears was 80.7% and 43.9%, 80.5% and 39.2% or 79.8% and 40.6% respectively . All three direct diagnostic methods were positive in 122 (45.4%) patients, 101 (82.8%) of them were positive with the latex test . Only in 33 (19.3%) patients with positive biopsy--culture for H . pylori anti-H . pylori antibodies were not observed . On the other hand, among 75 patients with negative all direct methods for H . pylori infections 39 (52.0%) of them were positive with the latex test . The latex test was also positive in 56 (54.9%) sera among 102 blood donor tested by us but this value was lower, in trems of statistical significance than in patient sera . In conclusion, the latex test may be useful as a screening serological test for the diagnosis of patients with H . pylori infections and for epidemiological studies. Rev Mal Respir, 1995, 12(1), 5 - 11 {Post-lung transplantation bronchiolitis obliterans}; Fournier M et al.; Bronchiolitis obliterans is an anatomical lesion with multiple aetiologies . In the lung transplant patient the pure forms of bronchiolitis obliterans are probably the consequence of a process of chronic rejection; in fact necropsy tissue or lungs removed which have been transplanted show that the lesions of bronchiolitis obliterans are often associated with parenchymal disorders, vascular and proximal bronchial disease, which are sequelae of phenomena of rejection or infection . The effect of bronchiolitis obliterans on lung function is constant; this may appear progressively or in stages . Increasing immunosuppressive treatment may arrest the progress . This rarely occurs and the development of respiratory failure tends to be the rule . It is exceptional to achieve the diagnosis of bronchiolitis obliterans from the examination of a transbronchial biopsy . It is a combination of features, both clinical and respiratory function, negative bacteriology and virological investigations as well as the absence of any efficacy of conventional treatment for rejection which leads to the diagnosis . In certain cases the question of a pulmonary re-transplantation is raised. Rev Mal Respir, 1995, 12(1), 13 - 23 {Respiratory toxicity due to atmospheric pollutants . General review and a study of the relation to respiratory infections}; Leduc D et al.; The main primary pollutants released into the atmosphere are sulfur dioxide (SO2), nitrogen monoxide and dioxide (NOx), particulate dust and in a less important part carbon monoxide (CO), hydrocarbons and heavy metals (Pb, Cd) . Sulfur and nitrogen oxides are released from combustion of coals and fuels . Sulfates, nitrates and ozone are secondary pollutants resulting from chemical reactions within the atmosphere . While governmental directives limiting emissions have decreased SO2 and particulate matter levels, air quality in urban regions has improved in the last two decades . The role of air pollution as a risk factor for respiratory infections is difficult to address . Animal experiments demonstrate that air pollutants decrease the efficacy of lung defense mechanisms and increase the sensibility to respiratory infections . Nevertheless, because of difference in sensitivity between animal species and between exposure conditions, these effects are difficult to extrapolate to humans . Moreover, it is obvious that direct exposure studies of the sensibility of humans to respiratory infections are rare for ethical reasons . Epidemiological data addressing the role of air pollutants at usual levels can only suggest that some pollutants (SO2, suspended particulates) constitute a risk factor for respiratory infections . Since most of these studies do not include bacteriologic and virologic confirmation, it is unclear whether this respiratory morbidity is due to respiratory irritation or infection . In conclusion, we think that high concentrations of air pollutants are very likely to increase sensibility to respiratory infections in humans . There are however no sufficient data to clearly establish whether air pollution constitutes a risk factor for respiratory infections at usual ambient concentrations. Gynecol Obstet Invest, 1995, 39(1), 54 - 9 Immune response characteristics in women with chlamydial genital tract infection; Cunningham DS; Immune responses in women with chlamydial genital tract infection who achieved a bacteriologic cure were prospectively compared to those women who had an incomplete clinical response . Local anti-chlamydia IgA antibody responses were significantly diminished in the outpatient treatment group who had an incomplete response, while circulating IgG responses did not differ significantly between groups . This is in contrast to both specific and non-specific lymphoproliferative responses which were similar between uninfected controls and women with a chlamydial genital tract infection, regardless of treatment outcome . Thus, the kinetics of successful outpatient treatment of chlamydial genital tract infections may have an immunologic component which can be measured at the time of initial evaluation, and may be predictive of the clinical response to adjunctive antibiotics. Kekkaku, 1995 Jan, 70(1), 67 - 72 {The examination of tuberculosis contacts: the current situations and perspective in Japan}; Ahiko T; Contacts of active tuberculosis cases are the most easily identified high-risk group for tuberculosis in Japan . Thus, examination of the contacts is one of the most useful methods for finding persons with disease or with infection . The purpose of this study is to analyze recent problems in the examination . Program assessment and evaluation for the contact examination were administered by a mail questionnaire to 74 Health Centers (HCs) in Tohoku District . The response rate was 100% . The Service Report of Activities of HCs (1992) was also utilized as the basic data for estimating statistical indices concerning contact examination . Results obtained are as follows: 1 . At a rough estimate, the number of persons who underwent the contact examination accounted for 1.6 per newly diagnosed cases with tuberculosis in Japan . This index remarkably varied according to the region, e.g., maximum was 6.6 in Okinawa and minimum was 0.9 in Yamaguchi . The contacts had a high incidence rate (0.65%) with active tuberculosis . This rate was twenty-five times higher than that by periodic mass X-ray examinations . 2 . In Tohoku District, only 17 HCs (23%) carried out the examination fitting "guidelines" that had been published by the Ministry of Health and Welfare . Results from the program assessment suggested that HCs should give priority of the examination to the contacts because they were risky . The risk of manifestation is mainly influenced by bacteriological severity of source cases . 3 . Main planners of the examination were public health nurses.(ABSTRACT TRUNCATED AT 250 WORDS) Kekkaku, 1995 Jan, 70(1), 17 - 23 {Shortening of hospitalization period for patients with pulmonary tuberculosis}; Suzuki A et al.; The development of specific chemotherapeutic agents revolutionally improved the prognosis of tuberculosis and markedly shortened the duration of the treatment . Evidence of successful treatment with short-course regimens for pulmonary tuberculosis has been accumulated . But, the duration of hospitalization tends to be determined empirically and varys among hospitals and clinicians . Generally speaking, the duration of hospitalization is longer in Japan than in the United States and Europian countries . We investigated retrospectively the duration of hospitalization, treatment period, and recurrence rate of the disease for patients with pulmonary tuberculosis who admitted to the Tokyo Metropolitan Fuchu Hospital in the years 1984, 1988, and 1991 . Patients who had been previously treated for more than 2 weeks and/or, had severe complications, such as malignancy and miliary tuberculosis were excluded from the study . Cases who died during the hospitalization and discharged without permission were also excluded . Numbers of subjects in each year were 114, 114, and 115 in 1984, 1988, and 1991, respectively . A total of 343 patients (M: 254, F: 89) were enrolled to the study and their average age was 49.4 yr old . A number of patients with both smear and culture positive in sputum bacteriology was 210 (61.2%), and 42 cases (12.2%) were smear negative and culture positive . The results are as follows: (1) Mean duration of hospitalization in the years 1984, 1988, and 1991 were 141, 102, and 72 days, respectively . That is, a mean hospitalization period was shortened to about half during these seven years . (2) According to the chest x-ray classification (Group A: I, II3, B: II1, II2, III3, C: III1, III2), mean durations of hospitalization were 186 days for group A, 143 days for group B, and 108 days for group C in 1984, and 96 days, 76 days, and 59 days in 1991, respectively . (3) According to sputum bacteriology, mean durations of hospitalization were 169 days for (S+/C+) cases, 105 days for (S-/C+) cases, and 90 days for (S-/C-) cases in 1984, and 83 days, 67 days, and 41 days in 1991, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) Rev Med Interne, 1995, 16(1), 63 - 6 {Necrotizing hepatic granuloma of brucellosis origin . Apropos of a case}; Debat-Zoguereh D et al.; The authors report on a case of febrile necrotizing brucellosis hepatic granulomatosis in a patient living in brucellosis endemia areas . This hepatic localization of brucellosis is rare: to our knowledge only 28 cases have been described in the literature . The bacteriological diagnosis was not established by blood or abscess pus cultures, but by Brucella serology only . Surgery completed by biantibiotherapy have permitted a complete recovery. Kyobu Geka, 1995 Jan, 48(1), 67 - 9 {Surgical treatment of infective endocarditis: application of DNA probe method}; Mizuno A et al.; DNA probe method is a new bacteriological method for diagnosis of bacteria . The authors tried to apply the method to diagnosis of bacteremia and treatment of infective endocarditis . We could diagnose the patient's illness as bacteremia with this method even when blood cultures are not positive . We suggest that cardiac surgery should be performed in case bacteria is detected repeatedly with DNA probe method . Therefore it is useful for decision whether cardiac surgery for patients with active infective endocarditis should be done or not. Int J Syst Bacteriol, 1995 Jan, 45(1), 186 - 7 Taxonomic note: implementation of the provisional status Candidatus for incompletely described procaryotes; Murray RG et al.; The International Committee on Systematic Bacteriology recommended that the category Candidatus, recently proposed by Murray and Schleifer (Int . J . Syst . Bacteriol . 44:174-176, 1994) to record the properties of putative taxa of procaryotes, should be implemented . This category should be used for describing procaryotic entities for which more than a mere sequence is available but for which characteristics required for description according to the International Code of Nomenclature of Bacteria are lacking . In addition to genomic information, such as sequences apt to determine the phylogenetic position of the organism, all information, including structural, metabolic, and reproductive features, should be included in the description of a provisional taxon, together with the natural environment in which the organism can be identified by in situ hybridization or other similar techniques for cell identification. Ther Umsch, 1995 Jan, 52(1), 75 - 81 {Infections of the hand}; Troeger H; The possibilities of hand injuries lead to the higher incidence of hand infections . The clinical signs of inflammation (pain, swelling, heat, loss of function and red colour) are found in near all cases . The start of pain and its localisation help to find quickly the layer of the inflammatory process . Bites, foreign bodies, puncture wounds and open wounds especially those acquired in slaughterhouse or agriculture are in most cases the predisposing conditions . Treatment of hand infections demands a consequent protocol consisting in: exact diagnostics including clinical picture, laboratory investigation, bacteriology and in some cases X-ray-examination; operative treatment including incision, irrigation, drainage, excision of necrosis and foreign bodies under the rules of hand surgery (i.g . blood--{without exsanguination} and painfree operation field, magnifying lenses, correct incision avoiding scar contractures); immobilisation (dressing or splinting) in intrinsic-plus-position while acute inflammation is going on, early movement combined with ergotherapy and physiotherapy after this . Use of antibiotics is indicated in septic cases or in cases of complications (sepsis, lymphangitis, osteomyelitis) in concordance with bacteriology but it cannot compensate mistakes in treatment . The most common infections are placed around and under nail (paronychia) and in the subcutaneous space of the distal phalanx (felon) . They are treated by incision and spontaneous drainage . More severe are infections of tendon sheath, joint, web space and deep palmar space . If pus is present in such cases there is no place for conservative treatment but operative treatment under clinical conditions is imperative. J Comput Assist Tomogr, 1995 Jan-Feb, 19(1), 52 - 5 Pulmonary nocardiosis: CT findings; Yoon HK et al.; OBJECTIVE: To evaluate CT findings of pulmonary nocardiosis in immunocompromised patients . MATERIALS ALND METHODS: Five patients with bacteriologically confirmed pulmonary nocardiosis were evaluated . Four patients were receiving corticosteroids with or without other immunosuppressive drugs for lupus nephritis (two patients), idiopathic thrombocytopenic purpura (one patient), and renal transplantation (one patient), and one patient had long-standing diabetes . Nocardia asteroides was isolated from blood culture, bronchial washing, pleuropulmonary aspirates, or open lung biopsy . Plain chest radiography and CT were performed on all patients, and follow-up CT was performed on one patient . RESULTS: On CT there were pleural effusion (four patients), air-space consolidation with internal low attenuation with or without cavities (four patients), multiple noncavitating pulmonary nodules and subpleural pulmonary nodules (three patients), and chest wall extension (three patients) . Follow-up CT after treatment showed marked improvement of the pleural and pulmonary lesions . CONCLUSION: In the immunocompromised and chronically debilitated host, pulmonary nocardiosis should be included in differential diagnosis if chest CT shows consolidation with low attenuation areas with or without cavitation, multiple pulmonary nodules, pleural effusion, and chest wall extension. J Nutr, 1995 Jan, 125(1), 92 - 8 Production of large amounts of {13C}leucine-enriched milk proteins by lactating cows; Boirie Y et al.; During protein metabolism kinetic studies, oral tracers are administered as labeled free amino acids and do not necessarily represent the metabolic fate of amino acids ingested as proteins . However, sufficient quantities of 13C-labeled proteins are not currently available . We here present a new methodology for producing large amounts of milk proteins intrinsically labeled with {13C}leucine . After surgical preparation, two lactating cows were infused with 80-90 g of L-{1-13C}leucine for 24-32 h, and milk was collected during and after the infusion . Casein and whey protein fractions were purified by membrane separation techniques . Arteriovenous balance across the udder indicated a very efficient extraction of leucine by the mammary gland . Five batches of pure casein and whey proteins, totaling 3854 g of protein of excellent bacteriological quality, were obtained . Two thirds of these proteins had {13C}leucine enrichments ranging from 10.5 to 19.4% ({13C}leucine atom percent excess) . The overall tracer recoveries were 22 and 27% (cows 1 and 2, respectively) . Thus, pure milk proteins were produced in large amounts with sufficient 13C enrichment to be used in human protein metabolism studies. Cancer Chemother Pharmacol, 1995, 35(3), 225 - 9 Treatment of advanced hormone-refractory prostate carcinoma with a combination of etoposide, pirarubicin and cisplatin; Naito S et al.; A total of 20 patients with hormone-refractory prostate carcinoma entered a pilot study of combination chemotherapy based on the EAP (etoposide, Adriamycin and cisplatin) regimen, in which Adriamycin was replaced by pirarubicin, a less cardiotoxic derivative of Adriamycin . The response was assessed by criteria modified from those of the National Prostatic Cancer Project: prostate-specific antigen was employed instead of acid phosphatase . Of 18 evaluable patients, 6 achieved a partial response, 5 had stable disease, and in 7 the disease had progressed during therapy; thus, the overall response rate was 33.3% {95% confidence interval (CI) 11.5-55.1%} . Significant pain alleviation and performance status improvement were obtained in 5 of 12 patients (41.7%; CI 13.8-69.6%) and 3 of 13 patients (23.1%; CI 0.2-46.0%), respectively . Although myelosuppression was moderate to severe, no chemotherapy-related deaths or bacteriologically documented sepsis occurred; nor was there any clinical cardiotoxicity . All the responding patients received maintenance chemotherapy with etoposide thereafter . At present, the median duration of response is 33 weeks (range: 23-91 weeks) and the median survival period for all patients is 42 weeks (range: 27(+)-136 weeks), with 12 deaths . In spite of the small number of patients treated, these results suggest that this chemotherapy regimen is active in advanced hormone-refractory prostate carcinoma. Arch Surg, 1995 Jan, 130(1), 20 - 3 Postoperative T-tube cholangiography: is routine antibiotic prophylaxis necessary? A prospective, controlled study; Sheen-Chen SM et al.; OBJECTIVE: To determine the value of antibiotic prophylaxis for the prevention of infection following postoperative T-tube cholangiography . DESIGN: A prospective, controlled study . SETTING: A tertiary care center . STUDY PARTICIPANTS: The role of antibiotic prophylaxis during postoperative T-tube cholangiography was prospectively evaluated in 164 patients . INTERVENTION: Sixty-two patients were administered antibiotic prophylaxis treatment (1 g of cephalothin sodium was infused intravenously 30 minutes before the procedure and 500 mg of cephalexin was given orally every 6 hours for 3 days after the procedure) . Seventy-one patients were in the control group and did not receive antibiotic therapy . MAIN OUTCOME MEASURES: Complications and adverse reactions following postoperative T-tube cholangiography were recorded and compared between the two groups . RESULTS: There was no significant difference between the groups in regard to age, sex, serum amylase level before T-tube cholangiography, white blood cell count, and liver function . The results of the bacteriologic culture specimens of the bile were also comparable between the groups . One patient who had received antibiotic therapy and one patient in the control group had fever (temperature, > 38 degrees C) and chills after the procedure . Two patients who had received antibiotic therapy and one patient in the control group had mild abdominal pain . These complications were treated conservatively without any event . No significant difference was found in the rates of complications and the success of postoperative T-tube cholangiography between the groups . CONCLUSION: Routine antibiotic prophylaxis for the prevention of infection following postoperative T-tube cholangiography is not necessary under selected conditions. Bull Soc Pathol Exot, 1995, 88(1), 7 - 10 {Extra-pulmonary tuberculosis and dissemination in patients infected by the human immunodeficiency virus in Bujumbura (Burundi)}; Fagard C et al.; Scattered and extra pulmonary tuberculosis patients coinfected with HIV represent in Bujumbura (Burundi) more than 56% of tuberculosis cases . The high prevalence of these forms could be explained partly by the hospital recruitment, therefore by patients already strongly immunocompromised . Performing further examinations as abdominal echography, ganglionic biopsy (or firstly a puncture sucking procedure) permit to reveal multifocal affections . These examinations provide valuable diagnostic arguments specially among the negative bacteriological forms. Stomatologiia (Mosk), 1995, 74(1), 38 - 40 {The use of immunoenzyme analysis for the diagnosis of an anaerobic infection of the maxillofacial area}; Tsarev VN et al.; Solid-phase EIA was used to titer antibodies to polysaccharide and ultrasonic disintegrate antigens of the most incident agents of anaerobic infections of the maxillofacial area . Comparison of the results of EIA with polysaccharide antigens of B.melaninogenicus, B.asaccharolyticus, F.nucleatum, P.intermedius, and Str.sanguis and the results of bacteriological detection of these bacteria in a closed pyoinflammatory focus in 283 patients with maxillofacial abscesses and phlegmons brought the authors to a conclusion that the suggested EIA technique may be used to prove the contribution of these bacteria to the development of an inflammatory process in a patient . Data are presented on the frequency of detection of a diagnostically significant level of antibodies in patients with positive results of bacteriological investigation. Ter Arkh, 1995, 67(3), 7 - 11 {Rovamycin (spiramycin)--a macrolide antibiotic for intravenous administration: a trial in the treatment of pneumonia}; Strachunskii LS et al.; An open non-comparative study of rovamycin (spiramycin produced by Rhone-Poulenc Rorer) for intravenous administration was performed to evaluate its clinical and bacteriological efficacy, safety and tolerance . Thirty patients (adults aged 16-65 years) with community-acquired pneumonia were involved into the study . Two patients were dropped out because of adverse events . Dosage regimen was 1,500,000 I.U . three times a day (intravenous infusion) . The treatment was continued after partial recovery (3,000,000 I.U . per os) . Spiramycin showed a high clinical efficacy . Approximately half of the patients (41.4-55.6%) had positive clinical trends by third day of spiramycin treatment . The overall clinical efficacy by the completion of the drug administration reached 90.0% . Bacteriological activity was observed in 93.4% of the patients treated . Adverse events were observed in 6 (20.0%) patients, including 2 dropouts . Serious side effects were not registered . As rovamycin showed high clinical efficacy and good safety the drug may be recommended for the treatment of adult pneumonia. Wien Klin Wochenschr, 1995, 107(7), 219 - 24 {Coexistence of infection of the oral cavity and stomach and duodenal mucosa with Helicobacter pylori in patients with ulcer and chronic gastritis}; Kopaanski Z et al.; In a group of 260 patients with a peptic ulcer of the stomach or the duodenum and/or chronic gastritis, bacteriological tests were conducted aiming at the detection of Helicobacter pylori in the mucosa of the stomach and the duodenum and in the gingival pockets . The presence of the infection of the mucosa of the stomach and/or of the duodenum was confirmed in 197 patients (75.8%) . In this group of patients the bacteria occurred simultaneously in the oral cavity in 77 (39.1%) patients . It was found that the frequency of coexistence of Helicobacter pylori infection in the gingival pockets with an infected gastric or duodenal ulcer was not statistically significant . However, there was a statistically significant correlation between the frequency of Helicobacter pylori infection in the oral cavity (83.3%) and the simultaneous occurrence of extensive infection of the gastric mucosa. J Infect, 1995 Jan, 30(1), 37 - 40 Factors determining ethnic differences in the incidence of bacteriologically confirmed genitourinary tuberculosis in south east England; Grange JM et al.; In South East England, genitourinary (GU) tuberculosis is a much less common manifestation of non-respiratory tuberculosis in patients of Indian subcontinent (ISC) ethnic origin than in those of European ethnic origin . When considered in relation to all bacteriologically confirmed cases of tuberculosis, both respiratory and non-respiratory, the ethnic difference in the occurrence of GU tuberculosis is much less evident, while there is a highly significant excess of other forms of non-respiratory tuberculosis among the ethnic ISC patients . Unlike other forms of non-respiratory tuberculosis, GU disease tends to occur in an older age range in the ethnic ISC population and, when stratified for age, the ethnic difference in the occurrence of this form of tuberculosis is not significant while that of lymph node tuberculosis remains significantly high . Thus, after elimination of the confounding factor of age, the occurrence of GU tuberculosis is very similar in the two ethnic groups while other forms of non-respiratory tuberculosis differ considerably. Acta Otorrinolaringol Esp, 1995 Jan-Feb, 46(1), 15 - 8 {Efficacy of topical ciprofloxacin in the treatment of chronic otorrhea}; Povedano Rodriguez V et al.; The aim of the present study was to assess the clinical and bacteriological efficacy of ciprofloxacin in the treatment of chronic otitis media . Ciprofloxacin was randomly administered for ten days to two groups of patients . Group A was given 500 mg . orally twice a day . Group B received drops of ciprofloxacin in saline solution locally twice a day . We obtained a favorable clinical and bacteriological response . Bacteriological response observed in group B was statistically higher than that of group A (p < 0.01) . Results obtained in this study suggest that ciprofloxacin locally administered is very effective in the treatment of chronic otitis media. Vestn Otorinolaringol, 1995 Jan-Feb, (1), 12 - 4 {Suppurative otitis media, bacteriologic study and therapeutic management}; Sako B; The patients of the ENT clinic at the Gabriel Ture hospital (Bomako, Mali) suffering from otitis media purulenta (96 patients under 70) were examined for pathogenetic agents in their purulent exudate . The infection was found in 96.9% of the samples . Monoflora dominated in 74%, mixed flora in 26% of the examinees . The patients received antibiotics . The antibioticograms proved high effectiveness of gentamycin, colistin, sisomicin and cefatoxin in the treatment of acute and chronic otitis media purulenta. Adv Pediatr Infect Dis, 1995, 10, 1 - 39 Atypical pneumonias in children; Hammerschlag MR; The major agents responsible for atypical pneumonia in children include a wide variety of organisms, one Mycoplasma species, two Chlamydia species, a rickettsia, and one fastidious bacterium . Mycoplasma pneumoniae and C . pneumoniae together may be responsible for over 40% of these infections . Recognition of the role that these agents play in pneumonia is important since many of the diagnostic methods used to detect these organisms are not available in most hospital microbiology laboratories . If you don't look, you won't find . Epidemiologic factors can provide valuable clues, especially with the less frequently encountered infections, since it is almost impossible to make a clinical diagnosis on which to base treatment . A reliable history of avian exposure should suggest psittacosis, exposure to sheep or pregnant cats suggests Q fever, and children with underlying malignancy or immunodeficiency or those receiving systemic steroids may have legionnaires' disease . None of these organisms are susceptible to beta-lactam antibiotics . Sometimes the diagnosis is not considered until after the child has failed to respond to a penicillin or a cephalosporin and routine bacteriology is negative . In view of the role played by M . pneumoniae and C . pneumoniae, a macrolide may be the first-line antibiotic for atypical pneumonia in children. Vet Med (Praha), 1995, 40(1), 7 - 10 {Association between BoLA antigens and bovine mastitis}; Simon M et al.; The association between BoLA class I antigens and mastitis was studied in Bohemian Pied breed (n = 17) and its crosses--Bohemian Pied x Red Pied Holstein (n = 161), Bohemian Pied x Red Pied Holstein x Ayrshire (37) . The diagnostics of mastitis was followed in the course of two years and two diagnostic parameters were included: 1 . a modified California Mastitis Test (CMT) was performed once a month; 2 . a bacteriological infection was examined once quarterly using biochemical and serological methods . BoLA class I antigens were determined by specific antisera in the standard microlymphocytotoxicity test . During testing the majority of cows had at least one positive reaction of CMT test . The bacterial findings were detected in 31.63% of animals . The antigen A16 was found to be significantly associated with susceptibility to mastitis in both diagnostic tests . Animals A16 positive showed the highest CMT values and repeated bacterial infections (Fig . 1) . The high values observed in A2 positive animals were not significant due to the very low frequency of this allele in the population under study . There was a slight increase of CMT values and the infection frequency in animals with higher parity number (Fig . 2) . However, the order of lactations did not influence the relationship of BoLA A16 and mastitis . This association was not significantly affected by the breed . The increased bacterial infection observed in the Bohemian Pied breed is likely due to relatively high incidence of A16 allele rather than to breed differences (Fig . 3). Pediatr Infect Dis J, 1995 Jan, 14(1), 51 - 5 Pediatric lung abscess: clinical management and outcome; Tan TQ et al.; Pulmonary abscess is an infrequent but significant problem in children . We retrospectively reviewed the charts of 45 children with documented lung abscesses admitted and treated at Texas Children's Hospital, Houston, over the 11-year period from January, 1982, to December, 1993, and report their presenting symptoms, bacteriology, clinical management and outcome. Immunol Invest, 1995 Jan-Feb, 24(1-2), 163 - 70 Bacterial contamination of blood products and the value of pre-transfusion testing; Blajchman MA; There has been a dramatic increase recently in the number of reports of septic episodes associated with both red cell and platelet concentrate transfusions . These reports suggest that transfusion-associated septic reactions may occur as often as 1 per 4000 platelet transfusions, however, the true incidence of the bacterial contamination of stored cellular blood components has not yet been established . Recently developed automated techniques for the detection of bacteria are much more rapid than direct plating techniques . Such rapid techniques can be used to monitor the sterility of cellular blood products with greater sensitivity than Gram staining; using a small aliquot of the blood product taken soon after collection . Using such equipment, the incidence of bacterial contamination of 15,838 random donor platelet concentrates collected over a six-month period was determined and evidence of bacterial contamination was found in 32 . Seven were classified as confirmed, 10 as unconfirmed and 12 as non-confirmed positives . The confirmed positivity rate was thus 4.4 per 10,000 . This rate represents the minimum incidence of bacterial contamination of platelet concentrates and the true rate is likely higher, as some of the unconfirmed positives are likely to have been found to be positives, had the original platelet concentrate been available for culture . The true positive rate is therefore estimated to be between 4.4 and 10.7 per 10,000 . Given this rate of bacterial contamination, it is our contention that all platelet concentrate units be monitored for bacteriologic sterility prior to their issue.(ABSTRACT TRUNCATED AT 250 WORDS) Vet Res, 1995, 26(1), 11 - 20 {Genital Ureaplasma diversum infection: investigations in cattle in France}; Le Grand D et al.; A first bacteriological study of infection by Ureaplasma diversum in cattle was performed in France on 50 bulls and 565 dairy cows . U diversum was isolated in 74% (37/50) of the bull semen and 40% (227/565) of the cows . No significant relationship was found in cows between infection and lesions of granular vulvitis, nor between infection and breeding performances . Serological studies of isolates by membrane filtration dot immunobinding showed a predominance of the serogroups B and C in males, and serogroup B in females. Can J Vet Res, 1995 Jan, 59(1), 20 - 5 Importance of Escherichia coli in young beef calves from northwestern Quebec; Ganaba R et al.; The objectives of this study were: (i) to investigate the prevalence of Escherichia coli producing F5 (K99), F41, or F165 fimbriae and STa enterotoxin; (ii) to determine serum antibody levels against these fimbriae; (iii) and to examine the association between bacteriological and serological results and the presence of diarrhea, in beef calves from northwestern Quebec . A total of 373 live three to four week old calves and 27 dead calves were sampled between January and March 1991 . No isolates positive for F5 were detected in live calves, and only one E . coli producing STa and F41 was isolated . Escherichia coli producing F41-like surface antigens or F165 fimbriae were isolated from 17.43% and 5.63% of live calves, respectively . Antibodies against F5, F41 and F165 were low . Escherichia coli isolates positive for F41-like surface antigen were most often observed in calves born between January and March . No association was found between bacteriological and serological findings, nor between these findings and diarrhea . Calves born from dams vaccinated against E . coli had higher median antibody levels than those born from unvaccinated dams . No E . coli positive for F5 or F41 fimbriae were isolated from dead calves . Escherichia coli with F41-like surface antigen or F165 were found in 55.56% and 11.11% of ileal samples; 4% and 16% of cecal samples, and 0% and 7.4% of colon samples, respectively . Escherichia coli positive for F41-like surface antigen were detected significantly more frequently in the ileum (chi (2)2df = 31.01, p < 0.001). Nephrologie, 1995, 16(1), 37 - 44 {Connectology for treatment by peritoneal dialysis for chronic renal insufficiency}; Durand PY et al.; With the exception of the simple Luer or Spike type systems all of the presently used CAPD devices have a system for intraluminal sterilization and/or an handling assist device . The sterilizing process can be chemical (antiseptics), physical (heat or ultraviolet (UV) light) or mechanical (flush effect) . Studies comparing various peritoneal dialysis devices have led to results which diverge greatly, and are not always controlled . Synthesis of these studies shown that disconnect systems (DS) seemed to be not more effective against bacteriological contamination than the last generations of UV non-disconnect (NDS) systems . Efficacy of heat sterilization NDS must be confirmed . The choice of a NDS does not result only from a medical indication. Pneumonol Alergol Pol, 1995, 63(1-2), 27 - 31 {The role of bronchoscopy and bronchoalveolar lavage in diagnosis of pulmonary tuberculosis in AIDS}; Zajaczkowska J et al.; Bronchoscopy was carried out in 32 HIV seropositive patients, most with AIDS during the period between January 1992 and August 1993 . In 14 patients tuberculosis was diagnosed, in 13 it was bacteriologically confirmed . The mean age of the examined patients was 35.5 years (range 22-49 years) . In 50% of the BAL samples bacterioscopy was positive . Bacteriological examination of the sputum and BAL fluid (bacterioscopy and culture) produced a confirmation of tuberculosis in 99.9% of the cases. Pneumonol Alergol Pol, 1995, 63(1-2), 21 - 6 {Characterization of patients with treatment failure in the Central Tuberculosis Registry}; Miller M et al.; An analysis was carried out in order to explain the reason of treatment failure in patients with bacteriology confirmed active tuberculosis registered in the Central Tuberculosis Register in the years 1988-1991 . The population of patients is whom failure of treatment was observed is older compared with the population of patients in whom the treatment did not fail . The regimens in both groups were similar although the duration of the regimens was shorter in the group in whom tuberculosis was not eradicated (less than 3 months or the treatment duration could not be established) . In the chronic sputum positive patients severer cases of tuberculosis were observed more often . Tuberculosis coexistent with other diseases was seen twice more often . The result of therapy in patients with bacteriologically confirmed tuberculosis can be effected by coexistency of tuberculosis and alcoholism. Acta Leprol, 1995, 9(3), 127 - 31 {The frequency of the appearance of perforating foot ulcers in patients with Hansen's disease as a function of treatment with disulone alone or with polychemotherapy}; Mane I et al.; Between 1986 and 1989, in 5 departments of Senegal, 436 new cases of leprosy were detected, of whom 225 were put under dapsone monotherapy and 211 under multidrug therapy (MDT) . Of them, 190 could be followed-up during 2 years by means of annual bacteriological and clinical examination, including neurological assessment . In 2 years, the onset of 10 (5.3%) chronic plantar ulcers (CPU) was observed: 4 (4%) among the 99 patients under dapsone monotherapy and 6 (6.6%) among the 91 under MDT (no significant difference) . Of the 10 CPU, 3 (2%) appeared among the 149 patients without any disability at detection while 7 (17%) were observed among the 41 others who presented a grade 1 disability at detection (p < 0.01) . Of the 6 CPU appeared in the patients under MDT, 5 (22%) were observed among the 23 who presented a grade 1 disability at detection and 1 (1.5%) among the 68 who did not (p < 0.01) . This difference was not noted in the patients under dapsone monotherapy . Our results need to be confirmed by other studies including a higher number of patients followed-up during a longer period of time . Nevertheless, they suggest that MDT could prevent the onset of CPU, but only in patients without any disability at detection . Therefore, they reemphasize the importance of early detection of the disease in leprosy control programmes. Pediatr Pol, 1995 Jan, 70(1), 59 - 65 {Evaluation of treatment efficacy in gastritis and duodenitis in children with Helicobacter pylori infection}; Ignys I et al.; The efficacy of Ventrisol treatment in gastritis and duodenitis in children infected with Helicobacter pylori was evaluated . Eighty-six children aged 3 to 18 years with chronic abdominal pain were examined . All children underwent gastrofiberoscopic examination . H . pylori infection was diagnosed on the bases of two of three diagnostic tests (urease, bacteriological, histological) . H . pylori was detected in 50 children (56.4%) . After a 4 week course of Ventrisol treatment, H . pylori eradication was obtained in 41 children (82%) . Twenty-one children (42%) were completely cured, whereas in 20 children (40%) elimination of HP was observed although macroscopic and histological inflammatory changes were still present . The drug was well tolerated by 92.5% of children and its accumulation was not observed. Indian J Lepr, 1995 Jan-Mar, 67(1), 45 - 59 Clinical features and diagnosis of relapses in leprosy; Ramu G; 1 . The definition of relapse as "occurrence of new signs and symptoms of the disease during the period of surveillance or thereafter in a patient who successfully completes an adequate course of multidrug therapy" accommodates the current policy of releasing patients even when there are clinical and bacteriological signs of activity after fixed duration treatment . 2 . The predisposing cause of relapse in the persistence of live M . leprae in various tissues in MB leprosy and in the nerve in PB leprosy . 3 . The precipitating causes of relapse include (a) inadequate therapy due to miscategorization of MB cases as PB when there are solitary or few MB lesions since skin smear examinations for AFB are not routinely done in PB cases . (b) Previously sulphone treated LL cases inactive for more than two years are not included for MDT . Relapses commonly seen in NLEP units are in such cases . (c) Multiple skin and nerve lesions in PB leprosy . (d) Pregnancy and lactation . (e) Mental depression which downgrades immunity . (f) HIV infection . 4 . There may be a change in type on relapsing, PB cases relapsing as MB and MB cases relapsing as PB . 5 . Criteria for diagnosis of relapse are: increase in the extent of lesions, infiltration and erythema, fresh skin and nerve lesions, positive skin smears for AFB in previously negative cases; and in bacteriologically positive cases during surveillance, an increase in BI by two logs at any site over the previous BI in two successive examinations . 6 . Relapses are but too often diagnosed as reversal reactions inspite of the absence of symptoms and signs of acute inflammation to the detriment of patients; a course of steroid therapy which is administered to these patients on the diagnosis of reversal reaction does not halt the progress of the disease especially in the nerve, resulting in disability. J Gynecol Obstet Biol Reprod (Paris), 1995, 24(3), 253 - 9 {Comparative study of ofloxacin+amoxicillin-clavulanic acid versus doxycycline+amoxicillin-clavulanic acid combination in the treatment of pelvic Chlamydia trachomatis infections}; Judlin P et al.; OBJECTIVE . To evaluate the efficacy and safety of ofloxacin+coamoxiclav versus doxycycline-coamoxiclav in the treatment of chlamydial pelvic infections . DESIGN . An open, comparative, randomised, monocentric study . SUBJECTS . A hundred and eighteen patients (85 endometritis and 33 salpingitis) were included . Clinical, laparoscopic and bacteriological assessments were performed before treatment . 30.4% of salpingitis were considered as severe (COGIT score > 6) . 25.4% of acute pelvic infections were only caused by Chlamydia trachomatis . TREATMENT . A hundred and eighteen patients were treated orally with 3 week combination ofloxacin (200 mg b.i.d.) + coamoxiclav (1 g b.i.d.) (n = 60) or with a 6 week coamoxiclav (1 g b.i.d.) + doxycycline (100 mg b.i.d.) (n = 58) . RESULTS . Oral combination ofloxacin-coamoxiclav is as effective as oral combination doxycycline+coamoxyclav with respectively 96.7% versus 96.6% and 100% versus 98.4% satisfactory clinical et bacteriological results. J Gastroenterol Hepatol, 1995 Jan-Feb, 10(1), 47 - 50 Survival after a first episode of spontaneous bacterial peritonitis . Prognosis of potential candidates for orthotopic liver transplantation; Altman C et al.; To determine the potential role of orthotopic liver transplantation (OLT) in cirrhotic patients surviving a first episode of spontaneous bacterial peritonitis (SBP), medical records of 79 patients presenting with a first episode of SBP were reviewed . Of these patients, 37 were selected as potential candidates for OLT using the following criteria: absence of hepatocellular carcinoma; no severe organ failure other than the liver; age < or = 66 years; and survival after SBP > 60 days . Survival time was calculated from the day of SBP diagnosis . Prognostic value of clinical, biological and bacteriological data recorded at the time of SBP was determined using univariate and multivariate analysis (Cox's regression model) . Survival rate of the potential candidates for OLT at 3 months, 1 year and 2 years was 94, 46 and 30% respectively . Serum creatinine value (P = 0.001) and Pugh score (P = 0.005) were independently correlated with death . The 1 year survival rate was 80% for the 11 patients with a Pugh score < 10, and 26% for the 26 patients with a Pugh score > or = 10 . Our results suggest that after SBP, OLT should be considered in patients with severe liver disease . Survival of patients with a moderate liver disease (i.e . Pugh score < 10) might be relatively high. Klin Med (Mosk), 1995, 73(2), 45 - 8 {Spiramycin (rovamycin), a macrolide antibiotic for oral treatment of outpatient pneumonia}; Strachunskii LS et al.; Spiramycin activity against acute pneumonia has been studied in 21 outpatients (15 adults and 6 children) . The drug was administered orally twice daily in a dose 3,000,000 units . The course lasted from 7 to 14 days . All the cases were confirmed roentgenologically . The disease ran a moderate-severity course . The response rate reached 95.2% . Another course of antibiotic therapy was not needed . Side effects were not registered . Bacteriological efficacy of spiramycin made up 71.3% . 14 out of 16 isolated strains of causative agents (S.pneumoniae, S.pyogenes, S.aureus, H.influenzae in 5, 1, 7 and 3 patients, respectively) proved sensitive to spiramycin . 2 patients developed mycoplasma infection diagnosed serologically . The findings confirm high therapeutic efficacy of spiramycin, its good tolerance . Spiramycin may be considered the drug of the priority choice in outpatient treatment of acute pneumonia. Antibiot Khimioter, 1995 Jan, 40(1), 41 - 4 {Effectiveness of cefmetazole in the treatment of puerperal pyo-septic diseases}; Zharov EV et al.; An open non-comparative clinical trial of cefmetazole in the treatment of 40 females with postnatal purulent septic diseases was performed . Excellent and good clinical efficacy of cefmetazole was observed in 100 per cent of the cases . The bacteriological efficacy also equaled 100 per cent . No severe side effects of cefmetazole were recorded . The use of cefmetazole was shown to be advisable in the treatment of postnatal purulent septic diseases. Antibiot Khimioter, 1995 Jan, 40(1), 31 - 6 {Effectiveness of cefmetazole in treatment of lower respiratory tract infections}; Strachunskii LS et al.; The efficacy of cefmetazole was studied in an open non-comparative clinical trial comprising 40 patients with infections of the lower respiratory tracts . The clinical efficacy of cefmetazole was excellent and good in 85 per cent of the cases . The bacteriological efficacy amounted to 75 per cent . Adverse reaction due to the treatment with cefmetazole in 6 patients (15 per cent) were recorded . The adverse reactions were not severe, did not require any special treatment or prolongation of the hospitalization term . The use of cefmetazole in the treatment of infections of the lower respiratory tracts was shown to be advisable. Antibiot Khimioter, 1995 Jan, 40(1), 27 - 30 {Effectiveness of cefmetazole in treatment of wound infection}; Eropkina AG et al.; The cefmetazole efficacy was studied in an open non-comparative clinical trial in the treatment of 40 patients with wound infections . The clinical results were excellent and good in 90 per cent of the cases . In 2.5 per cent of the cases the treatment failed . In 7.5 per cent of the cases the results could not be evaluated . The bacteriological efficacy of cefmetazole was equal to 80 per cent . The drug tolerance was good and only in 3 patients allergic reactions were observed . No hepatotoxic or nephrotoxic effects were recorded . The results were indicative of the advisability of the cefmetazole use in the treatment of wound infections. Pathology, 1995 Jan, 27(1), 58 - 60 Mycoplasma hominis pneumonia in aboriginal adults; Norton R et al.; Mycoplasma hominis (M . hominis) is a well recognized extragenital pathogen . Its role as a pathogen of the respiratory tract, however, remains difficult to determine . Four cases of pneumonia are presented in which M . hominis was isolated from blood, tracheal aspirates or post-mortem lung tissue . All 4 of these isolates were in young Aboriginal adult males . M . hominis is the least fastidious of the human mycoplasmas and grows well on most blood-containing bacteriological media . The recognition and identification of M . hominis is important as it is commonly resistant to erythromycin which would be the drug of choice in most atypical pneumonias . Early recognition and treatment with tetracycline instead may influence outcome. Arch Orthop Trauma Surg, 1995, 114(5), 298 - 301 Reactivation of a tuberculous coxitis due to loosening of a total hip endoprosthesis; Fink B et al.; A 45-year-old woman who suffered from juvenile tuberculous coxitis at the age of 4 is presented . Her hip joint replacement lasted for 18 years and then needed replacing . Intraoperatively removed caseous soft tissue and an opalescent secretion histologically resembled a tuberculous focus, and bacteriological culture grew a Mycobacterium tuberculosis strain . Four months after the replacement, the patient suffered from a tuberculosis-induced septic loosening of the newly replaced hip joint endoprosthesis . The tuberculosis relapse was probably due to aseptic loosening of the first hip joint endoprosthesis. Schweiz Arch Tierheilkd, 1995, 137(7), 297 - 305 {Preliminary results using a combined xylose absorption/hydrogen exhalation test in horses}; Bracher V et al.; In the present study the breath hydrogen (H2) excretion test was combined with the xylose absorption test in 4 normal horses and 9 clinical patients with chronic diarrhea (n = 3) or chronic weight loss without diarrhea (n = 6) . All horses underwent a thorough clinical examination . Laboratory evaluations consisted of haematology and serum biochemistry as well as bacteriological and parasitological examination of feces . In addition, serum electrophoresis and abdominocentesis was performed in all the clinical patients . Gastroscopy was carried out in 6 patients and rectal biopsies were obtained from 4 animals . Two animals were euthanized within 4 weeks after the evaluation . The diagnosis of chronic granulomatous enteritis was confirmed in one of them at necropsy, the cause of weight loss in the other remained unexplained . In the remaining animals, specific causes such as management, parasites, chronic infections and diseases of liver, kidneys and heart were excluded, but no specific diagnosis could be obtained . For the combined xylose absorption/H2 excretion test, the animals were starved overnight and given 0.5/kg/bwt xylose as a 10% solution by stomach tube the next morning . Blood samples were collected for plasma xylose analysis at 30 min intervals for 4 hrs, and breath samples were also collected at 30 min intervals for 8 hrs . With the exception of the animal with granulomatous enteritis, the diseased horses showed only slight alterations in either peak concentrations or times to reach peak levels of plasma xylose . None of the healthy animals showed an increase in breath H2 production after xylose administration, whereas five of the diseased animals showed distinct increases of variable heights . In addition, the diseased horses showed higher fasting breath H2 levels (range 7.5-61.5 ppm) than normal horses (range 0-5 ppm) . It is concluded that gastrointestinal disorders might be influenced or even induced by a change in intestinal microbial composition, as evidenced by an increased hydrogenic metabolism. Rev Pneumol Clin, 1995, 51(3), 115 - 21 {Mucoviscidosis: comparative analysis of epidemiological data of French and North American registries}; Rault G et al.; A national registry for cystic fibrosis was established in France in 1993 . A questionnaire is sent once a year to different health care units . The first questionnaire was analyzed in 1992: 1,893 patients (53% males) were identified . 28% were over 15 years of age, 13% more than 20, and 1% over 35 . Usually, diagnosis had been suggested by respiratory signs, followed by digestive tract signs and growth impairment and meconial ileus . 13% were diagnosed in screening programmes . Diagnosis was made before 1 year in 66% of the subjects (mean = 7 months) . All the data collected and the functional and bacteriologic data were compared with those observed in the United States and Canada . It should also be noted that 38 patients were grafted during this study year and that it is too early to analyze the general outcome for all subjects . The creation of this registry is an important step towards a better understanding of the epidemiology of cystic fibrosis in the French population. Rev Laryngol Otol Rhinol (Bord), 1995, 116(3), 187 - 9 {Bacteriology of maxillary sinusitis among members of the 11th parachutist unit}; Wery G et al.; When sinusoscopic examinations of chronic maxillary are made, bacteriological samples are the most often carried out . We report results of thirty one cases among young soldiers 19 to 23 years old . Our bacteriological results are similar to those reported in literature . A bibliographic study reminds the recent bacteriological findings according to countries or type of patients where pathogen germs were researched. Probl Tuberk, 1995, (5), 8 - 11 {Tuberculous osteitis in infants}; Mushkin AIu et al.; Clinical and diagnostic aspects, surgical outcomes, bacteriological findings were investigated for 72 infants under 3 years old operated for tuberculous ostitis . Tuberculin and seroimmunodiagnosis revealed infection allergy in 1/3 of the cases . The treatment comprises radical surgical reconstruction, drug and functional therapy . Tuberculous ostitis may arise due to vaccinal strain of M . tuberculosis. Probl Tuberk, 1995, (5), 39 - 41 {Characteristics of nephrotuberculosis in children, adolescents and young persons}; Iagafarova RK; According to the author, urogenital tuberculosis in children and young subjects occurs in 10% of all the cases with this disease . Antituberculosis service registers 71.2% of cases in preschool children, whereas in schoolchildren 70.4% of diagnoses are made by general practitioners . 90% of nephrotuberculosis cases are detected early, in 85% bacteriological examination. Int Orthop, 1995, 19(3), 151 - 6 {Replacement of infected total hip prosthesis in two stages}; Lenoble E et al.; Since 1975 we have treated 36 infected hip replacements by a two stage procedure in which the prosthesis and cement were first removed . Gentamicin impregnated beads were left at the sites of the prosthesis . Not less than 45 days later a fresh prosthesis was inserted into the hip . In two hips revision was not undertaken because of persistence of infection . The remaining 34 hips received a fresh prosthesis when the site was bacteriologically sterile . Gentamicin impregnated cement was used and antibiotics were given for a further three months . The functional results were satisfactory at an average of five years of follow up . Incomplete removal of methylmethacrylate was a factor in the persistence of infection and of pain in the absence of infection . The bacteriological efficacy of Gentamicin impregnated beads is uncertain, but their use gave a better functional result. An Otorrinolaringol Ibero Am, 1995, 22(5), 521 - 33 {Multicenter study comparing the efficacy and tolerance of topical ciprofloxacin (0.3%) versus topical gentamicin (0.3%) in the treatment of simple, non-cholesteatomaous chronic otitis media in the suppurative phase}; Lorente J et al.; A multicentre double-blind randomized study was carried out to compare topical ciprofloxacin and topical gentamicin in the treatment of simple non-cholesteatomatous purulent chronic otitis media . Three hundred and eight patients were included in the study, 159 treated with ciprofloxacin and 149 treated with gentamicin . The percentage of clinical success (elimination of otorrhoea) was 95% with ciprofloxacin and 94% with gentamicin (ns) . Likewise, the percentage of bacteriological erradication was 96% with ciprofloxacin and 93% with gentamicin . Both drugs were well tolerated, without changes in the audiometric values . In these patients, topical ciprofloxacin shows the same efficacy as topical gentamicin without any potential ototoxic effect. Schweiz Arch Tierheilkd, 1995, 137(6), 272 - 8 Suppurative pleuropneumonia and a pulmonary abscess in a ram: ultrasonographic and radiographic findings; Braun U et al.; This report describes a two-year-old White Alpine ram with suppurative pleuropneumonia and a lung abscess . Prior to admission, the ram had been unsuccessfully treated with antibiotics and levamisole . Clinical examination revealed that the general behaviour and condition of the ram were severely disturbed . The rectal temperature and respiratory rate were increased . Auscultation of the lungs revealed increased vesicular sounds . Based on clinical findings, a tentative diagnosis of bronchopneumonia was made . To confirm the diagnosis, blood was taken for serological testing for Maedi-Visna, and endoscopic examination of the respiratory tract and ultrasonographic and radiographic examination of the thorax were performed . Cytologic and bacteriologic examination of tracheal secretions revealed large numbers of neutrophils and Actinomyces pyogenes organisms . A pocket of gas, surrounded by a capsule of soft tissue density, overlying the base of the heart, and a horizontal fluid line were observed on radiographs . Ultrasonographic examination revealed an effusion between the pleura and the lung on the left side of the thorax; an encapsulated abscess was seen on the right side of the thorax . Centesis and aspiration of this accumulation of fluid yielded foul-smelling pus . Post mortem examination confirmed the clinical, radiographic and ultrasonographic findings . The ram had severe chronic suppurative pleuropneumonia with abscess formation between the pleura and lung on the right side. Adv Ther, 1995 Jan-Feb, 12(1), 62 - 71 Ampicillin/sulbactam compared with cefotaxime in the treatment of lower respiratory tract infections of bacterial etiology; Jauregui L et al.; This was a randomized, prospective, parallel study of the efficacy and safety of ampicillin/sulbactam (2 g/1 g) and cefotaxime (2 g), administered intravenously every 6 hours, in 53 hospitalized patients with lower respiratory tract infections . Thirty-four of the 36 patients treated with ampicillin/sulbactam and 16 of the 17 patients treated with cefotaxime were evaluable . Clinical and bacteriologic effectiveness did not differ significantly between the two groups (P = .828, P = .648, respectively) . Of the ampicillin/sulbactam-treated patients, 21 (61.8%) were cured, 8 (23.5%) were improved, and 4 (11.8%) were treatment failures . In the cefotaxime group, 9 patients (56.3%) were cured, 4 (25%) were improved, and 2 (12.5%) were treatment failures . All primary pathogens were eradicated in 19 (55.9%) ampicillin/sulbactam-treated patients and partially eradicated in 7 (20.6%); in cefotaxime-treated patients, all primary pathogens were eradicated in 10 (62.5%) patients and partially eradicated in 2 (12.5%) . Both study drugs were well tolerated, with the overall incidence of adverse events similarly low in the two groups. Adv Ther, 1995 Jan-Feb, 12(1), 1 - 10 Cefadroxil in skin and skin-structure foot infections: a retrospective review; Yu GV et al.; The efficacy and safety of cefadroxil in eradicating localized skin and skin-structure infections of the foot were investigated in a retrospective chart review of 222 consecutive patients from two private practices seen over a 10-year period . Of the 189 patients for whom follow-up data were available, 187 (99%) received cefadroxil 500 mg twice daily, and 2 patients (1%) received 250 mg twice daily . The duration of therapy was 2 weeks or less in 87% of patients, with a median duration of therapy of 11.4 days (range, 5 to 35 days) . Of the 189 clinically evaluable patients, 179 (95%) achieved a favorable clinical response to treatment; of the 57 patients with microbiologic cultures, 54 (95%) experienced a satisfactory bacteriologic response to therapy; no adverse events related to cefadroxil therapy were identified during the review . The overall results from this retrospective study suggest that cefadroxil is an effective agent with a favorable safety profile for the treatment of skin and skin-structure infections of the foot. J Hosp Infect, 1994 Dec, 28(4), 305 - 13 A hospital study of ice-making machines: their bacteriology, design, usage and upkeep; Burnett IA et al.; Ice-making machines have occasionally been implicated in nosocomial infection . We have examined the ice-making machines in our hospital both bacteriologically and for their general state of cleanliness and repair . Results were variable but, in most cases few organisms of significance were found . Some design features are considered and recommendations for the purchase, maintenance, cleaning and use of these machines are included. Neurosurgery, 1994 Dec, 35(6), 1144 - 9 Idiopathic chronic hypertrophic craniocervical pachymeningitis: case report; Botella C et al.; A 55-year-old woman with a unique form of chronic hypertrophic pachymeningitis involving the posterior fossa and upper cervical spine is reported . Unlike other cases previously described, the clinical picture was dominated by signs of increased intracranial pressure, lower cranial nerve disorders, and a progressive cervical radiculomyelopathy . The diagnosis was made by means of a contrast-enhanced magnetic resonance imaging scan and confirmed by histological examination of the excised dura . Surgical treatment with removal of the hypertrophic dura provided temporary relief, although the natural history of the disease was not modified . Exhaustive bacteriological and histopathological studies failed to identify a specific cause for this diffuse hypertrophy of the cranial and cervical dura . The literature is reviewed, and other histologically documented cases are discussed. J Clin Microbiol, 1994 Dec, 32(12), 3018 - 25 Restriction fragment length polymorphism Mycobacterium tuberculosis strains isolated from Greenland during 1992: evidence of tuberculosis transmission between Greenland and Denmark; Yang ZH et al.; In order to describe the transmission of tuberculosis (TB) at the clonal level in a defined geographic region during a certain period of time, all isolates of Mycobacterium tuberculosis collected during 1992 from Greenland were subjected to analyses of DNA restriction fragment length polymorphism (RFLP) . The RFLP patterns obtained by probing the genomic DNA with the repetitive insertion segment IS6110 revealed a high degree of similarity among the isolates, indicating a relatively high transmission rate and a close relationship between the individual M . tuberculosis clones . This was further confirmed by reprobing the Southern blots with two more-stable genetic markers, IS1081 and the DR sequence . The RFLP patterns were compared with those of 245 M . tuberculosis strains collected from Denmark during the same period (representing 91% of all new, bacteriologically verified cases of TB in Denmark in 1992) . One of the three prevalent IS6110-defined clusters was traced to a group of immigrants from Greenland living in a small, defined geographical region in Denmark and to a group of Danish citizens either with known contact with these immigrants or, in other cases, with a record of previous travel or working activities in Greenland . The study showed that the present technique is extremely helpful in monitoring the spread of TB and thereby also contributing to improved disease control. Baillieres Clin Obstet Gynaecol, 1994 Dec, 8(4), 759 - 72 Role of laparoscopy in the management of pelvic adhesions and pelvic sepsis; Henry-Suchet J et al.; Operative laparoscopy in pelvic sepsis is useful in acute cases: (a) for diagnosis, as there are 20-30% false positive and false negative diagnoses based on clinical and laboratory data alone; and (b) for treatment in severe cases and mainly in tubo-ovarian abscesses, laparoscopy allows aspiration of purulent discharge and, in recent cases, removal of fresh adhesions . In most cases, rapid and complete recovery is associated with treatment with an effective polyvalent antibiotic . Fertility is also preserved in most cases as assessed by a small series of bilateral abscesses with long-term follow-up . In CS associated with infertility, laparoscopic treatment is limited to velamentous adhesions or to dense adhesions of small extent . If performed after the completion of the inflammatory episode, laparoscopic surgery can give results comparable to those of microsurgery . A full bacteriological investigation and appropriate antibiotic treatment are necessary in order to stop or reduce the inflammatory condition which is usually associated with the development of adhesions and is a possible cause of their recurrence. Kekkaku, 1994 Dec, 69(12), 759 - 65 {Analysis of tuberculosis cases among students reported from Osaka prefectural high schools and counter--measures for tuberculosis}; Takatorige T et al.; The number of newly registered cases of tuberculosis has been increasing in the age group 15-19 year-old and over . To investigate the prevention of tuberculosis among young people under 20 years old, a survey was conducted on reported cases of tuberculosis among Osaka Prefectural high school students during the period from April, 1989 to May, 1994 . Altogether 67 cases were reported from their schools during this period . Although there was a decrease in the total number of students since 1990, there was no corresponding decrease in the number of cases of tuberculosis . Of the total number of cases among high school students registered at public health centers in Osaka, only 23% were reported from the high schools . Cases confirmed bacteriologically positive consisted 13% of all cases . Male students accounted for 61% of reported cases . The methods of detection included medical consultation due to symptoms (75%), mass radiography (18%) and pre-employment health checkup (7%) . 46% of cases reported during the first school year were discovered by mass radiography . While 24% of all cases were detected in April, no less than 46% of cases among those in the first school year were detected in April . Compared with those detected in any other school years, cases detected in the first school year showed some characteristic differences with regards to detection and bacteriological results . There has been one tuberculosis epidemic which accounted for six cases during the past five years.(ABSTRACT TRUNCATED AT 250 WORDS) J Appl Bacteriol, 1994 Dec, 77(6), 631 - 4 Bacteriological evaluation of groups of beef carcasses before the wash at six Alberta abattoirs; Jericho KW et al.; A method has been developed for the bacteriological evaluation of groups of beef carcasses which can be used to measure the degree of control over hygiene during hide removal and carcass dressing in abattoirs . This method, which enumerates aerobic mesophilic bacteria automatically using a hydrophobic grid membrane filter, was applied at six abattoirs . Two hundred excision samples (5 x 5 x 0.5 cm) were taken at 10 sites on the external surface of a group of 20 carcasses (five carcasses were sampled on each of four consecutive daily visits) for group-carcass evaluation at each abattoir . For each abattoir, the mean log10 Most Probable Number of Growth Units (MPNGU) and between-carcass variance component were obtained for each site and the average over sites . Using the average within-abattoir variance of this study and previously published studies involving 76 additional carcasses (Jericho et al . 1993), it was determined that 20 carcasses are more than adequate to estimate the mean log10 MPNGU per cm2 within 0.5 units at a site . The distribution of the log10 MPNGU per cm2 over the 10 sites was compared for the abattoirs, and sites were found to cluster into 2-4 homogenous groups . The means over sites of log10 MPNGU per cm2 for the abattoirs ranged from 1.52 to 2.64 and were unrelated to line speed. Arch Mal Coeur Vaiss, 1994 Dec, 87(12), 1721 - 9 {Infectious endocarditis induced by Actinobacillus actinomycetemcomitans . 8 new cases}; Grand A et al.; A commensal organism of the buccal cavity, Actinobacillus actinomycetemcomitans (AAC) has been responsible for at least four new cases of infectious endocarditis by year in France . This retrospective study was based on 90 new cases of infectious endocarditis by AAC, including 8 personal observations . One third of patients had no known cardiac disease before their infectious endocarditis, the portal of entry of which was usually dental . In cases of suspected infectious endocarditis, rapid and severe weight loss (43% of cases) and, less commonly, anicteric cholestasis (8%) should alert the physician for the possible pathological role of AAC . The echocardiographic appearances are non-specific . The diagnosis is confirmed on blood cultures but the organism grows slowly in CO2 enriched atmosphere . Initially, the course of the disease was favourable in one third of patients but, in two thirds of cases, complications were observed almost renal (26%), cardiac (24%) and neurological (18%) . Two thirds of patients were cured by the time they were discharged whereas the remainder had sequellae, mainly valvular and neurological . The hospital mortality was 9%; late mortality was 6% . Therefore, the prognosis of AAC endocarditis, seems to be better than that of other bacteriological forms . A combination of cephalosporin and aminoside, or even a simple third generation cephalosporin antibiotic therapy for at least 4 weeks are usually effective . The complementary surgical indications are the same as for other forms of infectious endocarditis . Prophylaxis depends on strict prophylactic amoxicillin therapy for all cardiac patients at risk of infectious endocarditis before dental treatment and on good bucco-dental hygiene. Tuber Lung Dis, 1994 Dec, 75(6), 454 - 9 Cerebral tuberculosis in the immunocompetent host: 8 cases observed in Switzerland; Labhard N et al.; 8 cases of cerebral tuberculosis were observed between January 1985 and June 1993 at the University Hospitals of Lausanne and Geneva, Switzerland . 5 patients were foreigners and 3 were Swiss, 2 of them alcoholics . All patients were HIV seronegative . Mycobacterium tuberculosis was isolated in 7 patients and M . bovis in one patient . All patients had radiological or bacteriological signs of pulmonary tuberculosis, and 3 had miliary tuberculosis . 3 patients died, 5 were cured . The main prognostic factors were age and the degree of neurological impairment at the beginning of treatment . The epidemiological, clinical, diagnostic and therapeutic aspects of this rare and severe form of extrapulmonary tuberculosis are reviewed. Nucl Med Commun, 1994 Dec, 15(12), 953 - 60 Diagnostic value of 99Tcm-d,l-HMPAO-labelled leukocyte scintigraphy in the detection of vascular graft infections; Krznaric E et al.; Prosthetic vascular graft infection is a relatively uncommon complication of peripheral vascular surgery . We retrospectively analysed technetium-99m-d,l-hexamethylpropylene amine oxime (99Tcm-d,l-HMPAO) labelled leukocyte scans of 21 patients with a suspected vascular graft infection . Operative findings, bacteriological cultures, radiological findings or clinical follow-up were used to confirm the diagnosis . We found eight true-positive and six true-negative cases . There were no false-positive scintigraphic diagnoses . The false-negative rate was 33% (n = 7) . Our results show a sensitivity of 53%, a specificity of 100% and an accuracy of 66% . The conclusion is that a negative 99Tcm-d,l-HMPAO-labelled leukocyte scan is of limited value in ruling out a vascular graft infection . A combination of computed tomography (CT-scan) and a 99Tcm-d,l-HMPAO-labelled leukocyte scan is probably the most efficient way of diagnosing a vascular graft infection. Int J Food Microbiol, 1994 Dec, 24(1-2), 93 - 102 Evaluation of a predictive model for the shelf life of cod (Gadus morhua) fillets stored in two different atmospheres at varying temperatures; Einarsson H; The shelf life of fish and food in general is difficult to predict especially if stored at varying temperatures . Shelf life models were constructed (Einarsson, 1992) for cod fillets stored at constant temperatures . The aim of this study was to evaluate if these models could be used to predict spoilage and bacterial growth in cod fillets stored in air and modified atmosphere at constant and varying temperatures . Fresh fillets were packed and stored at constant or varying temperatures between -2 degrees C and 5 degrees C . Samples were taken at regular intervals for bacteriological and sensory evaluation . The results showed that fish stored at +0.6 degrees C in air had a shelf life (assessed by sensory analysis) of 11 days which is close to what could be expected and predicted . The increase in bacterial number observed was generally less than predicted . For fish fillets, stored in air at +5 degrees C for 3 days, then at +0.6 degrees C for 3 days and finally at -2 degrees C, the shelf life was found to be 7 days which was in good agreement with the predicted shelf life . The shelf life of fillets stored at same the temperatures in modified atmosphere was found to be 9 days but by prediction 11 to 12 days . The models for predicting changes in sensory score were more accurate than those predicting changes in bacterial numbers. Cent Eur J Public Health, 1994 Dec, 2(2), 103 - 5 Water as a possible factor of transmission in mycobacterial infections; Slosarek M et al.; Mycobacterium kansasii and Mycobacterium xenopi are the most frequent species occurring in water in the Czech Republic . In the endemic area of M . kansasii in heavy industry and mining areas of North Moravia various mycobacterial species were detected in more than 20% of different water samples and M . kansasii was found in 1.5 to 1.9% of them, frequently in pit bathrooms and in the drinking water as well . Mycobacterium xenopi was detected in 35 and 50% of water samples collected in households of M . xenopi excretors in North Bohemia and in Prague . A nosocomial occurrence of M . xenopi was recorded in an hospital department in North Bohemia and in a rest home in Prague and all samples of water from the afflicted institutions were positive for M . xenopi . In a coal mine in Moravia a case of cutaneous involvement associated with the presence of M . marinum in mine water was also recorded . The incidence of various mycobacterial species (except of M . kansasii and M . xenopi) in spa and swimming pools in West Bohemia reached 35% positivity . Comprehensive reviews of bacteriological investigations for mycobacteria performed in the entire territory of the Czech Republic have been reported in annual reports since 1985 . In the period from 1985 to 1991 a total of 5167 samples of various kinds of water samples were examined and mycobacteria were detected in 8.2 to 47.7% of them. Mol Biol Cell, 1994 Dec, 5(12), 1281 - 8 Extracellular matrix controls tubulin monomer levels in hepatocytes by regulating protein turnover; Mooney DJ et al.; Cells have evolved an autoregulatory mechanism to dampen variations in the concentration of tubulin monomer that is available to polymerize into microtubules (MTs), a process that is known as tubulin autoregulation . However, thermodynamic analysis of MT polymerization predicts that the concentration of free tubulin monomer must vary if MTs are to remain stable under different mechanical loads that result from changes in cell adhesion to the extracellular matrix (ECM) . To determine how these seemingly contradictory regulatory mechanisms coexist in cells, we measured changes in the masses of tubulin monomer and polymer that resulted from altering cell-ECM contacts . Primary rat hepatocytes were cultured in chemically defined medium on bacteriological petri dishes that were precoated with different densities of laminin (LM) . Increasing the LM density from low to high (1-1000 ng/cm2), promoted cell spreading (average projected cell area increased from 1200 to 6000 microns2) and resulted in formation of a greatly extended MT network . Nevertheless, the steady-state mass of tubulin polymer was similar at 48 h, regardless of cell shape or ECM density . In contrast, round hepatocytes on low LM contained a threefold higher mass of tubulin monomer when compared with spread cells on high LM . Furthermore, similar results were obtained whether LM, fibronectin, or type I collagen were used for cell attachment . Tubulin autoregulation appeared to function normally in these cells because tubulin mRNA levels and protein synthetic rates were greatly depressed in round cells that contained the highest level of free tubulin monomer . However, the rate of tubulin protein degradation slowed, causing the tubulin half-life to increase from approximately 24 to 55 h as the LM density was lowered from high to low and cell rounding was promoted . These results indicate that the set-point for the tubulin monomer mass in hepatocytes can be regulated by altering the density of ECM contacts and changing cell shape . This finding is consistent with a mechanism of MT regulation in which the ECM stabilizes MTs by both accepting transfer of mechanical loads and altering tubulin degradation in cells that continue to autoregulate tubulin synthesis. Presse Med, 1994 Nov 26, 23(37), 1703 - 7 {Helicobacter pylori gastric infections in children}; Benhamou PH et al.; OBJECTIVES: Numerous reports have established the association of Helicobacter pylori and recurrent abdominal pain in children . We investigated the clinical, bacteriological and therapeutic features of our patients seen over a 1 year period . METHODS: We investigated 121 children during 1992 in Hospital Saint Vincent-de-Paul, Paris . At endoscopy, biopsies were taken and sent for histology and bacteriology and urease testing . A decision regarding treatment by amoxicillin and metronidazol was made after positive results of bacteriology and/or histology . RESULTS: Heliobacter pylori was found in 47 antral biopsies after pathology examination with Giemsa staining alone 16 times, bacterial culture 9 times and both methods 22 times . Abdominal pain was the prominent symptom, occurring in 35.5% of Helicobacter pylori+patients . In 25 of the positive negative patients, a nodular gastritis was observed (53.1%) and in 27.6% of them a weight loss or a delay in weight gain . Few patients became after combined treatment with amoxicillin and metronidazol whereas eradication rates after triple therapy with amoxicillin-metronidazol and H2 antagonist or proton pump blocker were higher . CONCLUSION: Helicobacter pylori related gastritis is a common cause of abdominal complaints in children . The most common symptom is recurrent abdominal pain . Antral nodularity is a peculiar endoscopic finding in children . Two-drug therapy associating amoxicillin-metronidazol is often ineffective to eradicate the bacteria whereas eradication rates after triple therapy amoxicillin-metronidazol and H2 antagonist or proton pump blocker are higher. Dtsch Med Wochenschr, 1994 Nov 25, 119(47), 1613 - 7 {Esophagomediastinal fistulae as a rare complication of tuberculosis in an HIV-infected patient}; Greten T et al.; A 57-year-old man with an HIV infection, diagnosed a year ago, complained of fever and cough . The haemoglobin level was 7.5 g/dl, white cell count 3800/microliters, T-helper cell count 60/microliters and the CD4-CD8 ratio 0.1 . Erythrocyte sedimentation rate was raised to 21/39 mm . Bacteriological tests were at first negative . The chest radiograph showed slight widening of the upper mediastinum which further increased over the next 10 days, at which time it also revealed a shadow in the right upper lobe . Computed tomography suggested necrotizing mediastinal lymph-nodes . Treatment was begun with rifampicin (600 mg daily) ethambutol (1.2 g daily), pyrazinamide (1.5 g daily) and ciprofloxacin (500 mg twice daily) . Oesophagoduodenoscopy, performed after 3 weeks, revealed several fistulae which, after ingestion of contrast medium, were demonstrated to communicate with the mediastinum, presumably as a result of lymph-node liquefaction . Mycobacterium tuberculosis was demonstrated in gastric juice, sputum and stool only after tuberculostatic drugs had been started. J Infect Dis, 1994 Nov, 170(5), 1216 - 23 Changing trends in the epidemiology of human brucellosis in California from 1973 to 1992: a shift toward foodborne transmission; Chomel BB et al.; From 1973 through 1992, 426 cases of human brucellosis were reported in California, of which 98% were laboratory confirmed . Brucella melitensis was identified in 185 cases (78.7% of the bacteriologically typed cases) . Hispanics accounted for 81% of the cases from 1983 to 1992 compared with 65% during the previous decade (P < .01) . The population-adjusted average annual incidence was higher in Hispanics, especially in children and teenagers, compared with non-Hispanic whites and African Americans . Slaughterhouse cases decreased from 25% during 1973-1982 to < 3% during the following decade . Changes in case distribution were characterized by a decreasing incidence in the Central Valley and an increasing incidence in the San Francisco Bay area and the southern Coast Range . Hispanics were more likely to report being infected by consumption of milk and cheese in Mexico during 1983-1992 than during the previous 10 years (relative risk, 1.45) . Between 1973 and 1992, human brucellosis in California evolved from an occupational to a foodborne illness. Am J Gastroenterol, 1994 Nov, 89(11), 2066 - 9 A case of chronic pancreatitis with pseudocysts complicated by infection and obstructive jaundice; Noda T et al.; We report a case of chronic pancreatitis with pseudocysts complicated by infection and obstructive jaundice . A 49-yr-old male was admitted with the complaints of fever and jaundice . Laboratory findings included high biliary tract enzyme values and normal serum amylase value . Ultrasonography and computed tomographic scan demonstrated a cyst, 4 cm in diameter, in the pancreas head . Cholangiography revealed a long, tapered obstruction of the common bile duct which was apparently compressed by the cyst . Although the jaundice improved after percutaneous transhepatic biliary drainage, fever continued, and the cyst was aspirated . Bacteriological examination of the contents revealed infection . The symptoms disappeared rapidly and the cyst decreased in size soon after aspiration . The stenosis of the common bile duct showed improvement for several weeks but then re