Microbiological

Andrologia, 1991 Mar-Apr, 23(2), 115 - 20
Etiology of severe asthenozoospermia and fertility prognosis . A screening of 5216 semen analyses; Marchini M et al.; A review of n = 5216 semen analyses performed in our two Clinics from January 1986 to December 1989 allowed to identify n = 35 patients whose sperm had constantly very low motility (less than 5% progressive motile gametes in three subsequent analyses; necrozoospermia cases were excluded from this study) . This apparently rare but severe anomaly was found to be associated not only with ultrastructural anomalies (n = 18), but also with positive seminal bacteriology (n = 8) or the presence of antisperm antibodies (n = 2) . In eight cases the cause(s) for this constant asthenozoospermia remained obscure . The fertility potential of the men affected was followed-up and is discussed in relation to their anamnesis, physical exam and seminal characteristics.

Rev Odontostomatol (Paris), 1991 Mar-Apr, 20(2), 149 - 61
{How and when to prescribe systemic antibiotics?}; Muster D; The use and prescription of antibiotics is getting everyday more and more complex for the general practitioner . Nowadays, due to the increasing number of antibiotics, it is necessary to know the patient's medical history, as well as be knowledgeable in bacteriology, pharmacology and toxicology, immunology and infectiology . It is important to determine the administration mode, the dosage and length of the antibiotic treatment, to get maximum effectiveness, while being aware of the possible drug interactions.

Cesk Oftalmol, 1991 Mar, 47(2), 81 - 6
{Pars plana vitrectomy in the treatment of exogenous suppurative endophthalmitis}; Karel I et al.; The authors evaluate the results of pars plana vitrectomy (PPV) in 12 patients with exogenous suppurative endophthalmitis (EHE) . EHE developed after operation of cataract in eight patients and after perforating injury of the sclera in four patients . The shape, size and appearance of the eye was preserved in 11 eyes, the function of the eye with a visual acuity of 0.5-1.0 was saved in six eyes (50%), in one eye with bacteriologically confirmed mycotic enophthalmitis and in five eyes where bacterial infection was assumed . Inoperable detachment of the retina characterized the ophthalmoscopic finding in all eyes with loss of function . Close cooperation of ophthalmological departments with vitreoretinal centres and early performance of urgent surgery are the basic prerequisites of better functional results of PPV in EHE.

J Infect Dis, 1991 Mar, 163(3), 650 - 2
Detection of Mycobacterium tuberculosis antigen 5 in cerebrospinal fluid by inhibition ELISA and its diagnostic potential in tuberculous meningitis; Radhakrishnan VV et al.; Inhibition ELISA was used to quantitate Mycobacterium tuberculosis antigen 5 in cerebrospinal fluid (CSF) specimens of 40 patients with a clinical diagnosis of tuberculous meningitis . In all 10 culture-proven patients, the assay was positive; in 30 culture-negative patients, the assay yielded positive results for 21 . CSF antigen 5 concentrations ranged from 9 to 82 ng/ml (mean +/- SD, 45.5 +/- 6.2) . In 40 patients with nontuberculous neurologic diseases, mean concentration was 1.45 ng/ml . Thus, inhibition ELISA for the detection of M . tuberculosis antigen 5 in CSF has definite diagnostic potential during the active phase of the disease and should be a routine diagnostic test, particularly when bacteriologic cultures in CSF are negative for M . tuberculosis.

Adv Contracept, 1991 Mar, 7(1), 55 - 65
Effects of chlorhexidine-coated intrauterine device on the bacteriology of the uterine cavity; Jackson R et al.; Twenty-nine women, aged 31-53 years, scheduled for an abdominal hysterectomy, participated in this study . The patients were divided into three groups . The first received a Multiload MLCu250 intrauterine device (IUD); the second group received a chlorhexidine acetate medicated Multiload MLCu250 IUD; the third group acted as a control group receiving no IUD . Bacteriological cultures of the vagina and ectocervix were taken prior to insertion of the IUD . At hysterectomy, some 18 hours later, specimens were taken from the cervical canal, uterine cavity, and the device itself, for culture of anaerobic and aerobic organisms using a standardized previously validated technique . In three of the nine control patients, organisms were cultured from the uterine cavity . There were no differences between the bacteriological results of the two groups with medicated and non-medicated devices, with regard to the cultures from the cervical canal, uterine cavity or the devices themselves . Nor was there any difference between the control and the IUD group.

Minerva Stomatol, 1991 Mar, 40(3), 101 - 5
{A bacteriological study of supragingival bacterial plaque in subjects undergoing orthodontic therapy}; De Siate A et al.; Direct contact between tooth enamel and bacteria is currently considered a sine qua non of tooth decay . Any condition which encourages the deposit and accumulation of bacterial plaque represents a risk factor for tooth decay . Dental therapy often entails the use of bands or brackets which house metal apparatus used to apply force or support mobile devices (plates, etc.) . It is therefore possible to hypothesise that, by preventing its mechanical removal, dental treatment can lead to quantitative and qualitative changes in bacterial plaque.

Br Vet J, 1991 Mar-Apr, 147(2), 133 - 9
Microscopic changes in infected bovine teats; Ngatia TA et al.; Two hundred and fifty-two teats from the udder quarters of 68 dairy cows were studied by bacteriological examination of quarter milk samples and microscopic examination of the teats . Of 252 quarters, 169 teats showed inflammatory changes, while 83 were of normal appearance . The inflammatory changes consisted of either neutrophil infiltrations, mononuclear cell infiltrations and fibrosis, or a combination of these changes . The reaction was restricted to the teat cisterns and/or Furstenberg's rosettes, but very rarely also in the teat canal . In 136 of 169 cases, the inflammatory reaction was associated with bacteria in the milk, while in 33 cases no bacteria could be recovered from milk, in spite of inflammatory changes in the teat structures . Only 36 of 83 of normal teats were bacteriologically positive.

Rev Fr Gynecol Obstet, 1991 Mar, 86(3), 229 - 32
{The value of C-reactive protein in the detection of chorioamnionitis in cases of premature rupture of membranes}; Berardi JC et al.; In a context of premature rupture of the membranes, the authors compare the sensitivity and ability to predict the onset of chorio-amnionitis of the conventional clinical signs (hyperthermia, fetal tachycardia, discolored amniotic fluid) and paraclinical signs (hyperleukocytosis and bacteriology of the amniotic fluid) with those of the assay of C reacting protein in the maternal plasma . The latter test is apparently more sensitive and of greater positive predictive value in this disorder.

Rev Fr Gynecol Obstet, 1991 Mar, 86(3), 213 - 9
{Salpingitis and bacteriology}; Berger D; Salpingitis remains a public health problem due to their direct cost (hospitalization) and indirect cost (sequelae) and they also confront the clinician with questions concerning the bacteriological diagnosis . It is necessary to multiply the samples taken in order to obtain a series of arguments to attribute the origin of the salpingitis to an organism, if a single organism is involved . The reliability of these examinations depends on the site and the care with which they are carried out as well as on the quality of the transportation and culture media . The convergence of these data leads to the prescription of appropriate antibiotics.

Rev Med Chil, 1991 Mar, 119(3), 273 - 8
{Spontaneous bacterial peritonitis: a frequent and recurrent complication in cirrhotic patients with ascites}; Chesta J et al.; One hundred and twenty consecutive patients with liver cirrhosis and ascites were prospectively studied in order to analyze the frequency, clinical and bacteriological features, recurrence, and prognosis of spontaneous bacterial peritonitis (SBP) . Two variants of SBP were defined: culture positive SBP and culture negative neutrocytic ascites (CNNA) . During a follow-up of 6 +/- 2 months, thirty three episodes in 23 patients were identified . Nineteen episodes had ascites positive cultures (58%) . The total mortality rate associated with SBP was 39% . (47% for culture positive form and 29% for CNNA) . Seven of 15 cirrhotics who had recovered from a first episode of SBP (46%) had 10 recurrences . Mortality associated with SBP recurrence was 50% . Six-month survival probability was 65% in patients with sterile ascites and 33% in SPB (p < 0.05) . Impairment of liver function was present in 23 episodes (70%) but abdominal complaints occurred only in one/third and 4 (12%) were asymptomatic . E coli was the most frequent agent involved in culture positive SBP . We confirm that SBP is a frequent, recurrent and severe complication of ascites in cirrhotics . Episodes of SBP without abdominal symptoms or with a silent course are not infrequent . Then, SBP recognition requires ample use of diagnostic paracentesis.

J Antimicrob Chemother, 1991 Feb, 27 Suppl A, 91 - 100
Comparative study of clarithromycin and ampicillin in the treatment of patients with acute bacterial exacerbations of chronic bronchitis; Bachand RT Jr; This double-blind, randomized (1:1), 33 centre clinical trial compared the safety and efficacy of 250 mg clarithromycin (2 x 125 mg capsules) 12-hourly and 250 mg ampicillin (one capsule) 6-hourly in the treatment of acute bacterial exacerbation of chronic bronchitis . Clinical and bacteriological evaluations were performed during treatment (study days 3-5, 8-10) and within 48 h following the end of therapy . Two hundred and twenty-five patients were included in the safety analysis . Both clarithromycin and ampicillin were effective with clinical success rates of 97% (28/29) and 91% (31/34), respectively . Pathogen eradication rates were 86% (36/42) for clarithromycin and 88% (37/42) for ampicillin . No significant difference in the number of patients reporting one or more adverse events was observed between treatment groups . Eleven clarithromycin and six ampicillin patients prematurely discontinued the study owing to adverse events . Clarithromycin 12-hourly was as safe and effective as ampicillin 6-hourly in the treatment of acute bacterial exacerbation of chronic bronchitis.

Int J Artif Organs, 1991 Feb, 14(2), 83 - 6
A new method to evaluate the CAPD-catheter-exit and other percutaneous devices; Knabe C et al.; A method that has proved to be the most sensitive approach for the early diagnosis of infection of the oral mucosa around dental implants has been used to monitor the exit-sites of percutaneous devices . For three months the state of the skin-catheter interface of 13 CAPD-patients was examined every four weeks . This examination included the measurement of pocket depth with the aid of a periodontal probe, the measurement of SFFR (sulcus-fluid-flow-rate) using standardized filter paper strips and a bacteriological swab of the exit-site . The results obtained demonstrated that SFFR can be measured around percutaneous implants . The measurement of SFFR appeared to be more useful in the monitoring of exit-sites of percutaneous devices than the measurement of pocket depth or the use of bacteriological swabs . Further studies for prolonged periods are necessary to determine whether measurement of SFFR can reliably predict onset of exit-site infection before clinical signs become evident.

Recenti Prog Med, 1991 Feb, 82(2), 80 - 2
A case of virus associated hemophagocytic syndrome and malignant histiocytosis: sometimes a difficult distinction; Vespignani S et al.; The differential diagnosis among hemophagocytic syndromes and particularly between the virus-associated hemophagocytic syndrome (VAHS) and the malignant histiocytosis (HM) is quite easy in typical cases . Difficulties of interpretation may sometimes ensue when viral-bacteriologic work-ups indicative of VAHS are negative and/or morphologic histiocytic aberrations indicative of HM are missing . The authors present a case of hemophagocytic syndrome with the latter characteristics and discuss the differential diagnosis.

Ann Pediatr (Paris), 1991 Feb, 38(2), 110 - 4
{Purulent meningitis in children in Yaounde (Cameroon) . Survey of complications using echoencephalography}; Gonsu Fotsin J et al.; Sixty-one infants aged 0 to 12 months with documented purulent meningitis underwent transfontanellar ultrasonography at the Yaounde Central Hospital . Twenty-eight (45.90%) infants had evidence of complications including communicating hydrocephalus (20 patients; 71.43%), ventriculitis (5; 17.86%), abscess with ventriculitis (2; 7.14%), and cerebral atrophy (1; 3.57%) . An analysis of the main epidemiological, bacteriological and clinical parameters found no correlation between the presence of ultrasound evidence of complications and age, sex, or color of the CSF . Conversely, a close correlation was found with both the time elapsed between onset and initiation of treatment and the severity of clinical manifestations (coma, seizures) . The authors, recommend routine ultrasound encephalography in infants with meningitis, improved information of parents, and close collaboration between pediatric radiologists and neurosurgeons.

J Reprod Med, 1991 Feb, 36(2), 118 - 20
Bacteriologic findings with ectopic pregnancy; Berenson A et al.; The fallopian tubes and peritoneum of 27 patients were cultured at the time of salpingotomy/salpingectomy to determine if active tubal infection was the cause of post-operative temperature elevations . Infection was documented in six patients (22%) . Previous exposure to Chlamydia trachomatis was documented with 2 endocervical cultures and 17 serum specimens positive for IgG antibody . The culture results, however, did not correlate with the postoperative febrile morbidity.

J Am Vet Med Assoc, 1991 Feb 1, 198(3), 447 - 9
Congenital peripheral vestibular disease attributed to lymphocytic labyrinthitis in two related litters of Doberman pinscher pups; Forbes S et al.; Five Doberman Pinscher pups from a litter of 10 (litter A) and 3 of 9 pups from a subsequent mating of the same bitch (litter B) had clinical signs consistent with unilateral or bilateral peripheral vestibular disease . Results of CBC, serum biochemical analysis, urinalysis, ophthalmologic examination, deep otoscopic examination, and CSF analysis were normal in all affected pups . Bacteriologic culture results from CSF were negative and affected pups did not have canine distemper antibody titers in CSF . The most severely affected littermates were euthanatized and necropsied at the owner's request . Gross lesions were not found at necropsy, but marked lymphocytic labyrinthitis was discovered microscopically in decalcified sections of the labyrinthine system . The case history and histologic findings were suggestive of an infectious, most likely viral, cause, but organisms were not isolated from specimens of CNS tissue . The involvement of the same bitch in the 2 litters suggests heritable factors . One mildly affected pup apparently recovered or compensated for its vestibular dysfunction.

Am Rev Respir Dis, 1991 Feb, 143(2), 262 - 7
A controlled clinical comparison of 6 and 8 months of antituberculosis chemotherapy in the treatment of patients with silicotuberculosis in Hong Kong . Hong Kong Chest Service/tuberculosis Research Centre, Madras/British Medical Research Council; The dynamics of conceptual change in twentieth century immunology; Institute of History of Medicine, John Hopkins University School of Medicine, Baltimore, Maryland 21205I have attempted here to define three distinct eras in the 110-year history of the discipline of immunology . The first, extending from 1880 to about the First World War, centered around the new bacteriology and infectious diseases, and had a distinctly medical orientation . Several of the components of the original research program in immunology failed to maintain their original momentum or to fulfill their initial high promise, and went into decline . These include the development of new vaccines, serotherapeutic approaches, the study of cellular immunity, and the study of diseases that might be mediated by cytotoxic antibodies . Two other subprograms followed a somewhat different course; the study of anaphylaxis and related diseases passed primarily into the hands of clinical allergists, while the development and adaptation of serodiagnostic techniques passed into the hands of the new discipline of serology, both fields out of the mainstream of post-World War I immunology . As interest in the components of the old program was falling away, there developed a new area of interest in immunology . Leadership in the field devolved upon a new group of individuals with a predominantly chemical orientation to the study of antigens and antibodies, who pursued a research program and developed a theoretical base that reflected this orientation well . It may be interesting to examine more closely the forces responsible for this shift in emphasis . When interest in the old areas waned, the medically oriented practitioners did not switch to more immunochemical lines, but went in other directions . Karl Landsteiner was the only prominent "old-timer" who contributed significantly to the newer immunology, and it was his work that set the tone and attracted the new generation of immunochemists who became the reigning Denkkollektiv . A science does not change its precepts and approaches spontaneously; it is moved to the new position by those who explore fertile new areas . This is not to say, however, that there was no longer interesting and important work to be done along the old lines--it was just that such work was no longer "fashionable", as the reception of the work of Dienes, of Rich, of Rivers, and of the early Medawar illustrates . Whereas the earlier immunological program had interacted extensively with many different fields of biology and medicine, the immunochemical era was characterized by a relative introversion, as compared with the broad influence exerted by the earlier immunological program (92) . We can date this second era from about the First World War until the late 1950s and early 1960s.(ABSTRACT TRUNCATED AT 400 WORDS)

Enferm Infecc Microbiol Clin, 1991 Feb, 9(2), 82 - 4
{Yield from studying the contacts of patients with tuberculosis}; Moliner Prada C et al.; Between march '88 and august '89 a total number of 437 contacts (CT) with 69 patients with tuberculosis were analyzed . According to the bacteriological status of the index case the observations were distributed into: Group I (197) CT with patients with positive sputum AFB stain test; Group II (24) CT with cases with positive sputum culture but negative AFB stain; and Group III (216) CT with cases with histologic diagnosis or cases in children . Following identical criteria and according to the bacteriologic situation of the Source case, we grouped the contacts on groups A (246), B (17), and C (174) . A clinical history, thorax radiography, and tuberculin test with 2 UT of PPD-RT 23 were performed in all CT cases . Tuberculin reaction was equal or greater than 6 mm in 45% (88/197), 25% (6/24), and 36% (77/216) of groups I, II, and III respectively . This reaction was also positive in 49% (121/246), 23% (4/17), and 26% (46/174) of groups A, B, and C respectively . Sixteen new cases of tuberculosis were discovered among which we identified 5 new source cases . A second tuberculin test was performed in 44% (116/266) of CT with a previous negative test, and in this population we observed 16 conversions . It is demonstrated: 1) a high yield in the detection of infection/tuberculous disease; 2) the analysis of CT in group A provided the highest index of tuberculous infection, and 3) revision of CT of groups II and III provided most of the new cases of disease as well as the identification of 5 new source cases.

J Antimicrob Chemother, 1991 Feb, 27 Suppl A, 101 - 8
A comparison of clarithromycin with ampicillin in the treatment of outpatients with acute bacterial exacerbation of chronic bronchitis; Aldons PM; One hundred and twenty-five outpatients with clinical symptoms of an acute bacterial exacerbation of chronic bronchitis were enrolled in a multicentre, double-blind, randomized clinical trial to compare the efficacy and safety of oral clarithromycin and ampicillin . Only those patients presenting with pathogens cultured from pre-treatment specimens susceptible to both study drugs were included in the study; beta-lactamase producing strains were excluded . Sixty patients received clarithromycin 250 mg 12-hourly and 65 had ampicillin 250 mg 6-hourly for 7-14 days . Clinical and bacteriological evaluations were performed pre-treatment, during treatment, and post-treatment within 48 h of cessation of therapy . All adverse events reported were evaluated . Twenty patients from the clarithromycin group and 24 from the ampicillin group were withdrawn from the study when no pathogen was isolated from the pre-treatment specimens . Twenty-eight patients who received clarithromycin and 23 who received ampicillin were evaluable for clinical and bacteriological efficacy . Both treatment groups were similar with respect to clinical and bacteriological response rates . The clinical cure rate for clarithromycin was 96% (27/28) compared with 91% (21/23) for the ampicillin group . Clarithromycin achieved a bacteriological cure rate of 96% (27/28) compared with 100% (23/23) for the ampicillin group . Adverse events, which were generally mild and associated with the digestive system, were reported by 11.7% of patients receiving clarithromycin and 1.5% of patients receiving ampicillin . Adverse events caused two patients in each group to discontinue treatment . Laboratory profiles for both groups were unremarkable throughout treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Harefuah, 1991 Jan 15, 120(2), 62 - 6
{Pitfalls in the diagnosis of tuberculous arthritis}; Finsterbush A et al.; Jewish immigrants from Russia, and Arabs added to the population register since 1967, have a relatively high incidence of bone and joint tuberculosis . These patients now account for most of this disease in Israel . Skeletal tuberculosis imitates various joint conditions, most commonly, rheumatoid arthritis, and therefore presents a diagnostic problem . Injections of corticosteroids and/or immunosuppressive therapy can reactivate quiescent tuberculous lesions . During a 12-year period 14 patients with tuberculous arthritis involving 16 joints were seen in this hospital . They included 9 males and 5 females, 14-70 years old, 4 of whom were known to have had previous skeletal tuberculosis: 3 had spinal and 1 had hip involvement . None of the other 10 had a clinical history of tuberculosis, nor X-ray evidence of active pulmonary disease . 7 patients were diagnosed postoperatively as having joint tuberculosis on histopathological and bacteriological examination; 3 had positive cultures from joint aspirations . Most commonly involved were the spine and knee--4 cases of each . The wrist and acromioclavicular joint were affected in 2 cases each, and the hip, sacroiliac joint, ankle and elbow joints in 1 case each . The youngest patient, 14 years old, had triple-joint involvement of the wrist and the acromioclavicular and sacroiliac joints; the others had single-joint disease . In 1 patient the disease was reactivated after 36 years by surgical conversion of a fused hip to a mobile artificial joint . 3, whose joints were injected with corticosteroids, developed active, destructive tuberculous arthritis . A patient with rheumatoid arthritis who underwent total knee replacement was found to have active tuberculous arthritis.(ABSTRACT TRUNCATED AT 250 WORDS)

J Am Med Rec Assoc, 1991 Feb, 62(2), 32 - 3
Laboratory reports issued on or after discharge date; Bartlett RC et al.; The authors of this article discuss the problem of ensuring that physicians are informed of bacteriology test results in a timely manner, a study they undertook, and the steps taken to solve the problem.

Lancet, 1991 Jan 5, 337(8732), 5 - 7
Rapid diagnosis of tuberculous meningitis by polymerase chain reaction; Shankar P et al.; The polymerase chain reaction (PCR) in cerebrospinal fluid was compared with conventional bacteriology and an enzyme-linked immunosorbent assay (ELISA) for cerebrospinal fluid antibodies in the diagnosis of tuberculous meningitis (TBM) . PCR was the most sensitive technique; it detected 15 (75%) of 20 cases of highly probable TBM (based on clinical features), 4 (57%) of 7 probable cases, and 3 (43%) of 7 possible cases . ELISA detected 11 (55%) of the highly probable cases and 2 each of the probable and possible cases . Culture was positive in only 4 of the highly probable cases . Among the controls (14 pyogenic meningitis, 3 aseptic meningitis, 34 other neurological disorders), 6 subjects tested early in the study (2 pyogenic meningitis, 4 other disorders) were PCR positive . Second DNA preparations from their stored cerebrospinal fluid samples were all PCR negative, suggesting that the false-positive results were due to cross-contamination . 18 PCR-positive TBM samples retested were all still PCR positive . The antibody ELISA was positive in 3 controls despite the use of a high cutoff value.

Arch Virol Suppl, 1991, 3, 217 - 24
Lesions in aborted bovine fetuses and placenta associated with bovine viral diarrhoea virus infection; Murray RD; Abortions in dairy cattle were investigated on 55 dairy farms sited in North West England, using a multi-level diagnostic technique . After pathological examination of fetal and placental tissues collected at the time of abortion, possible causes for these abortions could be identified, supported by bacteriological and serological laboratory findings . Of 150 abortions investigated, Bovine Viral Diarrhoea (BVD) virus infection was related to 40 episodes (27% of the total), often accompanied by evidence of concurrent infections . Lesions associated with BVD abortions were found in fetal eyelid, lung, and occasionally myocardium . Lesions in the lung were most consistent, characterized by mononuclear inflammatory cell infiltration of peribronchiolar and inter-alveolar tissues . Placental lesions were non-specific . It is concluded that the lesions observed are insufficient to be the primary cause of abortion . However, the pathological changes associated with BVD infection in the placenta may allow secondary opportunist pathogens to cross the feto-maternal barrier, thereby threatening the health of the fetus and the physiological and endocrinological functions of the placenta which maintain pregnancy.

Acta Chir Iugosl, 1991, 38(1), 23 - 33
{Use of taurolin in the prevention of septic complications in emergency abdominal surgery}; Popovic M et al.; The purpose of the study was to evaluate effectiveness of local application of Taurolin in prevention of septic complications after abdominal emergency surgery . Group A included 30 patients in whom intraoperative peritoneal lavage was performed with 0.5% solution of taurolin . In the first 12 postoperative hours peritoneal lavage was repeated through the drain . Group B included 30 patients in whom intraoperative lavage was performed with either physiologic saline or Povidon solution . All patients had suppurative peritonitis provoked by perforation of some of the abdominal organs . Intraoperatively samples of abdominal pus were taken for bacteriological analysis, while postoperatively samples were taken from drains placed abdominally and subcutaneously . Twelve hours after the surgery therapy was conducted according to the operative findings, postoperative course, x-ray and laboratory findings and results of sensitivity testing . Analysis of the results revealed significant differences in postoperative morbidity and mortality between the two groups . No fatal outcomes were recorded in the immediate postoperative course in group A where only one case of recurrent intraperitoneal infection occurred and three cases of wound infection . In group B, however, three patients died in the immediate postoperative course, recurrent intraperitoneal infection developed in four cases and wound infection in 12 . Intraoperative and early postoperative local application of Taurolin in addition to appropriate surgical treatment and postoperative care has an important role in prevention of postoperative septic complications and decrease of postoperative mortality.

Czech Med, 1991, 14(2), 87 - 96
Tuberculosis surveillance in the Czech Republic in 1989; Trnka L et al.; The authors report on tuberculosis situation in the Czech Republic (CR) in 1989 and compare the data with 1988 . The incidence of all cases of respiratory TB was 15.5 and that of bacteriologically confirmed cases 11.1/100,000 . The mortality from TB was also low (1/100,000) . Two-thirds of the patients were detected because of the patients' complaints . This passive case - finding was, however, inadequate in subjects with a poor health consciousness . Active screening was restricted to subjects with a high risk of TB (in contact with tuberculosis, with different diseases, with socio-economic factors, migrating subjects, non-cooperating subjects) . In 1989 for the first time in the CR stagnation of the incidence of bacteriologically confirmed TB of the respiratory organs was recorded . The number of patients (5.7/100,000) with TB with a microscopically positive bacteriological finding in sputum was also the same . A slowing down of the hitherto recorded favourable trend of TB must be foreseen . It will be important to maintain the contemporary system of TB surveillance.

Arkh Patol, 1991, 53(2), 65 - 7
{A case of tubercular laryngopharyngitis diagnosed by biopsy}; Bykova VP et al.; A 47-year-old man had ulcero-necrotic pharyngitis examined and treated without effect in various Moscow hospitals for 3 months . The diagnosis was established after histologic and bacteriologic examination of the biopsy.

Padiatr Grenzgeb, 1991, 30(3), 183 - 92
{Bacteriologic diagnosis in suspicion of bacterial infection in newborn infants--a review}; Spencker FB et al.; The present paper gives a survey about bacteriological examinations, which had proved worthwhile in relation to own experiences and to the literature . Besides methods of preliminary diagnostics cultural examinations of samples from normally sterile body sites are in the center of discussion . The value of body surface cultures, however, especially swabs used for possible prediction of threatening infection is also discussed.

Kansenshogaku Zasshi, 1991 Jan, 65(1), 96 - 109
{An optimum dose-finding study of HR810 (CPR) in chronic respiratory tract infections}; Soejima R et al.; In order to determine the optimal dose of cefpirome sulfate (HR810, CPR) against respiratory tract infections (RTI), an optimal dose-finding study was conducted on cases of chronic RTI, and the clinical properties of the drug were compared with those of ceftazidime (CAZ) . Inpatients with chronic RTI were randomly assigned to 3 groups: an HR 0.5 g group, receiving 0.5 g X 2/day of CPR an HR 1.0 g group, receiving 1.0 X 2/day of CPR and a CAZ group, receiving 1.0 g X 2/day of CAZ . As a rule, the drugs were administered by intravenous drip infusion for 14 days, after which period clinical efficacy, bacteriological response, safety, and utility were investigated . Of the total 121 cases, 106 were subject to analysis of clinical efficacy, including 38 cases in the HR 0.5 g group, 32 in the HR 1.0 g group, and 36 in the CAZ group . Efficacy rates in the assessment by the committee were 84.2% for the HR 0.5 g group, 75.0% for the HR 1.0 g group, and 86.1% for the CAZ group, without any significant difference between the 3 groups . The bacterial elimination rates were 73.9%, 75.0% m and 88.5%, respectively, without any significant difference between the 3 groups . Associated reactions were noted in 2 of 36 cases in the HR 1.0 g group (eruption and diarrhea), but not in the other 2 groups . The incidence of abnormal clinical laboratory findings was 23.1% in the HR 0.5 g group, 22.2% in the HR 1.0 g group, and 22.5% in the CAZ group, without any significant difference between the 3 groups . Utility rates were 84.2% for the HR 0.5 g group, 74.2% for the HR 1.0 g group, and 86.1% for the CAZ group, without any significant difference between the 3 groups . The HR 0.5 g and 1.0 groups showed no difference in clinical efficacy, bacteriological response, safety, and utility against RTI, and the results of both groups were about equal to those of the CAZ group.

Kansenshogaku Zasshi, 1991 Jan, 65(1), 35 - 9
{An outbreak of gastroenteritis possibly caused by Escherichia coli O167:H9}; Ohtani Y et al.; An outbreak of gastroenteritis involving a total of 256 patients (49.7%) among 515 persons occurred at a primary and secondary school in Agatsuma Town, Gunma Prefecture between the 23rd and 28th of June 1988 . The majority of the cases occurred within the first 4 days . The main symptoms were abdominal pain (81.6%), diarrhea (57.0%) and headache (40.2%) . In most cases, the stools were watery and occasionally mucous . Although food-borne infection was strongly suggested epidemiological evidence did not incriminate any foods as the cause of the outbreak . In the bacteriological study on stool specimens from 25 patients, Escherichia coli O167:H9 was isolated from 20 of these specimens, virtually in pure culture . The isolates of the E . coli serovar were negative for recognized diarrheagenic virulence properties: production of heat-labile and heat-stable enterotoxins, enteroinvasion, and production of Shiga-like toxin . When the HEp-2 cell-adherence test was used, however, they exhibited localized adherence . All the strains were demonstrated to carry 56 Md plasmids that presumably mediate the production of the adherence factor.

J Int Med Res, 1991, 19 Suppl 1, 44A - 49A
Intramuscular sulbactam/ampicillin combination therapy in gynaecological and obstetric bacterial infections; Abbassi AF et al.; Estimates were carried out on the clinical and bacteriological efficacy of an intramuscular combination of sulbactam/ampicillin, together with an assessment of its tolerability and safety in the treatment of gynaecological and obstetric infections . A total of 30 women with pelvic inflammatory disease, wound infections, vaginitis and puerperal sepsis received an intramuscular combination of sulbactam/ampicillin in a total daily dose of 1.5 g for between 3 and 7 days . Clinical cure and improvement were achieved in 27 (90%) cases but there was no response in three (10%) cases . No side-effects were seen in 29 (97%) cases, whereas tolerable local injection site pain was reported in one case . The safety of the sulbactam/ampicillin antibiotic combination was evident in all the cases studied, as there was no significant difference between the means of laboratory tests before and after therapy of blood and renal measures.

J Int Med Res, 1991, 19 Suppl 1, 36A - 43A
Sulbactam/ampicillin combination in the treatment of acute and chronic lower respiratory infections; Bisetti A et al.; The clinical and bacteriological efficacy of a sulbactam/ampicillin combination was compared with piperacillin in a group of 50 patients suffering from acute or chronic lower respiratory infections: 26 were treated intravenously with piperacillin and 24 with sulbactam/ampicillin . The treatment was continued for at least 7 days for 24 patients at the dosage of 3 g sulbactam/ampicillin twice daily, for a further 24 patients at the dosage of 6 g piperacillin twice daily and for two patients at the dosage of 8 g piperacillin twice daily . In the patients treated with sulbactam/ampicillin, a rapid decrease in the fever with the concomitant reduction in cough and sputum production was observed, with cure in 18 cases and improvement in six . In the patients treated with piperacillin cure was observed in 14 cases and improvement in 12 cases . In both treatment groups safety was excellent . There was no significant difference, either in effectiveness or tolerability, between the two groups.

Infection, 1991, 19 Suppl 3, S141 - 3
Do antibody-coated bacteria prove bacterial prostatitis?
Riedasch G, Mohring K, Ritz E.
Using the immunofluorescence technique in 187 patients with bacteriologically proven prostatitis according to the Meares-Stamey test demonstrated a significant amount of antibody-coated bacteria (ACB) in their ejaculates . The ACB test was useful to discriminate between chronic bacterial prostatitis and prostatodynia with a sensitivity of 65% and a specifity of 92%; likewise the ACB test is superior to complement and coeruloplasmin estimation in the ejaculate by radial immunodiffusion usually recommended for the differential diagnosis of inflammatory and psychosomatic diseases of the prostate.

Cardiovasc Intervent Radiol, 1991 Jan-Feb, 14(1), 63 - 8
CT-guided biopsy of pelvic masses; Triller J et al.; CT-guided fine-needle puncture (FNP) was carried out in 74 patients with pelvic masses and resulted in a correct diagnosis in 36/45 patients (80%) with malignant disease . FNP was true-positive in 66.7% and false-negative in 20% . In benign and inflammatory pelvic space-occupying lesions, FNP confirmed the suspected CT diagnosis in all cases by cytology and bacteriology . CT-guided puncture should always be used complementary to CT when a mass of unclear etiology is present.

Nihon Kyobu Shikkan Gakkai Zasshi, 1991 Jan, 29(1), 84 - 8
{A case of pulmonary nocardiosis with squamous cell carcinoma}; Okada S et al.; A 61-year-old man was admitted to our hospital with cough, bloody sputum, and chest pain . Bronchoscopy showed a tumor in the truncus intermedius which biopsy and brushing cytology revealed to be squamous cell carcinoma . Also, bronchial washings grew only N . asteroides . Treatment with minocycline and trimethoprimsulfamethoxazole (TMP/SMX) over one month resulted in some improvement in pulmonary symptoms and resolution of the infiltrates in the right lower field . Then, right pneumonectomy was performed . N . asteroides was isolated from the resected tumor . Aggressive bacteriological examinations should be utilized when the possibility of pulmonary nocardiosis is considered.

Jpn J Antibiot, 1991 Jan, 44(1), 48 - 57
{Clinical studies on the utility of ofloxacin for lower respiratory infections}; Sawae Y et al.; One hundred and thirteen patients who were treated at the Kyushu University Hospital and other related hospitals were randomly assigned to 2 groups to compare the effect of twice daily administration of 200 mg each and that of 300 mg each of ofloxacin (OFLX) . The patients included 41 cases with pneumonia, 18 with acute bronchitis, 33 with chronic bronchitis, 15 with bronchiectasis with infection, 3 with diffused panbronchiolitis, and 3 with other secondary infectious diseases . Fifty-five cases were administered 400 mg OFLX a day and 58 cases received 600 mg . The number of severe cases in the 600 mg group was greater than that in the 400 mg group . The ratios of general amelioration of clinical symptoms were 92.6% in the 400 mg group and 82.1% in the 600 mg group . Thus, the ratio of the 400 mg group was better than that of the 600 mg group . However, the ratio of significant amelioration in the 600 mg group was 35.7% which was better than that in the 400 mg group, 27.8% . For bacteriological effects the rate of disappearance and decrease in number of bacteria was 92% in the 400 mg group and was significantly better than that of the 600 mg group, 70% . The incidence of side effects in the 600 mg group was 22.4% and this was high in contrast to that in the 400 mg group, 3.6% . Most of the side effects in the 600 mg group involved symptoms of the central nervous system such as sleeplessness . No significant differences were observed in incidences of abnormalities of laboratory tests at 1.8% and 1.7%, respectively . Safety in the 400 mg group were 96.4% which was significantly higher in number than those in the 600 mg group, 77.6% . Efficacy rates of twice daily administrations each with 200 mg and 300 mg OFLX for lower respiratory infections were 94.4 and 79.3%, respectively . In conclusion, the daily dose of 400 mg was the most effective.

Rev Mal Respir, 1991, 8(1), 110 - 4
{Tuberculosis and acute respiratory insufficiency . Apropos of 2 cases}; Vergnenegre A et al.; We report two cases of death from acute respiratory insufficiency of tuberculous origin . There were rare clinical presentations in which the clinical and radiological aspects were particularly atypical, suggesting a diagnosis of an acute respiratory distress syndrome . Bacteriological confirmation is necessary but it is worth considering this aetiology with each case of unexplained respiratory distress because the mortality is high and the prognosis is related to how early drug therapy is given.

Enferm Infecc Microbiol Clin, 1991 Jan, 9(1), 22 - 5
{Necrotizing infections of the soft tissues . Apropos of 40 cases}; Sanchez Porto A et al.; The diagnosis of necrotizing soft tissue infection (NSTI) is based on a high suspicion index and/or clinical experience . Mortality is associated with delayed diagnosis and use of early surgical treatment, and also with the underlying disease and the patient's age . Usually they are mixed infections; therefore, in addition to surgical therapy an adequate antibiotic coverage is required . The latter, in cases of severe renal failure, might consist in monotherapy . All these guidelines can be modified on the basis of bacteriological findings . The Gram stain of a surgical sample can be very useful to select an appropriate empirical therapy . From a clinical point of view, we suggest to pay extreme attention to the findings consistent with NSTI: tenderness and/or crackling of soft tissue, rapid expansion through natural planes, or visualization of gas in the x-ray film of the involved zone, particularly if associated with a rapid deterioration of the general condition of the patient.

Sex Transm Dis, 1991 Jan-Mar, 18(1), 41 - 3
Multicenter study of a single 500-mg dose of cefotaxime for treatment of uncomplicated gonorrhea; Judson FN et al.; One hundred thirty-seven evaluable patients with uncomplicated gonorrhea were treated with a single 500-mg intramuscular dose of cefotaxime . All isolates were susceptible to concentrations of cefotaxime less than or equal to 0.1 microgram/ml . The minimum concentration of cefotaxime needed to inhibit 90% of isolates was less than 0.04 microgram/ml . At follow-up, infection was eradicated in 181 of 187 (97%) infection sites . Bacteriologic cures of 100 of 101 (99%), 55 of 56 (98%), 23 of 25 (92%), and 3 of 5 (60%) were attained at the urethral, endocervical, rectal, and oropharyngeal sites, respectively . Side effects were minor, and 90% of patients rated the injection-site pain as absent or mild . A single 500-mg dose of cefotaxime is an effective, economic treatment for uncomplicated gonorrhea.

Neurochirurgia (Stuttg), 1991 Jan, 34(1), 14 - 7
{Perioperative preventive use of antibiotics in neurosurgery . Experience with a fixed antibiotic combination of mezlocillin and oxacillin (optocillin)}; Mewe R et al.; We report a retrospective account of 200 patients who have been surveyed after having undergone neurosurgical intervention . They received as perioperative antibiotic prophylaxis a combination of Mezlocillin and Oxacillin in a ratio of 2:1 (Optocillin) in their management . The clinical and bacteriological efficacy including the side effects was examined with standardisation of sterility measures in the operating theatre, careful standardised operative procedures and ward after care . No problems in wound healing were found . There was no certain evidence of side effects.

Ann Dermatol Venereol, 1991, 118(1), 11 - 6
{Erysipelas: epidemiological, clinical and therapeutic data (111 cases)}; Crickx B et al.; A retrospective study of 111 patients admitted to the Dermatology department of the Bichat hospital, Paris, between 1981 and 1988 for treatment of erysipelas revealed the following data: 1 . Erysipelas was located on the lower limbs in 88.3 p . 100 of the cases and on the face in only 9.8 p . 100 . 2 . Facilitating and/or aggravating factors were: portal of entry in 75 p . 100 of the cases; impairment of venous and lymphatic circulations (41 p . 100); diabetes mellitus (13.5 p . 100); alcoholism and its socio-economic consequences (29 p . 100); unnecessary prescription of anti-inflammatory agents (11 p . 100) . 3 . Insufficient consideration was given to the clinical diagnosis: in 7.2 p . 100 of the patients erysipelas was diagnosed either after failure of heparin therapy or because phlebography was normal; some clinical features, notably bullae (30 p . 100) or purpura on the lower limbs (13 p . 100), confused the physicians . Delayed treatment was the main cause of local complications, such as abscess (4 cases) or focal cutaneous necrosis (4 cases) . Erysipelas was recurrent in 23.5 p . 100 of the patients . 4 . Bacteriological data in this series were insufficient to establish percentages of responsible organisms . However, penicillin G in mean doses of 12 million units per day administered intravenously for 5.5 days, then intramuscularly for 10 days was effective as first-line treatment in 80 p . 100 of the cases . Penicillin therapy may fail in patients with insulin-dependent diabetes or belated treatment with complications . No thromboembolic complication was observed (89 p . 100 of patients with lower limb erysipelas had received anticoagulants) . There was only one death due to a severe underlying condition.

Rev Fr Transfus Hemobiol, 1991 Jan, 34(1), 9 - 19
{Preparation of leukocyte-depleted human platelet concentrates by centrifugation and filtration of a pool of sterilely connected buffy-coats}; Angue M et al.; We describe a new method for the preparation of standardised therapeutic doses of leukocyte depleted platelets . The first step is to remove the buffy-coat from whole blood units drawn on triple Siamese ACD/SAGM bags (Maco-Pharma) by means of a Compomat (NPBI) . The second step is to connect (SCD Haemonetics) six buffy-coats and one plasma to a special kit (Maco-Pharma) including a PALL PL 100 filter; after centrifugation, the supernatant platelet concentrate is extracted, filtered and recovered in a 2 litre TOTM PVC bag . The volume, the number of platelets and leukocytes of these pools are measured . A comparison of these parameters is made with therapeutic doses prepared in the same way without filtration . Besides, pH measurements up to the 6th day of storage and bacteriological checks are carried out . The results show: no platelet loss related to filtration; a synergy between the preparation process out of buffy-coats and the filtration: so each dose contains less than 10(6) leukocytes; a good pH level allowing the storage for five days as it is associated to the bacteriological safety of the functionally closed system . This technique makes it possible to transfuse only leukocyte depleted platelet concentrates . In addition, it offers new prospects for standardisation and quality improvement.

J Infect, 1991 Jan, 22(1), 17 - 26
Diagnostic value of clinical and bacteriological findings in pertussis; Granstrom G et al.; Clinical and bacteriological findings in the diagnosis of pertussis were evaluated in 300 consecutive patients with parental or the patient's own suspicion of the disease . Serology was used as a reference method . Of the 285 (95%) patients fully sampled, 163 (57%) were diagnosed as having pertussis while the remaining 122 patients constituted the non-pertussis control group . The clinical and epidemiological data were collected at the first visit made on median day seven of illness . In this population of mainly unimmunised children, the highest predictive values were obtained for the physician's diagnosis of pertussis (100%) and for the physician's diagnosis of some other illness (93%) . The only clinical symptom with a high predictive value for pertussis was the report of whoops (92%) . Among epidemiological data the highest predictive value (90%) was obtained for reported household exposure in unimmunised children more than 1 year of age . Culture of Bordetella pertussis was found to have an overall 50% sensitivity . Isolation of other bacteria had no predictive value in the differential diagnosis of pertussis.

Ann Rheum Dis, 1991 Jan, 50(1), 23 - 6
Osteoarticular complications of brucellosis; Colmenero JD et al.; Two hundred and sixty three patients with a diagnosis of brucellosis between January 1984 and December 1987 were studied prospectively . Sixty five patients (25%) developed osteoarticular complications . These patients had a more prolonged course than those with no complications . Spondylitis in 38 (58%) and sacroiliitis in 29 (45%) were the most prevalent . There were no significant laboratory, serological, or bacteriological differences between patients with and without osteoarticular complications . At diagnosis 47 patients (72%) showed radiographic abnormalities, commonly in axial sites but rarely in peripheral sites . Radionuclide bone scan was positive with no radiographic abnormalities in 17 (26%) of cases . Fifty seven patients received medical treatment alone, 51 (89%) being cured with a single course of treatment . Treatment failed or there was a relapse in six patients (11%), of whom five had spondylitis . Eight of the 65 patients (12%), all of whom had spondylitis and paravertebral or epidural abscesses, also required surgical treatment.

J Bone Joint Surg Br, 1991 Jan, 73(1), 100 - 3
Brucellar and tuberculous spondylitis . A comparative study of their clinical features; Cordero M et al.; The clinical data from 19 patients with brucellar spondylitis and 15 with tuberculous spondylitis were compared . The former disease affects males whose occupations expose them to Brucella . The lumbar spine is usually involved and there are other symptoms of brucellosis . Tuberculous spondylitis is not usually accompanied by general symptoms . The dorsal spine is more frequently affected and may exhibit vertebral collapse and paraspinal abscesses . These differences permit a presumptive aetiological diagnosis, but the definitive diagnosis depends upon bacteriological tests.

Soc Sci Med, 1991, 33(5), 531 - 43
Efficiency in pathology laboratories: a survey of operations management in NHS bacteriology; Szczepura AK; In recent years pathology laboratory services in the U.K . have experienced large increases in demand . But the extent to which U.K . laboratories have introduced controls to limit unnecessary procedures within the laboratory was previously unclear . This paper presents the results of a survey of all 343 NHS bacteriology laboratories which records the extent to which such operations management controls are now in place . The survey shows large differences between laboratories . Quality controls over inputs, the use of screening tests as a culture substitute, the use of direct susceptibility testing, controls over routine antibiotic susceptibility testing, and controls over reporting of results all vary widely . The survey also records the prevalence of hospital antibiotic policies, the extent to which laboratories produce antibiograms for user clinicians, the degree of computerisation in data handling, and the degree of automation in processing specimens . Finally, the survey uncovers a large variation between NHS labs in the percentage of bacteriology samples which prove positive and lead to antibiotic susceptibility tests being carried out.

J Hyg Epidemiol Microbiol Immunol, 1991, 35(3), 251 - 8
Bacteriological quality of drinking water in Kaffa administrative region, south west Ethiopia; Tensay ZW; From May 1985 to June 1986, 21 water supply sources in 3 districts and 6 sub districts of Kaffa Administrative region, south west Ethiopia were surveyed . All together Eighty water samples were collected and bacteriological examinations were done in a public health laboratory in the region . The field survey have shown that the so called protected springs are in un desirable sanitary conditions . Bacteriological quality of the water was also found in unacceptable level (More than 50 coliform organisms per 100 ml . of samples) . The poor quality of water may be responsible for the predominance of water born and related diseases observed in the region . Therefore a prior consideration should be given to improve the quality of water, and sewage disposal system . To obtain and maintain good quality water an integrated plan and work system between the various governmental agencies is crucial.

Arkh Patol, 1991, 53(6), 41 - 6
{Morphological changes in experimental duodenogastric reflux}; Radev D et al.; The model of a total duodenal-gastric reflux was developed in 20 dogs and morphological changes in the stomach were studied . 5 dogs served as control . Histologic changes occurred 3.5 months and 1 year after the operation were characterized by metachromasia, increased mucus formation, proliferation of epithelial and parietal cells, moderate inflammation . Process of the disease had fluctuations . 6 months after the operation 5 dogs were reoperated for the elimination of reflux and were observed for another 6 months . A complete reversibility of all changes was established . Bacteriological studies showed a considerable increase of bacteria population in the stomach and a pH increase . The authors suggest the term 'reflux gastropathy" to replace the term "alkaline reflux-gastritis".

Acta Otolaryngol, 1991, 111(4), 785 - 96
Nasal mucosal changes in children treated with gammaglobulin . Aspects on middle ear pathology and nasopharyngeal bacteriology; Jorgensen F et al.; The present study was undertaken to evaluate possible beneficial effects of gammaglobulin treatment every 3 weeks during 6 months of 6-month to 2-year-old children . Every second of 44 children with recurrent acute otitis media (RAOM) received gammaglobulin, the other 22 served as controls . Nasal mucosal biopsy specimens were taken at 6-month intervals and analysed by light microscopy (LM) and scanning electron microscopy (SEM) . Additional biopsies were obtained from another 15 children with RAOM and from 27 "healthy" children . No morphological differences in nasal mucosa could be demonstrated between the gammaglobulin treated and non-treated children . The structural changes observed in the first biopsy specimens usually persisted for at least 6 months, i.e . the study period, and were most prominent in the epithelium . Children with two or more episodes of acute otitis media (AOM) during the study period had more microabscesses compared to the children without any episode of AOM . Microabscesses were also more common in cases with secretory otitis media compared to cases with normal middle ear status . No morphological differences could be revealed related to the age of the children . Microabscesses, cell destruction and discontinuity of the epithelial lining were more common in children who harboured Branhamella catarrhalis in their nasopharynx . We conclude that intramuscular administration to children of gammaglobulin every 3 weeks during half a year neither improved their resistance to RAOM nor reduced the frequency or extent of structural changes in their nasal mucosa.

Klin Khir, 1991, (6), 26 - 8
{Enteral detoxication using polymethylsiloxane in the comprehensive treatment of septic forms of acute hematogenous osteomyelitis in newborn babies}; Khanes GS et al.; With regard for the role of bacterial and viral toxins and proteases in the pathogenesis of septic forms of acute hematogenous osteomyelitis, the use of enteral detoxication in the pediatric practice has been substantiated . The authors within 1988-1989, in 35 newborns with septic forms of acute hematogenous osteomyelitis used for detoxication the "Enterosgel" preparation . Control of the state of patients was accomplished by means of bacteriologic, biochemical and immunologic methods . A high detoxicative and antiinflammatory activity of the preparation and its harmlessness for the newborns have been proved.

Ann Chir, 1991, 45(6), 497 - 501
{Implantable devices for permanent venous access . A single-center prospective study comparing an AIDS population with a control population (80 cases)}; Johanet H et al.; Although the tolerance of indwelling catheters in AIDS patients has been evaluated, the complications of implanted devices in this population are unknown . This encouraged us to compare in a prospective unicenter trial, dealing with 80 consecutive implanted devices, the complications of this kind of system in 20 AIDS patients, versus a control population . The follow-up was 10,658 days . No patient was excluded or lost to follow-up . In the control population, the infection rate was 5% (0.036 per 100 catheter days) . We observed 3 thromboses (5%) . In the AIDS group, the infection rate was 25% (0.21 per 100 catheter days) . We observed 1 thrombosis (5%) . This trial shows that implanted devices are more frequently infected in AIDS patients (p less than 0.05) than in a control population; it suggests that the infection rate in AIDS patients is not superior to the indwelling catheter rate, as reported in the literature . The precision of bacteriological tests and use of antibiotic therapy adapted to the clinical context should help to determine, in the presence of suspected infection, whether the implanted device can be maintained or should be removed in this high risk population.

Ann Fr Anesth Reanim, 1991, 10(4), 409 - 12
{Verification of bacteriological safety of PCM 40 air conditioner}; Dumas JL et al.; This study assessed the bacteriological safety of the bedside air conditioner PCM 40 (Howorth Airtech), used for prevention of intraoperative hypothermia, by blowing filtered warm air through a special mattress . The 3 microns bacterial filter of the device released 2,968 +/- 5,618 particles of diameter less than 3 microns per m3 of room air, containing 78,798 +/- 37,243 of such particles per m3 . The amount of bacteries in the air pulsed from the mattress was 30 +/- 41 cfu/m3 vs 120 cfu/m3 in the ambient air and in the hot air supply tubing it reached 6 +/- 5 cfu/m3 vs 175 +/- 77 cfu/m3 . It is concluded that bacteriological data do not contra-indicate the use of this air conditioner in the operating theater . The only limitations for use are the position (prone or lateral position) and type of surgery (neurosurgery).

Rev Mal Respir, 1991, 8(4), 387 - 90
{The usefulness of systematic follow-up of tuberculosis for the diagnosis of relapse in French Polynesia between 1971 and 1984}; Glaziou P et al.; Standard chemotherapy for one year was proposed for the treatment of tuberculous patients in French Polynesia between 1971 and 1978, and for nine months with the addition of pyrazinamide from 1979 to 1984 . After treatment, the patients were followed up systematically for a period of 5 years . The aim of this study was to evaluate the value of the follow up measures to detect relapses . Of 1,065 patients treated between 1971 and 1984 at the centre for the control of tuberculosis 35 (3%) presented with a relapse, of whom 30 were confirmed either by bacteriological examination or histological examination . The level of relapse seen was not linked to age, sex, nor type of treatment received (one year or nine months) . However, the level of relapse in non compliant patients to the initial treatment (7%) was significantly greater than those observed in patients who were totally compliant (2%) (p less than 0.0001) . Of the 35 relapses 9 (26%) were discovered during routine follow up visits, of whom 8 were detected during the first year . The median delay separating apparent recovery from relapse was 8 months . 28 patients (80%) presented with symptoms suggestive of a relapse . Over 5 years 5773 consultations were carried out, which meant 642 consultations to detect one relapse . The authors suggest that in French Polynesia a systematic follow up limited to one year after apparent cure should be adequate.

J Clin Lab Anal, 1991, 5(4), 233 - 7
Enzyme-linked immunosorbent assay to detect Mycobacterium tuberculosis antigen 5 and antimycobacterial antibody in cerebrospinal fluid of patients with tuberculous meningitis; Krishnan VV et al.; Inhibition ELISA and indirect ELISA was standardised to detect Mycobacterium tuberculosis antigen 5 and antimycobacterial antibody in cerebrospinal fluid (CSF) specimens of 75 patients with tuberculous meningitis, (TBM) and 75 patients with non-tuberculous neurological diseases (control group) . In both ELISAs, no false-negative results were observed in 15 culture proven patients with TBM . Detection of M . tuberculosis antigen 5 is more sensitive than detection of antimycobacterial antibody . However, both ELISAs showed 100% specificity for tuberculous aetiology in culture-negative patients with TBM . ELISA should be considered as one of the approaches in the laboratory diagnosis of TBM, particularly when standard bacteriological methods are unable to demonstrate M . tuberculosis in CSF specimens of patients with TBM.

Free Radic Biol Med, 1991, 10(5), 297 - 303
An in vitro bacterial model of cytotoxicity to living cells caused by dopamine and 6-hydroxydopamine oxidation at physiological pH; Giunta S et al.; The cytotoxicity of dopamine (DA) and 6-hydroxydopamine (6-OHDA) on living cells, in vitro, has been previously deeply investigated in neuroblastoma cells . This study was designed to explore the possibility to use bacteria as targets for studying DA and 6-HODA cytotoxicity . Both DA and 6-HODA oxidize when added to bacteriological media . The rate of autoxidation of 6-HODA was greater than DA within the first hours . The oxidation-dependent cytotoxicity caused bacterial growth-inhibition and killing at concentration of 10(-4)M . All the bacterial strains tested were slightly more susceptible to DA than to 6-HODA . Antioxidants (sodium metabisulfite, cysteine) prevented the oxidation and abolished the growth-inhibitory activity . The addition of exogenous catalase protected the cells against the effect of the oxidation of both the catecholamines up to the concentration of 5 mM, while the addition of exogenous superoxide dismutase protected the cells only at the minimal inhibitory concentrations . Taking into account that some of the results obtained are similar to those previously reported using neuroblastoma cells as targets, the use of bacteria for studying oxygen toxicity from these catecholamines seems to be a potentially useful model system.

Eur J Nucl Med, 1991, 18(6), 401 - 7
Comparison of technetium 99m polyclonal human immunoglobulin and technetium 99m monoclonal antibodies for imaging chronic osteomyelitis . First clinical results; Sciuk J et al.; The accuracy of technetium-99m human immunoglobulin (HIG) for the detection of chronic osteomyelitis (OM) was compared with white blood cell scintigraphy using 99mTc-labelled monoclonal mouse antibodies (MAB) . Seventeen patients suspected of having OM in 20 lesions went through three-phase skeletal scintigraphy, HIG scintigraphy and MAB scintigraphy . The final diagnosis was established by open surgery, histology and bacteriology . Chronic OM was proved in 14/20 lesions . Six of these 14 infections were located in peripheral areas without active bone marrow and 8/14 in central areas with active bone marrow . In peripheral OM, 5/6 with HIG and 6/6 with MAB were true positives . In the central skeleton all 8/8 infections appeared as cold lesions in the MAB study, which were defined as being false negative due to their non-specificity . Using HIG, 5/8 central infections were determined to be truly positive by showing photon-rich lesions . These 5 lesions were located in the hip region and in the pelvis, whereas 3 lesions of the spine were missed . There were no false-positive results in either studies . In conclusion, MAB was superior to HIG in peripheral OM concerning sensitivity, anatomical landmarks and differentiation of soft tissue versus bone infection . In central OM MAB detected all lesions accurately, but no differential diagnosis was possible due to the non-specificity of photon-low areas . In this respect HIG seems to be more specific due to the increased accumulation even in central infection sites.

Chemotherapy, 1991, 37 Suppl 2, 44 - 52
Intramuscular imipenem/cilastatin in multiple-dose treatment regimens: review of the worldwide clinical experience; Garau J et al.; Multicenter noncomparative trials of intramuscular administration of imipenem/cilastatin for the treatment of a variety of infections requiring multiple-dose therapy are reviewed . Fourteen centers in the United States and 18 centers elsewhere participated in these studies . A total of 686 patients (461 evaluable) were treated worldwide . The severity of the infection was rated as moderate in 58.9%, mild in 37.2% and severe in 0.6% . The most common sites of infection were the skin and soft tissue (36.2%) and intra-abdominal (17.6%) . Polymicrobial infections were relatively common (27%) . Dosing regimens in evaluable patients were 500 mg every 12 h (45.1%), 750 mg every 12 h (36.2%) and 500 mg every 8 h (18.6%) . The overall clinical outcome was favorable (clinical cure or improvement) for 95% or more of the evaluable patients with the various body system infections, except in gynecologic infections where 89% of the evaluable patients had a favorable outcome and for sepsis where the favorable outcome was 76% . Where data were available for analysis (skin and soft tissue infections) there was no difference in favorable clinical outcome among patients with moderate infection treated with 1.0 g/day (95% favorable) compared with 1.5 g/day (94% favorable) . The overall bacteriologic eradication rate was 91% . Clinical adverse effects were similar in type but less common in frequency than those noted in other studies with the intravenous formulation, with nausea, vomiting and diarrhea being most common; no instances of seizures or confusion were observed . The laboratory adverse effects were similar to those seen in other studies with the intravenous formulation, with increased liver enzyme values the most common . The intramuscular injection was well tolerated in 87% of the patients and moderately well tolerated in 6.6% . The efficacy and low incidence of side effects of the intramuscular formulation of imipenem/cilastatin are significant advantages in the cost-effective treatment of infections.

Ophthalmic Res, 1991, 23(1), 40 - 4
Polymorphonuclear leukocytes and bacterial growth of the normal and mildly inflamed conjunctiva; Ugomori S et al.; We examined 304 conjunctiva in 152 subjects by clinical, cytologic, and bacteriologic methods . Bacteriologic samples were evaluated after a 48-hour incubation . Bacterial growth was found in 8 (20.5%) of 39 patients with clinically normal conjunctiva and no polymorphonuclear leukocytes (PMNs), and in 8 (61.5%) of 13 subjects with clinically normal conjunctiva and evidence of PMNs . Bacterial growth also was observed in 4 (40.0%) of 10 patients with clinically mild conjunctivitis and no PMNs, in 10 (24.4%) of 41 patients with clinically mild conjunctivitis and a mixture of inflammatory cells or predominantly lymphocytes, and in 37 (75.5%) of 49 patients with clinically mild conjunctivitis and evidence of PMNs . The presence of PMNs was well correlated with the existence of rapid-growing bacteria.

Curr Eye Res, 1991, 10 Suppl, 131 - 7
Ocular ulcerative herpes following measles in Kinshasa, Zaire; Ukety TO et al.; Eight cases of ocular ulcerative herpes following measles are reported . The clinical features are characterized by dendritic corneal ulcer (6 cases) and ulcero-erosive blepharitis associated with corneal ulcer (2 cases) . Bacteriologic examination disclosed Pseudomonas aeruginosas in 2 cases . The serum level of retinol, RBP, prealbumin and albumin were generally diminished in cases of dendritic corneal ulcer . These data are discussed in relation to the onset and severity of ocular ulcerative herpes associated with measles.

Ther Hung, 1991, 39(1), 25 - 9
Klion in the prevention of early complications following appendectomy; Hajkova H et al.; The authors observations with prophylactic administration of metronidazole manufactured by the Gedeon Richter Company, Hungary (trade mark Klion) in children with phlegmonous appendicitis are reported . The drug was administered in three doses to 51 children . Results of bacteriology could be assessed in 42 children . The results of prophylactic administration of Klion in phlegmonous appendicitis were excellent . In our group there were no inflammatory wounds and/or intraperitoneal complications . For comparison, in a cohort of 1.008 children with phlegmonous appendicitis, without prophylaxis the rate of inflammatory complications was 3.62% . Klion has minimal side effects and is well tolerated and seems to be a superb drug for prophylaxis.

Med War, 1991 Jan-Mar, 7(1), 9 - 15
Primary, secondary, and tertiary prevention of genocidal weapons; Kahan E; For certain countries the availability of the technology and know-how has turned the nuclear weapons option, as well as the possession of chemical and bacteriological weapons, into a threatened reality of the present . Once a country embarks on a 'solution' such as this to its security problems, the countries in conflict with it are obliged to follow suit, thus accelerating the process of development and proliferation of similar weapons . Fear stimulates the creation of a spiral of false security that will inevitably result, if left to its 'natural' forces, in world-wide destruction . Nuclear war is examined here from an epidemiological viewpoint as a disease with two corresponding different possibilities: (a) the natural history of the disease, and (b) modifications produced by primary, secondary and tertiary prevention . Medical responsibility has no alternative but to work for the prevention of the incurable consequences of nuclear war.

Probl Tuberk, 1991, (4), 32 - 4
{Disseminated tuberculosis of the lungs in children}; Mitinskaia LA et al.; The infiltration phase of disseminated pulmonary tuberculosis has recently become a severe form of tuberculosis in children . It is accompanied by bacillary excretion (61.3%), lung tissue destruction (29.1%) and process generalization with extrapulmonary localization . Its course is most severe in the phase of destruction and has fatal outcome in 26.4% of cases which is mainly encountered in children of the early and pubertal age . The differential diagnosis of disseminated pulmonary tuberculosis in children with dissemination of non-tuberculous etiology is of importance considering a high percentage of diagnostic errors . Timely diagnosis of the destruction phase of disseminated pulmonary tuberculosis requires tuberculin diagnosis with Mantoux test with 2 TU PPD-L and bacteriological examination of all children with diffuse lung lesions staying in children's somatic hospitals.

Zhonghua Yi Xue Za Zhi (Taipei), 1991 Jan, 47(1), 24 - 30
Abdominal tuberculosis--a retrospective analysis of 121 cases; Chang HT et al.; From 1960 to 1989, a total of 121 patients with abdominal tuberculosis were treated at this hospital . Ages, at the time of diagnosis, ranged from 14 years to 81 years with a mean of 44 years . There were 86 males and 35 females . No clinical feature was diagnostic, but the leading presenting complaints were abdominal pain (79%) and fever (53%) . Chest x-ray showed that 80 patients (69%) had coexisting evidence of pulmonary tuberculosis . Lesions were most commonly located at the ileocecal region (40%) . The diagnosis was bacteriologically established in only 39 patients (32%) . It was difficult to obtain the definitive diagnosis, most of our patients (91 cases) were diagnosed while undergoing laparotomy with tissue biopsy . Although the principal treatment of abdominal tuberculosis was chemotherapy and operation should be reserved until complications occurred, there were still 96 patients (79%) who underwent surgical procedures . The reasons of high operative rate were the difficulty of early diagnosis and the delay of proper treatment . The common complications of abdominal tuberculosis and the related managements were discussed and the findings in our cases which were helpful in diagnosing abdominal tuberculosis were also presented . Sixteen severely ill patients who died tended to be older, poor nutrition and associated with underlying medical diseases . Abdominal tuberculosis is still persistent in Taiwan, and it must be included in the differential diagnosis of obscure abdominal conditions to avoid diagnostic delay and unnecessary illness and death.

Pneumonol Alergol Pol, 1991, 59(1-2), 22 - 7
{Evaluation of the effectiveness of ofloxacin in the treatment of respiratory tract}; Chyrek-Borowska S et al.; Ofloxacine (Tarivid-Hoechst) was used in 30 patients with infections of the respiratory system, including 12 with pneumonias, 18 with chronic bronchitis . The agent was given in oral form, in a 200 mg tablet every 12 hours for 7 to 10 days . Therapeutical and tolerance was analyzed being on clinical radiological, biochemical and bacteriological findings . Complete remission was found in 21 patients, in 7 more a significant clinical and radiological improvement was found . Altogether in 93.3% of the treated patients the therapeutical efficacy of the agent was found to be excellent . During treatment side effects were not observed . The results if this study demonstrate a high therapeutical efficacy and safety of the agent.

Pneumonol Alergol Pol, 1991, 59(9-10), 33 - 7
{Evaluation of the effect of chronic steroid inhalation therapy on the state of the upper airway in patients with chronic obstructive pulmonary disease}; Kozak E et al.; The aim of the study was to assess the effect of chronic steroid inhalation therapy on the upper airways in patients with chronic obstructive pulmonary disease (COPD) . 44 patients with a first time diagnosis of COPD were evaluated . 22 (11 males, 11 females) were treated with Beclomethasone (1 mg per day) for 6 months . 22 patients that were not treated made up the control group . All had a laryngological and phonic examination carried out, including stroboscopy of the vocal cords, bacteriological and mycological examination of the oral flora . Prior therapy in all patients abnormal findings were present . The six months therapy produced only further increase of hypo-tonus of the vocal cords, without significantly affecting the phonation time and voice pattern . An increase of voice hoarseness, fungal and bacteriological infections were not found.

Arq Gastroenterol, 1991 Jan-Mar, 28(1), 9 - 15
{Furazolidone and cimetidine in patients with active duodenal ulcer and Helicobacter pylori in the gastric antrum}; Coelho LG et al.; In order to assess the effect of furazolidone on duodenal ulcer disease and Helicobacter pylori (Hp), a double-blind, double-dummy, randomized, prospective pilot study comparing furazolidone and cimetidine was carried out in 31 antral Hp positive patients with endoscopically proven active duodenal ulcer . Clinical, endoscopical, bacteriological and histological studies were done before and at four weeks of the study in all patients . If the ulcer was not healed, the treatment was extended for a further four weeks and all the procedures repeated . The healed ulcer patients were followed-up and re-endoscoped, regardless the presence of symptomatology, at least at 3 and 6mo after the end of treatment . It was observed that furazolidone cleared Hp (18% x 0%), healed the ulcer (91% x 87%) and reduced the relapse rate (30% x 92%; p < 0.025).

Chirurgie, 1991, 117(7), 557 - 62; discussion 562-3
{Appendicitis and acquired immunodeficiency syndrome . Apropos of 19 cases}; Johanet H et al.; Appendectomy is the most current digestive surgical procedure in France . Ascending prevalence of infection by HIV, invites us to report 19 documented cases of appendicular syndroma in a population infected by HIV, within 13 cases who required criteria for AIDS . In 31.5% of cases, operation discovered infection by HIV or AIDS . 10 patients had an abscess or gangrenous appendicitis . Furthermore, a tumoral, inflammatory of infectious associated disease which required a treatment was found in 5 others patients . 2 patients died . In all cases, histologic, bacteriologic, virologic and parasitologic samps are warranted to discover current associated diseases.

Acta Univ Palacki Olomuc Fac Med, 1991, 131, 243 - 9
Prevalence of Helicobacter pylori in some patients undergoing upper endoscopy; Gregar I et al.; The group of 156 patients undergoing upper endoscopy at the Department of Central Endoscopy, University Hospital in Olomouc was followed up for determination of HP status by means of the methods of culture, microscopic examination and determination of specific IgG antibodies by ELISA method . Prevalence of HP was determined in individual groups of the series under study (peptic gastroduodenal lesion, antral gastritis of type B, duodenitis) and in subjects with normal endoscopic finding . The most frequent HP positivity was established by the method of specific antibodies determination by ELISA, then microscopic evidence of HP and finally culture . In the whole series under study HP positivity was found in 59.6% (bacteriology) and 79.8% (ELISA method) . The highest HP bacteriological positivity was recorded in antral gastritis of type B (87.1%), or 100% (ELISA method) . Individuals with normal endoscopic finding were HP positive in 24.2%, by serology in 38.8% . The group of 25 dialyzed patients with chronic renal insufficiency was HP positive in 28%, by serology in 53.3%.

Dev Biol Stand, 1991, 73, 329 - 32
Outbreak of pertussis in a residential facility for handicapped people; Tanaka Y et al.; An outbreak of pertussis was recognized and investigated in a ward for neurologically impaired residents . Of 50 residents ranging in age from 8 to 25 years old, 41 (82%) had serological or bacteriological evidence of pertussis infection and 28 (56%) developed typical symptoms of pertussis . Of the 50 residents, nine were immunized and 41 were unimmunized . There were no significant differences in the rate of infection and rate of developing typical symptoms between the immunized and unimmunized (9/8/4 vs 41/33/24) . Of 43 carers, 6 (14%) developed typical symptoms and four of the six showed serological evidence of pertussis infection . Epidemiological survey of this outbreak revealed that pertussis was introduced and spread by the carers . Erythromycin which was administered only to the residents did not prevent the spread of pertussis . We conclude that pertussis immunization including a booster dose should be considered for neurologically impaired people in a closed environment and erythromycin prophylaxis should include adult carers.

Khirurgiia (Mosk), 1991 Jan, (1), 76 - 9
{Therapeutic tactics after laparoscopic cholecystostomy in patients with acute cholecystitis}; Postolov PM et al.; Laparoscopic cholecystostomy was undertaken in 178 elderly and old-aged patients with acute cholecystitis . Dynamic cholecystoscopy with biopsy of the cystic mucosa and bacteriologic study of the bile was conducted for objective appraisal of the inflammatory process in the gallbladder . Concluding operations on the bile tract were carried out in 147 patients . New methods were applied in 10 patients: filling of the gallbladder and contact solution of the stones in the gallbladder and bile ducts.

Br J Clin Pract, 1991 Winter, 45(4), 294 - 5
Lingual abscess: a rarity; Knight LC; A lingual abscess is a great rarity . Only two cases have ever been reported from the United Kingdom, and only three cases have been recorded outside of India in the past fifty years . The third British case is reported and the previous literature reviewed, along with discussion of the aetiology, presentation, bacteriology and management of this rare condition.

Ter Arkh, 1991, 63(11), 50 - 4
{The clinical picture, diagnosis and treatment of acute viral hepatitis with a prolonged convalescence and protracted course}; Mel'nik GV; The paper presents the data on a comprehensive examination of 410 patients suffering from acute viral hepatitis (AVH) with lingering convalescence and lingering course . Based on the use of clinico-epidemiological, serological, bacteriological, immunological, cytochemical, ultrasonography and x-ray research methods, it has been established that virobacterial associations are essential in the pathogenesis and course of the disease . The author provides evidence for risk factors of the lingering course of AVH and recommends methods of rapid diagnosis, prediction and treatment of lingering convalescence and lingering disease.

Z Erkr Atmungsorgane, 1991, 177(1-2), 76 - 81
External quality control of mycobacterial laboratories in the Czech and Slovak Federal Republic and in the former German Democratic Republic; Slosarek M et al.; Simulated samples of sputa respectively negative sputa artificially contaminated with mycobacteria were sent to mycobacteriological laboratories in CSFR and the former GDR for the purpose of conducting an external quality control of the process employed in bacteriological examination . The average percentage of positive results corresponding with the reference material came to 75.7% in CSFR and 92.0% in former GDR . Methodological differences influencing the results of external laboratory control in both countries are discussed . Systematic external controls are recommended as an invaluable aid for improvement of the bacteriological demonstration of mycobacterial infections.

Clin Oral Implants Res, 1991 Jan-Mar, 2(1), 38 - 46
In vivo early human dental plaque formation on different supporting substances . A scanning electron microscopic and bacteriological study; Siegrist BE et al.; Different studies have shown that various substances may have an influence on early human dental plaque formation . The purpose of the present study was to compare on tooth substances and supporting prosthetic materials the amount of plaque deposition by SEM and the quantity of selected bacteria using anaerobic culturing techniques . 5 bridges, replacing a missing molar or premolar, were incorporated in 3 patients . In the midbuccal area of each pontic, a semi-precision attachment was placed allowing the insertion of the following test facings: enamel, dentine, non gamma 2-amalgam, alloys of 85% and 55% gold, silver-palladium, chrome-cobalt, chrome-cobalt-titanium, and ceramic . For each material, 2 facings were fabricated . After 4 and 24 hours in situ, bacteriological samples were taken and processed for further identification . After a 2nd period of 4 and 24 hours in situ, the same facings were carefully removed and prepared for SEM-examination . All 4-hour specimens exhibited various areas covered by plaque, the amount of which varied with the different supporting substances . The very smooth surfaces (e.g., gold) harbored sparse deposits, while the rougher (e.g., amalgam) were covered by more plaque . After 24 hours of plaque development, an increase in the number of micro-organisms was noted for all the specimens . After 4 and 24 hours of plaque accumulation, no specific trends suggesting a preferential colonization on the different substances were observed . This study has shown that the amount of early deposits on different substances seems to be related to the degree of their surface roughness, while plaque formation was qualitatively similar.

Cah Anesthesiol, 1991, 39(8), 541 - 5
{A rapid bacteriologic method for the diagnosis and surveillance of nosocomial pneumopathies}; Raymond J et al.; The authors report a rapid quantitative culture of endotracheal aspiration samples in mechanically ventilated children . There was a good correlation (94.7%) between clinical and radiographic features of pneumonia and a cutoff point of 10(5) cfu.ml-1 . The sensitivity of this rapid quantitative culture was 85% when compared with usual quantitative culture.

Infection, 1991, 19 Suppl 7, S380 - 3
Sequential therapy with i.v . and oral ofloxacin in lower respiratory tract infections: a comparative study; Feist H; The results of an open randomised trial comparing the efficacy of parenteral and oral ofloxacin with that of amoxycillin clavulanate are reported . Of 121 patients enrolled, 92 were clinically evaluable, of whom 59 were treated with ofloxacin and 33 with amoxycillin clavulanate . In the ofloxacin group all patients improved clinically, while in the amoxycillin clavulanate group 94% improved and 6% were clinical failures . In the ofloxacin group 95% showed satisfactory bacteriological response, while in the amoxicillin clavulanate group the bacteriological response was judged satisfactory in 82% of the patients . Seven percent of the patients had mild side effects (headache, nausea, vomiting and skin rashes) . All of these side effects disappeared after treatment . We conclude that ofloxacin is a safe and effective drug in oral and parenteral forms for the treatment of lower respiratory tract infections.

Acta Vet Scand, 1991, 32(2), 205 - 10
The seal death in Danish waters 1988 . 1 . Pathological and bacteriological studies; Heje NI et al.; During the seal epizootic in Danish waters in 1988 a total of 81 adult seals were necropsied . The cause of death was suppurative bronchopneumonia complicated by pleurisy . Histologically, an interstitial pneumonia with cytoplasmatic inclusion bodies typical of canine distemper was identified in many of the seals . The condition was in many cases complicated with a secondary infection with Bordetella bronchiseptica.

Nutrition, 1991 Jan-Feb, 7(1), 33 - 4
Effect of a betadine connection shield on central venous catheter sepsis; Halpin DP et al.; The effect on the rate of central venous catheter sepsis of incorporating the catheter hub in a povidone-iodine (Betadine) connection shield was evaluated in a randomized controlled clinical trial involving 47 Silastic catheters inserted in 35 patients solely for the administration of parenteral nutrition . All catheters were tunneled subcutaneously and once inserted were randomized to one of two subsequent management groups . Group 1 (n = 25) were managed in a standard fashion whereas Group 2 catheters (n = 22) in addition were managed by incorporating the catheter hub in a Betadine connection shield (Connection Shield 3; Travenol/Baxter) . The catheter lifespans in the two groups were similar (Group 1 mean 10.8 days; range 3-28: Group 2 mean 13.3 days: range 5-31) . There was a significant difference in the rates of both clinical sepsis (Group 1, 8 cases; 32%; Group 2, 1 case; 4.5%; p less than 0.05) and bacteriologic sepsis (Group 1, 6 cases; 24%; Group 2, 0 cases; p less than 0.05) in the two groups . Incorporating the catheter hub in a Betadine connection shield confers significant benefit in terms of reducing the incidence of catheter sepsis in patients receiving total parenteral nutrition.

Eye, 1991, 5 ( Pt 6), 717 - 22
Laryngeal and ocular granulation tissue formation in two Punjabi children: LOGIC syndrome; Ainsworth JR et al.; Two unrelated children, both born in the United Kingdom of Punjabi Muslim parents, developed within months of birth, nodules in the larynx, conjunctiva and nailbeds . Currently the younger female child, aged five, is developing skin papules while the elder boy, now aged 15, is debilitated by oral, oesophageal and tracheal granulation tissue formation . Numerous biopsies of the affected tissues have revealed subepithelial granulation tissue formation of unknown aetiology . Extensive haematological, biochemical and bacteriological investigations were uninformative as to the cause . Treatment with steroids, dapsone, antituberculous drugs, and local excision failed to control the disease . No description of this condition exists in the international medical literature available to us.

Chemotherapy, 1991, 37(4), 292 - 6
Treatment of acute pyelonephritis in women with intramuscular ceftriaxone: an out-patient study; Karachalios GN et al.; Ceftriaxone, a third-generation cephalosporin with a long half-life, was administered intramuscularly to 30 adult women suffering from acute pyelonephritis . Standard bacteriologic methods were used to identify the pathogens and their susceptibilities before treatment and at intervals during and after treatment . Overall cure was achieved in 25 (85%) of the patients 6 weeks after completion of therapy . The results demonstrate that ceftriaxone is an effective drug when given once a day intramuscularly to out-patients with acute pyelonephritis.

Probl Tuberk, 1991, (10), 31 - 4
{Differential diagnosis of pleurisy of tuberculous etiology}; Sokolov VA et al.; A combined ++clinico-roentgenological+ examination of 367 patients with a pleurisy syndrome was aimed at the study of a potential establishment of the etiologic diagnosis of the disease . Examination comprised the routine tests and findings of various types of biopsy, including pleural biopsy performed within the first two months from disease onset . The etiologic diagnosis of tuberculous pleurisy was most difficult in 96% of the patients who exhibited prolonged and stable maintenance of exudation or, on the contrary, very rapid regression of the pleural exudate without residual changes . Simultaneous morphologic and bacteriological examination of a pleural biopsy specimen contributed to the most efficacious and reliable diagnosis of tuberculous etiology of pleurisy.

Dev Biol Stand, 1991, 73, 343 - 55
The epidemiological situation of pertussis in the Federal Republic of Germany; Finger H et al.; Whooping cough continues to be a major childhood disease in parts of West Germany . At age six, more than one third of the children in our area have had pertussis according to parental information, whereas only 12% received a specific vaccination . During a four-year period from 1984 to 1987, a total of 2,881 clinically diagnosed cases of whooping cough were investigated . The children had a mean age of 4.1 years, 11% of all patients were younger than one year and 6% of the patients were adults with a mean age of 35.8 years . No sex difference was observed in children (less than 20 years) with clinically overt whooping cough . The seasonal distribution showed that whooping cough was present throughout the year, peaking in early winter . In relation to clinical symptoms, the isolation rate of Bordetella pertussis or Bordetella parapertussis from nasopharyngeal swabs continuously decreased with the duration of paroxysms, starting with 56% positive swabs on day 1 . Titers (greater than or equal to 1:100) of IgA-antibodies to B . pertussis antigens increased with the duration of paroxysmal coughing . B . pertussis, however, was also isolated from 152 of 964 patients without the clinical signs of whooping cough . IgA-antibodies were also found in 522 patients with non-typical respiratory symptoms, but not in healthy blood donors . Children with clinically diagnosed whooping cough were compared to a group of children showing the symptoms but without any clinical or laboratory signs of whooping cough . We can assume from our data that the incidence and duration of non-paroxysmal coughing, the nocturnal increase in coughing, fever, auscultatory findings and a contact anamnesis occurred with a similar frequency in the whooping cough group and the control group . Apart from the typical paroxysmal fits, whooping and vomiting were found significantly more often in the pertussis group . At least 19% of patients with a recent infection with B . pertussis, however, were not diagnosed by clinical symptoms . The leukocyte count differed only marginally between the three groups and was of no great diagnostic value . A relative lymphocytosis, however, was found significantly more often in whooping cough patients and in patients with laboratory-diagnosed infection with B . pertussis . Our study indicates that part of the symptomatology and some laboratory findings in whooping cough patients in endemic areas of West Germany may differ from the classical form of the disease . Furthermore, our data stress the importance of an accurate procedure in diagnosing B . pertussis infection, and this can be facilitated by a combination of bacteriological and serological tests.

Dev Biol Stand, 1991, 73, 333 - 41
Mixed outbreak of Bordetella pertussis and Bordetella parapertussis in an apartment house; Iwata S et al.; From September through November of 1985, a mixed outbreak of Bordetella pertussis and Bordetella parapertussis occurred in an apartment house in Ashikaga City, Japan . Bacteriological and serological investigations were conducted on seven families, comprising 13 adults and 19 children, living in the same apartment house and having social contacts . For all the subjects, cultivation of nasopharyngeal mucus and measurement of pertussis agglutinin antibody, anti-PT antibody, and anti-F-HA antibody were performed . On the basis of the clinical, bacteriological or serological findings, seven children of three families (families A, B and C), including the first child patient (index case) of family A, were diagnosed as having infections caused by B . pertussis, or B . parapertussis or both . B . pertussis and/or B . parapertussis were isolated from six of the seven child patients . B . pertussis alone was isolated from three children (one in each family), and two of them had not been vaccinated . B . parapertussis alone was isolated from two children, while both bacteria were isolated from one child . Those three children from whom B . parapertussis was isolated were in family C, which was the last of the three families to develop symptoms of infection . Josamycin had been administered to two of the three children from whom B . parapertussis was isolated before the nasopharyngeal mucus specimen was collected . In one of the two children from whom only B . parapertussis was isolated, the significant elevation of anti-PT antibody titer was observed, which was indicative of a mixed infection with B . pertussis.(ABSTRACT TRUNCATED AT 250 WORDS)

Proc Finn Dent Soc, 1991, 87(4), 463 - 75
Therapeutic use of sealants for incipient or early carious lesions in children and young adults; Handelman SL; Although the overall caries rate has declined significantly in the past decade, recent studies have shown that caries in occlusal pits and fissures continues to be a significant problem in adolescents and young adults . Radiographic and bacteriologic studies of sealed carious teeth were originally designed to allay the profession's concerns about continued progression of the carious process . These studies have demonstrated that caries is inhibited and may in fact regress under intact sealants . The changes in patterns of caries incidence and the positive results of the sealant studies suggest that alternative approaches to the treatment of incipient or early occlusal caries should be considered . In addition to the radiographic and bacteriological studies of sealed carious teeth, studies on retention over carious pits and fissures, wear, cost effectiveness and changing attitudes of dentists indicate that sealing incipient or early carious lesions is a viable alternative to restoration with amalgam.

Probl Tuberk, 1991, (11), 33 - 7
{Principles of differential diagnosis of diffuse lesions of the lungs}; Khomenko AG et al.; Intricate questions related to the differential diagnosis of diverse diffuse pulmonary disorders are analysed in more than 1500 patients . Among them 1100 patients had sarcoidosis, 284 alveolitis of different etiology (including 62 patients with fibrotic alveolitis of autoimmune genesis), 45 rare pulmonary diseases, 5 carcinomatosis and 40 disseminated tuberculosis . 70% of the patients were hospitalized for pulmonary tuberculosis . Each disease had its typical diagnostic algorithm . In most cases (86-98%) the diagnosis was morphologically evidenced by intrapulmonary transbronchial biopsy . The cytogram of bronchoalveolar washout was examined . Immunologic methods and immunodiagnosis were used to specify the patients' immune status . Considerable attention was given to external respiratory function . The diagnosis of disseminated tuberculosis was verified by bacteriologic examinations and tuberculin diagnosis.

Acta Otolaryngol, 1991, 111(6), 1139 - 45
Secretory IgA- and IgG-coated bacteria in the nasopharynx of children . An immunofluorescence study; Stenfors LE et al.; Bacterial samples were obtained from the posterior wall of the nasopharynx (NPH) of 18 healthy children (age range 1 to 14 years, 10 males, 8 females) and subjected for immunofluorescence studies using fluorescein-labelled goat anti-human IgG and goat anti-human SIgA antibodies . Quantitative and qualitative bacteriological analyses were performed simultaneously . IgG-coated bacteria in the NPH were observed in 1-year-old subjects and opsonized bacteria seemed to increase in numbers and fluorescence intensity with increasing age . SIgA-coated bacteria appeared later, and intensely fluorescing bacteria were not seen until the age of 3 to 6 years . Thirteen out of the 18 children harboured middle ear pathogens in the NPH, but generally speaking non-pathogens dominated the bacterial flora . Immunoglobulins are of the utmost importance for the mucosal defence system, including protection against bacterial attachment to the epithelial cells (SIgA), and bacteriolysis and opsonization of the bacteria (IgG).

Gynakol Rundsch, 1991, 31(3), 167 - 85
{Infection screening in pregnancy}; Gyr T et al.; The aim of screening for infectious diseases in pregnancy is to identify subjects who are at risk of a specific infection, which lends itself to effective intervention . The value of routine screening is determined by the validity of the test and the prevalence of the disorder in the population . During pregnancy, serological screening for rubella, syphilis, toxoplasmosis, HIV, hepatitis B and bacteriological screening for asymptomatic bacteriuria and gonorrhea is recommended . The search for additional infections is reserved for patients presenting special risk factors or clinical symptoms.

Scand J Gastroenterol Suppl, 1991, 186, 95 - 9
Helicobacter pylori and gastritis in children with abdominal complaints; Maaroos HI et al.; Gastroscopy with biopsies was performed in 178 children with upper abdominal pain . Of them 109 (61%) had gastritis and 104 (58%) Helicobacter pylori (HP) in antrum and/or corpus . Gastritis consisted in most cases (87% of antral and 86% of corpus gastritis) of mild superficial round cell infiltration . Mucosal atrophy was not found . Accumulation of granulocytes was present in 43 patients and lymphonoduli were found in 33 patients, usually in connection with gastritis . Gastritis affected only the antrum in 18%, only the corpus in 5% and both antrum and corpus in 62% of the cases of gastritis . There was a good correlation between morphology and bacteriology in the antrum and a satisfactory one in the corpus . However, in some cases gastritis was present without bacteria and in some cases a normal mucosa was associated with bacteria . Gastritis and HP prevalences showed a general increasing trend with age, but significances were with one exception lacking . It is tentatively concluded that gastritis begins in childhood as a slight and chronic superficial infiltration affecting usually antrum and corpus simultaneously . In the majority of cases gastritis is associated with HP infection, which seems to start the process . It is possible that the HP-related gastritis is a common cause of abdominal complaints in children; however, convincing evidence is lacking.

Probl Tuberk, 1991, (8), 68 - 71
{Use of dimephosphon in pathogenetic therapy of experimental tuberculosis}; Aleksandrova AE et al.; The results of a study of a new synthetic drug dimephosphon used as a pathogenetic means in the treatment of experimental tuberculosis are presented . Dimephosphon was found to be responsible for both the in vivo and in vitro decrease of the degree of MBT resistance to rifampicin . The findings of macroscopic, histologic and bacteriologic examinations demonstrated a significant increase in the effectiveness of antituberculous therapy . Dimephosphon monotherapy in mice elicited manifested stimulation of peritoneal macrophages: increase in O2- production, and decline in extracellular 5-nucleotidase activity . Nemolysine-synthetic cellular splenic activity in mice rose essentially . No direct stimulating influence of dimephosphon on functional macrophage activity in vitro was found.

Probl Tuberk, 1991, (7), 7 - 8
{Detection of destructive pulmonary tuberculosis in children at a hospital for somatic diseases}; Mitinskaia LA et al.; Tuberculosis-related examination of 123 children during hospital treatment in 2 pneumologic departments has revealed 9.8% of tuberculosis patients . Among the children with destructive lung processes one-third had tuberculosis in a destructive phase . Timely diagnosis of childhood tuberculosis in children's somatic hospitals, especially in those of a pneumologic type, requires the obligatory Mantoux test with 2 TU PPD-L and in children with destructive lung processes bacteriologic sputum examination for Mycobacterium tuberculosis.

Probl Tuberk, 1991, (7), 24 - 7
{Diagnosis of pleurisy of tuberculous etiology}; Sokolov VA et al.; Among the 367 patients with the pleurisy syndrome examined in a specialized diagnostic department, 167 (45.5%) had tuberculous pleurisy and the active stage of pulmonary tuberculosis was diagnosed in 42 (25.1%); in 125 subjects pleurisy was an independent form of tuberculosis . The possibilities of the clinico-roentgenologic, bioptic and bacteriologic diagnosis of the disease etiology have been studied in different variants of the X-ray picture (unblocked, partially sacculated, sacculated and adhesive pleurisy).

Lab Delo, 1991, (8), 77 - 9
{The results of a comparative study of different series of commercial casein-carbon agar}; Shepilova RG et al.; Comparative assessment of the diagnostic properties of 30 lots of commercial casein-carbon agar used in practical bacteriology for the diagnosis of pertussis has shown essential differences in the efficacies of various lots of this medium . Only 11 of the 30 tested lots provided the formation of B . pertussis colonies in the periods established by the instruction . Addition of antibiotics to the medium reduced its diagnostic characteristics still more.

Lab Delo, 1991, (9), 72 - 4
{Bacterioscopic and bacteriologic study of the vaginal contents of pregnant women}; Litiaeva LA; Comparative analysis of the results of bacterioscopic and bacteriologic studies of vaginal contents of 100 pregnant women suffering from nonspecific inflammatory diseases of the genitals has shown the advantages of the quantitative method of examination as against the bacterioscopic method . This method permits the detection of risk groups among women with Stage II vaginal purity and the identification of the etiologic factor of nonspecific inflammatory diseases of the genitals, thus being conducive to timely etiotropic therapy (bacterial agents).

Lab Delo, 1991, (5), 64 - 5
{Qualification requirements for physician-bacteriologists}; Ved'mina EA et al.; The authors present the qualification requirements to laboratory physicians specialized in bacteriology . The knowledge and skills of a bacteriologist, necessary for his organizations, methodologic, prophylactic, and diagnostic activities, are listed.

Respiration, 1991, 58(2), 65 - 71
Lymphocyte subpopulations analysis in pleural fluid and peripheral blood in patients with lymphocytic pleural effusions; Albera C et al.; Lymphocyte subpopulations analysis by an 11-monoclonal antibody (MoAb) panel was carried out in pleural fluid and in peripheral blood in 30 patients affected by newly diagnosed, untreated pleural effusion of different etiology determinated with bacteriological, cytological or histological criteria . Lymphocytes were the predominant cell type, in pleural fluid, in neoplastic pleural effusions as well as in congestive heart failure pleural effusions and, especially, in tuberculous pleural effusions . Lymphocyte analysis in pleural fluid and in peripheral blood suggests the involvement of different mechanisms for the lymphocyte accumulation in the pleural space according to different etiologies . Tuberculous pleural effusions showed an evident CD4+ and TEC T5.9+ lymphocyte accumulation from peripheral blood . In these patients, cutaneous skin test response to purified protein derivative was strongly related to this situation . In neoplastic pleural effusions there was a lower percentage of CD4+ lymphocytes, reflecting circulating lymphocyte pool; however, in neoplastic pleural effusions, various lymphocyte patterns may be sometimes observed depending on different histologies . Passive lymphocyte accumulation seems to be the most important mechanism in congestive-heart-failure pleural effusions.

Pediatrie, 1991, 46(10), 663 - 7
{Drinking water}; Dartois AM et al.; Water is essential for life . Thirst is a pressing need which always has to be satisfied . Infants need 3 times more water than adults if the requirements is calculated according to body weight . A correct balance in the sensory, physical, chemical and bacteriological qualities of water make it drinkable . Two laws have been passed recently concerning drinking water in France: one deals with water for human consumption (January 3 1989 decree), and the other deals with drinkable bottled mineral water (June 3 1989 decree) . Tap water and bottled water are under strict vigilance . For babies under 4 months of age, it is better to use bottled water with a low mineral content (nitrates less than 15 mg/l) . Hard water is safe; water softeners are useful only for hot water . Fluorination supplies of water is good for dental health at a concentration of 1 mg/l . Plastic bottles are as safe as glass ones.

Acta Clin Belg, 1991, 46(2), 94 - 9
{Emphysematous pyelonephritis in a diabetic patient . Literature review apropos of a case}; Picron B et al.; We report the history of a 65-year-old woman, diabetic for 25 years who presented progressive alteration of consciousness with hyperthermia, right upper quadrant pain and vomiting . Bacteriological and radiographic investigations, especially computerized tomography scan of the abdomen, led to the diagnosis of emphysematous pyelonephritis caused by Escherichia coli . Despite a large spectrum antibiotic therapy and surgical drainage of the gas collection, the patient remained septic . An emergency nephrectomy was eventually performed . We review the characteristics of emphysematous pyelonephritis . Early diagnosis is essential because without early nephrectomy mortality rates reach 75%.

Bone Marrow Transplant, 1991 Jan, 7(1), 61 - 3
Nosocomial legionnaires' disease in a bone marrow transplant unit; Benz-Lemoine E et al.; We report the outcome of nosocomial legionnaires' disease in three patients who were isolated in the same sterile unit after allogeneic bone marrow transplantation . In all three cases the disease presented with dramatic pulmonary symptoms, and diagnosis was ascertained by direct immunofluorescence on bronchoalveolar fluids . None of the patients underwent seroconversion . This report draws attention to: (1) the fact that bacteriological filters do not ensure absolute security; (2) the need for frequent monitoring of the two factors governing legionella growth, water temperature and chlorination; and (3) the effectiveness of quinolones as a curative and prophylactic treatment of legionnaires' disease in transplanted patients avoiding pharmacological cyclosporin interaction.

Cas Lek Cesk, 1990 Dec 7, 129(49), 1541 - 5
{Surveillance of tuberculosis in the Czech Republic in 1989}; Trnka L et al.; The authors report on the tuberculosis situation in the Czech Republic (CR) in 1989 and compare the data with 1988 . The incidence of all cases of TB was 18.4/100,000, the incidence of all cases of respiratory TB 15.5 and that of bacteriologically confirmed cases 11.1/100,000 . The mortality from TB was also low (1/100,000) . Two-thirds of the patients were detected because of the patients' complaints . This passive screening was, however, inadequate in subjects with a poor health consciousness . Active screening was restricted to subjects with a high risk of TB (in contact with tuberculosis, with different diseases, with socio-economic factors, migrating subjects, non-cooperating subjects) . In 1989 for the first time in the CR stagnation of the incidence of bacteriologically confirmed TB of the respiratory organs was recorded . The number of patients (5.7/100,000) with TB with a microscopically positive bacteriological finding in sputum was also the same . A slowing down of the hitherto recorded favourable trend of TB must be foreseen . It will be important to maintain the contemporary system of TB surveillance.

Nippon Jibiinkoka Gakkai Kaiho, 1990 Dec, 93(12), 2014 - 20
{Phinocerebral mucormycosis--report of a case}; Hayashi A et al.; Rhinocerebral mucormycosis is a rare and fatal deep fungus infection occurring in debilitated patients . Its reports have been recently increased because of the increase of such conditions as uncontrolled diabetics, leukemia, and cancer . A 60-year-old male suffering from continuous headache and fever was diagnosed as meningitis, and repeated culture of cerebrospinal fluid was negative . Antibiotic therapy was ineffective . CT scan revealed brain abscess in the right frontal lobe and bone defect over the right posterior ethmoidal sinuses . Both maxillary and ethmoidal sinuses were operated on 38 years ago . The patient was suspected to have rhinologic brain abscess . We intended to remove the source of infection in the right posterior ethmoidal sinuses beneath the base of the skull and to repair the defect of dura mater . The operation was tried on the 6th hospital day . There was a cyst in the posterior ethmoidal sinuses and an intact denuded dura mater over the cyst . The causative organism was not detected by smear test, bacteriological and fungal culture . He relapsed into lethargy, and died on the 21st hospital day due to the vast cerebral infarction . Autopsy revealed rhinocerebral mucormycosis . The literature on this disease was also reviewed and discussed.

J Antimicrob Chemother, 1990 Dec, 26 Suppl E, 93 - 101
Cefpodoxime proxetil: dosage, efficacy and tolerance in adults suffering from respiratory tract infections; Safran C; The efficacy of cefpodoxime proxetil has been studied in ten clinical trials conducted in adults suffering from lower respiratory tract infections (pneumonia, acute bronchitis or acute on chronic bronchitis) and upper respiratory tract infections (tonsillitis/pharyngitis or sinusitis) . All the trials were controlled, randomized, multicentre and international and seven were double-blind, double-dummy designed . Over a period of 18 months from July 1988 to December 1989, 2448 patients were included . Among them, 2429 (99%) were evaluated for tolerance, 2101 (86%) for tolerance and clinical efficacy and 1018 (42%) for tolerance and clinical and bacteriological efficacy . The clinical response was judged satisfactory in 1205/1263 (95.4%) patients treated with cefpodoxime proxetil and in 788/838 (94%) patients treated with comparative antibiotics . The bacteriological response was judged satisfactory for 662/699 (95%) pathogens for cefpodoxime proxetil treatment versus 427/463 (92, 2%) for comparators . Cefpodoxime proxetil has been given to 7351 patients in the course of its international development with no severe side-effect being observed . Common reactions have been noted with a similar frequency to that seen with the other beta-lactams . No pseudomembranous colitis has been observed during clinical trials . On this basis, cefpodoxime proxetil appears to be efficacious and well tolerated and could be an antibiotic of first choice in the treatment of lower and upper respiratory tract infections in adults and adolescents.

J Antimicrob Chemother, 1990 Dec, 26 Suppl E, 71 - 7
Efficacy and tolerance of cefpodoxime proxetil compared with ceftriaxone in vulnerable patients with bronchopneumonia; Zuck P et al.; This multicentre, randomized study compared the efficacy and tolerance of cefpodoxime proxetil and ceftriaxone in vulnerable patients with bronchopneumonia . Patients received cefpodoxime proxetil 200 mg bd orally or ceftriaxone 1 g daily im for a ten-day period . They were evaluated at days 10 and 30 . Ninety-six patients were evaluated for tolerance, 85 for clinical efficacy and 65 for bacteriological efficacy . At entry all patients had radiographic evidence of pneumonia and 74% of bacteriological samples were positive . The percentage of overall success (cured or improved) was 97.7% (43/44) in the cefpodoxime proxetil group and 95.1% (39/41) in the ceftriaxone group . The bacteriological efficacy was 94.3% in the cefpodoxime proxetil group and 97.4% in the ceftriaxone group . Clinical tolerance was satisfactory in both groups . In this study, the clinical and bacteriological results obtained with cefpodoxime proxetil were comparable with those obtained with ceftriaxone in the treatment of community-acquired bronchopneumonia in patients with additional risk factors.

Vet Rec, 1990 Dec 1, 127(22), 543 - 7
A field investigation of causes of abortion in dairy cattle; Murray RD; Cases of abortion on dairy farms on the Lancashire/Cumbria border were investigated by means of a systematic diagnostic procedure, using the facilities of a veterinary practice's laboratory, and the Ministry of Agriculture, Fisheries and Food veterinary investigation centre . Among approximately 3600 animals, 149 abortions were investigated on 54 farms in two years, an annual abortion rate of 2 per cent . A diagnosis was made in 34 per cent of the cases, based on a pathological examination of aborted material and bacteriological and serological findings . The most common pathogens associated with abortion were bovine viral diarrhoea virus (39 cases), bacterial or fungal infections (20 cases), infectious bovine rhinotracheitis virus (19 cases), and Leptospira hardjo (18 cases), either as single or multiple infections.

Lepr Rev, 1990 Dec, 61(4), 353 - 65
Tuberculoid relapse in lepromatous leprosy; Waters MF et al.; It is commonly accepted that the attainment of bacteriological negativity fails to restore the immune state of leprosy patients who have downgraded to lepromatous . We report six patients who had been lepromatous (LLs), and who, after many years of chemotherapy and bacteriological negativity, were found upon relapse to have upgraded to borderline-tuberculoid (BT) . Five had become Mitsuda lepromin positive . The relapses could be accounted for by proven or suspected dapsone resistance . The upgrading was associated with minimal signs of reaction, which was attributed to the low level of antigen in the almost resolved lesions . The manner of development of the new high immune lesions resembled the onset of a primary infection, clinically and histologically . The development of a positive Mitsuda reaction in longstanding LL leprosy is not necessarily an indication of cure.

Isr J Med Sci, 1990 Dec, 26(12), 700 - 4
Spontaneous bacterial peritonitis in alcoholic and nonalcoholic cirrhosis in southern Israel (the Negev); Yerushalmi B et al.; Spontaneous bacterial peritonitis (SBP) is a syndrome diagnosed in 8-18% of hospitalized cirrhotic patients with ascites . The purpose of our study was to investigate the incidence, clinical features, treatment and mortality rate among patients in the Negev (southern Israel) during the years 1982-87 . During this period, 21 patients were diagnosed, with a total of 39 episodes of SBP . While the incidence of SBP observed between 1982 and 1985 was 1.8%, this rate rose to 5.1% in 1986-87 (P less than 0.01), almost certainly a result of an increased awareness of the syndrome . Of our patients 13 had a history of nonalcoholic liver disease, while 8 others were diagnosed as having alcoholic liver disease . Nevertheless there were no significant differences regarding the clinical and laboratory features, the bacteria isolated and the outcome, between alcoholic and nonalcoholic patients, except for chills that were reported by 32% of patients with nonalcoholic liver disease and never by patients with alcoholic liver disease (P less than 0.05) . We conclude that despite the fact that alcoholic cirrhosis occurs much less frequently in Israel than in Europe or North America, SBP is as frequent among hospitalized cirrhotic patients and demonstrates a similar clinical and bacteriological picture.

Tubercle, 1990 Dec, 71(4), 303 - 5
Pulmonary disease caused by Mycobacterium asiaticum; Taylor LQ et al.; A 62-year-old male residing in Los Angeles, California, presented with a right upper lobe nodule associated with dry cough and weight loss . Mycobacterium asiaticum was isolated from sputum on two separate occasions . The patient was subsequently treated with four antituberculous drugs, with bacteriologic conversion . This is the first report of pulmonary disease caused by M . asiaticum in the United States . The bacteriologic, immunologic and clinical aspects are reviewed.

Med Radiol (Mosk), 1990 Dec, 35(12), 40 - 1
{Experience in organizing medical care for the victims of the accident at the Chernobyl Atomic Electric Power Station at a specialized hospital}; Nadezhina NM; Organization of health care for victims of radiation accidents requires well-adjusted organizational activities, including an inpatient clinic with well-equipped reception, dosimetric, karyological and bacteriological laboratories, an intensive care department, a surgical (burn) department, a blood transfusion laboratory and equipment for plasmapheresis and hemosorption . Therapy of such patients should be developed along the following lines: 1) prevention and therapy of infectious complications: 2) blood cell substitution therapy; 3) bone marrow transplantation; 4) detoxicating therapy; 5) correction of water-electrolyte metabolism; 6) therapy of local radiation injuries.

Arch Neurol, 1990 Dec, 47(12), 1313 - 7
Tuberculous meningitis . Short course of chemotherapy; Alarcon F et al.; In March 1986, we began a 6-month short course trial of therapy for tuberculous meningitis, in which 28 patients were analyzed . The diagnosis was based on the following cerebrospinal fluid test results: in 53.5% of the cases, Mycobacterium tuberculosis was identified by direct smear; in 57%, culture in Lowenstein-Jensen medium was positive; in 83.3%, the detection of anti-bacille Calmette-Guerin (BCG) antibodies by enzyme-linked immunosorbent assay was positive; and in 74%, the dosification of adenosine deaminase activity was positive . In addition, in 21.4% of the cases, the diagnosis was established by means of autopsy findings . Moreover, the diagnosis was supported by bacteriological analyses from another tissue or body fluids . Despite the administration of an antituberculous therapy, 32.4% of the patients died: all of the decreased had reached the last stage of the disease by the beginning of treatment . Sixteen percent of the patients who survived after more than 18 months of follow-up after therapy had ended suffered neurological sequelae . With the 6-month therapeutic regimen, the morbidity/mortality is similar to that found in the longer-course therapies . The latter regimen is therefore thought to be a good and acceptable therapeutic option for the treatment of tuberculous meningitis.

Grud Serdechnososudistaia Khir, 1990 Dec, (12), 18 - 22
{Characteristics of the epidemic process in pyoseptic infections in a heart surgery hospital}; Barbarash LS et al.; The authors conducted an epidemiologic analysis of hospital pyoseptic infections on the basis of study of the outcomes of 1,517 operations on the heart and the results of bacteriologic tests . A high frequency of secondary infectious endocarditis in acquired heart diseases was revealed, which allows operations in this group of patients to be related to the category of "conventionally clean" and shows that the proper antiseptic regimen must be organized during the operation without fail . The valves of the heart in 59.3% of patients with acquired heart diseases are affected with the causative agents of hospital pyoseptic infections . The epidemic process is characterized by high intensity of manifestations, dependence on the degree of aggression and invasion of the therapeutic and diagnostic process, the type of the operative intervention, and polymorphism of the clinical manifestations and the etiological structure . The process is of the intermittent dynamic type and is marked by a tendency towards growth of morbidity and mortality with prevalence of an endogenous mechanism of contamination . The main sources and routes of transmission of infection are shown.

An Fac Odontol, 1990 Dec, (26), 33 - 41
{Evaluation of oral health status of a preschool group with a predictive test based on mutans group and clinical studies}; Angulo M et al.; A children's population, aged from 2 to 5 years, was studied for three years . Bacteriological and clinical criteria were followed, with a determination of the M . st level in non-stimulated saliva in the age-groups of 3, 4 and 5 years . We found, as Alaluusua did, a correlation between the M . st level in saliva and the number of caries . With this study, a large number of caries-free children had a low M . st level . The largest amount of caries appears in children with a high M . st level . The highest caries incidence in this population appears at the 4 year children group . It has to be remembered that this is an age-group with specific characteristics . Caries is a disease depending on many factors and the M . st level would be very significant to an early detection of risks, but should be evaluated considering all the parameters as a whole . Its predictive value is not sufficient by itself but it has an unquestionable value when detecting risk patients of an early age . Therefore, treatment has to be the result of an etiological diagnosis addressed to prevention after an evaluation of all the factors related with the caries disease.

Nichidai Koko Kagaku, 1990 Dec, 16(4), 487 - 93
{A survey inquiry of clinical examination for 12 years at dental hospital attached to School of Dentistry at Matsudo}; Tanaka N et al.; Of the total of 1,371,122 out patients who received the clinical examination in the department of Clinical Pathology . Dental Hospital, Nihon University School of Dentistry at Mastudo for 12 years during April 1, 1977 to March 31, 1989, their clinical examination data were gathered and evaluated . The following results were obtained . 1) The average number of patients who received examination was 1,582.2 per year . 2) The ratio of male to female of the examined patients was 1 to 1.04 respectively . 3) The largest number of patients examined was in their age of 40's in both sexes . 4) Among the various clinical departments, oral surgery department most frequently requested clinical examination followed by head and neck surgery, pedodontics conservative dentistry and anesthesiology departments . 5) Among 7 major clinical examination including general, hematological, biochemical, serological, bacteriological, physiological, and pathological examinations, biochemical evaluation was most frequently requested . In average, 30.5 different examinations were performed per patient . 6) Recently, among pathological and serological examinations, the request of HBs antigen and syphilis examinations were increased.

Rev Sci Tech, 1990 Dec, 9(4), 1175 - 8
Isolation of Brucella organisms from the milk of seronegative cows; Zowghi E et al.; During an investigation of bovine brucellosis in Iran, conducted by the Razi Institute over a twelve-month period, samples of serum and milk were collected simultaneously from 6,472 cows in eight infected herds for serological and bacteriological testing . A total of 1,056 cows were serologically positive and 1,632 of 6,472 milk samples were positive to the milk ring test (MRT) . Culture of the positive milk samples yielded 397 isolates of Brucella, 119 of which came from the 5,686 seronegative cows . The isolates belonged to Brucella abortus biotypes 2 (one isolate), 3 (356 isolates) and 9 (40 isolates).

J Antimicrob Chemother, 1990 Dec, 26 Suppl E, 87 - 91
Comparison of cefpodoxime proxetil with cefaclor in the treatment of sinusitis; Gehanno P et al.; The efficacy and tolerance of cefpodoxime proxetil were compared with those of cefaclor in a multicentre, international, prospective, double-blind, placebo-controlled study in adult outpatients suffering from acute sinusitis . At the end of treatment, cefpodoxime proxetil was more effective than cefaclor, producing complete clinical cure in 84% of cases (102/122) vs 68% of cases (77/114) in the cefaclor group (P = 0.01) . The overall clinical efficacy (cure + improvement) was similar in the two groups with 95% (116/122) satisfactory responses in the cefpodoxime proxetil group and 93% (106/114) in the cefaclor group . Bacteriological response was similar with 95% eradication in the cefpodoxime proxetil group (55/58) vs 91% with cefaclor (63/69).

Tubercle, 1990 Dec, 71(4), 253 - 8
Five year results of a 3-month and two 5-month regimens for the treatment of sputum-positive pulmonary tuberculosis in south India; Balasubramanian R et al.; A controlled study of three short-course regimens was undertaken in South Indian patients with newly diagnosed, sputum-positive pulmonary tuberculosis . The patients were allocated at random to one of three regimens: a) Rifampicin, streptomycin, isoniazid and pyrazinamide daily for 3 months (R3); b) the same regimen as above but followed by streptomycin, isoniazid and pyrazinamide twice-weekly for a further period of 2 months (R5); c) the same as R5 but without rifampicin (Z5) . A bacteriological relapse requiring treatment occurred by 5 years in 16.8% of 113 R3, 5.2% of 97 R5, and 20.0% of 115 Z5 patients with organisms sensitive to streptomycin and isoniazid initially . The differences in the relapse rates between the R3 and R5 regimens and the R5 and Z5 regimens were statistically significant (p less than 0.01 for both) . Considering patients with organisms initially resistant to streptomycin or isoniazid or both, 7 of 52 patients (4 R3, 2 R5, 1 Z5) had a bacteriological relapse requiring retreatment.

Cesk Pediatr, 1990 Dec, 45(12), 715 - 8
{Clinical diagnosis and laboratory study of acute respiratory diseases of viral origin in children}; Stanek J et al.; The authors analyzed retrospectively a group of 477 children aged two months to 16 years (mean age 6 years and 5 months), hospitalized on account of acute respiratory disease and subjected to virological examination . The aetiology was revealed in 53% of the sick children . In the elucidation of the aetiology participated a number of respiratory viruses, in particular the respiratory syncytial virus . The clinical picture of the disease was very varied . It was confirmed that the clinical picture does not make it possible to express in a considerable proportion of patients suspicion of an actual infectious aetiology . A mixed aetiology of acute respiratory diseases and a varied clinical picture indicate the necessity of a rapid virological and bacteriological examination in hospital practice.

Antimicrob Agents Chemother, 1990 Dec, 34(12), 2337 - 41
Novel bacteriological assay for detection of potential antiviral agents; Block TM et al.; A prototype assay for the initial screening of potential antiviral agents that uses bacterial growth on selective media is described . The human immunodeficiency virus (HIV) protease recognition sequence was inserted into the tetracycline resistance (Tet) protein encoded by plasmid pBR322 of Escherichia coli . Expression of both the HIV protease and the modified Tet protein prevented growth in the presence of tetracycline . However, inhibition of the HIV protease restored tetracycline resistance . Thus, potential HIV protease inhibitors can be identified by their ability to confer tetracycline resistance to this bacterial strain . The assay is simple, rapid, and inexpensive, and this concept can be applied to the search for inhibitors of other viral proteases.

Vaccine, 1990 Dec, 8(6), 525 - 30
Mycobacterium vaccae in immunoprophylaxis and immunotherapy of leprosy and tuberculosis; Stanford JL et al.; Both leprosy and tuberculosis present continuing problems in their control, especially in the developing world, despite the availability of drugs effective in producing a bacteriological cure . Improved immunoprophylaxis, and an effective immunotherapy to be used with chemotherapy are urgently required . Intradermal injection of a suspension of killed Mycobacterium vaccae promotes cell-mediated responses to antigens common to all mycobacteria, and switches off the tissue-necrotizing aspects of the Koch phenomenon . These properties led to the use of the suspensions as an improved vaccine, either alone or in combination with BCG . The same properties led to the employment of the suspension in immunotherapy as an adjunct to chemotherapy in the treatment of both leprosy and tuberculosis . The evidence leading to these conclusions is reviewed and discussed.

Jpn J Antibiot, 1990 Dec, 43(12), 2035 - 68
{Clinical evaluation of cefuroxime axetil in acute dental infections . Double blind comparative study vs . cefaclor}; Sasaki I et al.; To evaluate objectively clinical efficacy, safety and usefulness of cefuroxime axetil (CXM-AX) in acute dental infections (periodontitis, pericoronitis and gnathitis), we carried out a comparison study using cefaclor (CCL) as the control . Both drugs were orally given after meals in a dose level of 250 mg (potency) t.i.d . for 3-7 days . 1 . Clinical efficacy rates in all the treated cases were 81.6% (102/125) in the CXM-AX group and 82.5% (104/126) in the CCL group according to the assessment by physicians in charge, and 89.6% (112/125) and 83.3% (105/126), respectively, according to the assessment based on scores . No significant difference was found between the 2 treatment groups . In clinical efficacy (assessment by score) classified by background factors, efficacy rate in the CXM-AX group (90.6%, 58/64) was significantly higher (P less than 0.05) than that in the CCL group (75.0%, 48/64) in cases receiving no surgical treatment on the first day of drug administration . Other background factors than the above (no surgical treatment) factor or scores on the first day of drug administration, however, did not appear to influence clinical efficacies of 2 treatment groups . 2 . As for the bacteriological response in all the treated cases, elimination rate in the CXM-AX group was 73.7% (28/38) and that in the CCL group, 78.3% (36/46), without significant difference between the 2 groups . 3 . Regarding the safety, no significant difference was found between the 2 treatment groups . Adverse reactions were observed in 1 out of 128 cases (0.8%) in the CXM-AX group and 6 out of 132 cases (4.5%) in the CCL group . Abnormal laboratory test values were noted in 8 out of 86 cases (9.3%) in the CXM-AX group and 5 out of 91 cases (5.5%) in the CCL group . None of these differences between 2 treatment groups was statistically significant . 4 . Usefulness rates in all the treated cases were 81.6% (102/125) in the CXM-AX group and 81.7% (103/126) in the CCL group, thus significant difference was observed between the 2 groups . From the above results, CXM-AX is considered to be a useful drug like CCL in the treatment of acute dental infections.

J Cell Sci, 1990 Dec, 97 ( Pt 4), 659 - 67
Segregation of the myogenic cell lineage in mouse muscle development; Jones GE et al.; With increasing interest in the idea of therapeutic implantation of normal muscle precursor cells into muscle lacking the protein product of the dystrophin gene, it has become important to obtain enriched populations of myogenic cells from biopsied muscle sources . Myogenic cells for implantation are highly favoured as they are the only cells that will fuse readily with host muscle fibres into which they are implanted, thus carrying the introduced gene into the target fibre with the maximum of efficiency . Second, myogenic cells appear less immunogenic than those of a non-myogenic nature; and third, the use of mononuclear myogenic cells may permit the introduction of multiple copies of a deficient gene into the patient's own cells . From a mixed population of cells obtained by the enzymic disaggregation of neonatal murine muscle we have selected, utilising a modification of the panning technique, for a cell population rich in myogenic cells . Segregation was accomplished using Mab H28, an antibody to the mouse neuronal cell adhesion molecule (N-CAM), derived from mouse/rat hybridoma cells . Following incubation with Mab H28, disaggregated muscle was applied to the surface of a bacteriological grade dish previously coated with anti-rat immunoglobulin . Cells segregated into two populations; those bearing N-CAM, and hence labelled with Mab H28, were adherent to the dish, whereas those not expressing N-CAM remained in suspension . Use of this technique, which involves minimal cell loss, resulted in the segregation of prefusion myogenic cells together with fibroblasts in the 'non-adherent' fraction, whereas cells in the adherent fraction consisted of a highly enriched population of actively dividing myogenic cells.

Tidsskr Nor Laegeforen, 1990 Nov 20, 110(28), 3608 - 11
{Treatment of tuberculosis . Drug combinations, therapeutic problems and results in a 10-year case load}; Morland L; The article describes the treatment of tuberculosis in 426 patients over a period of ten years . The length of treatment decreased during the period . The standard treatment was isoniazide and rifampicin, usually with initial administration of pyrazinamide . In pulmonary tuberculosis (n = 334) the median bacteriologic conversion time was five weeks . In 69 patients the medical regimen had to be changed because of side effects . Of the primary antituberculous drugs, isoniazide was the one producing the highest frequency of side effects . 31 patients showed lowered sensitivity to the usual antituberculous drugs and were treated with varying combinations of second line drugs . In two cases surgery was necessary in order to achieve bacteriologic conversion . Ten patients died of tuberculosis in spite of treatment . Five patients with pulmonary tuberculosis suffered a relapse after treatment . No relapse was noted among patients with extrapulmonary tuberculosis . There were large differences between the different pulmonary treatment centres in Eastern Norway as regards how they practised the Norwegian control routines.

J Am Vet Med Assoc, 1990 Nov 15, 197(10), 1361 - 2
Erysipelothrix rhusiopathiae-induced septic arthritis in a calf; Dreyfuss DJ et al.; A 14-week-old Holstein heifer with a 48-hour history of left tarsocrural joint effusion was referred for evaluation when lameness developed 24 hours after needle aspiration was attempted at the farm . Results of synovial fluid analysis were compatible with diagnosis of septic arthritis, and bacteriologic culture of the fluid yielded Erysipelothrix rhusiopathiae . The calf responded to tarsocrural joint lavage and penicillin G administration.

Tidsskr Nor Laegeforen . 1990 Nov 10;110(27):3505.
{Guidelines for insertion of intrauterine devices}; Jerve F; PIP: The copper-containing IUD has lost some popularity during the past few years but is still used by over 60 million women around the world . This article presents a short review of the major considerations in prescribing an IUD and in the procedure of inserting it . Suspicion of pregnancy, chronic infection or malignity in the genitalia, and multiple sexual partners are the main contraindications . Previous expulsion or pregnancy with an IUD are strong contraindications, since there may be a tendency for these episodes to repeat . Dysmenorrhea and menorrhagia may become more frequent with an IUD . A general practitioner may insert an IUD, but unless he or she performs the procedure often enough to stay familiar, it is better to refer the patient to a more experienced colleague . Before the IUD is inserted, the patient should receive a usual gynecological examination . The condition of the cervix should be checked and a bacteriological culture made if there is evidence of infection, especially of chlamydia . The position of the uterus should be determined and if it is prolapsed or otherwise out of position, a sounding should be taken as a guide for proper insertion into the fundus . The actual insertion should be done slowly and gently with the patient informed of the progress . The IUD may be inserted at any time in the menstrual cycle but if there is any change of impregnation, it is better to wait until early in the next cycle .

Schweiz Med Wochenschr, 1990 Nov 10, 120(45), 1672 - 7
{The diagnosis of pneumonia in the ventilated patient}; Pugin J; The diagnosis of ventilator-associated pneumonia is difficult to confirm because the usual clinical criteria lack predictive value . Risk factors evaluated recently serve to assess subgroups of exposed patients . Bronchoscopic bronchoalveolar lavage (BAL) or protected specimen brush, together with quantitative bacteriology, are the present method of choice for diagnosis of nosocomial pneumonia during mechanical ventilation . Nonbronchoscopic "blind" BAL catheters provide new, attractive, accurate and easy sampling techniques . This could become the technique of choice in the future . Efforts are needed to standardize diagnostic criteria, in order to allow comparisons between groups of patients or clinical trials for prevention or treatment of ventilator-associated pneumonia.

Jpn J Antibiot, 1990 Nov, 43(11), 1914 - 47
{Clinical evaluation of BMY-28100 for bacterial pneumonia in comparison with cefaclor in a double-blind study}; Oizumi K et al.; The efficacy, safety and usefulness of BMY-28100 for the treatment of bacterial pneumonia were compared with those of cefaclor (hereinafter referred to as CCL) in a double-blind study . The daily dosages were 750 mg for BMY-28100 and 1,500 mg for CCL, divided into 3 administrations daily . These drugs were administered orally for at least 14 days . A total of 172 cases were enrolled in this study . Of these, cases which deviated from the protocols were excluded from evaluations . Thus, clinical efficacy was evaluated in 124 cases, adverse reactions were evaluated in 160 cases, and abnormal laboratory test values were evaluated in 146 cases . The following results were obtained . 1 . Efficacy rates ("good" or better responses) in bacterial pneumonia cases as evaluated by the subcommittee were 81.7% (49/60) in the BMY-28100 group and 89.1% (41/46) in the CCL group, thus no significant difference was found between the 2 groups . 2 . Efficacy rates ("good" or better responses), as evaluated by investigators, in the same bacterial pneumonia cases which were subjected to the evaluation by the subcommittee were 83.3% (50/60) in the BMY-28100 group and 88.9% (40/45) in the CCL group, thus no significant difference between the 2 groups was found also . 3 . Bacteriological response rates in bacterial pneumonia cases were 86.2% (25/29) in the BMY-28100 group and 85.7% (18/21) in the CCL group with no significant difference between the 2 groups . 4 . Incidences of subjective/objective clinical adverse symptoms were 3.5% (3/85) in the BMY-28100 group and 1.3% (1/75) in the CCL group, and no significant difference was observed between the 2 groups . No significant difference was also found between the 2 groups in incidences of abnormal laboratory test values, as abnormalities were found in 21.1% (16/76) of the cases in the BMY-28100 group and 25.7% (18/70) in the CCL group . 5 . As for overall usefulness of the drug in bacterial pneumonia cases, utility rates ("useful" or better evaluations) as evaluated by the subcommittee were 83.6% (46/55) in the BMY-28100 group and 90.5% (38/42) in the CCL group, and the rates as evaluated by investigators in cases judged as evaluable by the subcommittee were 78.3% (47/60) and 82.2% (37/45), respectively . There were no significant differences between the 2 groups . The utility rates as evaluated by investigators in cases in which diseases were diagnosed as bacterial pneumonia or lung abscess by investigators were 78.3% (47/60) in the BMY-28100 group and 82.2% (37/45) in the CCL group.(ABSTRACT TRUNCATED AT 400 WORDS)

J Antimicrob Chemother, 1990 Nov, 26 Suppl D, 83 - 91
A comparative study of ofloxacin and amoxycillin/clavulanate in hospitalized patients with lower respiratory tract infections; Khajotia R et al.; We conducted an open randomized trial to compare the efficacy of parenteral and oral ofloxacin with that of amoxycillin/clavulanate . A total of 121 patients was studied; 92 were clinically evaluable . Of these, 59 patients were treated with ofloxacin and 33 with the comparator drug . Patients were given the drugs intravenously for a minimum of three days followed by oral preparations for the next seven to ten days . Ofloxacin was usually administered as a 200 mg dose bd . In the ofloxacin treated group all patients showed clinical improvement . In the comparator group 94% improved clinically (either a complete or partial response), while 6% were clinical failures . Of the bacteriologically evaluable patients 19 of 20 showed a satisfactory bacteriological response in the ofloxacin treated group, while in the comparator group the bacteriological response was judged satisfactory in 14 of 17 patients . A small proportion of patients (7%) treated with ofloxacin suffered mild adverse effects (nausea, vomiting, headache, hypotension and rash) . On the whole, ofloxacin was well tolerated by our patients . The two deaths that occurred were in the comparator group . We conclude that ofloxacin in both oral and parenteral forms is an effective and safe drug in the treatment of lower respiratory tract infections.

Kekkaku, 1990 Nov, 65(11), 755 - 62
{Recent status and control measurement of tuberculous patients in the aged}; Takatorige T; Percentage of aged patients tends to increase year by year in Japan . The mortality and incidence of tuberculous cases is still higher among the aged 60 years or more, those of male are about two times higher than of female . A survey was made on the newly registered tuberculosis patients in Osaka Prefectural health centers during the periods from January 1 to December 31 in 1984, 1987, 1989 respectively . It was the survey regarding their background factors such as sex, age group, occupation, type of tuberculosis, previous history of tuberculosis, bacteriological findings at registry, mode of detection, history of X-ray examinations, X-ray classification of tuberculosis at detection, symptoms, patient's delay, doctor's delay, kinds of first visiting medical facilities and kinds of diagnostic ones, the number of family members living together and tuberculous history of family living together, etc . The coverage by the survey was 80.9% in 1984, 86.9% in 1987, 86.7% in 1989 for the newly registered cases . The proportion of patients with previous history of tuberculosis was higher in the aged groups of 60 and over than in the other age groups . The proportion of patients detected by visiting doctors was higher in the aged groups than the other age groups . The rate of taking chest X-ray examinations during past one year was lower in the aged than the young age groups . The proportions of the cavitary tuberculosis was higher in the aged than the young groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Kekkaku, 1990 Nov, 65(11), 733 - 7
{A new approach to tuberculosis case management}; Mori T; Some characteristics of the Japan's recent tuberculosis epidemiology are discussed . Slowing-off of the decreasing trend of the incidence during the last 10 years has not been well explained . Furthermore, the incidence of bacteriologically confirmed cases has remained almost constant during these period, and the incidence of smear positive cases is even on the increasing trend among old ages . These newly shown features of tuberculosis cast a shadow on the prospects of tuberculosis elimination of the county . The generation gap in the prevalence of tuberculosis infection is very sharp today, and it will be more in the future, which will lead to the greater chance of outbreak of tuberculosis microepidemics in the future . The coverage of chemoprophylaxis as shown by the number of new infections and the registered chemoprophylaxis cases is estimated as about 15% . The contact examination should be more important in the future . The number of examinations in relation to one index case is increasing.

Kekkaku, 1990 Nov, 65(11), 687 - 92
{Observation on the scales of tuberculosis control in Tochigi prefecture}; Kobayashi M; The annual the incidence rate of tuberculosis in Tochigi prefecture has been slowed in decreasing or rather been increasing since 1980 . The purpose of this study is to clarify the factors influencing the yearly changes of the incidence . The incidence rate of tuberculosis, positive rate in bacteriological findings, average duration with active tuberculosis, and etc were observed from 1981 to 1987 by tuberculosis control analytical chart . The results thus obtained were as follows: 1 . The incidence rate of tuberculosis has increased since 1982 in Tochigi prefecture . 2 . In Tochigi prefecture, the proportion of patients with bacteriological examinations was lower, and the rate of patients with positive findings was higher than that of Japan . 3 . The incidence rate in the age group of 5-14 years in Tochigi prefecture was higher than that of Japan . Younger age group should be given health education of tuberculosis . 4 . While the duration of active tuberculosis had been being shortened until 1984 in Tochigi prefecture, but since then the average duration became as long as that of whole Japan . 5 . The proportion of infectious patients without medical treatment in Tochigi prefecture had decreased until 1983, but since then it became as high as that of Japan . The surveillance system of tuberculosis should be used to find infectious patients without medical treatment.

J Reprod Med, 1990 Nov, 35(11 Suppl), 1091 - 4
Therapeutic dilemmas in the treatment of pelvic infections; Gall S; The identification of pathogens and the early recognition of pelvic infections in patients after hysterectomy, cesarean delivery and vaginal delivery were analyzed . Criteria for administering cephamycin therapy were established, as were guidelines for evaluating the progress of the infection . In a comparative study of the safety and efficacy of cefmetazole and cefoxitin in 145 hospitalized patients with pelvic infections there were no significant differences between either the bacteriologic or clinical cure rates of the two antibiotics . Both were efficacious and safe for the treatment of obstetric-gynecologic soft tissue infections.

Rinsho Byori, 1990 Nov, 38(11), 1254 - 9
{Clinical laboratory works and taxonomy in bacteriology}; Yabuuchi E; Taxonomy is the basic stand point for every field of bacteriology and provides a common language to each worker and researcher in bacteriology throughout the world . Proper identification of isolates from human pathological specimens or from hospital environments is one of the five principal fields of bacterial taxonomy . Before the establishment of classification and stabilization of nomenclature, any isolate can not be identified . Collection of unidentifiable strains is the starting point of new taxonomic investigation . Doctors in medical fields tend to be too much concerned to the infrasubspecific subdivisions, such as serological classification, toxigenicity, resistance to antimicrobics, rather ignoring the classification above the rank of subspecies . Doctors who take care patients and workers in clinical bacteriology laboratories should recognize the importance of bacterial taxonomy in general and use the necessary information in taxonomy selectively.

Klin Padiatr, 1990 Nov-Dec, 202(6), 436 - 9
{Hemophagocytic syndrome in childhood}; Lucking-Famira KM et al.; Disorders of the histiocyte-macrophage system in childhood comprise a manifold variety of clinical entities . The basic immunopathological mechanisms have still not been clarified in detail . We report on a 15 months old Yugoslavian boy of non-consanguineous parents, who developed persistent high temperatures and bloody diarrhoea at the age of 11 months, followed by a rapidly progressive dystrophy, hepatosplenomegaly and peripheral pancytopenia . An extensive virological, bacteriological and protozoal diagnostic program failed to reveal a pathological result . A bone marrow aspiration showed an extremely hypocellular marrow without infiltration of pathological cell populations . In spite of extensive supportive care and systemic steroid therapy, the patient died by bleeding complications due to severe untreatable thrombocytopenia . In post-mortem-biopsies a marked infiltration of RES-organs (lymph nodes, liver and spleen) by mature histiocytes, showing marked hemophagocytosis, was seen.

Rev Prat, 1990 Nov 1, 40(25), 2341 - 3
{Upper respiratory tract infections in patients with tracheal intubation}; Boles JM; Nosocomial sinusitis (NS) is observed in 10 to 30 per cent of patients under mechanical ventilation (MV) and in up to 40 per cent in those with nasotracheal intubation . This complication occurs in the first two weeks of MV in 3 out of 4 cases . Apart from a pyrexia, the clinical signs are inconsistent . Radiography at the bedside using a cradle to immobilize the head, shows either opacification of the sinus or a fluid-air level . Cerebral CT scanning is justified when intracranial extension of the infection is suspected . NS is the source of many complications: parasinusitis, intracranial infection, septicemia, and, above all, nosocomial pneumonia . The treatment requires withdrawal of nasal tubes, cleaning the nostrils, nasal decongestants and drainage after transmeatal puncture . The latter procedure enables samples of pus to be taken for bacteriological investigation . The potential gravity of NS justifies a systematic work-up in all patients on MV and strict surveillance of the efficacy of the chosen treatment.

Kekkaku, 1990 Nov, 65(11), 701 - 9
{Purified protein derivatives prepared from Mycobacterium tuberculosis (PPDs) and M . intracellulare (PPD-B) in differential diagnosis of mycobacteriosis}; Shigeto E; To reveal the possibility of differentiating diseases caused by M . tuberculosis and M . intracellulare, simultaneous tuberculin testing by PPDs and PPD-B was carried out among X-ray suspects of tuberculosis and health persons . PPD-B was prepared by Dr . Tasaka (Department of Bacteriology, Hiroshima University) from M . intracellulare (ATCC 13950) . For tuberculin testing, 0.05 micrograms of PPDs from M . tuberculosis (Nihon BCG Co.) and 0.1 microgram of PPD-B were used . The study included 61 patients with disease caused by M . tuberculosis (TB), 23 patients with that of M . avium complex (MAC) and 40 healthy persons with no roentgenological abnormality (H) . Forty healthy persons had been vaccinated with BCG . Statistical analysis of the diameter of reaction (redness) in each antigen in each group has been done by Boxplotting method . The results were as follows: (75% upper quartile point, median, 25% lower quartile point/mean +/- S . D.): PPDs in TB (41.8, 30.0, 19.0/32.0 +/- 17.7); PPD-B in TB (15.0, 10.5, 5.0/10.9 +/- 8.1); PPDs in MAC (26.0, 10.0, 7.0/16.4 +/- 13.9); PPD-B in MAC (20.5, 17.5, 12.5/19.1 +/- 11.4); PPDs in H (18.0, 12.0, 6.0/13.5 +/- 10.9); PPD-B in H (7.0, 2.8, 0.0/4.4 +/- 5.4) . Mean of PPDs in TB patients and PPD-B in MAC patients were significantly (P less than 0.01) larger than those in other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Chin Med J (Engl), 1990 Nov, 103(11), 909 - 14
Nosocomial tuberculosis in hospital staff . The size of the problem in a Hong Kong chest hospital; Kwan SY et al.; In the past three decades, among 831 staff (over 6,862 staff-years) under regular chest radiographic survey in the Grantham Hospital, Hong Kong, the cumulative incidence of active pulmonary tuberculosis requiring treatment was 27 (belonging to 23 staff) . Number of cases detected per year ranged from 0 to 3 . The mean duration from the beginning of employment to the first evidence of disease was 6.43 years . Although this incidence is low, yet the hospital caters for quite a large number of patients with bacteriologically confirmed tuberculosis, we feel that the active screening program for hospital staff should be maintained, and that review of the situation is also recommended.

Ann Ostet Ginecol Med Perinat, 1990 Nov-Dec, 111(6), 372 - 8
The pharmacologic therapy of post-cauterization and post-laser vaporization with polydeoxyribonucleotide; Perino A et al.; The most widely used ablative techniques in the therapy of benign cervical lesions are physical treatments with cauterization or laser vaporization; these are, however, usually used for the largest or symptomatic lesions . Many Authors suggest, after physical treatment, the use of topical chemotherapy in order to abolish any possible inflammatory reaction . The use of drugs such as polydeoxyribonucleotide (PDRN) 5 mg (POLIDES 5--Farmigea), provided with reepithelialization and anticomplement action, seems to promote a quicker recovery of the cauterized or vaporized zone, avoiding, at the same time, the secondary inflammatory reaction . The Authors have assessed the quality of reepithelialization by means of PDRN 5 mg ovules of the cervical zone which has been previously subjected to laser vaporization or cauterization for benign cervical lesions or CIN I . The trial was performed with two groups of patients: Group A: laser vaporization, 45 patients, 23 of whom treated with PDRN and 22 with placebo . Group B: cauterization, 46 patients, 24 treated with PDRN and 22 with placebo . The treatment with PDRN 5 mg ovules started on the day of physical treatment and continued for twelve days . The examination of the patients, performed before the treatment (TO) included the following tests: bacteriological test; PAP-smear, colposcopic examination with eventual direct biopsy . The first follow-up (T 1) was performed after 14 days and included a Pap-smear, colposcopic examination and microcolpohysteroscopy (MC) carried out in the zone where physical treatment had been performed, in order to obtain a map of the reepithelialization process process.(ABSTRACT TRUNCATED AT 250 WORDS)

J Antimicrob Chemother, 1990 Nov, 26 Suppl C, 103 - 10
An open multicentre study of the efficacy and tolerance of cefodizime 1 g bd intravenously or intramuscularly in lower respiratory tract infections; Sollet JP; The efficacy and tolerance of cefodizime in lower respiratory tract infections in hospitalized adults was evaluated in an open, non-comparative multicentre trial . Cefodizime (HR 221), was administered as a dose of 1 g by slow iv or im injection every 12 h (2 g daily) to 301 hospitalized patients aged 18-91 years . The mean duration of treatment was 10 +/- 3 days (median 9, range 1.23) . All 301 patients were evaluable for tolerance, 270 were evaluable for clinical efficacy, and 204 were evaluable for bacteriological efficacy . A satisfactory clinical response was achieved in 87.8% (237/270) of patients and a satisfactory bacteriological response in 90.2% (184/204) . Of the patients given the drug iv, 3.9% (6/153) had pain at the site of the injection compared with 7.4% (11/148) of those given the drug im . Tolerance was good; only five patients experienced an adverse reaction, and a relationship with cefodizime was considered probable in four of these cases . Haematological, hepatic and renal function tests revealed 27 abnormalities, all considered to have a doubtful relationship with treatment.

Radiat Med, 1990 Nov-Dec, 8(6), 219 - 21
Intrahepatic cholangiocarcinoma with cystic formation; Kokubo T et al.; We present a case of intrahepatic cystic cholangiocarcinoma with unusual radiologic appearance . Computed tomography, ultrasonography, and magnetic resonance imaging showed a cystic mass with thick wall, that mimicked liver abscess, and cystic or necrotic metastasis . The fluid in the cyst was not mucinous and was negative bacteriologically . Histologic examination showed cholangiocarcinoma with large cavities resulting from necrosis.

Arzneimittelforschung, 1990 Oct, 40(10), 1156 - 8
Pivmecillinam treatment in acute cystitis . Three versus seven days study; Pitkajarvi T et al.; In an open randomized study pivmecillinam (Selexid; CAS 32886-97-8) was studied by general practitioners in 345 female patients with uncomplicated acute cystitis . Out of the bacteriologically evaluated 299 patients 151 patients were treated for three days with two tablets of pivmecillinam 200 mg t.i.d . and 148 patients for seven days with one tablet t.i.d . There were no significant differences in the bacteriological effect between the two regimens . In the 3-day group 91% and 88% were cured at the first and the second control; in the 7-day group 94% and 95%, respectively . There was no significant difference in the total clinical effect, either . Adverse reactions, usually gastrointestinal disturbances, occurred in 10% of the 3-day group and in 11% of the 7-day group (N.S.) . Pivmecillinam treatment in acute cystitis in women was equally effective whether given for three or seven days, with the same total frequency of adverse reactions for the two regimens.

Z Hautkr, 1990 Oct, 65(10), 937 - 40
{Tuberculosis cutis luposa gigantea with Mycobacterium bovis detection}; Bonnekoh B et al.; In an 80-year-old woman, retired farmworker, we observed lupus vulgaris extending over more than half of her leg . The extreme size of the affected area made us talk of a giant form in this case . Bacteriological investigation revealed Mycobacterium bovis . The minimal amount of tuberculin required to induce a positive intradermal reaction was 10 IU (GT Behring) . Another case with similar dimensions (reported by Christiansen in 1967) had been caused by Mycobacterium avium and developed over a period of at least 5 years . The vast cutaneous affection of our patient, in contrast, had developed within only one year, starting from a brownish macula of the size of a palm on her upper leg . This macula - presumably the manifestation of quiescent lupus vulgaris - had not changed for more than 40 years . This late exacerbation of post-primary tuberculosis might have been favored by the patient's reduced immunologic resistance on account of her advanced age . In addition, local cofactors - namely ankylosis of her knee and contact eczematous dermatitis - have to be considered . In accordance with the resistogram, the disease responded to monotherapy with isoniazide.

Eur J Clin Microbiol Infect Dis, 1990 Oct, 9(10), 758 - 60
Persistent colonization of carbon dioxide incubators with Candida parapsilosis; Schar G et al.; Recurrent contamination of bacteriological specimens with Candida parapsilosis led to epidemiological investigations which indicated persistent colonization of carbon dioxide incubators as the most likely source . Changes in the technical arrangements and institution of a meticulous cleansing protocol eliminated contamination of specimens but not colonization of the incubators . Tests for tolerance of 17% NaCl and survival at 50 degrees C, and SDS-PAGE analysis of crude cell extracts allowed discrimination between epidemic and non-epidemic isolates, while enzyme profile analysis and susceptibility studies failed as typing methods.

Zhonghua Liu Xing Bing Xue Za Zhi, 1990 Oct, 11(5), 274 - 7
{A preliminary investigation of an outbreak of Legionnaires' disease caused by Legionella micdadei at a building-site in the rural area of Beijing}; Wan C; During the period from December 1989 to January 1990, An outbreak of upper respiratory infection (influenza-like syndrome) took place in the workers of a building-site in a rural area of Beijing . An epidemiological investigation and bacteriological examination were carried out in this area . The results showed that it was an outbreak of Legionnaires' Disease caused by Legionella micdadei (Lm) . The incidence was 26.67% (24/90) . This was the first report on Lm infection in China.

Kekkaku, 1990 Oct, 65(10), 619 - 31
{Studies on the changes in clinical features of tuberculosis}; Toyoda T; The epidemiological and clinical features of tuberculosis have largely changed in recent years owing to rapid improvement of social environments and therapeutics . For the determination of these changes, especially clinical ones, the author made comparative studies on all patients hospitalized in National Sanatorium Higashi Saitama Hospital during the periods from 1964 to 1966 and from 1985 to 1988 . The 1964-66 group included 400 patients and the 1985-88 group included 508, making a total of 908 . The results are as follows: 1 . Primary treatment cases with positive bacteriology, atypical mycobacteriosis cases and those with complications increased in number, while re-treatment cases decreased . 2 . Comparison was made for bacteriologically positive primary treatment cases between the two groups, namely 112 patients of 1964-66 group and 213 patients of 1985-88 group . The results were: (1) 1985-88 group included larger number of more aged patients and patients with complications . (2) The two groups showed no marked differences in radiological findings such as the size of affected areas or cavities and the rate of cavitation . The patients with radiologically fibrocaseous findings increased in number . (3) The incidence of lower lung field tuberculosis was almost doubled in the 1985-88 group, and this type of tuberculosis was more frequently observed among patients below 29 and over 70 years of age and among those complicated with diabetes mellitus . In chest CT, eight out of 10 patients with lower lung field tuberculosis showed some changes in their mediastinum and/or hilar lymph nodes . This may suggest that the primary mediastinum and/or hilar lymph nodes tuberculosis had perforated into the trachea or bronchi . (4) Although the two groups did not show difference in mortality, deaths due to complications were observed more in the 1985-88 group . However, 4 patients in this group died of tuberculosis itself, all within about 40 days after hospitalization.

J Neurol Sci, 1990 Oct, 99(1), 93 - 9
Detection of mycobacterial antigen in cerebrospinal fluid: diagnostic and prognostic significance; Radhakrishnan VV et al.; Inhibition enzyme-linked immunosorbent assay (ELISA) was standardised to quantitate circulating mycobacterial antigens in cerebrospinal fluid (CSF) specimens . Of the 40 patients with clinical diagnosis of tuberculous meningitis, the assay was found to be positive in 26 patients . In a control group of 42 patients with non-tuberculous neurological diseases the assay was negative . The assay showed a sensitivity of 65 and 100% specificity for tuberculous meningitis . In 8 patients with tuberculous meningitis receiving chemotherapy, multiple CSF examinations were subjected to this assay . The antigen concentration showed a gradual decrease between 3 and 4 weeks after the commencement of antituberculosis chemotherapy . There was a positive correlation between clinical recovery and antigen concentration . Detection of mycobacterial antigen in CSF specimen by inhibition ELISA has not only diagnostic utility but also could be applied to monitor antituberculosis chemotherapy in patients with tuberculous meningitis . The assay is reproducible and feasible for routine immunology laboratory . It also could be considered as a diagnostic aid when repeated bacteriological cultures are negative in CSF specimens of patients with tuberculous meningitis.

Am J Vet Res, 1990 Oct, 51(10), 1527 - 33
Use of inflammatory cell activities in bovine milk to diagnose mastitis; Lilius EM et al.; The activity of leukocytes, determined by chemiluminescence (CL) emission, was compared with the somatic cell count (SCC) in 4,883 quarter-milk samples from 132 dairy cows . The presence of bacteria was determined by bacteriologic culture of samples in which SCC and CL were high . Chemiluminescence was measured with an automated illuminometer system at 37 C after separating the leukocytes from milk by allowing them to adhere to cotton-wool swabs . Chemiluminescence emission was induced by opsonized zymosan and enhanced by luminol . After luminol and zymosan were added to the measuring vials containing the swabs, CL emission increased rapidly, reaching its maximum usually at about 15 minutes of reaction time, and decreasing slowly thereafter . In general, good correlation was found between CL and SCC (r = 0.876; P less than or equal to 0.001; n = 4,883) . Even milk samples with low SCC gave reliably measurable CL signals . Minor pathogens in the milk caused about a sevenfold increase in both SCC and CL, whereas major pathogens caused 14- and 25-fold increases in SCC and CL, respectively . The diagnostic situation that requires both sensitivity and specificity to be at least 90% was attained only by the CL assay for major pathogens . These results suggest that the measurement of milk leukocyte activity by CL assay applies well to the diagnosis of mastitis, and has the potential to become a large-scale laboratory test, as well as a simple cowside test.

Zentralbl Veterinarmed B, 1990 Oct, 37(8), 624 - 30
Influence of estradiol administration to lactating cows on bacterial growth in milk whey; Saad AM et al.; Bacterial growth (E . coli) in whey was studied by turbidometric technique during estradiol benzoate administration (0.02 mg/kg of body weight/day for 12-19 days) to 13 ovariectomized cows at three stages (early, mid and late) of the 1st- and 3rd-lactations . Whey samples from cows at early stage (60-90 days) of 1st-lactation promote the growth of E . coli during the estradiol treatment . This included a significant increase in the maximum turbidity and a decrease in the generation time . Bacterial growth was inhibited in whey from cows at other stages of lactation during the hormone treatment . The degree of inhibition varied at different stages of lactation . No significant alterations in the ability of whey to support bacterial growth were observed in 3 ovariectomized cows treated with the drug vehicle (arachis oil) alone . Majority of the quarters included in the present study were bacteriologically negative throughout the study.

Zentralbl Veterinarmed B, 1990 Oct, 37(8), 611 - 4
Isolation of Mycoplasma arthritidis from the joint fluid of boars; Binder A et al.; During an outbreak of a disease in a swine insemination centre in Bavaria, Fed . Rep . of Germany, characterized by conjunctivitis, severe polyarthritis and infertility mycoplasmas have been isolated from the joint fluids of the three boars investigated . Two of the isolate could be typed as Mycoplasma (M.) arthritidis which causes arthritis in rats, mice and rabbits, the third as M . collis, a probably apathogenic rodent mycoplasma species . One of the two isolated M . arthritidis strains (strain D 263) was injected intravenously in rats and mice, which developed mild to severe polyarthritis or even died, depending on the numbers of organisms inoculated . Since the bacteriological and virological investigations of the joints of boars did not yield a causative agent, it is to suppose that M . arthritidis played the substantial role in the production of the disease of the boars . It is very likely that the boars caught the mycoplasmas from rodents infected with the isolated species.

Oral Surg Oral Med Oral Pathol, 1990 Oct, 70(4), 414 - 9
Diffuse sclerosing osteomyelitis of the mandible: a new concept of its etiology; van Merkesteyn JP et al.; Diffuse sclerosing osteomyelitis of the mandible is a disease of unknown etiology . The clinical and radiographic findings suggest an infectious origin, but bacteriologic and histologic findings do not support this concept . Analysis of clinical symptoms, localization of the condition, and posttreatment findings in a group of 27 patients suggest a chronic tendoperiostitis due to muscular overuse as an etiologic factor in diffuse sclerosing osteomyelitis of the mandible . This hypothesis was supported by the initial results of muscle relaxation treatment in 13 of these patients.

Zh Mikrobiol Epidemiol Immunobiol, 1990 Oct, (10), 95 - 8
{The immune structure of occupational groups of the population in relation to Legionella pneumophila serogroup 1}; Gerchikova NM et al.; The immune structure of different professional groups with respect to L . pneumophila has been studied . A wide spread of Legionella infection among subway construction workers, subway personnel and railroad conductors has been established, which makes it possible to regard these professions as high risk groups susceptible to Legionella infection . The risk factors for this group are as follows: work in the atmosphere of high dust content with air supply by means of air conditioners, contact with soil in the process of earthwork . The bacteriological study of water samples obtained in dining cars has resulted in the isolation of two strains of L . pneumophila, serogroup I, which confirms the possibility of cases of Legionella infection among railroad personnel.

Arch Roum Pathol Exp Microbiol, 1990 Oct-Dec, 49(4), 331 - 8
Specific antibodies and mycobacterial antigens in patient sera with pulmonary tuberculous and nontuberculous diseases . Note II; Stavri D et al.; "Two-assay" tests (TAT), immunoenzymatic determination of both specific antibodies and mycobacterial antigens in sera of tuberculous and non-tuberculous subjects, was undertaken in our territorial conditions, where BCG vaccination is systematically applied and the prevalence of tuberculous infection is relatively high . The sensitivity of the method, calculated on 42 patients with active pulmonary tuberculosis and on 39 patients with post-tuberculosis syndromes is high, i.e . 0.952 . The specificity of the method separately calculated for 44 young subjects (under 21 years old), for 78 healthy adults and for 201 lung diseased patients, bacteriologically not ascertained as tuberculosis at the moment of sera prelevation, varied between 0.830 and 0.489 . "TAT", performed with crude immunologic reagents, produces false-positive reactions in early BCG vaccinated subjects . Method specificity low values in pulmonary non-tuberculous patients group may be partially explained by the difficulty in establishing the real relationships, in time, between host and mycobacteria, by the bacteriological method imperfections or sample prelevating methods . Our results certainly underestimate the diagnosis value of "TAT".

Ned Tijdschr Tandheelkd, 1990 Oct, 97(10), 414 - 7
{Bacteriological tests in periodontal practice}; Mikx FH; The specificity, sensitivity and predictive value of bacteriological tests in periodontology are reviewed . It is stated that the bacteriological aim in periodontal therapy is the change of the subgingival flora in a facultative flora which is compatible with the host . Bacteriological tests can be used to identify indicator bacteria . It is discussed how a microscopical or a bacteriological identification test can support periodontal diagnoses and indication of periodontal therapy.

Arch Intern Med, 1990 Oct, 150(10), 2105 - 8
Clinical spectrum of endobronchial tuberculosis in elderly patients; Van den Brande PM et al.; We describe 11 elderly patients with bacteriologically proved endobronchial tuberculosis, representing 15% of our 73 geriatric patients with pulmonary tuberculosis in the period 1980 to 1987 . In seven (64%) of the 11 patients, an incorrect diagnosis was initially made . Cough, mostly nonproductive, was invariably present, and general symptoms (fever, anorexia, weight loss) predominated over specific pulmonary symptoms . The radiographic features were rather "unusual": in only two (18%) of the 11 cases, apicoposterior consolidations with or without cavitation were found . Fiberoptic bronchoscopy showed a range of endobronchial abnormalities that included ulcerations, mass lesions, and fibrostenoses . Antituberculous treatment generally led to satisfactory results . Still, residual bronchostenosis was observed in four (57%) of seven patients in whom a control bronchoscopy was done . In one of these four patients, a pneumonectomy had to be performed for uncontrollable retro-obstructive infections, and in another, repeated endoscopic dilatations were effective . In elderly patients, endobronchial tuberculosis should be considered in the differential diagnosis, especially in the presence of chronic cough . In these patients, the chest roentgenogram may be clear or suggestive of bronchial carcinoma or pneumonitis.

Rev Argent Microbiol, 1990 Oct-Dec, 22(4), 167 - 74
{Bacteriological detection of crude oil contamination in the Bahía Blanca estuary}; Cabezali CB et al.; In order to evaluate the distribution of occasional oil spills produced by floating system for transferring crude oil, the number of hydrocarbon-degrading bacteria was counted in superficial sediments from Bahia Blanca Estuary, using the Most Probable Number method . Sediment were collected from ten stations located between buoys 21 and 16 . Heterotrophic aerobic marine bacteria were counted on Marine Agar 2216 . Determination of organic carbon was also carried out . On the base of the number of hydrocarbon-degrading bacteria, statistical analysis differentiated two zones with different degree of pollution, one including the stations of the Principal Channel, with average values, expressed as log10, which ranged from 2.98 to 3.65 bacteria/g of dry sediment, and the other from 4.16 to 4.37, located in small channels on the Southern coast . These results suggest a drift of the oil perpendicular to the Principal Channel, probably caused by the action of predominant winds with direction N, NNW . A linear regression analysis determined highly significant relationship between organic carbon and both bacterial groups . This study shows that the spilled oil is affecting productive zones of the estuary.

Vet Med (Praha), 1990 Oct, 35(10), 577 - 85
{Allergic and serologic diagnosis of paratuberculosis in cattle}; Pavlas M; The use of allergenodiagnosis in cattle herds where paratuberculosis is to be eradicated depends on the allergenogenic properties of the causative agent of this disease . An evaluation of the reliability of an intradermal allergic test performed to diagnose paratuberculosis in cattle in the given area revealed that this method is important especially if the result of this test is explicitly negative . A cultivation proof of the causative agent of paratuberculosis is of greatest importance among bacteriological methods for infection diagnosis . The agreement of the bacteriological and serological examination which reached 80% in young cattle pointed out the high specificity of an indirect haemagglutination test . In cows, unlike calves and heifers, the specificity of diagnostic tests was considerably lower . It is recommended to use an elimination method mainly in young cattle: regular examinations of calves from their age of three months will help to form a group of heifers free of infection, observing the basic infection controlling measures and providing conventient diet.

Stomatol Mediterr, 1990 Oct-Dec, 10(4), 255 - 62
{Effect of spiramycin on the interbacterial aggregation process in dental plaque formation}; Rossetti B et al.; The Authors valued on 18 periodontal patients the bleeding, probing depth, plaque indexes before and after antibiotic therapy with spiramycin . After bacteriological test and coaggregation test the Authors concluded spiramycin all day long is endowed with a good activity in periodontal diseases.

Minerva Urol Nefrol, 1990 Oct-Dec, 42(4), 235 - 8
{A case of lithiasis and stenosis of the urethra . Diagnostic and therapeutic problems}; Polo M et al.; The association of urethral stenosis and stones is not frequent . The urethral stenosis, particularly common in males, recognizes, as predisposing causes, urethritis, IPB, perineal trauma, neurogenic bladder and, last, but not the least important, endoscopic treatments or repeated catheterism . The authors report a case of a 42 year old man who underwent, for urolithiasis, several endoscopic examinations, which became urethral-stenosis with stones within four years . With responsible and critical behaviour, etiology, the diagnostic procedures and the therapy (invasive or not) of the urethral-stenosis are examined and evaluated . Diagnosis must be based on a non painful approach (clinical, bacteriological, ultrasonography, uro-dynamic studies); the invasive procedures must be limited as much is possible . Whatever treatment is used, which may always give sequences or complications, a prolonged follow-up is mandatory to have an objective evaluation of the results.

J Vet Diagn Invest, 1990 Oct, 2(4), 283 - 7
A survey of causes of bovine abortion occurring in the San Joaquin Valley, California; Anderson ML et al.; The causes of abortion in cattle in the San Joaquin Valley of California were surveyed from submissions to the California Veterinary Diagnostic Laboratory at Tulare . Four hundred sixty-eight abortion cases were examined . Most submissions (89%) were from large drylot dairies, milking an average of 814 cows . Abortion evaluations included necropsy, histopathology, bacteriology, virology, and other immunologic and serologic tests . A specific cause was identified in 29.5% of the abortions . Bacterial infections, most of which were sporadic, accounted for 16% of all abortions . Viral causes and protozoal infections were diagnosed in 5.6% and 3.2% of the abortions, respectively . Fetuses with protozoal infection had histologic lesions of focal nonsuppurative necrotizing encephalitis, and protozoa were detected . Similar histologic lesions were seen in 80 additional fetuses (17.1%), and although an etiologic agent was not identified for these cases, a protozoal infection was suspected.

Enferm Infecc Microbiol Clin, 1990 Oct, 8(8), 501 - 4
{Comparative study with digoxigenin and biotin markers for the DNA probe identification of genes coding for type TEM beta-lactamases}; Hermida M et al.; We have tested two non-isotopic labels: digoxigenin--11-dUTP and biotin-7-dATP for the detection of TEM-1 beta-lactamase gene with a TEM-1 probe by DNA:DNA hybridisation (using spot technique) . The use of radioactive labels is inconvenient and not available to all the clinical bacteriological laboratories . The strains tested were: 16 on file (14 carriers of different types of beta-lactamase) and 19 clinical isolated strains . Previously, the plasmid beta-lactamase of these strains had been identified by analytical isoelectric focusing . Using the probe labeled with digoxigenin-11-dUTP, the correlation between results obtained by DNA:DNA hybridisation and those by analytical isoelectric focusing was excellent, with no false positives; with the biotin--7-dATP labeled probe, reading was difficult and some false positives were observed.

Jpn J Antibiot, 1990 Oct, 43(10), 1796 - 805
{A clinical study on cefdinir in pediatrics}; Satoh Y et al.; Clinical evaluations of cefdinir (CFDN, FK482) were carried out . The obtained results are summarized as follows . 1 . Clinical responses to CFDN of 43 patients with pediatric infections were excellent in 23, good in 15, fair in 4 and poor in 1 . The overall efficacy rate was 88% . 2 . Bacteriologically, the eradication rate for 34 isolates presumed to be pathogens was evaluated and the eradication rate was 85.3% . 3 . Side effects observed were diarrhea in 4 of 48 patients . The incidence was 8.3% . Abnormal laboratory findings were an elevation of GOT, an elevation of eosinophils and an increase in platelet counts . The results suggested that CFDN might be a very useful and safe drug for the treatment of pediatric infections.

Zh Mikrobiol Epidemiol Immunobiol, 1990 Oct, (10), 48 - 53
{The formation of the normal intestinal microbiocenosis in newborn infants and under antibiotic therapy}; Trapezov EV et al.; The dynamic study of the microecological state of the intestine in 41 newborns up to the age of 3 months has been made by biochemical and bacteriological investigation methods . The results of the biochemical rapid analysis have been found to be in complete agreement with those of the bacteriological analysis and, besides, to provide essential additional data . The biochemical rapid analysis permits the evaluation of the state resistance to the colonization of the intestine in children, starting from the age of 6 days . The presence of beta-alanine and ninhydrin-positive unidentified Nos . 7, 8a-1, 8d, 9, 10, 11 and 21 is indicative of a greater decrease in the level of the colonization of the digestive tract.

J Dent, 1990 Oct, 18(5), 281 - 3
Cross-infection hazards associated with the use of pumice in dental laboratories; Witt S et al.; The bacteriological contamination of pumice slurry in polishing units in a dental clinical area (high risk), a production laboratory (medium risk), and a non-clinical teaching laboratory (low risk), was investigated . Slurry samples taken from all three areas were found to be heavily contaminated with pathogenic organisms . The investigations were repeated following the addition of a disinfectant with both bacteriocidal and virucidal properties to the pumice . Lower bacterial counts were obtained indicating that routine disinfection of pumice slurries is desirable.

Nippon Hinyokika Gakkai Zasshi, 1990 Oct, 81(10), 1466 - 72
{Clinico-bacteriological studies on the etiology of bacterial prostatitis . II . Virulence factors of E . coli in bacterial prostatitis}; Yamada D; The virulence factors of E . coli in bacterial prostatitis were studied using 59 E . coli isolated from uncomplicated prostatitis . O-antigens of prostatitis-derived E . coli belonged to some specific serotypes such as 0-4, 6, 18, 22 and the haemolysin production was positive in 64.4% . With regard to the fimbriae, the majority of the strains had type 1 fimbriae (81.4%) . Mannose resistant (MR) fimbriae were also positive in 59.3% and both type 1 and MR fimbriae were positive in 55.9% . Among MR strains, P-fimbriated and S-fimbriated strains were present in 25.7% and 28.6%, respectively, indicating that these two MR fimbriae were not always specific for the prostatitis-derived E . coli . Although the specific adhesion of E . coli onto the human prostatic epithelium mediated by MR-fimbriae was equivocal, that mediated by type 1 fimbriae was observed clearly . Therefore, type 1 fimbriae was thought to be one of the most significant virulence factors in the pathogenesis of prostatitis caused by E . coli.

J Hosp Infect, 1990 Oct, 16(3), 249 - 55
A bacteriological assessment of ampicillin with sulbactam as antibiotic prophylaxis in patients undergoing biliary tract operations . The West of Scotland Surgical Infection Study Group; Edwards GF et al.; A prospective audit of 644 patients undergoing biliary tract operations has been conducted in ten district general hospitals . All patients received a single dose of ampicillin 2 g and sulbactam 1 g as antibiotic prophylaxis . Bacteria were cultured from the bile of 121 patients . In patients with sterile bile the incidence of postoperative infection was 2.5%, while in those with colonized bile it was 22% (P less than 0.0001) . The 35 patients from whose bile bacteria of two or more species were isolated, had a higher incidence of wound infection (34%) than those whose bile yielded only one species of bacterium (17%; P less than 0.05) . Seventeen of the 27 patients with colonized bile who developed postoperative infection were shown to be infected by the same organisms that had been isolated from their bile . The patients whose bile yielded organisms resistant to the prophylactic antibiotic combination did not have a significantly higher rate of infection than those from whose bile only sensitive organisms were obtained . A marked difference in sensitivity patterns between the participating hospitals was observed.

Dent Cadmos, 1990 Sep 30, 58(14), 54 - 8, 61
{Sutures in dentistry . Traditional and PTFE materials}; La Scala G et al.; Suture material in PTFE is successfully used in vascular and orthopaedic surgery since many years . More recently it has been applied also in periodontal surgeries, in the guided tissue regeneration technique, thanks to its chemical-physical, mechanical and biological characteristics . The Authors tried to evaluate the indications for the use of this material in different situations in the dental practice . Furthermore a microbiologic study has been carried out, both in vivo and in vitro, and this material has been compared with the twisted coated silk to evaluate the different bacteriological characteristics . In particular it has been demonstrated the reduced adhesion of PTFE in comparison to the twisted silk . This characteristic seemed to be even more relevant after a longer stay of the materials in the oral cavity.

Minerva Stomatol, 1990 Sep, 39(9), 739 - 43
{Dental fluoride prophylaxis: the chemical and bacteriological aspects}; Fagnoni V et al.; In the first part of this paper the chemical and bacteriological rationale of dental caries fluoride prophylaxis is discussed in detail . In the second part the different possibilities of administration of fluorine, their advantages and disadvantages are exposed, with a full description of ionophoresis . This technique is recommended for its reliability, effectiveness and lack of side-effects.

Przegl Dermatol, 1990 Sep-Oct, 77(5), 348 - 54
{Chancriform pyoderma as a clinical problem: observation of 45 patients treated at the Dermatology Clinic, Medical Academy, in Cracow 1962-1986}; Starzycki Z; A clinical, bacteriological and serological pictures of 45 patients with chancriform pyoderma are presented, A single ulcer (92.8%), localized on genitals (91.1%) in adult males (93.3%), imitating or very similar to syphilitic primary chancre in our material was observed . A second case in the literature, of chancriform pyoderma on the dorsal surface of the tongue was recorded.

Kokubyo Gakkai Zasshi, 1990 Sep, 57(3), 430 - 40
{Clinical, bacteriological, and immunological examination and treatment of two Papillon-Lefevre syndrome patients}; Umeda M et al.; Papillon-Lefevre Syndrome (PLS) is a rare disease accompanied by palmo-plantar hyperkeratosis and rapidly progressive periodontal breakdown of deciduous and permanent dentition . Two unrelated female PLS patients, four and seven years old, with severe periodontal destruction were examined . Antibody titers against seven strains by the enzyme-linked immunosorbent assay (ELISA), microbial cultures from deep periodontal pockets and mouth rinse samples and immunoblotting analysis were performed . Titers against Actinobacillus actinomycetemcomitans (A.a.) were found to be high by the ELISA test . Microbial cultures of A . a . were found in high percentage and immunoblotting results against sonicated extracts of an A . a . Y4 strain had similar patterns . All deciduous teeth were extracted from the younger patient, later permanent dentition erupted uneventfully and A . a . colonies could not be detected . However, the older patient did not exhibit improvement with conventional periodontal therapy and antibiotic (minocycline/erythromycin) treatment and A . a . colonies could be consistently cultured . After a subsequent ofloxacin medication, A . a . colony detection was suppressed . Furthermore, a reduction of gingival inflammation and pocket depth were observed . Therefore, A . a . was associated as an important pathogen in the etiology of periodontal disease in these PLS patients.

Berl Munch Tierarztl Wochenschr, 1990 Sep 1, 103(9), 306 - 11
{Use of bacteriological techniques in the quality control of poultry slaughtering}; Fries R; Factors influencing the bacteriological status of materials, treated on a special stage of processing, can be detected by analysis of the flow of production . Changing the design of equipment, change of the production flow and education of the personnel who is handling the equipment can eliminate or minimize the risks . The data are to be collected on the basis of the special conditions of the plant . The daily checks can be performed by visual inspection or by using physical techniques.

Res Vet Sci, 1990 Sep, 49(2), 223 - 8
Effect of creep feeding on the incidence, duration and severity of post-weaning diarrhoea in pigs; Kelly D et al.; The effect of creep feeding on the response of pigs weaned at two or three weeks old to infection with an enteropathogenic strain of Escherichia coli (O149; K91{B}, K88 a, c {L}) was studied in two separate experiments . Gastric intubation was adopted to regulate the intake of creep feed during the sucking period . Animals were given the enteropathogenic strain either before weaning or at weaning and the course and outcome of the infection followed bacteriologically and clinically . The response of the animals to the infection varied considerably in accord with recent reports of multiple phenotypes (to K88 +ve organisms) among pigs but consumption of creep feed before weaning did not significantly affect the prevalence, duration or severity of the diarrhoea induced experimentally by the organism . Hence reputed immunological responses mounted against dietary antigens did not predispose to or protect against this infection.

Zentralbl Veterinarmed B, 1990 Sep, 37(7), 549 - 55
Trials with an enzyme-linked immunosorbent assay (ELISA) for the diagnosis of subclinical genital infections in rams caused by Histophilus ovis and Actinobacillus seminis; Tekes L et al.; The performance of an enzyme-linked immunosorbent assay (ELISA) was evaluated in the serological diagnosis of subclinical genital infection in 6 naturally infected ram flocks and 2 experimentally infected ram hoggets . The test employs lipopolysaccharide (LPS) antigen prepared by autoclaving from Actinobacillus seminis and Histophilus ovis . A total of 193 sheep (118 unmated virgin rams and 75 mature breeding rams) were examined clinically, serologically (by ELISA) and bacteriologically (semen bacteriology) at the same time . Serum samples from all animals were also tested by an ELISA employing LPS antigen prepared from Brucella ovis in the same way . Shedding of A . seminis and H . ovis did not show close correlation with serological positivity (Table 1), as only 9 (15.0%) out of the 60 A . seminis shedders were ELISA seropositive at the same time . As regards H . ovis only 10 (19.2%) out of the 52 H . ovis shedders were ELISA seropositive at the same time . The results indicate that, when used alone, the ELISA employing LPS antigen is unsuitable for diagnosing subclinical genital infection caused by H . ovis and A . seminis in rams . The authors discussed shortly the employing fields of this ELISA test in the diagnostic work.

Int J Lepr Other Mycobact Dis, 1990 Sep, 58(3), 540 - 7
Antigenic protein from Mycobacterium leprae released in macrophages in vitro as indicator of viability of bacteria; Nair I et al.; Peritoneal macrophages from randombred, Swiss white mice, when cultured and infected with Mycobacterium leprae for 24 hours, are able to show the presence of antigen(s) with binding affinity to antibodies present in the sera of bacteriologically positive, lepromatous leprosy patients . Such antibodies are not seen in sera from normal and healthy persons, tuberculoid leprosy patients, or long-term-treated, bacteriologically negative, lepromatous leprosy patients . The production of the antigen(s) is blocked by the anti-M leprae drug rifampin . Other mycobacteria when incubated with macrophages from mice show very little antigens in the lysate but the antigens have an equal affinity for antibodies in sera from both normal individuals and lepromatous patients . Only the lysates from macrophages exposed to live M . leprae could discriminate and could exhibit differential binding to sera from leprosy patients compared to sera from normal individuals . This antigen(s) does not have any binding ability to the monoclonal antibodies available to the antigens of M . leprae identified at present and shown to be specific to M . leprae . This indicates a separate identity of this product which has potential for further exploitation in exploring host-pathogen interactions related specifically to the leprosy infection and the tolerance of M . leprae inside cells.

Int J Lepr Other Mycobact Dis, 1990 Sep, 58(3), 480 - 90
Operational value of serological measurements in multibacillary leprosy patients: clinical and bacteriological correlates of antibody responses; Roche PW et al.; The antibody responses of 100 previously untreated multibacillary (MB) leprosy patients to one protein and two carbohydrate antigens were examined: 94% of the patients had Mycobacterium leprae-specific antibodies; 89% directed to the species-specific epitope on phenolic glycolipid (PGL-I), 89% against the specific epitope on the 35-kDa protein, and 94% against one or both of the two . By contrast, 67% of the patients had anti-lipoarabinomannan (LAM) antibodies . There were trends for the seropositivity rate and the antibody level to rise with the increasing extent of the disease and as patients moved to the polar lepromatous end of the spectrum . The bacillary load, as measured by the bacterial index, was moderately correlated with the IgM anti-PGL-I and the anti-35-kDa antibody levels and, to a lesser extent, with the IgG antibodies directed at the common mycobacterial carbohydrate LAM . The sensitivity of the IgM anti-PGL-I antibodies for detecting smear-positive MB disease was 91%; that for the anti-35-kDa antibodies was 92%.

Arch Intern Med, 1990 Sep, 150(9), 1907 - 12
The optimum use of needle aspiration in the bacteriologic diagnosis of cellulitis in adults; Sachs MK; Twenty-five adult inpatients with cellulitis were prospectively studied to determine if distinctive predisposing factors, characteristic clinical findings, or specific laboratory features were predictive of isolating a pathogen from needle aspiration cultures of the leading edges of their lesions . In the univariate analysis, age, underlying disease, temperature, and white blood cell count at admission to the hospital correlated with a positive needle aspiration culture . A series of logistic regressions were performed to determine if each of these variables was independently associated with a positive needle aspiration culture . The final model demonstrated that underlying disease and body temperature were independent predictors of obtaining a positive needle aspiration culture . Consequently, the addition of white blood cell count and age failed to enhance the model's predictability . For most patients this procedure will not be helpful {corrected} in establishing a bacteriologic diagnosis . On the basis of these results, the needle aspiration technique will most likely yield pathogens in patients with underlying disease that predisposes to the acquisition of cellulitis . These patients may also fail to mount a febrile response to infection.

Am J Med, 1990 Sep, 89(3), 275 - 81
Extragenital Mycoplasma hominis infections in adults; McMahon DK et al.; PURPOSE: To heighten awareness of the role of Mycoplasma hominis as an extragenital pathogen in adults . PATIENTS AND METHODS AND RESULTS: Patients ranged in age from 14 to 76 years . Thirteen patients were immunosuppressed, including nine organ transplant recipients; three were receiving steroids, and two had an underlying malignancy . The remainder were immunocompetent . Thirteen patients had prior surgery at or near the site of infection . M . hominis was isolated from normally sterile sites such as blood or cerebrospinal, pleural, abdominal and joint fluids, and bone . Non-sterile sites of isolation included surgical wounds and pulmonary secretions . The organism was detected in anaerobic cultures of clinical specimens sent to the laboratory for routine bacteriologic culture . Gram stains of fluids or wound drainage revealed neutrophils but no bacteria . Anti-mycoplasmal therapy was effective in eradicating the organism in 13 of 15 patients who were treated . Of those in whom treatment failed, one patient had an antibiotic-resistant isolate and the other had M . hominis isolated from the lung at postmortem after just 2 days of therapy . CONCLUSION: Our experience suggests that significant infections due to M . hominis, although uncommon, are not rare, and methods to isolate and identify this organism should be available for general adult medical and surgical populations.

J Periodontal Res, 1990 Sep, 25(5), 308 - 15
Effect of infection with Eikenella corrodens on the progression of ligature-induced periodontitis in rats; Samejima Y et al.; The periodontopathic ability of Eikenella corrodens 1073-R (EcR) on ligature-induced periodontal defects in immunosuppressed and non-immunosuppressed rats was studied bacteriologically and histologically . Silk ligatures were placed around the maxillary second molars of rats, and the rats were divided into eight groups . Four groups received cyclophosphamide (CY), an immunosuppressive agent, the day after ligature placement . On days 3 and 4, the oral cavities of the rats in all four groups were inoculated with 8 x 10(8) cells of live EcR . Rats were sacrificed on d 1, 3, 5, 8, 11 and 18 . Alveolar bone resorption of ligated rats was enhanced by the implantation of EcR, although the number of total cultivable bacterial cells from ligated sites was not changed by the implantation of EcR . CY suppressed the number of white blood cells, inflammatory cellular infiltrates in gingival tissue, and repair of periodontal tissue, and enhanced bone destruction . The implantation of EcR in the ligature- and CY-treated rats also enhanced osteoclastic bone resorption . Without ligatures, high doses of CY or EcR inoculum did not result in periodontal destruction . These results indicate that it is possible to establish EcR in conventional rat flora with a ligature and that EcR causes osteoclastic bone resorption in this model.

Indian J Pediatr, 1990 Sep-Oct, 57(5), 639 - 44
New approaches to the diagnosis of tuberculosis in childhood with special reference to neurotuberculosis; Grange JM; Bacteriological diagnosis of tuberculosis in childhood is often unsuccessful owing to the difficulty in obtaining suitable specimens . Many attempts have been made to diagnose tuberculosis immunologically but with very limited success . Positive tuberculin reactions may be the result of nonspecific sensitization while negative reactions occur in undernourished children . Serodiagnostic tests suffer from problems of specificity, even when very specific antigens are used, and are often least helpful in diagnostically difficult cases . Detection of antigen has proved to be of more value, especially with clean specimens such as cerebrospinal and pleural fluids . Detection of specific components of Mycobacterium tuberculosis by linked gas chromatography and mass spectroscopy is very sensitive and specific but the equipment is very costly . Detection of specific DNA sequences of M . tuberculosis in specimens by use of labelled 'DNA probes' is rather insensitive although the sensitivity may be increased greatly by use of the polymerase chain reaction to amplify small amounts of the specific DNA . Non specific indicators of tuberculosis are generally unhelpful although the bromide partition test and assay of the enzyme adenosine deaminase in cerebrospinal fluid appear to be of value in the diagnosis of tuberculous meningitis . More research is required to develop a simple, specific and automated test for tuberculosis in childhood.

Arch Mal Coeur Vaiss, 1990 Sep, 83(10), 1597 - 600
{Malignant non-Hodgkin's lymphoma in the superior vena cava and the right ventricle . A case report}; Mesbahi R et al.; A 39-year old patient presented with small, sudden hemoptyses and a diagnosis of pulmonary tuberculosis was made on radiographic pleural and parenchymatous lesions but without bacteriological confirmation . Two years later, the patient was admitted to hospital following severe hemoptysis . Echocardiography revealed the presence of a tumour in the right ventricular outflow tract . At surgery, nodules were also resected from the superior vena cava . Histological examination of the surgical specimens suggested that the tumour was an angiosarcoma . Six months later, the patient returned complaining of a painful swelling in the left iliac fossa . Immuno-histochemical analysis of the cardiac and abdominal tumours finally concluded that it was in fact a malignant non-Hodgkinian lymphoma.

Vet Med (Praha), 1990 Sep, 35(9), 523 - 8
{Biologic characteristics of mycobacterium strains isolated from cattle from herds with clinical paratuberculosis}; Pavlas M; In the period from 1983 to 1986, bacteriological examination for paratuberculosis was performed in 263 samples of lymph nodes, intestinal mucous membrane and excrements of cattle, kept on a farm where clinical paratuberculosis occurred . Seventy-nine strains of mycobacteria were isolated during the culturing . On selective agar medium with mycobactin as the growth stimulator, 71 strains were isolated which had failed to grow on the conventional mycobacterium-culturing media . In the subculture, the dependence of mycobacteria on the mycobactin declined and the number of mycobacterium strains growing in the subculture on conventional mycobacting-free media doubled . Two thirds of the mycobacteria which did not depend on mycobactin during growth exhibited the same antigenic properties as Mycobacterium avium 1, 2, 3, 8 during serotypification . Ability to induce sensibility to PPD avian tuberculin or paratuberculin was demonstrated during the bioassays of mycobactin . Almost a half of the strains inducing animals' sensitivity to the above-mentioned allergens were found to be virulent to pullets that had tuberculosis in their parenchymatous organs . Of the laboratory animals, the highest virulence of the mycobactin-dependent mycobacterium strains was demonstrated in mice subjected to intravenous infection, accompanied by hyperplasia of the spleen, with reisolation of the mycobacterium culture within six eight weeks after infection.

Biochem Biophys Res Commun, 1990 Aug 16, 170(3), 1314 - 8
Laminin "A" chain fragment of Mr 43 kilodalton contains PC12 cell attachment promoting site; Rao CN et al.; In the present study, the ability of a 43 K fragment, originating from the long arm of the 400 K laminin "A" chain (Rao and Kefalides, manuscript in press), to promote the attachment and de novo neurite outgrowth by the pheochromocytoma cell line, (PC12) was studied . Unprimed PC12 cells (not treated with nerve growth factor, NGF), just as the primed cells (treated with NGF), rapidly and efficiently attach to the laminin fragment but less efficiently to the intact laminin coated bacteriological plastic surfaces . The neurite outgrowth was continuous from primed cells attached to both laminin and laminin fragment substrates, when cultured for four days in the presence of NGF . On the other hand, no significant neurite outgrowth was observed from unprimed PC12 cells attached to the laminin fragment coated bacteriological dishes, in the absence of NGF . These data suggest that the 43 K laminin "A" chain fragment contains the PC12 cell attachment promoting site.

J Infect Dis, 1990 Aug, 162(2), 546 - 9
Respiratory viruses interfere with bacteriologic response to antibiotic in children with acute otitis media; Chonmaitree T et al.; Fifty-eight infants and children with acute otitis media were prospectively studied for bacterial and viral pathogenesis and response to antibiotic therapy . Tympanocentesis for bacterial and viral cultures of middle ear fluids (MEF) was done before and 2-4 days after beginning treatment . Patients were followed until the end of antibiotic course . Bacteria were cultured from the preantibiotic MEF in 43 cases (74%) . Viruses were cultured from the preantibiotic MEF in 11 cases (19%); all of these MEFs also contained bacterial pathogens . A significantly higher proportion of patients with both virus and bacteria (50%) failed to respond with clearing of bacteria 2-4 days into therapy compared with the group with bacteria alone (13%) . The patients with persistently positive viral cultures of the MEF seemed to have purulent otitis of longer duration . Presence of virus in the MEF may interfere with bacteriologic and clinical responses to antibiotic . The mechanism of interference deserves further investigation.

Cesk Otolaryngol, 1990 Aug, 39(4), 204 - 8
{Tuberculosis of the cervico-facial lymph nodes in childhood}; Cerny L et al.; The authors proved a tuberculosis origin of lymphadenitis of the cervicofacial area in 16 of 63 children operated on account of this suspected diagnosis . In all instances it was verified by bioptic examination of the removed lymph nodes . However, in no instance acid resistant rods were detected in the microscopic sections . Only in two bacteriological evidence was provided of the presence of mycobacteria tuberculosis in the preoperative punctate from colliquated lymph nodes but not in material obtained from the nodes . The attempt at typing of the causative agent was, however, not successful . In the submitted work the authors paid attention to some aspects of this disease in children, its problems in the area of the parotid gland.

Jpn J Antibiot, 1990 Aug, 43(8), 1462 - 7
{Clinical evaluation of cefdinir in pediatric field}; Mikuni K et al.; We studied the clinical efficacy of cefdinir (CFDN), a new oral cephalosporin, in 18 children with ages 2 years and 4 months to 11 years and 4 months with pediatric infections . The diagnoses consisted of respiratory tract infections in 15 cases, impetigo in 2 and balanoposthitis in 1 . Clinical efficacies were excellent in 11 patients and good in 7, with an efficacy rate of 100% . Bacteriologically, 9 (64.3%) of the 14 strains of clinical isolates were eradicated . No side effects nor abnormal laboratory findings were observed . We have concluded that CFDN is a useful antibiotic for the treatment of mild to moderate pediatric infections.

Vrach Delo, 1990 Aug, (8), 89 - 90
{The hygienic mapping of water resources by the degree of pollution}; Baranovskii VA; The author describes a method of designing a map of the Ukrainian SSR (1:150,000) aimed at hygienic cartography of water objects according to their degree of pollution in the large and small rivers of the Ukraine with consideration of the organoleptic toxicological properties and sanitary regimen . Bacteriological indices were not used.

Rozhl Chir, 1990 Aug, 69(8), 532 - 7
{Prophylactic administration of Klion in acute appendicitis}; Hajkova H et al.; The authors present their experience with the prophylactic administration of metronidazole of Richter Co . Hungary (trade name Klion) in children with phlegmonous appendicitis . The preparation was administered in three doses to 51 children . The bacteriological results were evaluated in 42 children . The results of Klion administration in phlegmonous appendicitis were excellent . In the investigated group there were no wound inflammatory nor intraabdominal complications . For comparison the authors mention a group of 1008 children with phlegmonous appendicitis without prophylactic provisions where the number of inflammatory wound complications was 3.62% . Klion has minimal side-effects, was well tolerated and proved excellent for prophylactic administration.

Neth J Med, 1990 Aug, 37 Suppl 1, S43 - 6
General perianal skin problems; Stolz E et al.; In this paper attention is focused on the following conditions: perianal skin problems such as pruritus in the perianal area, the eczemas, psoriasis, premalignant and malignant tumours such as Bowen's disease and Bowenoid papulosis, squamous cell carcinoma, dermatophyte and yeast infections and sexually transmitted diseases such as syphilis, condylomata acuminata (warts) and genital herpes . Principles of clinical, bacteriological and histopathological diagnosis will be discussed briefly for each of the above-mentioned diseases . For some of these, therapeutic effectiveness and particular side effects due to the use of topically applied drugs containing corticosteroids, anaesthetics, antibiotics and preservatives will also be considered.

J Laryngol Otol, 1990 Aug, 104(8), 645 - 7
A 'silent' intracranial complication of frontal sinusitis; Daya S et al.; Intracranial complications of frontal sinusitis, although rare today, do still develop despite widespread use of antibiotics . We report a case which demonstrates how silently a frontal lobe abscess may present with subtle changes in mood and behaviour, with no focal neurological signs . Diagnosis and management are discussed and a brief review of the incidence of intracranial complications of frontal sinusitis, mode of spread, clinical presentation, investigations, treatment and bacteriology is presented.

Postgrad Med J, 1990 Aug, 66(778), 647 - 9
Pulmonary infiltrates and fever induced by isoniazid; Salomaa ER et al.; An 88 year old woman with bacteriologically confirmed pulmonary tuberculosis was first treated with isoniazid, rifampicin and pyrazinamide . Two weeks later she developed pulmonary infiltrates with fever . A drug-induced reaction was suspected but the reaction recurred three times until isoniazid was identified as the cause . The reaction became worse each time, finally being nearly fatal.

Kekkaku, 1990 Aug, 65(8), 527 - 37
{Present aspect of infection and incidence of tuberculosis in youth registered in Aichi Prefecture}; Fujioka M; In this study, 151 school children and students with tuberculosis registered in Aichi Prefecture during 1983 to 1987 were investigated . The results were as follows: 1) The extent of lesions were not so advanced, as shown by the fact that 27.2% were cavitary and 31.8% were bacteriologically confirmed . 2) They were detected mainly by symptomatic visit to physicians (39.1%), periodic mass radiography (31.8%) and contacts survey (20.6%) . The proportion of the former symptomatic visit was comparatively lower than in other age groups . 3) Patient's delay in cases detected by symptomatic visit was not so evident, however, there is a certain grade of doctor's delay; for instance, 22.0% of them took 2 months and more to be diagnosed . 4) 77.5% of them were vaccinated with BCG once or more, in most cases more than 5 years before their detection . 5) Sources of infection were specified in 52.3% of the cases . Most of them were found in their household and were bacteriologically confirmed at the time of detection . In some students their classmates were suspected as their possible source of infections.

Kansenshogaku Zasshi, 1990 Aug, 64(8), 1048 - 56
{Clinical and bacteriological studies in four cases of pulmonary infection caused by Protomonas extorquens}; Hayashi T et al.; A novel bacterium, Protomonas extorquens was isolated from sputum, pleural effusion and ascitis in four cases of pulmonary infection by buffered charcoal yeast extract agar (B-CYE) which was generally used for Legionella spp . Three cases were so-called immunocompromised hosts (2 malignant diseases, 1 renal failure), and they died from underlying diseases . Protomonas extorquens was newly named by Komagata in 1984, which was characterized by production of pink pigment, growth in methanol medium and positive production of oxidase and catalase . This organism is ordinarily isolated from soil and dead leaves . This is the first report for isolation of P . extorquens from clinical specimens in Japan and it seems to have a significant role in immunocompromised hosts.

J R Soc Health, 1990 Aug, 110(4), 141 - 3
Undiagnosed tuberculosis in hospitalized patients--an autopsy survey; Lee JK et al.; Tuberculosis (TB) causes unnecessary deaths because of failure to diagnose and treat what is today a curable disease . A retrospective study was carried out in a general hospital to assess the magnitude of undiagnosed tuberculosis in hospitalized patients . Sixty-three cases of active tuberculosis, 39 of which were diagnosed only at autopsy, were found among 1306 autopsy cases during a three year study period . The reasons for the failure of diagnosis are discussed . For a correct diagnosis, the post-mortem examination must be systematic and include bacteriological and histological studies.

J Neurol Neurosurg Psychiatry, 1990 Aug, 53(8), 662 - 6
Intrathecal synthesis of anti-mycobacterial antibodies in patients with tuberculous meningitis . An immunoblotting study; Sindic CJ et al.; Cerebrospinal fluid (CSF) and serum samples from eight patients with bacteriologically proven (6) or clinically suspected (2) tuberculous meningitis were tested for the presence of anti-mycobacterial IgG antibodies by an affinity-mediated immunoblot technique . This technique is based on agarose gel isoelectric focusing of paired CSF and serum samples diluted to the same IgG concentration, and transfer of the specific IgG antibodies onto mycobacterial antigen-loaded nitrocellulose sheets . An intrathecal synthesis of anti-mycobacterial oligoclonal IgG antibodies, often superimposed on diffuse polyclonal production was shown in all patients but not in patients with tension headache or other neurological disorders . Similar results were obtained when a purified mycobacterial antigen, A60, was used for coating the nitrocellulose sheets in place of a whole mycobacterial homogenate, indicating that A60 was a major immunogen . The number of anti-mycobacterial oligoclonal IgG bands increased with time, and persisted for years even in clinically cured patients . Some IgG bands had no detectable anti-mycobacterial activity, at least with the antigens preparations used in this study . The demonstration of such anti-mycobacterial IgG bands in the CSF could be a useful adjunct for the diagnosis of tuberculous meningitis, especially in the case of negative cultures.

G Ital Dermatol Venereol, 1990 Aug, 125(7-8), 349 - 52
Sporotrichoid infection . Two cases; Puiatti P et al.; The Authors describe two cases of Sporotrichoid infection characterized by the onset, above previous skin accidental injuries, of a papulo-pustular lesion, with further development of centripetal satellite lesions similar to the first one . A precise etiological definition was possible only after the cultural,l mycological and bacteriological examination of biopsy material . The very similar clinical features of the two cases were due to different etiological pathogens: Sporothrix schenckii in one case and Mycobacterium marinum in the other case . A complete healing of the skin lesion was obtained with Itraconazole in the first case and Rifampin in the second case.

Jikken Dobutsu, 1990 Jul, 39(3), 397 - 400
An attempt at embryo transfer as a means of controlling Bordetella bronchiseptica infection in the rabbit; Suzuki H et al.; Embryo transfer was attempted in order to control disease in rabbits . Embryos were collected by flushing of the oviducts of donor rabbits on Day 2 of gestation, into small tubes containing the medium, transported within the body warmth of the person carrying the tubes and transferred into the oviducts of SPF pseudopregnant recipients . The time between embryo collection and transfer was 7-8 hours . Ten of 56 embryos derived from Bordetella bronchiseptica infected animals developed into newborns . As a result of bacteriological examination of intranasal exudate in six weanlings, no pathogens were detected . We suggest that embryo transfer is an effective and simple alternative to caesarean operation in Bordetella bronchiseptica infected rabbits.

Neurochirurgia (Stuttg), 1990 Jul, 33(4), 110 - 2
{Cerebrospinal fluid penetration of ofloxacin (Tarivid) in non-inflamed meninges}; Staffensky RH et al.; In 9 patients, who underwent lumbar drainage after transsphenoidal surgery for pituitary adenoma, we collected 69 samples of CSF and plasma, respectively . The concentration of ofloxacin was measured bacteriologically . Considering the ofloxacin CSF and plasma levels related to time some aspects of pharmacokinetics are discussed . With maximum CSF concentrations coming up to 40% of plasma levels liquor penetrability is quite good . Ofloxacin seems to be able to prevent (postoperative) meningitis, even with grampositive Cocci.

J Bacteriol, 1990 Jul, 172(7), 3609 - 19
Diversity and origin of Desulfovibrio species: phylogenetic definition of a family; Devereux R et al.; The different nutritional properties of several Desulfovibrio desulfuricans strains suggest that either the strains are misclassified or there is a high degree of phenotypic diversity within the genus Desulfovibrio . The results of partial 16S rRNA and 23S rRNA sequence determinations demonstrated that Desulfovibrio desulfuricans ATCC 27774 and "Desulfovibrio multispirans" are closely related to the type strain (strain Essex 6) and that strains ATCC 7757, Norway 4, and El Agheila Z are not . Therefore, these latter three strains of Desulfovibrio desulfuricans are apparently misclassified . A comparative analysis of nearly complete 16S rRNA sequences in which we used a least-squares analysis method for evolutionary distances, an unweighted pair group method, a signature analysis method, and maximum parsimony was undertaken to further investigate the phylogeny of Desulfovibrio species . The species analyzed were resolved into two branches with origins deep within the delta subdivision of the purple photosynthetic bacteria . One branch contained five deep lineages, which were represented by (i) Desulfovibrio salexigens and Desulfovibrio desulfuricans El Agheila Z; (ii) Desulfovibrio africanus; (iii) Desulfovibrio desulfuricans ATCC 27774, Desulfomonas pigra, and Desulfovibrio vulgaris; (iv) Desulfovibrio gigas; and (v) Desulfomicrobium baculatus (Desulfovibrio baculatus) and Desulfovibrio desulfuricans Norway 4 . A correlation between 16S rRNA sequence similarity and percentage of DNA relatedness showed that these five deep lineages are related at levels below the minimum genus level suggested by Johnson (in Bergey's Manual of Systematic Bacteriology, vol . 1, 1984) . We propose that this branch should be grouped into a single family, the Desulfovibrionaceae . The other branch includes other genera of sulfate-reducing bacteria (e.g., Desulfobacter and Desulfococcus) and contains Desulfovibrio sapovorans and Desulfovibrio baarsii as separate, distantly related lineages.

Head Neck, 1990 Jul-Aug, 12(4), 293 - 7
Quantitative bacteriology of intraoperative wound tissue in contaminated surgery; Becker GD et al.; This study was designed to evaluate the predictive value of quantitative bacteriology of intraoperative wound tissue in identifying the patient likely to develop wound infection, as well as its subsequent flora . Forty-one patients undergoing contaminated cancer surgery of the head and neck were studied . Intraoperatively, a sample of wound tissue was cultured and anaerobic and aerobic bacterial isolates quantitated . The wound infection rate was 22% (9 of 41) . There was no significant correlation between intraoperative tissue bacterial density and subsequent wound infection, or contaminating and infecting bacteria.

Vestn Oftalmol, 1990 Jul-Aug, 106(4), 75 - 7
{Case of anaerobic infection in penetrating injury of the eye}; Golychev VN et al.; A patient with penetrating wound of the eye is described, whose wound has been contaminated with anaerobic infection . Clinical picture of anaerobic panophthalmitis has been rather typical, with the infection penetrating into soft tissues of the orbit . Evisceration of the eyeball was performed . Multiple-modality treatment was carried out . The infectious process has not progressed beyond the orbit . The diagnosis has been confirmed bacteriologically.

Respir Med, 1990 Jul, 84(4), 273 - 6
Skin reactivity to atypical mycobacteria in cystic fibrosis; Mulherin D et al.; Atypical mycobacterial disease has been described in a small number of patients with cystic fibrosis . Apart from one uncontrolled study, there is little information regarding atypical mycobacterial skin reactivity in this group of patients . We evaluated delayed cutaneous hypersensitivity to purified extracts of Mycobacterium avium, Mycobacterium intracellular, Mycobacterium kansasii and Mycobacterium bovis in 23 healthy controls and 43 adult and adolescent patients with cystic fibrosis . Fifteen of the cystic fibrosis group were receiving regular corticosteroids . Additionally, direct smear examination and Lowenstein Jensen culture were performed on sputum from the cystic fibrosis group . The prevalence of positive skin reactions was similar in the group with cystic fibrosis (30%) and in the control group (57%) . Subgroup analysis showed that those cystic fibrosis patients receiving corticosteroids had a markedly lower prevalence of positive reactions (7%) compared to controls (P less than 0.01) . When this subgroup was excluded from analysis, the prevalence of positive skin reactions among patients with cystic fibrosis was 43% . In the prospective sputum bacteriology study, one of the 43 cases grew Mycobacterium avium-intracellulare and had clinical and radiological evidence of this disease . Of note, this patient showed positive skin tests to all four mycobacterial species tested . Our data show no difference in the prevalence rate of positive skin reactions to atypical mycobacterial antigens between a control population and an adult cystic fibrosis population . In addition, the predictive value of skin testing is low in cystic fibrosis due to the high prevalence of cross-reactivity between different mycobacterial species and the high prevalence of anergy among those patients with advanced disease receiving treatment with corticosteroids.

Endoscopy, 1990 Jul, 22(4), 164 - 7
Antibiotic prophylaxis of infectious complications with endoscopic retrograde cholangiopancreatography . A randomized controlled study; Sauter G et al.; Biliary sepsis represents a major percentage of fatal complications after endoscopic retrograde cholangiopancreatography . We performed a randomized controlled study to investigate the value of antibiotic prophylaxis, and to assess the frequency and source of infectious complications associated with ERCP . Ninety-six patients who underwent 100 endoscopic retrograde cholangiopancreatographies were included in the study . Half of the patients received antibiotic prophylaxis (Cefotaxime 2 g i.v . 15 min before the procedure) . Bacteremia was detected in 2% of the patients receiving antibiotic prophylaxis, as compared with 16% (p less than 0.02) in the control group . In order to determine the source of bacteremia, bile samples and irrigation fluid from the suction channel of the endo-scope were obtained for bacteriological evaluation . Several lines of evidence suggested that bacteremia associated with ERCP was essentially caused by mucosal lesions of the oropharynx . Bacteremia was asymptomatic, with the exception of two patients who subsequently developed fever, but recovered rapidly under antibiotic therapy . The frequency of cholangitis following ERCP was not significantly reduced by antibiotic prophylaxis (4% vs . 2%) . Recommendations for antibiotic prophylaxis are discussed.

Rev Infect Dis, 1990 Jul-Aug, 12 Suppl 6, S590 - 609
Treatment of syphilis, 1989; Zenker PN et al.; With the introduction of penicillin after World War II, the incidence of syphilis in the United States decreased . Because of penicillin's great success, clinical trials stopped after an initial period of intensive investigation . Syphilis is a difficult disease to study; the natural history may span decades in an individual, and diagnosis and outcome are usually defined serologically, not clinically or bacteriologically . Although the recommended penicillin regimens changed, clinical trials were not repeated . Furthermore, because the early studies occurred before modern clinical-trial methodology was developed, interpretation of the results is difficult . As a result, while current regimens for syphilis therapy are effective, they may or may not be optimal . With the accumulation of reports of treatment failures and the recent appearance of human immunodeficiency virus, current regimens for the treatment of syphilis are being questioned . As background for a meeting at which treatment guidelines were reviewed, the available literature on syphilis therapy is summarized herein.

Arch Roum Pathol Exp Microbiol, 1990 Jul-Sep, 49(3), 207 - 14
Diagnosis methods for pneumococcal etiology determination in lower respiratory tract infections; Vereanu A et al.; A comparative study of etiological diagnosis in lower respiratory tract infections (LRTI), by conventional bacteriological methods and by pneumococcal antigen direct detection in sputum was performed . This work followed the establishing of rapid methods place, respectively of coagglutination (CoA), counterimmunoelectrophoresis (CIE), within the methodology of bacteriological diagnosis in lower respiratory tract infections presenting pneumococcal etiology . The results of investigations performed on 84 sputa from LRTI patients proved the utility of CoA method in determining a rapid etiological diagnosis, important for applying an emergence targetted antibiotherapy . CoA method, with the reagents in use, covering only 10 out of 83 serological types of S . pneumoniae in not capable of replacing conventional methods of bacteriological diagnosis; they complete each other, increasing the efficiency of etiological diagnosis in LRTI . CIE method is less sensitive and more difficult to perform, being less useful in rapid etiological diagnosis of LRTI.

J Wildl Dis, 1990 Jul, 26(3), 360 - 71
Brucella abortus in captive bison . I . Serology, bacteriology, pathogenesis, and transmission to cattle; Davis DS et al.; Two groups of six, non-brucellosis vaccinated, brucellosis seronegative pregnant American bison (Bison bison) were individually challenged with 1 x 10(7) colony forming units (CFU) of Brucella abortus strain 2308 . Three days after challenge, each bison group was placed in a common paddock with six non-vaccinated, brucellosis susceptible, pregnant domestic heifers . In a parallel study, two groups of six susceptible, pregnant cattle were simultaneously challenged with the identical dose as the bison and each group was placed with six susceptible cattle in order to compare bison to cattle transmission to that observed in cattle to cattle transmission . Blood samples were collected from bison and cattle weekly for at least 1 mo prior to exposure to B . abortus and for 180 days post-exposure (PE) . Sera from the bison and cattle were evaluated by the Card, rivanol precipitation, standard plate agglutination, standard tube agglutination, cold complement fixation tube, warm complement fixation tube, buffered acidified plate antigen, rapid screening, bovine conjugated enzyme linked immunosorbent assay, bison or bovine conjugated enzyme linked immunosorbent assay, and the hemolysis-in-gel techniques for the presence of antibodies to Brucella spp . At the termination of pregnancy by abortion or birth of a live-calf, quarter milk samples, vaginal swabs, and placenta were collected from the dam . Rectal swabs were collected from live calves, and mediastinal lymph nodes, abomasal contents and lung were taken at necropsy from aborted fetuses for culture of Brucella spp . These tissues and swabs were cultured on restrictive media for the isolation and identification of Brucella spp . Pathogenesis of brucellosis in bison was studied in an additional group of six pregnant bison which were challenged with 1 x 10(7) CFU of B . abortus strain 2308 . One animal was euthanatized each week PE . Tissues were collected at necropsy and later examined bacteriologically and histologically . Lesions of brucellosis in bison did not significantly differ grossly or histologically from those in cattle . There were six abortions and two nonviable calves in the bison group, as compared to nine abortions in the 12 similarly inoculated cattle . As determined by bacterial isolations, transmission of B . abortus from bison to cattle (five of 12 susceptible cattle became infected) did not differ statistically from cattle to cattle transmission (six of 12 susceptible cattle became infected) under identical conditions . No single serologic test was constantly reliable to diagnosing B . abortus infected bison for 8 wk PE.(ABSTRACT TRUNCATED AT 400 WORDS)

Infect Immun, 1990 Jul, 58(7), 2320 - 8
Penetration and intracellular growth of Brucella abortus in nonphagocytic cells in vitro; Detilleux PG et al.; In pregnant ruminants, Brucella abortus localizes and replicates within the rough endoplasmic reticulum of trophoblastic epithelial cells . In this study, Vero cells were exposed to B . abortus to investigate its internalization and intracellular growth in nonphagocytic cells . A new double-fluorescence staining procedure to discriminate between extracellular and intracellular bacteria was developed . Studies with the double-fluorescence staining procedure and quantitative bacteriologic culture of disrupted host cells showed that various B . abortus strains replicated within Vero cells, including smooth virulent (strains 2308S and 544), smooth attenuated (strain 19), and rough (strains 45/20 and 2308R) strains . Rough brucellae were more adherent and entered a greater number of Vero cells . Intracellular replication occurred in a larger percentage of cells with smooth virulent (2308S and 544) strains than with smooth attenuated (19) or rough (45/20 and 2308R) strains . Differences in adhesiveness and invasiveness were correlated to hydrophobicity of the organism, as measured by hydrocarbon adherence . Ultrastructurally, intracellular smooth (2308S) and rough (45/20) brucellae were consistently found within cisternae of the rough endoplasmic reticulum and nuclear envelope . The results suggest that transfer to the rough endoplasmic reticulum is the limiting step in the infection of nonphagocytic cells by B . abortus.

Schweiz Med Wochenschr, 1990 Jun 2, 120(22), 817 - 22
{Quantitative and qualitative analysis of various blood-preserving measures in heart surgery}; Walpoth BH et al.; We assessed quantitative aspects of blood salvage retrospectively in 270 consecutive coronary bypass patients over one year . They were assigned either to group A (n = 10, Cellsaver {Haemonetics}), B (n = 189, centrifugated oxygenator blood), C (n = 107, retransfusion of shed mediastinal blood) or D (n = 74, combination of method B and C) . In addition, blood quality was studied prospectively in group A (n = 5), B (n = 10) and C (n = 10) and each group compared to a control group . Results (mean values/patient) were: Blood salvage with A yielded 570 +/- 230 ml (hematocrit = 50%), B 509 +/- 156 ml (69%) and C 593 +/- 430 ml (26%) . The required homologous blood products, i.e . packed cells (PC) and fresh frozen plasma (FFP) diminished significantly when combined autologous blood salvage was used (PC 6.0 +/- 3.4 vs 3.4 +/- 1.9, p less than 0.05; FFP 3.4 +/- 3.8 vs 2.6 +/- 3.0) . Autologous erythrocyte function assessed by 2,3DPG was normal in all three methods (range 14.77-16.03 mumol/gHb) . ATP was nearly normal in A (3.34 +/- 0.45 mumol/gHb), reduced by 20% in B (3.21 +/- 1.14 mumol/gHb) and by 30% in C (2.56 +/- 0.78 mumol/gHb) compared to the corresponding preoperative patient value . Hemolysis (free plasma hemoglobin) (was elevated in A (63 +/- 7 mg/dl), B (202 +/- 57 mg/dl) and C (211 +/- 44 mg/dl) . However, no increase of free plasma hemoglobin was encountered in our patients after retransfusion of either A, B or C . No side effects were detected and bacteriology remained negative in all examined blood samples in C.(ABSTRACT TRUNCATED AT 250 WORDS)

Kansenshogaku Zasshi, 1990 Jun, 64(6), 752 - 7
{Combination therapy with ofloxacin and chloramphenicol against typhoid fever}; Kurimura O et al.; Recently we experienced two male typhoid patients who required additional treatment with CP sodium succinate (CP succinate) to OFLX therapy . Although both of the cases were administered 900 mg/day of OFLX orally for three and four days, respectively, the clinical efficacies were not sufficient . We added 2.0 g/day of CP succinate intravenously for six days, although a lasting high fever returned to normal level in a few days . The administration of OFLX was continued up to 14 days . The daily doses of OFLX during the co-medication with CP succinate were 600 mg in one case and 900 mg in the other case . In both cases no recurrence was observed clinically and bacteriologically for six months after their discharge . No adverse reaction was observed throughout the therapy.

Lepr Rev, 1990 Jun, 61(2), 145 - 50
Serodiagnosis of leprosy in patients' contacts by enzyme-linked immunosorbent assay; Gonzalez-Abreu E et al.; Serum samples from 3336 contacts of leprosy patients were tested for antiphenolic glycolipid I antibodies by enzyme-linked immunosorbent assay with the albumin coupled synthetic disaccharide antigen . The overall positivity rate was 9.3% . No significant differences were seen between a group of household contacts of lepromatous patients and those of the other types of the disease . The proportion of ELISA positives was slightly higher in the relatives as compared to workplace contacts and neighbours but significantly different only between the two former (p less than 0.05) . Among those contacts with absorbance values higher than 0.100, 5 new leprosy patients were diagnosed, 2 of them with positive skin smears . A sixth contact was detected with a very high absorbance value in whom no single skin lesion was found but whose lepromin reaction was 0 mm and the skin smear showed a bacteriological index of 3+.

Can Crit Care Nurs J, 1990 Jun, 7(2), 4 - 11
Postoperative autotransfusion: an overview of techniques and clinical efficacy; Rebeyka DM; In summary, the purpose of this discussion has been to provide an overview of the theoretical, technical and clinical nursing considerations in the use of postoperative autotransfusion . The relative safety and efficacy of utilizing autotransfusion techniques following cardiac surgery has been reported by many researchers . However, there remains other aspects and considerations in the use of autotransfusion that require further clarification . The limited documentation on the reported number of positive bacteriological cultures with open system and the associated risks of systemic sepsis warrants additional investigation . The comparative risk of sepsis between the open and closed systems requires more extensive evaluation . Another aspect of the technique that remains unestablished is the period of time that an autotransfusion system remains effective in replenishing red cell mass . This is apparent in the reported variations in time frames that have been described with the use of this technique . Protocol comparisons among various institutions that employ this technique might yield significant information about this variation . Concerns associated with the risks and cost of homologous blood products have been firmly established . The hazard of AIDS contamination secondary to blood transfusion, although remote, is often foremost in the patient's perception of risks associated with expectant surgery . Nurses have a vital role to play in providing patients with information on current medical treatment modalities, and can thereby potentially reduce preoperative anxiety . Furthermore, the education of nurses on the technique of postoperative autotransfusion provides them with the capability to safely utilize this valuable technology in patient care.

Am J Hosp Pharm, 1990 Jun, 47(6), 1350 - 3
Pharmacist intervention in prescribing of cefuroxime for pediatric patients; Strong DK et al.; A targeted drug review of cefuroxime use in pediatric patients is described . Because of a 65% increase in cefuroxime costs over one year, pharmacists assessed the appropriateness of cefuroxime therapy from October 13 to December 20, 1987 . This assessment was done within 48 hours after the prescription was written and again after 72 hours of cefuroxime therapy, when bacteriology and susceptibility data were available . When a drug order was inappropriate, a pharmacist intervened with the prescribing physician . For comparison, data collection forms were completed for patients who had received cefuroxime before and after the study period . Before the study period, 42% of the cefuroxime orders were inappropriate with respect to dosage or indication at the time of the initial order; this rate fell to 26% during the study period and increased to 33% after the study period . After 72 hours of therapy, the rates of inappropriate prescribing were 48% (before study period), 32% (during study period), and 40% (after study period) . During the study period, pharmacists intervened in only half of the 51 cefuroxime orders initially deemed to be inappropriate, and only 26% of these interventions resulted in an order change . Although pharmacists met with some success in increasing the appropriateness of cefuroxime prescribing, both pharmacists and physicians resumed their previous monitoring and prescribing habits after the study period had ended.

Arch Intern Med, 1990 Jun, 150(6), 1190 - 4
Cytologic and bacteriologic analysis of fluid and pleural biopsy specimens with Cope's needle . Study of 414 patients; Escudero Bueno C et al.; This article describes the results of a dual diagnostic procedure, thoracentesis and pleural biopsy with a Cope's needle, in 414 patients with pleural effusion of unknown origin . A diagnosis of neoplasia or pleural tuberculosis was obtained in 241 subjects (149 with neoplasias and 92 with pleural tuberculosis) . In an additional 55 patients, a diagnosis of tuberculosis or neoplasia was obtained using other procedures (15 with tuberculosis and 40 with neoplasias) . In 105 subjects, the effusion was neither tuberculosis nor neoplasia . Thirteen patients were excluded from this study due to the impossibility of follow-up . The diagnostic process was repeated in 64 patients . Complications occurred in 46 patients (11%), of which 42 were pneumothorax . The dual diagnostic sensitivity in our series of thoracenteses and pleural biopsies made with a Cope's needle was 86% in tuberculosis and 79% in neoplasia with 100% specificity . The probability of a case being neither tuberculosis nor pleural neoplasia (negative predictive value) when the liquid and the pleural biopsy specimen are nonspecific (each procedure having been applied only once on each patient) is 56%, although a negative result does not exclude these diagnoses . In our opinion, the repetition of the dual procedure is indicated considering the scant morbidity and zero mortality.

Can J Surg, 1990 Jun, 33(3), 233 - 7
Abdominal tuberculosis; al-Hadeedi S et al.; Forty-two cases of abdominal tuberculosis seen between June 1984 and June 1988 at Amiri Hospital in Kuwait were reviewed retrospectively . The clinical diagnosis was correct in only 35% . Nine patients presented as an emergency, but in none was a diagnosis of tuberculosis considered . Abdominal pain and tenderness were the commonest clinical findings; "doughy abdomen" and a mass in right iliac fossa were uncommon . Thus, symptoms were vague, signs nonspecific and investigations nonpathognomonic . In spite of this, abdominal tuberculosis should be considered in any patient who has obscure abdominal symptoms, weight loss and lethargy . Laparoscopy and colonoscopy with biopsy for histologic and bacteriologic study led to a definitive diagnosis in 66% of cases, obviating the need for exploratory laparotomy in many . Histologic examination was the surest way to establish the diagnosis.

Am Rev Respir Dis, 1990 Jun, 141(6), 1483 - 6
Tuberculosis morbidity and infection in Vietnamese in Southeast Asian refugee camps; Sutter RW et al.; During the last decade, the refugee population in less-developed countries has undergone unprecedented growth . High tuberculosis rates have been documented in refugees, particularly among those from Asia and Africa, generating interest in tuberculosis control efforts . To assess the tuberculosis burden among Vietnamese refugees, we screened refugees within 1 or 2 days after arrival in camps in Thailand and in the Philippines . Refugees in camps in Thailand were screened with chest radiographs . Persons with radiographic findings consistent with tuberculosis received microscopic and culture examination of sputum specimens . The prevalence of bacteriologically confirmed pulmonary tuberculosis was 5.8 per 1,000 refugees . Males had a higher risk than females (relative risk RR = 1.7, 95% confidence interval CI = 1.2 to 2.4) . Refugees in the Philippines were given a tuberculin skin test . An annual risk of infection of 2.2% was calculated for this group . Males had a higher risk of infection (RR = 1.9, 95% CI = 1.5 to 2.4) than females . The age-specific prevalence of tuberculosis and the tuberculous infection increased with age . A high proportion of refugees (85%) with positive tuberculin skin tests were eligible for preventive therapy . Special efforts may be necessary to target Vietnamese refugees, as well as other persons originating from countries of high tuberculosis prevalence, for enhanced diagnostic and preventive intervention against tuberculosis to achieve the national goal of tuberculosis elimination by the year 2010.

Epidemiol Infect, 1990 Jun, 104(3), 361 - 80
The Stafford outbreak of Legionnaires' disease; O'Mahony MC et al.; A large outbreak of Legionnaires' disease was associated with Stafford District General Hospital . A total of 68 confirmed cases was treated in hospital and 22 of these patients died . A further 35 patients, 14 of whom were treated at home, were suspected cases of Legionnaires' disease . All these patients had visited the hospital during April 1985 . Epidemiological investigations demonstrated that there had been a high risk of acquiring the disease in the out patient department (OPD), but no risk in other parts of the hospital . The epidemic strain of Legionella pneumophila, serogroup 1, subgroup Pontiac 1a was isolated from the cooling water system of one of the air conditioning plants . This plant served several departments of the hospital including the OPD . The water in the cooling tower and a chiller unit which cooled the air entering the OPD were contaminated with legionellae . Bacteriological and engineering investigations showed how the chiller unit could have been contaminated and how an aerosol containing legionellae could have been generated in the U-trap below the chiller unit . These results, together with the epidemiological evidence, suggest that the chiller unit was most likely to have been the major source of the outbreak . Nearly one third of hospital staff had legionella antibodies . These staff were likely to have worked in areas of the hospital ventilated by the contaminated air conditioning plant, but not necessarily the OPD . There was evidence that a small proportion of these staff had a mild legionellosis and that these 'influenza-like' illnesses had been spread over a 5-month period . A possible explanation of this finding is that small amounts of aerosol from cooling tower sources could have entered the air-intake and been distributed throughout the areas of the hospital served by this ventilation system . Legionellae, subsequently found to be of the epidemic strain, had been found in the cooling tower pond in November 1984 and thus it is possible that staff were exposed to low doses of contaminated aerosol over several months . Control measures are described, but it was later apparent that the outbreak had ended before these interventions were introduced . The investigations revealed faults in the design of the ventilation system.

Agressologie, 1990 Jun, 31(6), 380 - 4
{Hyperthermia in meningeal hemorrhage . Contribution of daily determination of inflammation proteins}; Jourdan C et al.; This paper studies the causes of hyperthermias occurring after a subarachnoid hemorrhage by ruptured aneurysm in 54 patients, totalizing 66 febrils episodes . Only 29 episodes bacteriologically proved infections . The profile of thermic curve, the hemodynamical profile, and clinical examination are not convincing . The most convincing elements for the diagnosis of infection are the increasing number of the leucocytes counts, the increasing curve of CRP, and simultaneous decreasing curve of C4 . The evolution of these parameters permit to follow the efficiency of antibiotics.

G Ital Dermatol Venereol, 1990 Jun, 125(6), 255 - 8
{Lyell's syndrome and lymphoma}; Bianchi L et al.; The authors present the case of a patient affected by Lyell's Syndrome and Lymphoma that was revealed in the post-mortem examination . At onset the disease showed mucosal hyperaemia, oedema and erosions . In about ten days macular lesions with vesciculation and bullae appeared on the abdomen . General conditions did not seem to be affected . Three weeks later a fever was noted . No important illness, nor drug assumption were detectable in the history of the patient . At the beginning of the fourth week a dramatic worsening occurred with erythrodermic state and high fever . Death occurred at the sixth week in spite of therapy . Bacteriological and virological examinations were always negative . Post-mortem examination showed retroperitoneal and pelvic neoplastic tissue, involving lumboaortic lymph nodes . Histopathology demonstrated a low grade malignancy non Hodgkin Lymphoma, diffused type with small lymphocytes showing plasmocytic differentiation . The lack of drug intake or infectious disease in the history, underlines the peculiar association between the tumor and the syndrome . Rare cases of TEN associated with lymphoproliferative neoplasm are reported in the literature, and the pathogenetic problem of the syndrome is reviewed.

Rozhl Chir, 1990 Jun, 69(6), 385 - 90
{Bacteriological findings in bronchial secretions of the lower respiratory tract in resected lungs}; Lonsky V et al.; The authors investigated during operation the bacteriological findings in the bronchial secretion of the respiratory pathways of resected lungs . Of 100 patients whom they included in the group they detected a positive finding in 42 . Wound in 27 patients . Twenty of them had a positive bacteriological finding in the lower respiratory pathways . The authors discuss the problem of prophylactic use of antibiotics in pulmonary surgery . Based on data in the literature and their own observations, the authors recommend preventive administration of antibiotics in pulmonary surgery.

Jpn J Antibiot, 1990 Jun, 43(6), 1143 - 51
{Clinical experience with chemotherapy using sulbactam/cefoperazone for severe infections accompanying malignant hematological disorders}; Fujii Y et al.; Clinical and bacteriological efficacies of sulbactam/cefoperazone (SBT/CPZ) were studied in 44 patients with serious infections associated with hematological malignancy . 1 . SBT/CPZ was clinically effective in 33 cases (76.7%) . Excellent effects were obtained in 23 cases, good effects in 10 cases and fairly good effects in 7 cases . Clinical effectiveness of SBT/CPZ was not dependent on neutrophil number in peripheral blood . 2 . Bacteriologically SBT/CPZ was effective against all of the isolated organisms from 21 cases . 3 . Adverse reactions were not significant except one case with eruption, 2 cases with abnormalities in hepatic function tests and 3 cases with abnormalities in renal function tests.

Rev Esp Enferm Dig, 1990 Jun, 77(6), 419 - 24
{Percutaneous cholecystostomy guided by ultrasonography . A preliminary experience}; Lopez-Cano A et al.; Surgical cholecystostomy is a palliative treatment for cholecystitis and distal biliary obstructions when the general condition of the patient does not allow complex techniques . Percutaneous cholecystostomy (PC) guided by ultrasonography is an alternative to that procedure as well as a method of direct access to the biliary tract for diagnostic examinations (bacteriologic study of bile and percutaneous cholangiography) . During one year, 9 female patients, mean age 74 (49 to 90) underwent this approach; 5 patients had cholecystitis, 2 were suspicious of biliary sepsis and 2 had angiocholitis . Because of poor general condition, no other approach was possible in any of the cases . There were no relevant complications . All 5 cases of cholecystitis improved after the procedure although 3 patients died within 30 days of causes unrelated to PC . In two cases biliary sepsis was ruled, and the probe was withdrawn, without complications . The two patients with angiocholitis improved significantly; in both cases it was shown that the cause was cholelithiasis: later on, they were treated by different methods (endoscopic sphincterotomy in one case and surgery in the third case) . These preliminary results suggest that PC guided by echography should be included as a routine therapeutic and diagnostic method in the management of digestive diseases.

Tubercle, 1990 Jun, 71(2), 87 - 93
Immunotherapy with Mycobacterium vaccae as an adjunct to chemotherapy in the treatment of pulmonary tuberculosis; Stanford JL et al.; 47 patients with adult-type pulmonary tuberculosis attending the Chest Diseases Hospital in Kuwait were given a single injection of 10(9) irradiation-killed M . vaccae after 1 month of a 9-month course of chemotherapy . The patients were followed-up for 3 more months in double blind comparison with 65 patients given an injection of saline (placebo) . The immunotherapeutic injection produced a small local lesion in 44/47 patients, 18 of which ulcerated and produced small scars . Immunotherapy made no measurable difference to the bacteriological, biochemical, haematological, or radiological parameters measured . However it was associated with significantly improved weight gain, reduced size of skin test response to Tuberculin, increased lymphocyte proliferation to common mycobacterial antigens, and increased antibody levels to mycobacterial antigens . The changes in skin test and LTT responses were related and occurred in 29% of patients whose recognition of common mycobacterial antigens returned to normal . The remaining patients did not differ in these respects from those receiving placebo . The proportion of patients whose responses were improved was very similar to that achieved using the same immunotherapeutic agent in a group of treated multibacillary leprosy patients.

Onderstepoort J Vet Res, 1990 Jun, 57(2), 143 - 4
The isolation and serology of Brucella melitensis in a flock of goats in central RSA; Ribeiro LM et al.; Brucella melitensis biotype 1 was isolated in pure culture from the lungs, liver, spleen, kidney, stomach contents, abomasum and brain of an aborted caprine (Boer goat) foetus in the district of Cullinan near Pretoria . The 18 does and 1 ram in the flock of Boer goates were examined serologically by means of the complement fixation (CF) test, using Brucella abortus antigen . Six weeks later they were examined again, using B . abortus as well as B . melitensis biotype 1 antigens . No significant differences were found between the 2 CF tests using B . abortus antigen, or between the results obtained by using the B . abortus and B . melitensis antigens . Twelve goats, showing CF antibody titres, were slaughtered and examined bacteriologically . No relationship was found between the serological and bacteriological results.

Rev Fr Gynecol Obstet, 1990 Jun, 85(6), 359 - 63
{Female genital tuberculosis in Tunisia . Apropos of 118 cases at the Rabta Neonatology and Maternity Center in Tunis (January 1984-December 1988)}; Sfar E et al.; The authors have reviewed 118 cases of female genital tuberculosis collected over a 5 year period, from 1st January 1984 up until 31 December 1988, and have compared their results (study group, SG) with those of a similar study (reference group, RG) carried out in the same centre 2 years previously . The following points stand out: the incidence of the disease is stable (6.6 p . cent in the SG versus 5.6 p . cent in the RG); the profile of the woman with genital tuberculosis is that of a young woman of rural origin, generally unvaccinated; sterility is increasingly the predominant motive for consultation (81 p . cent in the SG versus 73 p . cent in the RG); the latent form of genital tuberculosis constitutes 96.4 p . cent of cases in their series versus 93.8 p . cent in the RG; the diagnosis of genital tuberculosis was confirmed histologically in 46 p . cent of cases versus 30 p . cent in the RG, and bacteriologically in 7 p . cent of cases versus 4 p . cent in the RG; medical treatment was initiated for the acute and evolutive forms (35 p . cent of cases) . Surgical treatment was indicated for macro-lesional forms which were resistant to medical treatment.

Int J Lepr Other Mycobact Dis, 1990 Jun, 58(2), 273 - 80
Controlled clinical trial of two multidrug regimens with and without rifampin in highly bacilliferous BL/LL south Indian patients: a five-year report; Thomas A et al.; A controlled clinical trial of two multidrug regimens in multibacillary lepromatous and near-lepromatous patients with a bacterial index (BI) of 2.5 or more was conducted . Patients were randomly allocated to either a two-drug regimen of dapsone plus clofazimine for 60 months or a four-drug regimen of rifampin, isoniazid, dapsone, and clofazimine for the first 3 months and clofazimine plus dapsone for the next 57 months . There was no difference between the rifampin and nonrifampin regimens with respect to the clinical improvement or bacteriological status of the patients at 60 months . Reactive states and neuritis were observed to be equal in the two patient groups.

J Otolaryngol, 1990 Jun, 19(3), 197 - 200
Wound infection in head and neck surgery: prophylaxis, etiology and management; Tabet JC et al.; Antibiotic prophylaxis in clean-contaminated major head and neck surgery is mandatory . Many prospective, randomized and double blind studies have established the efficacy of antibiotics against a large spectrum of bacteria . Prophylaxis should be initiated prior to surgery, and prolonged administration of antibiotics beyond the first 24 hours following surgery is unnecessary . The experience of the Eye and Ear Hospital of Pittsburgh is presented along with other studies concerning the effect of different regimens on wound outcome . The pathophysiology, bacteriology, evaluation and treatment of a postoperative infection are discussed, emphasizing the importance of gentle tissue handling and meticulous surgical technique.

Vestn Khir Im I I Grek, 1990 Jun, 144(6), 31 - 3
{Prognosis in acute suppurative lactation mastitis using the method of measuring electric impedance}; Khachatrian AP et al.; An investigation of impedance of secretion and breast wound at different post-operative periods in patients with purulent lactation mastitis was performed . A relation of the dynamics of impedance of secretion and wounds with morphostructural and bacteriological alterations in them was established . An express method of predicting the course of the disease by results of impedancemetry has been proposed.

Methods Find Exp Clin Pharmacol, 1990 Jun, 12(5), 325 - 32
A new approach to optimal antibiotic dosage regimen by coupling pharmacokinetics and killing curve parameters; Garraffo R et al.; Antibiotic therapy is directed against bacteria responsible for infectious pathology which are able to resist treatment mainly when the dosage is misadapted . The choice of the initial dosage regimen actually takes into account toxicological, bacteriological and pharmacokinetic parameters . The determination of the classical bacteriological data is performed in vitro using fixed drug concentrations that are far from human therapy conditions, and moreover the efficiency is not well defined . The estimation of the pharmacokinetic parameters is realized in animals, healthy subjects or ill patients but takes into account only the drug disposition without correspondence with the kinetics of the antibiotic effect on the bacteria . Thus, each type of evaluation is made independently from the others without any correlation between the observed phenomena . It appears, therefore, interesting to propose a new approach including pharmacokinetic and bacteriological data to enable approximation of drug efficacy . The coupled evaluation of individual pharmacokinetic estimation and the killing curve determinations of an antibiotic will allow this type of development . On the basis of these data, a preliminary profile of the optimal dosage would be possible . This methodology has been applied to three antibiotics: teicoplanin, amikacin and ofloxacin and demonstrates a time- or dose-dependent activity, with interesting possibilities for optimization of dosage.

Offentl Gesundheitswes, 1990 Jun, 52(6), 282 - 6
{Implementation of preventive measures recommended by the federal public health office and acceptance of advice by managers of commercial solaria--studies by the public health office of the Ammerland district}; Dahmen HG; Commercial solaria are not always up to the standards that would be desirable from a Public Health point of view in respect of protection of users against health hazards of exposure to UV radiation, and also with regard to supervision, qualified personal advice given to users by the staff, and qualification of the staff members to give such advice . Hygiene is definitely also a problem, as is evident from bacteriological swabs made from tanning beds . However, the talks conducted by a local Public Health board in Lower Saxony (North Germany) revealed considerable open-mindedness on the part of the entrepreneurs who were quite willing to follow expert health advice and to display a poster with recommendations regarding protective measures . This was combined with a questioning procedure that has proved successful with the proprietors.

Rinsho Byori, 1990 Jun, 38(6), 683 - 7
{Comparative studies of serological test for Mycoplasma pneumoniae on 73 cases of lower respiratory infection disease}; Shitara M et al.; The purpose of this report is to evaluate a test kit based on the High Density Composite Particle Agglutination Test Method (HDPA method, Newly developed by Tokuyama Soda Co., Ltd) . Diagnosis of Mycoplasmosis has been done with clinical symptoms, breast x-ray examination, serum anti-M . pneumoniae antibody detection and bacteriological test result . Recently, we had the chance to use this HDPA method (IMMUNOTICLES MYCO) and compared the results with bacteriological test, complement fixation method (CF) and particle agglutination method (PA) using the cases of seventy-three (73) lower respiratory infected patients . The evaluation outcomes (positive rate, sensitivities and specificities) comparing with the conventional methods based on the clinical cultured results and clinical diagnostic results respectively are shown as follows . 1) The evaluation outcomes based on the cultured results . Forty-one (41) cases of 73 samples, we could isolate the M . pneumoniae (56.2%) . a) The HDPA method is correlated with CF (r = 0.885, n = 73) and PA (r = 0.764, n = 73) respectively . b) The positive rate of HDPA, PA and CF are 45.2%, 31.5% and 20.5% respectively . 2) The evaluation outcomes based on the clinical diagnosis . a) The sensitivity of the HDPA method is 66.0% and this one is much higher than the one of CF and PA . b) The specificity of the HDPA method is 92.3% . c) The positive rate of the HDPA method is higher than the one of PA and CF even though the assay was done within seven-days . In conclusion, the HDPA method is a very sophisticated method for diagnosis of M . pneumoniae and able to be substituted to any other conventional methods.

Thorax, 1990 Jun, 45(6), 431 - 7
Trends and district variations in the hospital care of childhood asthma: results of a regional study 1970-85; Anderson HR; Trends and district variations in the pre-hospital and hospital care of children aged 0-14 years admitted with acute asthma were surveyed in all 13 districts of a health region by examining case notes for 1970, 1978, and 1985 . From 1970 to 1985 there was a substantial increase in admissions and some reduction of hospital stay . Over this time adrenergic drugs remained the most frequently used treatment with a large shift towards selective beta2 agonists administered by nebulisation . Use of corticosteroids fell in the under 5s with a decrease in the parenteral route of administration but rose in the 5-14 age group with an increase in the oral route of administration . There was an increase the use of oral xanthines but this was outweighed by falls in the use of suppositories and in parenteral administration . The use of antibiotics became less frequent and that of sedatives and antihistamines fell to almost nil . There were also important changes in other aspects of management, notably an increase in the use of lung function tests (from 3% to 70%) and falls in the use of chest radiographs, blood tests, bacteriology, and physiotherapy . In nearly all aspects of management there were significant and often very extreme variations in practice between districts, which were unlikely to be explained by differences in morbidity . These variations would be a suitable focus for medical audit, with the aim of establishing which treatment regimens have the best outcome and avoiding unnecessary cost and discomfort . Because early hospital drug treatment is closely related to the type of treatment given before admission such audit activities would need to include general practitioners.

Int J Gynaecol Obstet, 1990 Jun, 32(2), 129 - 31
Laparoscopic observations of pelvic organs in pulmonary tuberculosis; Tripathy SN et al.; Sixty-two cases of bacteriologically positive pulmonary tuberculosis were studied in the Department of Tuberculosis and Chest Diseases at the V.S.S . Medical College Hospital, Burla, India . Apart from other investigations, all patients underwent laparoscopy to determine the incidence of genital involvement . Positive findings were observed in 37 women; tubercles were present in the tubes of 15 women . At dilatation and curettage, the endometrium was obtained in 37 women . Tuberculous endometritis was detected in 4 women.

J Am Vet Med Assoc, 1990 May 15, 196(10), 1639 - 40
Pleuroscopic diagnosis of disseminated hemangiosarcoma in a horse; Rossier Y et al.; A 7-year-old Thoroughbred mare was examined because of persistent bilateral epistaxis and respiratory distress . Evidence of bilateral pleural effusion was found during physical examination, and a large amount of serosanguineous fluid was drained from the right side of the thorax . Cytologic examination and bacteriologic culture of the transtracheal aspirate and pleural fluid did not yield evidence of sepsis . A coagulation profile was unremarkable . Radiographic and echographic changes were seen in the lung parenchyma . Pleuroscopy, with the horse standing, revealed numerous dark nodules on the pleura, diaphragm, and lung surface . On the basis of biopsy and necropsy findings, the histopathologic diagnosis was disseminated hemangiosarcoma.

J Am Vet Med Assoc, 1990 May 15, 196(10), 1601 - 4
Isolation of Leptospira interrogans serovar bratislava from stillborn and weak pigs in Iowa; Bolin CA et al.; Leptospira interrogans serovar bratislava was isolated from a herd of swine in Iowa with a history of stillborn and weak neonatal pigs . Placentas, kidneys, and lungs of stillborn and weak pigs from 3 litters were processed to detect leptospires by use of bacteriologic culture and fluorescent antibody testing . Sera from stillborn and weak pigs were tested to detect agglutinating antibody against leptospires . A low antibody titer against L interrogans serovar bratislava was detected in the sera of stillborn and weak pigs . Small numbers of leptospires were sometimes detected in tissues by use of the fluorescent antibody test . Serovar bratislava was isolated from placentas, stillborn pigs or weak pigs from each of the 3 litters.

Am J Med, 1990 May 14, 88(5A), 51S - 55S
Emergence and persistence of beta-lactamase-producing bacteria in the upper respiratory tract in children treated with beta-lactam antibiotics; Eliasson I et al.; PURPOSE: To assess the ecologic impact, in terms of selection of beta-lactamase-producing respiratory tract bacteria, of a single course of peroral beta-lactam antibiotics . PATIENTS AND METHODS: One-hundred fifty consecutive children with clinical signs of bacterial respiratory tract infection were randomly assigned to a seven-day course of treatment with either penicillin V, amoxicillin, or cefaclor . Bacteriologic specimens were collected before treatment, at its termination, and at follow-up four weeks later . RESULTS: All three drugs investigated caused a similar increase in beta-lactamase-producing bacteria, both in absolute and relative terms, an increase that persisted over a period of at least one month after completion of treatment . CONCLUSION: Penicillin V, amoxicillin, and cefaclor all act as selective agents for beta-lactamase-producing bacteria in the upper respiratory tract . Treatment with a peroral beta-lactam antibiotic puts patients at risk of becoming persistent carriers of beta-lactamase-producing bacteria.

Vet Rec, 1990 May 12, 126(19), 481 - 3
Serological, bacteriological and clinical observations on an outbreak of canine infectious tracheobronchitis in Norway; Ueland K; During the autumn of 1988 an outbreak of canine infectious tracheobronchitis, which seemed to be more infectious than usual, occurred throughout Scandinavia . Paired serum samples and bacterial swabs were collected from 52 dogs with clinical signs of infectious tracheobronchitis in three districts of Norway . The results revealed a fourfold or greater rise in the titre of antibodies against canine parainfluenza virus in 79 per cent of the cases, strongly suggesting that the virus was of aetiological importance in the outbreak . Bordetella bronchiseptica was not isolated from the diseased dogs, and they showed no rise in the titres of antibodies against influenza virus, reovirus or adenovirus.

Med Clin (Barc), 1990 May 5, 94(17), 641 - 50
{Combined treatment of gaseous gangrene with hyperbaric oxygen therapy, surgery and antibiotics . A national cooperative multicenter study}; Desola J et al.; 85 confirmed gas gangrene cases from general hospitals where hyperbaric oxygen chambers with single or multiple places are available were reviewed . The diagnosis was made on the basic of muscle necrosis with the characteristic color and odor of the wound, and suggestive clinical and bacteriological findings . The treatment consisted on surgical excision, multiple antibiotic therapy, and hyperbaric oxygen at 3 absolute atmospheres . There was a male predominance (76.5%); 49.4% of them had previous risk factors; the origin of the disease was spontaneous in 18.8% of cases, after trauma in 37.6%, and after surgery in 43.5% . The surgery had been orthopedic in 18.8%, vascular in 16.5% and other in 1.2% . The lesion was in the lower limbs in 71.8%, with abdominal origin of propagation in 18.8% and perineal propagation in 8.2% . 44.7% of patients had shock on admission . The outcome was good in 50.6% of patients, who had a full recovery, and fair in 16.5%, who had minor sequelae or small re-amputations; this amounts to 67.1% of satisfactory evolutions . Outcome was poor in 20% in whom amputation or other major surgical procedures were required (p less than 0.05) . Overall mortality rate was 20%, although only in 12.9% death directly related with gas gangrene . Mortality was significantly higher in women, in abdominal localization, and in patients with shock . It was 37.5% in spontaneous and 29.7% in postsurgical cases . There was no death in traumatic cases (p less than 0.005) . Death directly related with the disease occurred in the first three days and nonrelated death after two weeks . More severe cases could be cared for in hospitals where multiple place hyperbaric oxygen chambers were available than in those with single place chambers, with a definite outcome towards cure or death with less intermediate situations . The relevant literature is reviewed . It is concluded that this combined therapeutic schedule has the best efficacy to treat gas gangrene, particularly in the more severe forms.

Jpn J Antibiot, 1990 May, 43(5), 768 - 78
{Therapeutic efficacy of ceftibuten in chronic respiratory tract infections}; Watanabe A et al.; We evaluated the therapeutic efficacy of ceftibuten (CETB, 7432-S), a new cephem antibiotic for oral use, in chronic respiratory tract infections . A daily dose of 400 mg (b.i.d.: 15 cases) or 600 mg (t.i.d.: 5 cases) of CETB was given orally for 3-14 days (mean: 10.6 days) to 20 patients: 9 with infected bronchiectasis, 3 with infection supervened on pulmonary emphysema, 3 with acute pneumonia (supervened on bronchiectasis in 2 of 3 cases), 2 with infected bronchial asthma, 1 each with infection supervened on old pulmonary tuberculosis, chronic bronchitis and pulmonary fibrosis . The clinical effects were excellent in 3, good in 11, fair in 3 and poor in 3 . Eighteen strains were identified as causative organisms . Eight of 15 strains for which bacteriological responses were evaluable were eradicated by the use of CETB . Eosinophilia in 2 patients and an elevation of S-GPT value was observed in 1 patient . These adverse reactions disappeared after the completion of the therapy . From the above results, we conclude that CETB is one of the most useful antibiotics for oral use as a first choice in chronic respiratory tract infections.

Bol Med Hosp Infant Mex, 1990 May, 47(5), 324 - 31
{Treatment of diarrheic disease at home . Comparison of 2 forms of oral solutions: liquid and concentrated in small bags}; Mota-Hernandez F et al.; One hundred children, ranging in ages from a month to a year, with acute diarrhea who were treated at home following the basic standard recommendations, were studied . In order to prevent dehydration, half of the children were given oral solution (OS) containing the concentrated official formula in packets (group A), and the remaining half was given a commercially prepared ready-to-use OS (group B) . During the treatment period, two house calls were made and the third day the patient was asked to come in for a check-up at the hospital . The clinical and socioeconomic characteristics were similar in both groups . The majority of parents made some reference to the "salty" taste of their OS, while only a few thought it has a sweet taste . In Group B, there were greater numbers of relatives who did not wash their hands before administering the OS and did it through bottles . A reminder was given on suggestive signs of dehydration expected, during the second home visit, although they were few . In both groups the average amount of OS administered was greater than 40 mL/kg/24 hours . The majority of the patients gained weight during the treatment . Four patients showed signs of slight dehydration (three from group A and one from group B) . The OS's bacteriologic examination was positive for enteropathogens in 16% of the samples from group A and in 5% from group B . The average time the diarrhea continued was similar for both groups . Sodium concentration ranged from 60 to 120, potassium from 15 to 30 mmol/L, in 85% of those cases in group A and 98% in group B.(ABSTRACT TRUNCATED AT 250 WORDS)

J Laryngol Otol, 1990 May, 104(5), 423 - 5
Radio-necrosis of the temporal bone presenting as cerebellopontine angle lesion; Small M et al.; We report a case of osteoradionecrosis of the temporal bone which presented with symptoms and signs of cerebellopontine angle lesion . The clinical, radiological, histological and bacteriological findings are reported . The occurrence of osteoradionecrosis of the temporal bone and the factors which predispose to it are discussed with particular emphasis on the time lapse between radiotherapy and its development . This presentation has not previously been reported.

Infection, 1990 May-Jun, 18(3), 152 - 6
Serology, clinical manifestations and treatment of brucellosis in different age groups; Colmenero JD et al.; We prospectively studied 339 patients diagnosed of brucellosis over a six year period in order to evaluate the clinical and serological characteristics of brucellosis in the elderly . 319 patients (94.1%) were under 65 years of age (group A), and 20 patients (5.9%) were older than 65 (group B) . No patient in group B developed splenomegaly as opposed to 69 (21.6%) in group A (p less than 0.05) . The percentage of positive blood cultures (Brucella melitensis isolated in all cases) was 72.1% in group A and 60% in group B . The mean titer of IgM antibodies measured by indirect immunofluorescence test was significantly lower in the elderly patients, with no other differences in serologic response between the two groups . 103 patients (32.2%) in group A and seven patients (35%) in group B developed some complications; spondylitis was more common and severe among group B patients . There was no therapeutic failure or relapse among patients over 65 . We conclude that clinical, bacteriological and serological characteristics and the outcome of brucellosis in the elderly are similar to those seen in younger patients.

Br Vet J, 1990 May-Jun, 146(3), 211 - 8
The effects of age, environmental temperature and relative humidity on the bacterial flora of the upper respiratory tract in calves; Woldehiwet Z et al.; The effects of age, environmental temperature and relative humidity on the bacterial flora of the nose and trachea of calves were investigated by sequential sampling of three groups each of eight Friesian-Holstein male calves kept in three different environmental conditions . All calves were vaccinated with a live attenuated vaccine against infectious bovine rhinotracheitis (IBR) when they were 12 weeks old . Nasal and tracheal swabs were collected at 14-day intervals for bacteriological examinations . The upper respiratory tract of calves started to be colonized by various species of bacteria within the first day of life . Although they were born at different periods of the year, the calves in all three groups had similar bacterial loads in their noses and tracheas when they were 1 day old (P greater than 0.05) . The total bacterial colony forming units (BCFU) were highly variable from calf to calf and from one time of sampling to another . Despite these variations, there were age-related increases in the total BCFU in nasal and tracheal swabs in all experiments . These increases were influenced by environmental temperature . Vaccination of the calves with a live IBR vaccine appeared to enhance the bacterial colonization of the upper respiratory tract.

Radiol Med (Torino), 1990 May, 79(5), 507 - 12
{Transcutaneous pulmonary fine-needle aspiration biopsy under fluoroscopic guidance . Our experience}; Esposito S et al.; The authors report the radiological method and the cytohistologic and bacteriologic technique of percutaneous fine-needle aspiration biopsy of the lung under fluoroscopic guidance . The results are reported of 620 biopsies of benign and malignant lung lesions; the biopsies were performed from January 1981 to September 1989 . Surgery, follow-up, and autopsy confirmed the high diagnostic accuracy of this method . The advantages of fluoroscopic guidance are discussed and compared with those of CT guidance.

Br J Urol, 1990 May, 65(5), 524 - 9
Necrotising soft tissue infections of the perineum and genitalia . Bacteriology, treatment and risk assessment; Baskin LS et al.; Necrotising soft tissue infections of the perineum and genitalia are associated with a high rate of mortality and morbidity . We reviewed the records of 29 consecutive patients to investigate the possible correlation between clinical outcome and number of types of bacteria cultured, focus of infection, presence of diabetes, patient age, renal function and delay until presentation . The patients had an average of 3.9 bacterial organisms cultured intra-operatively (range 1-9) . Patients with a rectal focus of infection had a greater number of bacteria and required longer hospitalisation and more operative procedures than patients with dermal or urethral foci . Those over the age of 60 had significantly longer hospital stays and higher mortality . Diabetes and impaired renal function did not increase mortality or morbidity . Suprapubic cystostomy was required in 24 patients (83%), diverting colostomy in 9 (31%) and orchiectomy in 3 (10%) . Six patients (21%) died despite broad spectrum antibiotics and aggressive and frequent surgical debridement.

J Pediatr Surg, 1990 May, 25(5), 483 - 6
Atypical mycobacterial infection of the parotid gland; Rieu PN et al.; A localized atypical mycobacterial infection of the major salivary gland is a rare disease . In this report the cases of three patients with this lesion are presented . The diagnosis was based on the clinical picture, skin testing with specific antigens, bacteriologic culture, and histopathologic findings . The patients were successfully treated by total parotidectomy with facial nerve preservation, which in our opinion is the therapy of choice in localized atypical mycobacterial infections.

Am Rev Respir Dis, 1990 May, 141(5 Pt 1), 1236 - 40
Why tuberculosis is not prevented; Glassroth J et al.; Because of the effectiveness of isoniazid in treating tuberculosis infection, progression to tuberculosis should be largely preventable . Thus, each case of tuberculosis that occurs may be viewed as a "failure" of the prevention system . We studied the reasons for these "failures" at three centers in different geographic areas in the United States . Two hundred seventy-nine patients with bacteriologically confirmed tuberculosis were evaluated by means of a questionnaire . Our results suggest three main reasons for these missed opportunities of tuberculosis prevention . (1) Patients are out of the health care system until they develop tuberculosis . (2) Patients are in the system but are either not screened for tuberculous infection or, if screened, are not offered preventive therapy when it is appropriate . (3) Because of false negative skin test results, screening may be ineffective at the time it is applied . Advances in tuberculosis prevention will require attention to these areas.

Eur J Obstet Gynecol Reprod Biol, 1990 May-Jun, 35(2-3), 153 - 7
Blood-stained maternal milk: prevalence, characteristics and counselling; Merlob P et al.; Blood-stained maternal milk at delivery and during lactation was prospectively studied in 7774 livebirths over a period of 2 years (1986-1988) . Eight mothers had this atypical breast discharge, a prevalence rate of 1:971 livebirths (0.1%) . The characteristics of this phenomenon were: early appearance (frequently a short time after delivery), with normal bacteriologic and cytologic investigations, disappearance in 2 to 5 days, without adverse effects on the mothers and their babies, no recurrence after cessation, and occurrence in the previous pregnancies (3 of the 5 multipara) . As a result, the best policy is to reassure the parents about the benign and transient course of this condition and to recommend continuation of breast feeding.

Arch Otolaryngol Head Neck Surg, 1990 May, 116(5), 557 - 9
Topical and oral treatment of chronic otitis media with ciprofloxacin . A preliminary study; Esposito S et al.; The clinical and bacteriological efficacy of ciprofloxacin was studied in three groups composed of 20 patients each, all of whom were affected by chronic otitis media in the acute stage . Ciprofloxacin was randomly administered according to the following schedules for 5 to 10 days: 250 mg orally twice a day (group A); 3 drops (250 micrograms/mL in saline solution) locally twice a day (group B); and both of the previous treatments twice a day (group C) . A high percentage of favorable clinical response (100% and 95%) and bacteriological eradication (95% and 85%) was observed in groups B and C . A low percentage of patients (65% and 40%) were clinically and bacteriologically cured by the oral therapy (group A) . No worsening of the audiometric and vestibular function was observed after local therapy . The results of this preliminary study suggest that the use of topical ciprofloxacin is effective in curing chronic otitis media, even when it is caused by Pseudomonas (47% of the total bacterial detections).

Vet Med (Praha), 1990 May, 35(5), 257 - 65
{The genetic contribution of cows to the prevalence of mastitis in the following generation}; St'avikova M et al.; Investigations of mastitis prevalence were performed in 1227 dam-daughter pairs during 1985-1988 . From the records of the last 10 years, the findings concerning mammary gland were obtained . Six herds of agricultural co-operatives in the Brno region were investigated . In the early period the Bohemian Pied breed, later the crosses of this breed with Red Holstein and a low genetic proportion of Ayrshire cattle, dominated in the set of cows . Udder health was assessed using the clinical and bacteriological findings in individual udder quarters and the results of the rapid mastitis test NK . Based on this data, the cows were divided into two groups--resistant and susceptible . The lactation order in which the disease appeared for the first time was of great importance . The occurrence of the disease in daughters and udder health in dams were in a significant relation (P less than or equal to 0.01) . While nearly 50% of daughters of susceptible dams were affected, it was only 25% in daughters of the resistant group . The assessment of heritability of resistance to mastitis was carried out on the principle of dam-daughter regression . The index of heritability h2 = 0.52 +/- 0.06 was calculated . The results show that the genetic contribution of dams to the susceptibility of daughters to mastitis is significant.

Kansenshogaku Zasshi, 1990 May, 64(5), 564 - 9
{Efficacy of acellular pertussis vaccine}; Saito T et al.; An outbreak of pertussis occurred in one room of a residential facility where 19 children aged 5 to 36 months were residing . They were prospectively surveyed to estimate the efficacy of acellular pertussis vaccine . Among the 19 residents, 9 were immunized with acellular pertussis vaccine . Among the 19 residents, 9 were immunized with acellular DTP vaccine and 10 were unimmunized . The spread of pertussis was surveyed bacteriologically and serologically for 2 months . Among the 9 immunized, 7 children acquired the laboratory-confirmed pertussis and 1 of the 7 developed the typical symptoms (whooping or paroxysmal coughing attack lasting for 14 days or more) . Among the 10 unimmunized, 7 children acquired the laboratory-confirmed pertussis and 6 of the 7 developed the typical symptoms . There was no difference in the rate of secondary infection (7/9:7/10), but there was a significant difference in the rate of development of the typical symptoms (1/7:6/7 p less than 0.05) . The point estimate of protective efficacy of the acellular DTP vaccine against typical pertussis was (6/10 - 1/9)/(6/10) x 100 = 81% . It was concluded from these findings that acellular DTP vaccine could not prevent the infection of Bordetella pertussis, but could prevent the development of the typical symptoms.

Monatsschr Kinderheilkd, 1990 May, 138(5), 244 - 8
{Pertussis: diagnosis, clinical aspects and therapy}; Hoppe JE; Isolation of the causative agent remains the "gold standard" for the early diagnosis of pertussis . For this purpose, the nasopharynx is swabbed with a calcium alginate swab . Cephalexin-containing charcoal horse blood medium is used for the transport of the swabs to the bacteriology laboratory . As an alternative, the isolation of bordetellae can be performed at the paediatrician's office by direct inoculation of charcoal horse blood agar plates . Long-lasting cough of unknown aetiology is the main field for pertussis serology (ELISA) . Even today, severe courses of whooping cough requiring hospitalization are not rare, especially in infants . Erythromycin (given in high doses for 14 days) is the antibiotic of choice for pertussis . As an alternative to the macrolides, cotrimoxazole may be administered or amoxycillin . Salbutamol and the corticosteroids have been shown to be useful for the symptomatic treatment of severe pertussis in infants.

J Antimicrob Chemother, 1990 May, 25(5), 843 - 51
Intraperitoneal ciprofloxacin for the treatment of peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD); Ludlam HA et al.; Ciprofloxacin was evaluated as single-agent therapy for the empirical treatment of patients presenting with CAPD peritonitis in an open, uncontrolled trial . Seventy-five episodes of peritonitis in 44 patients receiving continuous ambulatory peritoneal dialysis were entered in the study . The antibiotic was administered intraperitoneally, at a dose of 50 mg/l in each bag of dialysate, for seven days . Treatment with ciprofloxacin was appropriate (organisms isolated sensitive to ciprofloxacin) and successful (clinical and bacteriological cure of peritonitis) in 62 (83%) of the 75 episodes . The mean ciprofloxacin concentrations in serum and effluent were 1.1 mg/l (range 0-2.9 mg/l) and 10.0 mg/l (range 0.2-33.4 mg/l), respectively, with no evidence of accumulation . Side effects were seen in two patients only, and were mild and transitory.

Am J Med, 1990 May, 88(5N), 1N - 8N
Prognosis of patients hospitalized with community-acquired pneumonia; Fine MJ et al.; PURPOSE: Our purpose was to determine which clinical features predict short-term mortality in patients with community-acquired pneumonia . PATIENTS AND METHODS: We conducted a prospective multicenter study of 347 patients hospitalized in Pittsburgh (the derivation cohort) and 253 hospitalized and ambulatory patients in Boston (the validation cohort) with clinical and radiographic evidence of pneumonia . Patients in the derivation cohort underwent an extensive microbiologic evaluation including bacteriologic sputum culture, blood cultures, direct fluorescent antibody testing for Legionella species, and serologic testing for Mycoplasma pneumoniae, Legionella species, and Chlamydia TWAR . RESULTS: The overall mortality was 18% in the derivation cohort and 13.2% in the validation cohort . We identified five independent predictors of mortality in the derivation cohort: pleuritic chest pain (risk ratio, 0.4; 95% confidence interval {CI}, 0.17 to 0.99), mental status changes (risk ratio, 2.6; 95% CI, 1.4 to 4.6), a severe vital sign abnormality (risk ratio, 2.1; 95% CI 1.2 to 3.6), neoplastic disease (risk ratio, 5.0; 95% CI, 2.7 to 9.1), and "high-risk" pneumonia etiology (risk ratio, 2.8; 95% CI, 1.6 to 5.0) . A mortality index based on these factors accurately classified patients into five risk classes of increasing mortality . In the derivation cohort, the 6-week mortality rates were 0% in class I, 2.9% in class II, 13.1% in class III, 32.7% in class IV, and 89.5% in class V . There was little deterioration in the predictive accuracy of the model when tested in the validation cohort: mortality was 2.2% in class I, 0% in class II, 13.5% in class III, 33.3% in class IV, and 55.6% in class V . CONCLUSIONS: This prognostic classification may help direct triage decisions, assess appropriateness of care, and guide the design and analysis of therapeutic trials in patients with community-acquired pneumonia.

J Am Acad Dermatol, 1990 May, 22(5 Pt 1), 883 - 5
A bacteriologically controlled, randomized study comparing the efficacy of 2% mupirocin ointment (Bactroban) with oral erythromycin in the treatment of patients with impetigo; McLinn S; Sixty patients participated in a bacteriologically controlled, randomized, parallel group comparison of 2% mupirocin ointment (Bactroban) and oral erythromycin ethylsuccinate for the treatment of impetigo . The trial included clinical and bacteriologic evidence and safety assessments . The Investigator's Global Evaluation, which compared the overall efficacy and safety of the trial drugs, demonstrated a more favorable performance for the mupirocin regimen . This difference was statistically and clinically significant . There were no significant differences between the trial regimens for any of the other efficacy variables examined . The bacteriologic success rate was 100% for both treatment groups . There was a clinically significant difference in adverse experience rates between treatment groups, with four (13%) of the erythromycin-treated patients reporting six adverse experiences versus none of the mupirocin-treated patients . The results of the trial indicate that 2% mupirocin ointment is as safe and effective as oral erythromycin ethylsuccinate in the treatment of patients with impetigo.

Acta Eur Fertil, 1990 May-Jun, 21(3), 151 - 3
A possible role of Chlamydia trachomatis in unexplained infertility and sterility; De Punzio C et al.; To estimate the presence of latent Chlamydia Trachomatis (C.T.) infections, we have carried out a study on a selected group of couples affected by unexplained sterility and infertility . We examined 193 women and, as control group 210 healthy fertile women . For both groups the main risk factors that could explain the infection epidemiology have been analyzed . The parameters considered are age of first intercourse, number of partners, social-economic conditions and number of voluntary abortions . Amongst all the causal agents of sexually transmitted diseases (STD), C.T . was most common, with an incidence of about 12 per cent in the study group versus the 5.7 per cent of the control group (chi 2 = 4.12)PIP: The incidence of Chlamydia infection and factors associated with it in 193 women consulting for infertility was analyzed in comparison with 210 matched controls . All study subjects received a clinical exam, history interview, Pap test, vaginal bacteriology, colposcopy, cervical virology for Chlamydia and enzyme-linked assay for Chlamydia, herpes, rubella and toxoplasma antibodies . Results were tabulated as percent distributions for Chlamydia-positive and -negative in index cases and controls, broken down by the descriptive factors, age at 1st intercourse, number of partners, socio economic class and numbers of induced abortions . 43.5% of the index cases had primary infertility, 21.7% had secondary infertility and 34.8% were sterile . 11.9% of the study group were positive for Chlamydia infection, compared to 5.7% of controls . The only significant difference in factors related to STD infection were: earlier age at 1st intercourse among controls; higher percentage with 3 sexual partners, higher socioeconomic class and more induced abortions in the study group of infertile women; but no difference in chlamydia infection rates with abortion history . This study is unusual in finding higher socioeconomic class in the infertile women than in controls .

Pancreas, 1990 May, 5(3), 330 - 3
Bacteriologic status of necrotic tissue in necrotizing pancreatitis; Banks PA et al.; To confirm the accuracy of guided percutaneous aspiration (GPA) in distinguishing sterile from infected pancreatic necrosis, we have performed Brown-Brenn tissue Gram stains on pancreatic and peripancreatic necrotic tissue removed operatively in 15 patients . In eight patients judged to have sterile necrosis on the basis of negative cultures of pancreatic exudate obtained first preoperatively (by GPA) and then intraoperatively, necrotic tissue debrided at surgery was also free of bacteria . In seven patients judged to have infected necrosis on the basis of positive cultures of pancreatic exudate obtained first preoperatively (by GPA) and then intraoperatively, necrotic tissue debrided at surgery harbored a considerable number of bacteria . We conclude that GPA targeted to areas of necrosis accurately distinguishes infected necrosis from sterile necrosis, and in infected necrosis, the solid necrotic tissue as well as the fluid component contains bacteria . We therefore believe that infected necrosis is not likely to be eradicated by catheter drainage and should be treated by surgical debridement.

Wiad Lek, 1990 Apr 15, 43(8), 318 - 23
{Effect od external drainage of the biliary tract on bile infection}; Kubiak J et al.; After a brief review of the pertinent literature the results are presented of bacteriological examinations carried out in patients with calculosis of the gallbladder and bile ducts . The study demonstrated that E . coli was the prevailing bacterium in the bile and that external drainage of the bile ducts exerts a direct effect on increased incidence of contamination of bile in bile ducts even despite antibiotic treatment.

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