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 . Amon