Wien Med Wochenschr, 2003, 153(7-8), 163 - 5 Determination of the frequency of inadequate antibiotic therapy using calculation of indication failure (IF), cumulative indication failure (CIF), and balanced indication failure (BIF); Burgmann H; Because results of pathogen identification are often lacking when antibiotic therapy is initiated, treatment must frequently be instituted on an empirical basis . The type of empirical therapy will depend on the anticipated pathogen spectrum and naturally also on the prevailing resistance patterns . Inadequate antibiotic therapy may not only be associated with increased overall treatment costs, but will also have adverse effects on mortality . The clinician is frequently faced with an overabundant variety of microbiological data and may fail to interpret them correctly . Therefore, the present study has attempted to "translate" the available microbiological resistance data, frequently presented in the form of percentage rates, into concrete patient numbers and thus illustrate the frequency of inadequate antibiotic therapy . For this purpose, "Indication Failure" (IF), "Cumulative Indication Failure" (CIF) and "Balanced Indication Failure" (BIF) have been calculated based on available microbiological data . For the indication "nosocomial pneumonia", calculations of the BIF show that only one out of 67 or one out of 63 patients is inadequately treated with a therapy with cefepime or imipenem, while one out of 25 patients is inadequately treated when using ceftazidime . However, it must be pointed out that these calculations only represent an interpretation of microbiological data and the success of antibiotic therapy will ultimately also depend on parameters such as the pharmacodynamic properties of an antibiotic or on the immunocompetence of the patient treated. BJOG, 2003 Apr, 110 Suppl 20, 128 - 30 The critical role of perinatal pathology; Jeffrey IJ; In spite of great advances in imaging and biochemistry, histological examination of tissues remains a vital part of the multidisciplinary approach to the prevention of the onset, morbidity and mortality of preterm birth . There has been increasing interest in the role of infection and inflammatory cytokines in causation both of early labour and the white matter damage in the brain of preterm infants . However, labour itself is associated with the build up of increased numbers of inflammatory cells in the uterine cervix and increased concentrations of inflammatory cytokines and positive microbiological cultures may reflect carriage or contamination . Confirmation of an infective aetiology in an individual case is best achieved by demonstration of a pathological inflammatory response in tissues, for example, by showing the presence of chorioamnionitis in the placenta . A proper understanding of the poor response to neonatal intensive care of some preterm babies often requires histological examination of the lungs after death, where unsuspected pneumonia, interstitial emphysema and/or pulmonary hypoplasia may help provide an explanation for the adverse outcome in individual cases . The pathophysiological mechanism of brain injury in preterm infants is undergoing re-evaluation, and the systemic study of brain tissue using the latest histological techniques may elucidate the importance of apoptosis in this situation and could point the way towards an effective preventative strategy . Paediatric pathology is also essential to explain many cases of sudden unexpected death in preterm infants, as demonstrated by the recent realisation that death may be caused by total parenteral nutrition fluid-associated myocardial necrosis, and acute cardiac tamponade. Org Lett, 2003 May 29, 5(11), 1837 - 9 Two syntheses of FF-MAS; Blume T et al.; {reaction: see text} Follicular fluid-meiosis activating sterol (FF-MAS) has been shown to be an efficient inducer of meiotic maturation . It can potentially be used for improvements of in vitro fertilization techniques . Two short synthesis of FF-MAS are presented in this article . Both syntheses are based on microbiological degradations of sterol side chains . FF-MAS can be synthesized in nine steps from commercially available starting materials by both routes. J Int Acad Periodontol, 2003 Apr, 5(2), 52 - 60 The use of tetracycline fibres in the treatment of generalised aggressive periodontitis: clinical and microbiological findings; Sakellari D et al.; The purpose of the present study was to evaluate the effects of tetracycline fibres (TCF) as an adjunct to scaling in the treatment of generalised aggressive periodontitis and to compare the effects with mechanical treatment only . Ten patients, 24-39 years old referred for treatment to the Department of Preventive Dentistry, Periodontology and Implant Biology, Aristotle University of Thessaloniki took part in the study . A split-mouth experimental design was used . Measurements referring to bleeding on probing (BOP), pocket depth (PD) and clinical attachment level (CAL) were performed at 12 sites randomly selected . Clinical recordings were made at baseline, 2 and 6 months, after treatment . Subgingival plaque samples were taken for microbiological analysis using the 'checkerboard' DNA-DNA hybridisation technique at baseline, immediately after treatment and at 2 and 6 months . Full-mouth scaling and root planing were performed, with the exception of 2 pre-selected sites, which served as controls . Tetracycline fibres were applied in 5 pockets located in the same half mouth . Analysis of clinical findings showed that mechanical instrumentation in combination with TCF application led to a greater improvement in clinical parameters than scaling and root planing only . Microbial analysis showed a statistically significant greater reduction in the percentages of detection for B . forsythus, P . nigrescens and A . naeslundii genospecies II in pockets where tetracycline fibres were applied . In conclusion, the clinical and microbiological data of the present study suggest that the adjunctive use of TCF improves the clinical response of scaling and root planing in aggressive periodontitis patients. Ned Tijdschr Geneeskd, 2003 May 3, 147(18), 846 - 8 { 'Severe acute respiratory syndrome' (SARS) in perspective}; Zaaijer HL; In the Netherlands, the risk of an outbreak of the severe acute respiratory syndrome (SARS) appears to be limited, if people in contact with a possibly imported case observe strict measures to prevent contamination . SARS may well be a zoonosis . Bovine spongiform encephalopathy and outbreaks of virus infections in the bioindustry, such as swine fever, foot-and-mouth disease and classical avian influenza, have led to massive killing of cattle, swine and fowl in the Netherlands . The possibility that the bioindustry constitutes a risky microbiological 'experiment' makes a discussion as to its future in the Netherlands urgent. Crit Rev Clin Lab Sci, 2003 Apr, 40(2), 183 - 208 Acetaldehyde, microbes, and cancer of the digestive tract; Salaspuro MP; Excessive alcohol consumption and heavy smoking are the main risk factors of upper digestive tract cancer in industrialized countries . The association between heavy drinking and cancer appears to he particularly prominent in Asian individuals who have an inherited deficient ability to detoxify the first metabolite of ethanol oxidation, acetaldehyde . Alcohol itself is not carcinogenic . However, according to cell culture and animal experiments acetaldehyde is highly toxic, mutagenic, and carcinogenic . In addition to somatic cells, microbes representing normal human gut flora are also able to produce acetaldehyde from ethanol . After the ingestion of alcoholic beverages, this results in high local acetaldehyde concentrations in the saliva, gastric juice, and the contents of the large intestine . In addition, microbes may produce acetaldehyde endogenously without alcohol administration . This review summarizes the epidemiological, genetic, and biochemical evidence supporting the role of locally produced acetaldehyde in the pathogenesis of digestive tract cancer . Special emphasis is given to those factors that regulate local acetaldehyde concentration in the contents of the gastrointestinal tract . The new evidence presented in this review may open a microbiological approach to the pathogenesis of digestive tract cancer and may have an influence on future preventive strategies. Microb Ecol, 2003 Jul, 46(1), 83 - 91 Epub 2003 May 21. Characterization of microbial activities and U reduction in a shallow aquifer contaminated by uranium mill tailings; Elias DA et al.; A characterization of the Shiprock, NM, uranium mill tailing site focused on the geochemical and microbiological factors governing in-situ uranium-redox reactions . Groundwater and aqueous extracts of sediment samples contained a wide concentration range of sulfate, nitrate, and U(VI) with median values of 21.2 mM, 16.1 micro M, and 2.7 micro M, respectively . Iron(III) was not detected in groundwater, but a median value of 0.3 mM in sediment extracts was measured . Bacterial diversity down gradient from the disposal pile reflected the predominant geochemistry with relatively high numbers of sulfate- and nitrate-reducing microorganisms, and smaller numbers of acetogenic, methanogenic, nitrate-dependent Fe(II)-oxidizing, Fe(III)-reducing, and sulfide-oxidizing bacteria . In aquifer slurry incubations, nitrate reduction was always preferred and had a negative impact on sulfate-, Fe(III)-, and U-reduction rates . We also found that sulfate-reduction rates decreased sharply in the presence of clay, while Fe(III)-reduction increased with no clear impact on U reduction . In the absence of clay, iron and sulfate reduction correlated with concentrations of Fe(III) and sulfate, respectively . Rates of U(VI) loss did not correlate with the concentration of any electron acceptor . With the exception of Fe(III), electron donor amendment was largely unsuccessful in stimulating electron acceptor loss over a 2-week incubation period, suggesting that endogenous forms of organic matter were sufficient to support microbial activity . Our findings suggest that efforts to accelerate biological U reduction should initially focus on stimulating nitrate removal. Infez Med, 2002 Dec, 10(4), 239 - 44 {World microbiological unification according to Woodrow Borah}; Sabbatani S; Now that developments in communication media are turning the world into a "global village" and there are risks of global epidemics due to infectious agents spread by possible terrorist attacks, this article aims to remind us of what happened in the "New World", where in the space of a few decades the indigenous civilizations disappeared . When, following the geographical discoveries of the 15th, 16th and 17th centuries, millions of people met European sailors, soldiers and traders, the outbreak of pathocenosis was destructive--the intensity of this effect was directly related to the degree of isolation of the indigenous populations colonised by the Europeans . The author of this article recalls the Woodrow Borah thesis . Borah, a former History Professor at Berkeley University, elaborated a theory according to which the microbiological unification of the world is the prime cause of the genocide of the indigenous population in America and Oceania . The author emphasises that the events following the discovery of the American continent are very similar to the plague epidemic which started in 1348 in Europe. Scand J Infect Dis, 2003, 35(3), 207 - 9 Acanthamoeba keratitis in a non-contact lens wearer with human immunodeficiency virus; Hansen B et al.; Acanthamoeba keratitis is potentially blinding and often associated with contact lens wearing . A human immunodeficiency virus (HIV)-positive patient, a non-contact lens wearer, presented with keratitis . She experienced a protracted course of disease, characterized by exacerbations and remissions, and was treated with various topical antibiotics and steroids . 13 months after symptom onset the eye was removed owing to serious scarring of cornea and unbearable pain . Microbiological and histopathological examination of the cornea showed Acanthamoeba . In non-contact lens wearers suffering from Acanthamoeba keratitis the diagnosis is delayed, pathognomonic features are often not seen and visual outcome is usually poor . There is no known relation between HIV infection and Acanthamoeba keratitis. Mikrobiologiia, 2003 Mar-Apr, 72(2), 259 - 67 {Microbial metabolism of the carbon and sulfur cycles in Shira Lake (Khakasia)}; Pimenov NV et al.; Microbiological and biogeochemical studies of the meromictic saline Lake Shira (Khakasia) were conducted . In the upper part of the hydrogen-sulfide zone, at a depth of 13.5-14 m, there was a pale pink layer of water due to the development of purple bacteria (6 x 10(5) cells/ml), which were assigned by their morphological and spectral characteristics to Lamprocystis purpureus (formerly Amoebobacter purpurea) . In August, the production of organic matter (OM) in Lake Shira was estimated to be 943 mg C/(m2 day) . The contribution of anoxygenic photosynthesis was insignificant (about 7% of the total OM production) . The share of bacterial chemosynthesis was still less (no more than 2%) . In the anaerobic zone, the community of sulfate-reducing bacteria played a decisive role in the terminal decomposition of OM . The maximal rates of sulfate reduction were observed in the near-bottom water (114 micrograms S/(1 day)) and in the surface layer of bottom sediments (901 micrograms S/(dm3 day)) . The daily expenditure of Corg for sulfate reduction was 73% of Corg formed daily in the processes of oxygenic and anoxygenic photosynthesis and bacterial chemosynthesis . The profile of methane distribution in the water column and bottom sediments was typical of meromictic reservoirs . The methane content in the water column increased beginning with the thermocline (7-8 m), and reached maximum values in the near-bottom water (17 microliters/l) . In bottom sediments, the greatest methane concentrations (57 microliters/l) were observed in the surface layer (0-3 cm) . The integral rate of methane formation in the water column and bottom sediments was almost an order of magnitude higher than the rate of its oxidation by aerobic and anaerobic methanotrophic microorganisms. Mikrobiologiia, 2003 Mar-Apr, 72(2), 221 - 7 {The biometric analysis of bacteria in soil}; Guzev VS et al.; The biometric analysis of bacterial cells in soil by light, fluorescence, and scanning electron microscopy showed that their average size is 0.8 micron in diameter, 1.4 microns in length, and 0.7 micron 3 in volume . In soil loci with enhanced microbiological activity (the rhizoplane of plants and the intestinal tract of soil invertebrates), the average size of bacterial cells was found to be 40% smaller than that of cells occurring in other parts of soil . It is the first experimental evidence showing that the metabolic activity of soil bacteria and their concentration and allometric parameters are related. Gesundheitswesen, 2003 Apr, 65(4), 255 - 62 {Hygienic quality of the water of public swimming pools--comments on a current German ordinance draft}; Hentschel W et al.; In April 2002, a new draft regarding the quality of the water of public swimming pools in Germany was published . This draft was adapted to the new regulations for drinking water in respect of its structure and regulations . Microbiological tests for assessing the quality of bathing water are given priority . With regard to basic differences in facilities for drinking water and such for bath water and to legal aspects, many data (n = 14,425 data) on the practical experience of public health authorities are presented, obtained during the last few years . With regard to the data and in respect of the great delay between sampling and obtaining the results it is concluded that microbiological methods are inappropriate parameters for rapid assessment of the quality of bath water . Hence it is recommended to implement the evaluation of disinfection by chlorination including pH as an indicator for the quality of a bath water, parallel to the guidelines on technical standards . A high frequency of chlorination testing can markedly reduce the number of microbiological tests . Additionally, microbiological tests of the filtrate before disinfection by chlorination are recommended . This procedure has proved successful in legionella control. Anal Bioanal Chem, 2003 Sep, 377(1), 32 - 8 Epub 2003 May 16. Preparation, homogeneity and stability studies of a candidate LRM for Se speciation; Bodo ET et al.; A laboratory reference material (LRM) was prepared from Brazil nuts (Bertholletia excelsa) for quality control (QC) purposes of selenium speciation . The preparation of this LRM led through the usual operation steps applied during routine reference material production from biota samples-preparation of the raw material, homogenisation, storage design, checking of homogeneity, microbiological status and possible irradiation effects, and monitoring the species stability vs time at different storage temperatures . The selenium speciation studies to check species stability were carried out on a HPLC-UV-HG-AFS measurement set-up . Special attention was paid to the correct identification of selenium species by applying independent HPLC separation techniques (ion-pairing and anion-exchange chromatography) . The concentration of selenomethionine (SeMet) and total Se content were quantified (79.9 microg g(-1) (calculated as Se) and 82.9 microg g(-1), respectively) . The homogeneity and stability of this candidate reference material passed the relevant tests recommended by Bureau Communautaire de Reference (BCR). Anal Bioanal Chem, 2003 Jun, 376(4), 431 - 5 Epub 2003 May 14. The role of organic colloids in herbicide transfer to rivers: a quantitative study of triazine and phenylurea interactions with colloids; Irace-Guigand S et al.; For moderately hydrophobic compounds such as most pesticides adsorption on colloids (<0.2 microm) may play a key role in pesticide mobility as well as in their degradation by chemical and microbiological processes . However, until now, pesticide-organic colloid interactions are poorly understood . Quantitative data for sorption equilibria on colloids of two series of herbicides including triazines (atrazine, simazine, terbutylazine, prometryne, desethylatrazine, and desisopropylatrazine) and phenylureas (isoproturon, linuron, neburon, and diuron) sampled in the Seine river (urban zone) and the Marne river (agricultural zone) are presented . Partition coefficient of herbicides on colloids (K(com)), were evaluated by solid-phase extraction coupled with high-performance liquid chromatography-UV diode-array detection (SPE-HPLC-UV/DAD) . In the case of triazines a satisfactory log-log correlation was found between K(com) and octanol-water coefficient (K(ow)) values . Phenylureas did not obey this correlation, with K(com) values being about two times higher than those of triazines . The existence of two distinct types of adsorption behaviour on colloids partly explains the different occurrence of triazines and phenylureas in surface waters. Folia Microbiol (Praha), 2003, 48(1), 76 - 82 Long-term fertilization affects the abundance of saprotrophic microfungi degrading resistant forms of soil organic matter; Gryndler M et al.; The effect of mineral and organic fertilization on the occurrence of soil microorganisms was determined in a field experiment . The colony-forming unit counts of saprotrophic microfungi, when estimated on a silicate gel medium containing fulvic acid as a sole carbon source, increased significantly with increasing doses of mineral and organic fertilization . Partial correlation analysis indicated that, unlike bacteria and actinomycetes, microfungi utilizing fulvic acid were significantly associated with soil organic carbon . No significant effects on bacteria and microfungi counted on common microbiological media were observed but counts of actinomycetes increased in a manured soil extensively fertilized by a mineral fertilizer . Fulvic acid utilizing microfungi, which are associated with areas rich in organics, play possibly the main role in mineralization of resistant forms of soil organic matter. Probl Tuberk, 2003, (3), 26 - 30 {Role of ultrasmall forms of Mycobacteria in the pathomorphology of tuberculosis}; Golyshevskaia VI; Microbiological and histological studies made in patients with active tuberculosis revealed that 65.5% of cases had revertants from ultraminor forms (UMF) of Mycobacteria tuberculosis (MBT), which are typically bacterial in shape and referred to as representatives of the genus Mycobacterium tuberculosis . Cultivation of the diagnostic material containing MBT UMF the enriched liquid nutrient medium could detect rod-shaped bacterial forms of MBT in 18% of the patients with tuberculosis . Inoculation of the MBT UMF-containing material isolated from patients with tuberculosis to guinea-pigs revealed productive sarcoid-like changes in the organs of the experimental animals in 30.6% of cases . A postmortem study of the organs of experimental animals inoculated the material containing "visible, but not growing" mycobacteria detected paraspecific tissue reactions and infiltration of lung tissue by multiple cells of the macrophageal series. Analyst, 2003 Apr, 128(4), 320 - 2 The Walkerton tragedy --issues for water quality monitoring; Brown RS et al.; One of the most significant weaknesses in modern day water quality management is the detection of microbiological indicators . Microbial tests are normally conducted off-site, often resulting in long turn-around time, risk of contamination, cross contamination and adulteration . Here Stephen Brown and Moe Hussain present a thought provoking case study where limitations in current analytical technologies for water monitoring had fatal results and discuss new approaches to microbiological monitoring that might prevent similar disasters occurring in the future. Antibiot Khimioter, 2003, 48(1), 27 - 30 {Microbiological evaluation of differences between cephalosporins of second and third generations in general hospital}; Bogdanov MB et al.; The aim of the current investigation was to evaluate practical impact of modern NCCLS recommendations for the selection of 2nd and 3rd generation cephalosporins in Moscow teaching multi profile hospital . The sensitivity of clinically significant 96 strains from patients with pyelonephritis and 180 strains from patients with lower respiratory tract infections (pneumonia, COPD) was compared for cefuroxime and cefotaxime or ceftriaxone according NCCLS recommendations during 2000-2001 years . At the lower respiratory tract infection total sensitivity of all pathogens was 70.6% and 72.8%, at the pyelonephritis 71.9% and 76.0% for 2nd and 3rd generations respectively . The differences between cephalosporins were not statistically significant . Based on the application of modern NCCLS recommendations in the routine microbiological practice similar clinical efficacy of 2nd and 3rd generations cephalosporin in lower respiratory tract infections and pyelonephritis could be predicted. Ned Tijdschr Geneeskd, 2003 Apr 26, 147(17), 813 - 5 {Severe diarrhea and eosinophilic colitis attributed to pinworms (Enterobius vermicularis)}; de Jong MD et al.; In a 32-year-old woman suffering from severe diarrhoea, eosinophilic infiltration of colonic mucosa and a peripheral eosinophilia, microbiological investigations only revealed large numbers of Enterobius vermicularis (pinworm) in the faeces . Treatment with mebendazole resulted in a rapid resolution of symptoms and disappearance of the eosinophilia, which strongly suggested a causative role of this pinworm in the clinical syndrome of the patient . E . vermicularis is generally regarded as an innocent nematode, which at most causes perianal pruritus due to migration of worms from the colon and expulsion of eggs onto the perianal skin . Although the pinworm maturates and lives in the gut, gastrointestinal symptoms have seldom been reported . E . vermicularis infection should be considered in patients with unexplained eosinophilic enteritis. Schweiz Rundsch Med Prax, 2003 Apr 16, 92(16), 751 - 9 Antibiotic-associated diarrhea: incidence, risk factors of antibiotics and patients, pathophysiology and differential diagnosis--an interdisciplinary approach to a common problem; Lembcke B et al.; Antibiotic-associated diarrhea (AAD) is a common complication of antibiotic treatment, most often seen in non-hospitalised patients . In principle, such diarrhea can be triggered by any antibiotic . An interdisciplinary working group discussed the different aspects of AAD in view of its gastroenterological, microbiological, paediatric, general medical and pharmaceutical implications, also in consideration of the position of patients and health insurance funds . The incidence, risk factors of antibiotics and patients, the pathophysiology of the various types of AAD and the differential diagnosis are reviewed. Infez Med, 1999, 7(3), 195 - 202 The use of antidiphterial serotherapy in Bologna in 1895 . A pilot experience; Sabbatani S et al.; It was the year 1894 and the international scientific community was experiencing a historic moment . It was around this time that Pasteur, Kock, L efler, Yersin and Behring discovered the microbiological causes of commonly occurring infectious diseases . In Bologna it was decided to eradicate the diphtheria epidemic which had claimed 152 victims, mainly children, the previous year by experimentally adopting specific serotherapy successfully applied in France shortly before . Supported by local government funding and with the aid of some enterprising local doctors, an efficacious serum was soon produced in Bologna . Good clinical results were obtained and production and sale costs were able to be considerably reduced . Little more than a century later, this is an example of applicative research where there is much still to be revealed. Acta Derm Venereol, 2003, 83(2), 88 - 92 The vulva skin microclimate: influence of panty liners on temperature, humidity and pH; Runeman B et al.; Many women use panty liners between menstrual periods . The aim of this study was to investigate whether the use of such products might influence the vulva skin . Twelve healthy women were studied on four occasions with three different product constructions and on one occasion without products . Temperature, surface wetness and surface pH were measured on vulva skin . Mean skin temperature when the women were wearing a conventional panty liner (with a non-breathable back sheet) was 35.9 degrees C, compared to 34.4 degrees C when wearing no panty liner at all (p < 0.01) and 34.5 degrees C when using a panty liner with a breathable (i.e . vapour permeable) back sheet (p < 0.01) . Skin humidity was significantly higher when the conventional panty liner was used compared to no panty liner or to the breathable panty liner (both cases p < 0.01) . The mean pH value at the exterior aspect of the labium majus was 5.8 with the conventional panty liner, 5.2 with no panty liner and 5.3 with the breathable panty liner (p < 0.001 and p < 0.01, respectively) . The results indicate that the conventional panty liner changes the vulva skin microclimate, but that the breathable panty liner to a substantial degree keeps the microclimate at an undisturbed level . The actual effect of these differences on microbiological flora will be addressed in a subsequent study. Eur J Clin Microbiol Infect Dis, 2003 May, 22(5), 310 - 2 Epub 2003 May 07. Lack of portosystemic bacterial translocation in patients with liver cirrhosis after placement of transjugular shunt; Cohnen M et al.; The purpose of this study was to clarify whether bacteria are transferred from the portal venous system into central venous blood during the placement of a transjugular portosystemic stent shunt (TIPSS) . TIPSS was created in 30 consecutive cirrhotic patients for recurrent variceal bleeding ( n=12), refractory ascites ( n=16), or hepatorenal syndrome ( n=2) . Microbiological analysis was performed prospectively on central venous blood before and on portal venous blood immediately after puncture of the portal vein . Twenty minutes after the placement of TIPSS, another sample of central venous blood was obtained . None of the first two sets of blood cultures showed bacterial growth, so that no bacterial transfer was seen at the time of TIPSS placement . Four of the third sets of blood samples showed skin and mouth flora, interpreted as iatrogenic contamination. Anal Bioanal Chem, 2003 May, 376(1), 102 - 9 Epub 2003 Mar 29. Evaluation of stability of arsenic species in rice; Pizarro I et al.; Although most edible vegetables do not accumulate As at a high rate, rice, carrots and certain others are exceptions . In addition to nutritional or toxicological considerations, the relatively high level and variety of As species present in rice make it a very suitable matrix for a candidate reference material representative of terrestrial biological samples.An analytical procedure was developed for As speciation in rice based on the use of a 1:1 methanol-water mixture for species extraction, an anion Hamilton PRPX-100 column (at pH 6, and phosphate mobile phase 10 mM), and a cation Hamilton PRP-X200 column (at pH 2.8 in pyridine formiate 4 mM) for species separation and final determination by HPLC-ICP-MS.The detection limits for dry flour rice expressed as As were 2 and 3 ng g(-1) for As(III) and AsB on the cation column and 3, 6 and 5 ng g(-1) for As(V), MMA and DMA, respectively, on the anion column.The methodology developed was applied to check the stability of As species in the water-methanol extract and also under different processing steps and storage time and temperature conditions.It was demonstrated that the As species in the water-methanol extracts stored at +4 degrees C remained stable for at least one month . Once the rice grains are ground, the MMA and As(V) species are not stable under any storage conditions probably due to microbiological activity . When ground rice is gamma-irradiated species remain stable although the AsB does not appear. J Can Dent Assoc, 2003 May, 69(5), 292 - 6 Oral health promotion for high-risk children: case studies from British Columbia; Harrison R; Socio-economics, family stress and parenting style each plays as important a role in the development of early childhood caries as dietary and microbiological factors . Therefore, to be successful, oral health promotion initiatives should be designed and implemented with due consideration of issues such as collaboration with community partners, the role of dental health in overall child health and the involvement of the community in program planning . This article briefly describes 3 programs that have been undertaken in British Columbia either as public health initiatives or as demonstration research projects to improve oral health in young children from diverse communities with a high prevalence of early childhood caries. Bioresour Technol, 2003 Mar, 87(1), 125 - 7 Quality assessment of compost prepared from fly ash and crop residue; Gaind S et al.; Fly ash was co-composted with wheat straw and 2% rock phosphate (w/w) for 90 days and different chemical and microbiological parameters monitored to evaluate its effect on the composting process . Fly ash addition at 20% level resulted in the lowest C/N of 16.4:1 and highest available and total phosphorus . Increasing the addition of fly ash from 40 to 60% (w/w) did not exert any detrimental effect on either C:N or the microbial population. Infez Med, 1998, 6(1), 18 - 24 {Treatment of Community Acquired Pneumonia (CAP) in adults with amoxicillin/clavulanic acid switch therapy: a multicenter italian study}; Legnani D et al.; Patients with community acquired pneumonia (CAP) previously treated with other oral antibiotics (Cephalosporins 35,3%, Macrolides 26,9%, Tetracyclines 14,1%, Quinolones 12,8%, other 10,9%) for at least 72 hours at home were considered for this national multicentre study . 43 hospitalized patients (17 males and 26 females) ranging between the ages of 19 and 79 were treated with Amoxicillin/Clavulanic acid (AMC) 1,2 g e.v., T.l.D . for at least 3 days . I.V . Treatments were switched to AMC p.o . after apyrexial status . Average treatment duration was 10,8 + 3.6 . Sputum/B.A.L . samples were obtained from all patients submitted for microbiological exams in order to determine microbiological aetiology of CAP in patients who have failed on previous antibiotics . At the end of treatment, 30 patients (96,8%) were considered cured, while treatment failed in 1 patient (3,2%) . 12 patients were considered not evaluable because serology was positive for M.pneumoniae (5 pts); for C.pneumoniae (3 pts.); 1 patients was positive for Mycobacterium tuberculosis; 1 patient was positive for HIV and Mycobacterium spp.; 2 patients were non-evaluable for lung or bronchial tumor . Not reported adverse events. Eur J Pharm Sci, 2003 May, 19(1), 31 - 6 Stability of sufentanil and levobupivacaine solutions and a mixture in a 0.9% sodium chloride infusion stored in polypropylene syringes; Jappinen A et al.; We have evaluated the chemical and microbiological stability of sufentanil citrate, levobupivacaine hydrochloride and a mixture in a 0.9% sodium chloride infusion in order to provide background information on the storage of a sufentanil-levobupivacaine mixture in polypropylene (PP) syringes . Chemical assays were performed by HPLC on days 0, 1, 2, 3, 8, 14, 23, 28 and 30 after storage at 4, 21, and 36 degrees C . Microbiological stability was evaluated under aseptic conditions using a laminar air flow station, with a grade A environment and a B background . The samples taken for microbiological analysis were collected immediately after preparation of the solutions and then after 7, 14, 21 and 28 days storage . At 4 degrees C the sufentanil citrate solution was stable for 23 days . At 21 degrees C the sufentanil citrate solution maintained chemical stability for 3 days, but thereafter the concentration of sufentanil decreased 15% from day 3 to day 8 . At 36 degrees C a similar decrease was noticed from day 1 to day 3 . On the contrary, the levobupivacaine hydrochloride solution maintained chemical stability for 28 days at 4 and 21 degrees C and for 23 days at 36 degrees C . The sufentanil-levobupivacaine mixture maintained chemical stability for 28 days at 4, 21 and 36 degrees C . The sufentanil and levobupivacaine solutions and the mixture studied maintained microbiological stability for 28 days . According to the chemical and microbiological stability studies, the sufentanil-levobupivacaine mixture in PP syringes could be stored for 28 days at 4 and 21 degrees C. Rev Bras Enferm, 2002 Jul-Aug, 55(4), 414 - 9 {Validation of the sterilization procedure of medical and hospital devices according to different packaging types}; Brito Mde F et al.; Safety in the processing of medical and hospital devices in healthcare organizations is an important measure of nosocomial infection control . This investigation aimed at establishing the period during which it is safe to use medical and hospital articles processed through sterilization by saturated steam under pressure using different types of packaging at a private hospital . The methodological procedure consisted of four phases: preparation of articles, evaluation of autoclave functioning, sterilization cycle and microbiological tests . Results showed bacterial growth on articles packed in surgical grade paper with and without film on the 21st day, in crepe paper on the 90th day and absence of growth when raw cotton packaging was used . In face of the results, a 21-day period was established for the use of articles after sterilization by saturated steam under pressure regardless of the type of packaging utilized, considering that storage conditions were also evaluated. J Clin Virol, 2003 May, 27(1), 74 - 82 Are waterborne astrovirus implicated in acute digestive morbidity (E.MI.R.A . study)? Gofti-Laroche L, Gratacap-Cavallier B, Demanse D, Genoulaz O, Seigneurin JM, Zmirou D. BACKGROUND: With rotavirus and Norwalk-like viruses, astroviruses are now recognized as important etiologic agents of viral gastroenteritis in all age groups . However, astrovirus is neither routinely screened for in stool samples, nor in environmental samples, and data on the health impact of waterborne astrovirus are lacking . OBJECTIVES: To assess the potential impact of astrovirus in drinking water on the incidence of acute digestive conditions (ADC) among a panel of volunteers . STUDY DESIGN: The Epidemiology and MIcrobial Risk Assessment (E.MI.R.A.) study combined a daily epidemiological follow-up of digestive morbidity among a panel of 544 volunteers supplied by French public water systems, and a microbiological surveillance of drinking water . Cases of digestive morbidity were collected through weekly telephone calls . The bacterial, virological and parasitic quality of tap water was assessed monthly . Additional samples were collected if the incidence of ADC increased . The relationship between incidence of ADC during a 7-day period centered about the water sampling day and astrovirus RNA prevalence in drinking water was modeled by regression techniques, taking into account several confounders . RESULTS: 12% (8/68) of the analyzed water samples were positive for astrovirus, and presence of astrovirus RNA was associated with a significant increased risk of ADC: RR=1.51 (95% CI={1.17-1.94}, P value=0.002) . CONCLUSIONS: This result suggests a role for waterborne astrovirus in the endemic level of digestive morbidity in the general population . Perhaps astrovirus is a candidate test target for viral surveillance of drinking water. Int J Antimicrob Agents, 2003 May, 21(5), 452 - 6 Does dexamethasone affect ceftriazone penetration into cerebrospinal fluid in adult bacterial meningitis; Buke AC et al.; Trough cerebrospinal fluid (CSF) ceftriaxone concentrations were measured daily to investigate the effect of dexamethasone on ceftriaxone penetration into CSF in adult patients with acute bacterial meningitis . Patients were divided into two groups in this double blind randomized study . In group 1 (n=6) patients were given ceftriaxone with dexamethasone whereas in group 2 (n=6) patients were only administered ceftriaxone . Plasma and CSF samples were collected at 24, 48, 72, 96 and 264 h following the study treatments . The trough CSF ceftriaxone concentrations were measured using high performance liquid chromatography (HPLC) and microbiological assay . CSF ceftriaxone concentrations were 3.21 mg/l at 24 h in group 1 and 4.85 mg/l at the same time in group 2 by HPLC . Although microbiological assay results were lower than HPLC the trough CSF ceftriaxone concentrations in dexamethasone group were at least 10(3) times higher than the minimum inhibitory concentrations of the susceptible strains . It was concluded that the ceftriaxone concentration in CSF was adequate and ceftriaxone penetration was not significantly affected by concomitant dexamethasone use in adult patients with acute bacterial meningitis. Int J Antimicrob Agents, 2003 May, 21(5), 393 - 402 Use of imipenem as empirical treatment of febrile neutropenia; Klastersky JA; Based on past information from the literature and our own review, it appears that imipenem can be used effectively as an initial empirical therapy of febrile neutropenia, as a monotherapy, even in patients with haematological malignancies . The response rate is outstanding in microbiologically documented infections, namely bacteraemias, although more information is needed about its optimal use when pneumonia is present . There is no logical or medicine-based evidence suggesting that imipenem should be reserved for second line therapy in patients with febrile neutropenia not responding to empirical treatments that did not contain imipenem . A lower dose of imipenem (500 mg every 6 h) is probably as effective and definitely better tolerated, than higher doses, especially as far as nausea and vomiting are concerned. An Pediatr (Barc), 2003 May, 58(5), 432 - 7 {Epidemic outbreak of tuberculosis in a primary and secondary school in Granada (Spain)}; Sanchez Marenco A et al.; OBJECTIVE: To describe the diagnosis and early treatment of an epidemic outbreak of tuberculosis and determine the utility of polymerase chain reaction (PCR) compared with routine culture in gastric juice . MATERIAL AND METHODS: A computer studies teacher, with clinical features suggestive of tuberculosis and caverns on X-ray, was diagnosed with bacilliferous tuberculosis . Primary health care services carried out a Mantoux test on the school's 387 students as well as on teachers and other staff . The children with a positive Mantoux test underwent laboratory, radiological, and microbiological investigations for one week in the Pediatric Respiratory Unit of Hospital Clinico in Granada.In the teaching and non-teaching staff, active tuberculosis was ruled out through bacilloscopy of sputum samples, Mantoux test, and chest X-ray . RESULTS: In the first screening, the Mantoux test was positive in 67 children . Of these, 7 children were diagnosed with tuberculosis and 60 were found to be infected . Of the 7 children with tuberculosis, five presented positive gastric juice culture in Lowenstein medium while Roche COBAS PCR was negative . In the second screening, 9 children became tuberculin positive . Of these, 8 were diagnosed with tuberculosis and one was infected . Cultures were positive in 3 and PCR was negative . In 77.6 % of the children (59/76), the Mantoux induration was equal to or higher than 18 mm . All of the 15 children with tuberculosis were aged between 9 and 14 years old, except one who was 5 years old . CONCLUSIONS: The Mantoux test remains a basic screening method in diagnosis and epidemiological research, whereas the results of microbiological investigation remain poor and in our study the results DNA were disappointing . The screening of tuberculosis and of other infectious diseases should be more closely monitored in professional groups, such as teachers, that are in contact with large numbers of children . This would identify infected adults and prevent epidemics such as that described in the present study. J Med Microbiol, 2003 May, 52(Pt 5), 435 - 40 Acute viral gastroenteritis: proportion and clinical relevance of multiple infections in Spanish children; Roman E et al.; Dual infections associated with acute infectious diarrhoea and its microbiological, epidemiological and clinical findings have been evaluated in patients selected from a comprehensive survey of children under 4 years old, admitted to hospital emergency rooms from October 1996 to November 1997 . A total of 820 children (433 males and 387 females) were enrolled . Stools were tested for rotavirus, adenovirus, astrovirus and bacterial enteropathogens . Patients were grouped according to age, and the seasonality of mixed infections was evaluated . Clinical trends and severity of gastrointestinal disease by Ruuska's score were also analysed . Mixed infections were identified in 39 cases (5 %), of which 23 were males and 16 were females . The majority of cases were in the 7-18-month age group (26 cases) and occurred in autumn (67 %) . Virus-virus co-infections were more frequent (26/39) than virus-bacteria co-infections (13/39) . More than two infectious agents were detected in only four cases . The most common viral co-infections were rotavirus-astrovirus (13/26) and rotavirus-adenovirus (10/26) . The present report is the first prospective analysis of clinical-epidemiological trends of dual infections in young Spanish children with acute viral gastroenteritis . Our results emphasize the clinical importance of mixed infections as a cause of severe diarrhoea in children. J Agric Food Chem, 2003 May 7, 51(10), 2888 - 95 Direct fluorometric determination of fluorescent substances in powders: the case of riboflavin in cereal flours; Zandomeneghi M et al.; Front-face emission spectra of powders can be recorded with a commercial spectrofluorometer . By combining the emissions of a scatterer powder and of a wheat flour sample, the scattering contribution to the front-face emission spectra of flour is removed, and the fluorescence of the flour is isolated . The fluorescence depends on the concentration of the fluorophores . By choosing convenient measurement parameters and by measuring the emission spectra of flour samples suitably enriched with riboflavin, the fluorescence of riboflavin could be isolated from that of other substances present in flours and the concentration of vitamin B(2) in native substrates could be determined . This method is particularly apt for the measurement of vitamin B(2) in low riboflavin-containing powders such as wheat flours, which are usually analyzed through complex chemical and microbiological methods . The method is essentially phenomenological, in view of the interpretation difficulties connected to the origin of the fluorescence resulting from the absorption of multiply scattered photons. Infez Med, 2003 Mar, 11(1), 25 - 30 {Treatment of bacterial conjuntivitis with topical ciprofloxacin and norfloxacin: a comparative study}; Chisari G et al.; The authors studied the epidemiology of external ocular infections and the therapeutic efficacy of topical ciprofloxacin and norfloxacin in the treatment of conjunctivitis and blepharitis . Signs and symptoms in two study-group (ciprofloxacin group A = 95 patients and norfloxacin group B = 95 patients) as well as the microbiological data obtained from the conjunctival swab before and after treatment were considered . The clinical and bacteriological success rate in the two study-groups was respectively 91% (group A) and 83% (group B) . The results of the present study confirm the therapeutic efficacy of topical fluoroquinolones in the treatment of bacterial conjunctivitis and blepharitis. Eur J Intern Med, 2003 Mar, 14(2), 77 - 88 Tuberculous pleural effusions; Valdes L et al.; Tuberculosis is the most frequent cause of death due to infectious diseases . In Europe, it is one of the most frequent types of pleural effusions in young patients . Tuberculosis is caused by the rupture of a pulmonary subpleural caseous focus, which releases mycobacterium into the pleural cavity, thereby triggering an immune response involving mainly macrophages, CD4+ T lymphocytes, and the cytokines released by these cells (especially interleukin 1, interleukin 2, and gamma-interferon) . In recent years, classical microbiological and histological methods of diagnosis have been joined by biochemical analyses of pleural fluid, which are faster and can be more sensitive . In particular, tuberculous effusions have high adenosine deaminase (ADA) activity, apparently due to high levels of the ADA isoenzyme ADA2, which is only found in monocytes and macrophages (although certain data suggest the possible involvement of activated T cells, too) . It has been recommended that treatment for tuberculosis be initiated if analysis of pleural fluid shows high ADA activity, a lymphocyte/neutrophil ratio greater than 0.75, and no malignant cells . Another highly efficient marker is gamma-interferon, which is released by activated CD4+ T cells, but its high price is an obstacle to its routine determination in clinical practice . Identification of mycobacterial DNA by means of the polymerase chain reaction (PCR) is less efficient, apparently because its sensitivity depends heavily on mycobacterium concentration . No other biochemical parameters currently appear to be of marked relevance for the diagnosis of tuberculous pleural effusion (TPE) . TPE responds well to the standard treatment for tuberculosis . However, 50% of TPE patients have a thickened pleura as a result of the accumulation of fluid, and in 16% the quantity of effusion increases during treatment, even if corticosteroids are administered . It therefore seems reasonable for treatment with antituberculous drugs to be preceded by therapeutic thoracocentesis to remove as much fluid as possible. Cytometry B Clin Cytom, 2003 May, 53(1), 54 - 62 Standardized immune monitoring for the prediction of infections after cardiopulmonary bypass surgery in risk patients; Strohmeyer JC et al.; BACKGROUND: Infections are the most common cause of late complications in cardiopulmonary bypass (CPB) surgery patients, and are difficult to predict . Here we studied the diagnostic value of a standardized immune monitoring program based on recent advances in flow cytometry (exact quantification of surface-marker expression) and cytokine determination (semiautomatic systems) . METHODS: CPB patients (56) at risk for complications (age >70 years and/or preoperative left-ventricular ejection fraction < 25 %) were classified into three groups: without (33), with suspected (14), and with confirmed (9) infection . Applying the Quantibrite trade mark -system, we daily quantified the expression of CD11b, CD64, CD71, CD86, and HLA-DR on monocytes/granulocytes . Furthermore, the ex vivo secretion of tumor necrosis factor (TNF)-alpha as well as the plasma interleukin (IL)-10 levels were determined by a semiautomatic system . Ex vivo elastase release was measured by enzyme-linked immunosorbent assay (ELISA) . RESULTS: All patients showed signs of granulocyte activation and monocyte deactivation . Monocytic HLA-DR and plasma IL-10 were the best markers to discriminate patients with infection from those without as early as day 1 . Using a cutoff of 5792 HLA-DR molecules per cell, both sensitivity and negative predictive value for patients who developed microbiologically confirmed infection was 1.0, and the area under the curve (AUC) was 0.85 . CONCLUSIONS: Our data suggest that a standardized immune monitoring at day 1 might be useful for early discrimination of patients at elevated risk for infections . J Gynecol Obstet Biol Reprod (Paris), 2003 Apr, 32(2), 169 - 74 {Determination of nosocomial infection incidence in mothers and newborns during the early postpartum period}; Malavaud S et al.; BACKGROUND: We wished to determine the incidence of nosocomial infections in the mother and the newborn during the early postpartum period . MATERIAL AND METHODS: Over a three-month period, the same investigator collected 50 different clinical and microbiological, standardized data related to infectious diseases in parturients and their newborns . RESULTS: Data were collected on 804 deliveries . The overall rate of nosocomial infection was 2.9% (23/804) . For vaginal deliveries, the rate was 1.9% (12/615) and for deliveries by Cesarean section, the rate was 5.8% (11/189) . Of 745 newborns followed until discharge from hospital, 0.7% (5/745) had a nosocomial infection . CONCLUSION: These results are in line with previously published rates of nosocomial infections, which varied between 0.2% to 2.3% for vaginal deliveries, 1.6% to 18.9% for Cesarean section, and 0.2 to 4% in newborns . Regular surveys of the incidence or the prevalence of nosocomial infections are necessary to monitor the effectiveness of educational programs, aimed to reduce hospital acquired infections. Braz J Med Biol Res, 2003 May, 36(5), 613 - 6 Epub 2003 Apr 22. Comparative performance of two air samplers for monitoring airborne fungal propagules; Tavora LG et al.; Many studies have attempted to evaluate the importance of airborne fungi in the development of invasive fungal infection, especially for immunocompromised hosts . Several kinds of instruments are available to quantitate fungal propagule levels in air . We compared the performance of the most frequently used air sampler, the Andersen sampler with six stages, with a portable one, the Reuter centrifugal sampler (RCS) . A total of 84 samples were analyzed, 42 with each sampler . Twenty-eight different fungal genera were identified in samples analyzed with the Andersen instrument . In samples obtained with the RCS only seven different fungal genera were identified . The three most frequently isolated genera in samples analyzed with both devices were Penicillium, Aspergillus and Cladophialophora . In areas supplied with a high efficiency particulate air filter, fungal spore levels were usually lower when compared to areas without these filters . There was a significant correlation between total fungal propagule measurements taken with both devices on each sampling occasion (Pearson coefficient = 0.50) . However, the Andersen device recovered a broader spectrum of fungi . We conclude that the RCS can be used for quantitative estimates of airborne microbiological concentrations . For qualitative studies, however, this device cannot be recommended. Br J Ophthalmol, 2003 May, 87(5), 574 - 6 The Endophthalmitis Population Study of Western Australia (EPSWA): first report; Morlet N et al.; BACKGROUND/AIM: Over the period of 19 years to 1999, cataract surgery numbers increased 6% per annum in Western Australia (WA), promoted by the convenience, efficacy, and general safety of outpatient phacoemulsification surgery . Although endophthalmitis is an uncommon complication, it is a major cause of post-cataract surgery blindness . The present population study investigates not only the prevalence of endophthalmitis but provides an accurate incidence of endophthalmitis in WA over the same period . METHODS: Using the hospital morbidity data system (HMDS) of the WA Record Linkage Project, and cross validating against three independent databases (anaesthetic and microbiological databases and surgeons' logbooks) the authors examined 698 case notes that were potentially cases of endophthalmitis for the period 1980 to June 1999 . As the database linkage was incomplete for 1999, only the 188 confirmed cases to 1998 were included in the present study . Additional case note validation was performed to confirm the correct codes for the cataract surgical procedure . RESULTS: Despite changes in surgical technique and prophylaxis over the study period of 19 years, the incidence of endophthalmitis remained largely unchanged, averaging one in 500 surgical cases overall . However, the incidence fluctuated over time and varied with the location of surgery ranging from 0.65 per 1000 operations to 16.4 per 1000 operations . CONCLUSION: These data highlight previously undescribed temporal and geographic variations in the incidence of endophthalmitis . It is uncertain whether the wide variation in prophylactic practices throughout the ophthalmic community has any bearing on the incidence of endophthalmitis. Perit Dial Int, 2003 Mar-Apr, 23(2), 127 - 31 Pharmacokinetics of teicoplanin in patients undergoing continuous ambulatory peritoneal dialysis; Stamatiadis D et al.; OBJECTIVE: To achieve concentrations of teicoplanin in serum and dialysate within the therapeutic range in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) . DESIGN: Pharmacokinetic study . SETTING: A tertiary-care hospital . PATIENTS: Eight hospitalized anuric patients undergoing CAPD . INTERVENTIONS: One single dose of 10 mg/kg teicoplanin was administered intravenously, and blood and dialysate were sampled at regular time intervals for 48 hours post drug infusion . Concentrations of teicoplanin were determined by microbiological assay . RESULTS: Teicoplanin serum levels above 10 microg/mL, the level desired to treat systemic infections, were detected for 24 hours after administration . All dialysate concentrations were very low . Teicoplanin presented two phases of elimination: an early first phase and a late second phase . Mean maximum serum concentration was 75.56 microg/mL, mean half-life (t 1/2) of the early elimination was 3.34 hours, mean t 1/2 of the late elimination was 61.68 hours, mean area under the serum-concentration-time curve was 1491.92 mg x hr/L, mean clearance rate was 10.68 mL/ minute, mean apparent volume of distribution was 0.80 L/kg, and mean volume of distribution at steady state was 0.22 L/kg . Mean dialysate excretion was 3.16% and mean peritoneal clearance rate was 0.023 mL/minute . CONCLUSIONS: Based on the time period with the achieved serum levels and on the prolonged t 1/2, it is proposed that teicoplanin might be administered at 10 mg/kg every 24 hours for the therapy of systemic infections in patients undergoing CAPD . However, its intravenous administration should be avoided in the treatment of peritonitis, because the achieved dialysate concentrations were very low. Wei Sheng Yan Jiu, 1999 Jan 30, 28(1), 37 - 9 {Significance of collection of chick embryo blood specimen for the determination of hemoglobin folate}; Li Y et al.; A method for embryo-blood collection (about 100 microliters/embryo) from chorioallantoic blood vessels of day 10 White Leghorn chick embryo was developed and the embryonic hemoglobin folate concentrations (folate/hemoglobin, microgram/g) were measured by the microbiological assay on microtitre dried blood spots to test the hypothesis whether homocysteine (HCY) would increase in folate depletion during early development stage of embryo . The results showed folic acid (FA) and HCY having been placed in the enlarged air cell could quickly pass through inner shell membrane and chorioallantoic membrane, and enter into blood, on the highly vascularized membrane of chick embryo aged 10 days . After 5 micrograms FA were placed on the inner shell membrane, there was a striking increase of hemoglobin folate with a peak in 60 min at 22.26 micrograms/g, followed by a decline . In contrast, 8 mumol of D . L-HCY did not result in the obvious increase of embryonic hemoglobin folate during the total transient time course (0-480 min) . By 60 min posttreatment the hemoglobin folate concentration for joint group (HCY 8 mumol + FA 5 micrograms/embryo) had obviously decreased in comparison with single FA group (P < 0.001) . The results supported the above hypothesis mentioned . Moreover, both advantages and disadvantages of this method were evaluated. Naturwissenschaften, 2003 Apr, 90(4), 167 - 72 Epub 2003 Mar 22. Modern terrestrial analogues for the carbonate globules in Martian meteorite ALH84001; Kazmierczak J et al.; Modern carbonate globules, located in cracks of submerged volcanic rocks and in calcareous pinnacles in alkaline (sodic) Lake Van, Turkey, appear to be analogues for the approximately 3.9 billion-year-old carbonate globules in Martian meteorite ALH84001 . These terrestrial globules have similar diameters and are chemically and mineralogically zoned . Furthermore, they display surface and etching structures similar to those described from ALH84001, which were interpreted as fossilized microbial forms . These terrestrial carbonates formed at low temperatures where Ca-rich groundwaters enter the lake . Chemical, mineralogical, microbiological, and biomolecular methods were used in an attempt to decipher the process responsible for the genesis of these structures . Although the exact mode of formation of Lake Van carbonates remains an enigma, their similarity to the Martian globules indicates that the ALH84001 carbonates may have formed in similar setting on ancient Mars. Lancet, 2003 Apr 19, 361(9366), 1319 - 25 Coronavirus as a possible cause of severe acute respiratory syndrome; Peiris JS et al.; BACKGROUND: An outbreak of severe acute respiratory syndrome (SARS) has been reported in Hong Kong . We investigated the viral cause and clinical presentation among 50 patients . METHODS: We analysed case notes and microbiological findings for 50 patients with SARS, representing more than five separate epidemiologically linked transmission clusters . We defined the clinical presentation and risk factors associated with severe disease and investigated the causal agents by chest radiography and laboratory testing of nasopharyngeal aspirates and sera samples . We compared the laboratory findings with those submitted for microbiological investigation of other diseases from patients whose identity was masked . FINDINGS: Patients' age ranged from 23 to 74 years . Fever, chills, myalgia, and cough were the most frequent complaints . When compared with chest radiographic changes, respiratory symptoms and auscultatory findings were disproportionally mild . Patients who were household contacts of other infected people and had older age, lymphopenia, and liver dysfunction were associated with severe disease . A virus belonging to the family Coronaviridae was isolated from two patients . By use of serological and reverse-transcriptase PCR specific for this virus, 45 of 50 patients with SARS, but no controls, had evidence of infection with this virus . INTERPRETATION: A coronavirus was isolated from patients with SARS that might be the primary agent associated with this disease . Serological and molecular tests specific for the virus permitted a definitive laboratory diagnosis to be made and allowed further investigation to define whether other cofactors play a part in disease progression. Z Naturforsch {C}, 2003 Mar-Apr, 58(3-4), 249 - 55 Microbiological and chemical transformations of argentatin B; Maatooq GT; Argentatin B is a naturally occurring tetracyclic triterpene isolated from Parthenium argentatum x P . tomentosa . It was microbiologically transformed to 16, 24-epoxycycloartan-3alpha, 25-diol, (isoargentatin D), by Nocardia corallina var . taoka ATCC 31338, Mycobacterium species NRRL B3683 and Septomyxa affinis ATCC 6737 . The later microbe also produced 16, 24-epoxycycloartan-3beta, 25-diol (argentatin D) and 1, 2-didehydroargentatin B, (isoargentatin D) . Sodium hydroxide converted argentatin B to argentatin D and isoargentatin D . Hydrochloric acid treatment gave cycloartan-25-ol-3, 24-dione . Cerium sulfate/sulfuric acid/aqueous methanol induced scission of the isopropanol moiety and provided an isomeric mixture of 24-methoxy-25-27-trinorargentatin B . Oxidation of this isomeric mixture with pyridinium chlorochromate, selectively, attacked the isomer with the equatorial proton at position-24 to give the corresponding lactone, 24-oxo-25-27-trinorargentatin B . The produced compounds were characterized by spectroscopic methods. Clin Transplant, 2003 Apr, 17(2), 114 - 20 Detection of simultaneous beta-herpesvirus infections in clinical syndromes due to defined cytomegalovirus infection; Razonable RR et al.; Human herpesvirus (HHV)-6 and HHV-7 are increasingly being recognized as emerging pathogens among transplant recipients . Using quantitative polymerase chain reaction assays, we demonstrate the presence of HHV-6 and/or HHV-7 in 18 of 20 episodes of clinically presumed or microbiologically confirmed cytomegalovirus (CMV) infection . Seventeen (89%) of 19 microbiologically confirmed cytomegalovirus (CMV)-infected patients had concomitant HHV-6 variant B (47%) and/or HHV-7 (63%) infection . The degree of HHV-6 coinfection was significantly correlated with hyperbilirubinemia while HHV-7 coinfection demonstrated a non-significant trend toward cytopenias . In one of the 20 episodes described herein, the 'viral syndrome' was due solely to HHV-7 infection; clinical and virological response was observed during intravenous ganciclovir therapy in this patient . While this study emphasizes the significance of HHV-6 and/or HHV-7 coinfection during episodes of CMV infection, it significantly highlights the novel observation of the causal role of HHV-7 (in the absence of HHV-6 and CMV) in a clinical illness presumed to be caused CMV . Thus, HHV-7 (and HHV-6) should be considered as a pathogen (or copathogen) in the viral syndromes following organ transplantation. J Environ Qual, 2003 Mar-Apr, 32(2), 541 - 9 Distribution of chromium contamination and microbial activity in soil aggregates; Tokunaga TK et al.; Biogeochemical transformations of redox-sensitive chemicals in soils can be strongly transport-controlled and localized . This was tested through experiments on chromium diffusion and reduction in soil aggregates that were exposed to chromate solutions . Reduction of soluble Cr(VI) to insoluble Cr(II) occurred only within the surface layer of aggregates with higher available organic carbon and higher microbial respiration . Sharply terminated Cr diffusion fronts develop when the reduction rate increases rapidly with depth . The final state of such aggregates consists of a Cr-contaminated exterior, and an uncontaminated core, each having different microbial community compositions and activity . Microbial activity was significantly higher in the more reducing soils, while total microbial biomass was similar in all of the soils . The small fraction of Cr(VI) remaining unreduced resides along external surfaces of aggregates, leaving it potentially available to future transport down the soil profile . Using the Thiele modulus, Cr(VI) reduction in soil aggregates is shown to be diffusion rate- and reaction rate-limited in anaerobic and aerobic aggregates, respectively . Thus, spatially resolved chemical and microbiological measurements are necessary within anaerobic soil aggregates to characterize and predict the fate of Cr contamination . Typical methods of soil sampling and analyses that average over redox gradients within aggregates can erase important biogeochemical spatial relations necessary for understanding these environments. Pneumonol Alergol Pol, 2002, 70(7-8), 359 - 67 {Direct detection of mycobacterium tuberculosis complex in clinical specimens by gen-probe amplified direct test}; Augustynowicz-Kopec E et al.; The amplified Mycobacterium tuberculosis direct test (MTD) (Gen-Probe Inc., San Diego, CA, USA) is a rapid technique of nucleic acid amplification which can be used directly on processed clinical specimens . It is based on the enzymatic amplification of ribosomal RNA via DNA intermediates, with detection of amplified product by an acridinum-ester-labeled DNA probe . The purpose of this study was to evaluate the clinical utility of this test for diagnosis of tuberculosis by comparing the sensitivity and specificity of the test with acid-fast smear, mycobacterial culture and clinical evaluation . The study included 399 specimens from patients, suspected of Tb which were submitted to the microbiological laboratory of our Institute over a 12 months period . Compared with bacterioscopy, conventional culture on L-J and rapid systems of cultivation (Bactec-450 Tb, MB/Bact, Bactec 960 MGIT) MTD had a sensitivity 93.2% and specificity 98.5% . We conclude, that MTD test which is completed within 6-8 hours, when used rationally, mainly in conjunction with routine smear and culture is a useful, rapid diagnostic test for suspected tuberculosis patients. Int J Artif Organs, 2003 Mar, 26(3), 181 - 7 On-line production of ultrapure substitution fluid reduces TNF-alpha- and IL-6 release in patients on hemodiafiltration therapy; Guth HJ et al.; On-line hemodiafiltration (HDF) has been introduced into clinical practice in the last few years . The most important technical and regulatory challenges were the safety and microbiological quality of ultrafiltrated substitution/replacement fluid . The application of ultrafilters in a different technical arrangement in the fluid path based on polysulfone or polyamide membranes should prevent patient contact with endotoxins and other pyrogenic or bacteria-derived substances . After resolving these problems and providing clinically safe and technically robust product solutions, increasing numbers of patients have been treated, especially those with severe clinical conditions, e.g., diabetes, hypo- or hypertension . The benefit for patients was brought about by the increase of substitution rate in hemodiafiltration and enhancing convective mass transfer . The impact of highly convective therapy modes on the state of immunomodulation towards the syndrome of microinflammation has not been investigated in a systematic prospective manner . In this study, 8 patients undergoing bag-HDF treatment with lactate buffered solution were investigated before on-line HDF treatment with commercially available whole blood stimulation assays testing for TNF-alpha and IL-6 release . Both assays are based on phytohemagglutinine (for TNF) and lipo-polysaccharide stimulation (for IL-6) . Thereafter the patients were switched to on-line production of substitution fluid . After a wash-out period of 2 sessions the whole blood stimulation assays were applied to the same patients . The Wilcoxon test (for paired analysis) was done, revealing a statistically significant lower release of proinflammtory cytokines from patients' blood upon stimulation with PHA or LPS . The reduction of IL-6 and TNF concentration and release capacity in whole blood may be attributed to the use of high quality ultrapure substitution fluid and dialysate in on-line treatment instead of lactate buffer bag solution . These results indicate that not only an increase of convective mass transfer by higher volume exchange, but also a decrease in unspecific activation of immunocompetent cells may have advantages for HDF-treated patients. HIV Med, 2003 Apr, 4(2), 127 - 32 Impact of highly active antiretroviral therapy on the occurrence of bacteraemia in HIV-infected patients and their epidemiologic characteristics; Meynard JL et al.; OBJECTIVE: 1 . to assess the impact of highly active antiretroviral therapy (HAART) on the occurrence of bacteraemia in HIV-infected patients and their clinical and microbiological characteristics . 2 . to identify risk factors for bacteraemia in this setting . METHODS: The files of all HIV-infected patients hospitalized for an episode of bacteraemia in a 28-bed infectious diseases unit between January 1995 and December 1998 were reviewed . Cases occurring during HAART were compared to cases occurring in patients not receiving HAART . Furthermore, in a case-control study, patients with bacteraemia occurring during HAART were compared with other patients receiving HAART . RESULTS: There were 74 episodes of bacteraemia in patients not receiving HAART and 31 episodes in patients receiving HAART . The occurrence of bacteraemia fell from 10.5/100 hospitalizations in 1995 to 5.5/100 in 1998 (P = 0.02 trend test) . The occurence of P . aeruginosa bacteraemia fell sharply (9/398 vs 1/273, P = 0.05) . A significant fall in catheter-related infections was observed between 1995 and 1998 (5.5% vs 1.8%) . The two-thirds/one-third distribution of hospital-acquired and community-acquired infections remained stable throughout the period study . In patients receiving HAART, the case-control study showed by multivariate analysis, that a CD4 cell count of less than 100/ micro L {OR = 7.3 (1.9-49.7)}, and the use of exogenous devices {OR = 13.3 (2.5-71)} were significantly associated with the risk of bacteraemia . CONCLUSION: The introduction of HAART has been associated with a significant fall in the occurrence of bacteraemia . However, patients with a low CD4 cell count remain at risk of bacteraemia with similar microbiological and epidemiological characteristics than in the pre-HAART era. Water Sci Technol, 2003, 47(5), 133 - 8 Monitoring of microbial diversity by fluorescence in situ hybridization and fluorescence spectrometry; Ivanov V et al.; The goal of the research was the development of a simple method to quantify microbial groups in environmental samples . Fluorescence intensity was measured in the sample before and after whole cell fluorescence in situ hybridization with rRNA-targeted, fluorochrome-labeled oligonucleotide probes . To determine specific and non-specific binding of different oligonucleotide probes the following approaches have been used: (1) incubation of the sample with probes at two different temperatures; (2) hybridization of labeled probe in the presence of unlabeled probe; (3) incubation of the sample with labeled specific probe or labeled nonsense probe . Specific binding (hybridization) of the probe was calculated as the difference between total binding and non-specific binding of the probe . Specific binding was 40-50% of total binding in the environmental samples tested . The ratio of the specific binding of different probes may be used to quantify the ratio of different microbial groups in the environmental samples . This quantification is suitable for the microbiological monitoring of microbial aggregates because it is a simple technique and the results can be measured by a portable fluorometer. Infez Med, 2002 Mar, 10(1), 31 - 6 {Candidal vulvovaginitis: an epidemiological survey among immigrant prostitutes}; Bellitti F et al.; Objectives: Candidal vulvovaginitis is a frequent infectious process in adult women that assumes particular clinical, epidemiological and social importance in prostitutes due to its possible sexual transmission . The aim of the study was to evaluate the frequency of symptomatic or non-symptomatic vulvovaginitis caused by Candida spp and its possible relationship to behavioural risk factors, by a prospective study carried on 153 immigrant prostitutes from various African countries . Patients and methods: All subjects (average age 27 yrs; range 18-50 yrs) coming from sub-Saharan areas (Nigeria, Ghana, Benin, Senegal) and resident in the coastal area northwest of Naples (southern Italy) underwent a microbiological investigation to detect the possible presence of Candida in vaginal, rectal and pharyngeal swabs . Agar Sabouraud with the addition of chloramphenicol was used for cultures and the mycotube system for identification; in vitro sensitivity tests with amphotericin, nystatin, 5-fluorocytosine, econazole, and fluconazole were also performed according to the Kirby Bauer technique . Results: The rate of Candida detection from vaginal swabs was 45% (69/153) with the following distribution by specie: C . albicans 75.4%, C . glabrata 7.2%, C . krusei 2.9%, C . tropicalis 1.4%, Candida spp 13% . The incidence of Candida from pharyngeal and rectal swabs was 18.3% and 26.1%, respectively . The overall resistance of Candida was comprised between 6% for fluconazole and 27% for econazole . No strain was resistant to 5-fluorocytosine, nystatin and amphotericin . Conclusions: The incidence of Candida in this particular population of immigrates was very high and correlated to many well-identified risk factors. J Endotoxin Res, 2002, 8(6), 473 - 6 The clinical relevance of endotoxin in human sepsis: a critical analysis; Opal SM; Correlations between circulating endotoxin levels from the blood of septic patients with clinical outcome measures have proven to be rather difficult . The clinical impact of endotoxin in septic patients depends upon the kinetics of LPS release, the concentration of LPS binding proteins, the cellular responsiveness to endotoxin, and numerous other immunogenetic, microbiological and physiological variables . Failure to account for these variables adequately has limited the clinical utility of endotoxin measurement . Several clinical studies have associated high levels of LPS with an excess risk of morbidity and mortality in sepsis that is largely independent of the nature of the micro-organism responsible for the septic episode. BMC Infect Dis . 2003 Apr 04;3(1):2. Chlamydia trachomatis infection in early neonatal period; Numazaki K et al.; BACKGROUND: The clinical characteristics of Chlamydia trachomatis respiratory tract infections in Japanese neonates were investigated . METHODS: Clinical, laboratory and microbiological characteristics of five infants with pneumonia due to C . trachomatis in early neonatal period were analyzed . RESULTS: Only C . trachomatis was identified in 4 infants . Both C . trachomatis and cytomegalovirus was identified in one . Wheezing, tachypnea and cyanosis were common in infants . Mothers of five infants had negative chlamydial EIAs at 20 weeks of gestation . CONCLUSIONS: We identified five cases of C . trachomatis respiratory tract infections in early neonatal period with the possibility of intrauterine infection . Targeted screening, early diagnosis, and effective treatment of perinatal and neonatal chlamydial infections seems to be necessary. Z Orthop Ihre Grenzgeb, 2003 Mar-Apr, 141(2), 153 - 9 {First experiences with fluorodeoxyglucose-positron-emission tomography (FDG-PET) in the evaluation of painful total knee and hip joint replacements}; Kisielinski K et al.; AIM: The aim of the study was to describe first experiences using FDG-PET in the examination of painful arthroplasties . METHOD: 12 patients prior to revision of a total hip or knee joint replacement underwent PET . Histopathology, microbiological analysis and intraoperative diagnosis were compared to preoperative PET findings . RESULTS: The analysis of intraoperative findings, of microbiological examinations and of histopathology showed that besides the well known determinants infection and early postoperative granulation tissue, polyethylene wear induced foreign-body reaction was a major cause for increased FDG consumption . CONCLUSION: In vivo imaging of marked foreign-body tissue reaction induced by polyethylene wear is feasible by FDG-PET . This observation, however, leads to reduced specificity of PET imaging for the diagnosis of periprosthetic infection. Acta Anaesthesiol Scand, 2003 Apr, 47(4), 425 - 9 Environmental temperature stress on drugs in prehospital emergency medical service; Helm M et al.; BACKGROUND: Drugs used in prehospital emergency medical service (EMS) in principle are subject to the same storage restrictions as hospital-based medications . The prehospital emergency environment however, often exceeds these storage recommendations . Main stress factors are sunlight, vibration and extreme temperature, which may lead to alteration in chemical and physical stability of stored pharmaceuticals, as well as microbiological contamination and concentration enhancement of pharmacological inserts . METHODS: The purpose of this study was to determine the environmental temperature stress upon drugs used in the prehospital EMS under real mission conditions within different types of rescue vehicles (rescue helicopter {HEMS}, ambulance {AMB} and emergency physician transport vehicle {EPTV}) during a 'summer' and 'winter' monitoring period (2 months duration each/location: southern Germany) . RESULTS: Recorded temperatures varied from -13.2 degrees C to +50.6 degrees C . The recommended maximum storage temperature (+25 degrees C) was exceeded in all rescue vehicles (33-45% of total exposure time), whereas the recommended minimum storage temperature (0 degrees C) only fell short in the EPTV (19% of total exposure time) . The daily maximum temperature variations ranged from 19.0 degrees C (winter) to 32.9 degrees C (summer) . CONCLUSIONS: These results show that even in a moderate climatic zone, drugs used in prehospital EMS are significantly influenced by temperature stress; furthermore, these results recommend the usage of temperature-controlled drug boxes. Scand J Infect Dis, 2003, 35(2), 114 - 20 Transrectal prostatic ultrasonography in acute bacterial prostatitis: findings and clinical implications; Horcajada JP et al.; To evaluate the role of transrectal ultrasonography (TRUS) in the diagnosis of acute bacterial prostatitis (ABP) and to analyse the possible relationship between sonographic findings and clinical presentation and evolution, a prospective study using TRUS in patients with ABP was conducted . 45 patients (aged 58.2 +/- 14.6 y; mean +/- SD) with a clinical diagnosis of ABP admitted to a university hospital were studied prospectively . Clinical, analytical and microbiological data were recorded . TRUS was performed on admission and after 1 month of antibiotic therapy . Findings were correlated with clinical and evolutive data . The mean prostatic volume on admission was 40.5 +/- 17.9 ml . 21 patients (46.6%) had sonographically demonstrable lesions in peripheral prostatic lobules . One month later, when treatment had ended, lesions had disappeared or improved in 61.1% of patients, and the mean prostatic volume was 24.3 +/- 10.5 ml (p < 0.0005) . Clinical, analytical and microbiological data and evolution of ABP were not significantly different in patients with or without sonographically demonstrable lesions . TRUS does not need to be performed in every patient with suspicion of ABP; the only indication for TRUS in ABP is the exclusion of prostatic abscess. Leuk Lymphoma, 2003 Jan, 44(1), 97 - 101 Pneumonia in acute leukemia patients during induction therapy: experience in a single institution; Specchia G et al.; Pneumonia is still a complication leading to high morbidity and mortality rates in acute leukemia (AL) patients . To evaluate the incidence, risk factors and outcome of pneumonia in a single institution we retrospectively studied 288 patients observed between 1994 and 2000, affected by AL (218 acute myeloblastic leukemia and 70 acute lymphoblastic leukemia {ALL}) treated with an anthracycline-containing induction regimen . Of 288 patients, 80 (27.7%) developed pneumonia: 67/80 had acute myelogenous leukemia (AML) and 13/80 had ALL . At univariate analysis only advanced age correlated with the risk of pneumonia (P < 0.001) . Of the 80 pneumonia cases, 25 (31.2%) were microbiologically documented and 65 (68.8%) were clinically demonstrated; pneumonia responded to treatment in 44/80 (55%) patients; among the patients with positive outcome of their pneumonia 33/44 (75%) achieved complete remission whereas only 2/36 (5%) patients with a negative outcome achieved complete remission . At multivariate analysis the determinants of positive outcome of pneumonia were younger age (P < 0.05), the achievement of complete remission (P < 0.005) and the recovery of neutrophils (P < 0.005). Curr Opin Clin Nutr Metab Care, 2003 May, 6(3), 319 - 25 Intravenous in-line filters: filtering the evidence; Ball PA; PURPOSE OF REVIEW: The routine use of intravenous in-line filters on infusion lines has been controversial for many years, with strong advocates, detractors and many fence-sitting observers . The purpose of this review was to examine the literature for new developments and to cast the net a little wider than in previous reviews in an attempt to draw useful parallels . RECENT FINDINGS: There were recent major policy statements or recommendations from a working party of the British Pharmaceutical Nutrition Group and from the US Centres for Disease Control . The first was focussed on filters and was broadly in favour, the second was not focussed on the subject but made quite a strong statement against, on microbiological issues alone . The major purpose of filters, however, is particulate contamination, and whilst there was little in the literature directly on this subject, useful parallels could be drawn from papers describing the therapeutic use of particles and also from their effects in intravenous drug users . SUMMARY: When all the available information is considered, and the role of filters in particulate contamination, in-line chemical precipitates, identifying problems in parenteral therapy practice, microbial contamination and entrapped air is examined, the case for routine use appears strong. Community Dent Health, 2003 Mar, 20(1), 27 - 33 The effect of choosing different units of analysis when estimating risk of presence of dental caries in the primary dentition; Scheutz F et al.; BACKGROUND: Data on caries are usually collected with the tooth surface or the tooth as the unit, but subsequently analysed by aggregating the data at the level of the individual . AIMS: To evaluate how different units of analysis may affect the result of the statistical analyses in a study of the association between deciduous dental caries and a set of risk factors . METHOD: 293 children (mean age: 7.5 yrs) from two primary schools in Dar es Salaam, Tanzania were examined . Thus the study design was cross-sectional . Logistic regression analysis was used to determine the association between caries experience and nutritional status, socioeconomic background, and microbiological and salivary characteristics using the subject, the tooth, and the tooth surface as unit of analysis, allowing for the fact that teeth and surfaces within the same individual must be considered non-independent . RESULTS: When aggregated data were used, point estimates were larger in some instances . The precision of the estimates increased considerably when the tooth as compared to the individual was used as the unit of analysis . No or limited gain in precision was obtained when the tooth surface as compared to the tooth was used as unit of analysis . CONCLUSIONS: The choice of unit of analysis may strongly influence the result of the statistical analyses and thus the conclusion of an investigation. Crit Care Med, 2003 Apr, 31(4), 1102 - 7 Factors predicting ventilator-associated pneumonia recurrence; Combes A et al.; OBJECTIVE: To determine the factors associated with ventilator-associated pneumonia recurrence in patients alive after 8 days of treatment for a first episode . DESIGN: A 16-month, prospective, observational cohort study of patients diagnosed with a first ventilator-associated pneumonia episode . Predictors of recurrence were assessed by logistic regression analysis . SETTING: Two intensive care units in a university hospital . PATIENTS: Bronchoscopy was performed in 124 patients with clinically or radiologically suspected ventilator-associated pneumonia . Ventilator-associated pneumonia was confirmed by the presence of at least two of the following criteria: >/=2% of cells with intracellular bacteria found on direct examination of bronchoalveolar lavage fluid, protected specimen brush sample culture >/=103 colony-forming units/mL, or bronchoalveolar lavage culture >/=104 colony-forming units/mL . Ventilator-associated pneumonia recurrence was confirmed using the same microbiological criteria . Antibiotic treatment for ventilator-associated pneumonia lasted 14 days . MEASUREMENTS AND MAIN RESULTS: Clinical, radiologic, and biological data at intensive care unit admission, on the day of bronchoscopy (D1) and on D8, and outcome variables were prospectively recorded . Ventilator-associated pneumonia recurred in 28 patients (all of them still on mechanical ventilation on D8), 21 +/- 9 days after the first episode (82% after D14) . Factors significantly associated with recurrence were: acute respiratory failure as initial reason for mechanical ventilation, D1 radiologic score >7, D8 radiologic score >8, adult respiratory distress syndrome on D8, mechanical ventilation persistence on D8, D8 temperature >38 degrees C, and D8 temperature >D1 temperature, but not disease-severity scores at inclusion and D8, or first-episode pathogen(s) . Multivariate analysis identified D1 radiologic score >7 (odds ratio = 3.9; 95% confidence interval, 1.3-11.6), D8 temperature >38 degrees C (odds ratio = 4.4; 95% confidence interval, 1.4-13.4), and adult respiratory distress syndrome on D8 (odds ratio = 14.6; 95% confidence interval, 1.5-143.5) as predictors of recurrence . CONCLUSIONS: Factors of ventilator-associated pneumonia recurrence evaluated on D8 of a 14-day course of antibiotics are linked to the severity of lung injury and persistence of fever, but not to first-episode pathogen(s). Riv Biol, 2002 Sep-Dec, 95(3), 497 - 503 Simulated microgravity (SMG) and bacteria; Huitema C et al.; This past century has been a scientific revolution in the understanding of the cell as the basic unit of life . However an immense paucity of knowledge exists on microbial growth, survival, function and structure in space . However, there are significant constraints placed on conducting biological research in space such as time, available stowage space, trained personnel, power requirements, weight and the possibility of accidental microbiological contamination . One Earth-based approach is to use a modification of a clinostat known as a HARV (high-aspect-ratio-vessel; Synthecon Inc., Houston, Texas, USA) to conduct this research . In this note we describe the use of the HARV to examine the effects of randomized microgravity (RMG) on bacterial growth and membrane polarization. Int J Surg Investig, 2001, 2(5), 347 - 52 Effect of teicoplanin and G-CSF on survival in experimental MRSA pneumonia in neutropenic mice; Oz N et al.; AIM: To evaluate the effects of Teicoplanin and/or Granulocyte-Colony Stimulating Factor (G-CSF) on survival in an experimental model of MRSA pneumonia . MATERIAL AND METHOD: Seventy five Swiss Albino mice weighing 35 gr (32-43) were used . 50 microl of clinical isolate of MRSA (3 x 10(8) CFU/ml in saline solution) was administered by tracheal puncture to neutropenic mice . Neutropenia was achieved by using Cyclophosphamide 200 mg per kg intraperitoneally . The groups were consisted of tracheal puncture control in neutropenic mice (group 1) (n = 15), pneumonia in neutropenic mice (group II) (n = 15), Teicoplanin therapy for pneumonia in neutropenic mice (group III) (n = 15), G-CSF therapy for pneumonia in neutropenic mice (group IV) (n = 15), Teicoplanin and G-CSF combined therapy for pneumonia in neutropenic mice (group V) (n = 15) . Differences in the survival rates within 72 hours among the groups, microbiological analysis of various tissue samples were accomplished and white blood cell counts were obtained . Kaplan-Meier statistics was used for survival analysis . Subgroup comparisons were done by using Breslow statistics . RESULTS: Teicoplanin therapy increased the survival rate (p = 0.0001) whereas G-CSF therapy did not in comparison to other groups . Teicoplanin and G-CSF combination therapy improved survival rate when compared with groups II, III, IV (p = 0.0001, p = 0.003, p = 0.0001, respectively) . CONCLUSION: Teicoplanin and G-CSF combination therapy seems effective in reducing mortality rates in MRSA pneumonia in an experimental setting . Further animal and clinical studies must be done to achieve success in the treatment of nosocomial MRSA pneumonia. J Chemother, 2003 Feb, 15(1), 43 - 6 Pancreatic concentrations of cefepime in experimental necrotizing pancreatitis; Papagoras D et al.; To evaluate the penetration of cefepime in the inflamed pancreas, three doses of 50 mg/kg were administered intramuscularly at 8-h intervals after induction of acute necrotizing pancreatitis using intraperitoneal injection of DL-ethionine in 35 rabbits and in 33 controls . Animals were sacrificed and concentrations of cefepime were determined by a microbiological assay . Cefepime reached its peak concentrations 60 min after the last drug dose when mean values of 46.05 microg/ml, 22.34 microg/g and 34.74 microg/ml were found in serum, pancreas and bile, respectively, in rabbits with acute necrotizing pancreatitis and 45.19 microg/ml, 12.68 microg/g and 20.77 microg/ml respectively in controls . Tissue/serum ratios of cefepime were 0.48, 0.23, 0.15 and 0.09 at 60, 90, 120 and 180 min, respectively, after the last dose of cefepime in rabbits with acute necrotizing pancreatitis and 0.28, 0.18, 0.16 and 0.16, respectively at 60, 90, 120 and 180 min in controls . It is concluded that the administration of cefepime in rabbits with acute necrotizing pancreatitis resulted in pancreatic tissue levels well above the MIC90s of the common pathogens involved in pancreatic superinfection, so that its administration might be proposed for the therapy of superinfection following acute necrotizing pancreatitis in humans. J Indian Med Assoc, 2002 Jul, 100(7), 463 - 4 Intra-abdominal actinomycosis presenting as complex abdominopelvic mass; Chaudhuri S et al.; A rare case of intra-abdominal actinomycosis in a 70-year-old lady presenting as abdominopelvic mass mimicking malignancy is presented . Intra-abdominal actinomycosis may present a serious diagnostic problem both pre- and peroperatively and can lead to extensive surgical intervention due to the anticipation of malignancy . The diagnosis is difficult specially in the absence of characteristic discharging sinus . The diagnosis of this disease, potentially curable by antibiotic is more often made postoperatively by histopathology and microbiological methods. Pathologe, 2003 Mar, 24(2), 146 - 9 Epub 2003 Feb 12. {Thoracic aortic aneurysm in the setting of metastatic mediastinitis}; Harrer E et al.; The aetiological spectrum of thoracic aortic aneurysms is extensive . Infectious aneurysms (formerly mycotic aneurysms) constitute only a small percentage of all thoracic aortic aneurysms, they are usually small and often develop as complications of bacterial endocarditis . We report the case of a 39-year-old insulin-dependent diabetic, who developed a leaking aneurysm of the thoracic aorta as a late complication of a knee empyema with subsequent metastatic mediastinitis . Clinical, radiological, biochemical and microbiological data are correlated with histopathological findings . The development of this unusual thoracic aortic aneurysm is shown from impending rupture to successful vascular graft implantation. J Infect Chemother, 2003 Mar, 9(1), 68 - 74 Clinical analysis of pulmonary Mycobacterium avium complex disease in association with corticosteroid treatment; Kobashi Y et al.; We studied the clinical characteristics of nine patients with pulmonary Mycobacterium avium complex disease occurring in association with corticosteroid drugs collected from our associated hospitals during the past 6 years . The average age of the nine patients was 62.2 years and the male/female ratio was 3 : 6 . Regarding underlying disease, respiratory diseases existed in four of the patients and nonrespiratory diseases in the other five patients . The duration of corticosteroid treatment ranged from 5 months to 5 years, and the total dose of corticosteroid drugs ranged from 1.78 to 43.20 g . Pulmonary Mycobacterium avium complex disease was detected by clinical symptoms during corticosteroid treatment in six patients, and purified protein derivative was positive in three of eight patients tested . Radiological findings showed an infiltration shadow without cavity and bronchiectasis in the lower lung field . Microbiological examination was smear-positive in three patients, and the isolated mycobacterium was Mycobacterium intracellulare in five patients and Mycobacterium avium in four . Tolerance was shown to all antituberculous drugs, except for clarithromycin, in all patients . Although treatment including clarithromycin was performed for seven patients, the sputum conversion rate was 33% and an improved clinical effect was noted in only one patient . No change occurred in four and worsening occurred in four . Attention should be paid to the clinical symptoms and radiological findings of patients who have received corticosteroid drugs over a long period of time, because pulmonary Mycobacterium avium complex is characterized by atypical radiographic findings with no relationship to the total dose or duration of the administered corticosteroid drugs. Clin Immunol, 2003 Feb, 106(2), 106 - 15 Circulating inflammatory mediators predict shock and mortality in febrile patients with microbial infection; Groeneveld AB et al.; The host response to microbial infection is associated with the release of inflammatory mediators . We hypothesized that the type and degree of the systemic response as reflected by levels of circulating mediators predict morbidity and mortality, according to the invasiveness of microbial infection . We prospectively studied 133 medical patients with fever and culture-proven microbial infection . For 3 days after inclusion, the circulating levels of activated complement C3a, interleukin (IL)-6, and secretory phospholipase A(2) (sPLA(2)) were determined daily . Based on results of microbiological studies performed for up to 7 days, patients were classified as having local infections (Group 1, n = 80 positive local cultures or specific stains for fungal or tuberculous infections) or bacteremia (Group 2, n = 52 plus 1 patient with malaria parasitemia) . Outcome was assessed as the development of septic shock and as mortality up to 28 days after inclusion . Fifteen patients (11%) developed septic shock and overall mortality was 18% (n = 24) . Bacteremia was associated with shock and shock predisposed to death . Circulating mediator levels were generally higher in Group 2 than in Group 1 . Circulating levels of IL-6 and sPLA(2) were higher in patients developing septic shock and in nonsurvivors, particularly in Group 1 . High C3a was particularly associated with nonsurvival in Group 2 . In Group 1, the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for the peak sPLA(2) for shock development was 0.79 (P < 0.05) . The AUC of the ROC curve of the peak IL-6 and sPLA(2) for mortality was 0.69 and 0.68 (P < 0.05), respectively . In Group 2, the AUC of the ROC for peak C3a predicting mortality was 0.73 (P < 0.05) . In conclusion, in medical patients with fever and microbial infection, the systemic inflammatory host response predicts shock and death, at an early stage, dependent on the invasiveness of microbial infection . The results suggest a differential pathogenetic role of complement activation on the one hand and release of cytokine and lipid mediators on the other in bacteremic and local microbial infections, respectively . They may partly explain the failure of strategies blocking proinflammatory cytokines or sPLA(2) in human sepsis and may extend the basis for attempts to inhibit complement activation at an early stage in patients at risk of dying from invasive microbial infections. Br J Haematol, 2003 Apr, 121(1), 86 - 93 Clinical manifestations associated with the aberrant expression of the soluble granulocyte-macrophage colony-stimulating factor receptor in patients presenting with haematological malignancies; Trus MR et al.; The receptor for granulocyte-macrophage colony-stimulating factor (GM-CSF) can exist as both transmembrane (tmGMRalpha) and soluble (solGMRalpha) isoforms, and the latter, is a normal constituent of human plasma . We investigated if aberrant solGMRalpha expression occurs in haematopoietic malignancies and whether or not solGMRalpha expression levels correlated with clinical presentation . Compared with the normal population, patients with acute lymphoblastic leukaemia (ALL) had low levels of solGMRalpha whereas clonal disorders of the myeloid lineage demonstrated higher levels of solGMRalpha . Patients with acute myelogenous leukaemia (AML) and high levels of solGMRalpha presented with a distinct clinical picture . These patients were older, predominantly belonged to the M4 and M5 French-American-British (FAB) subtypes, and they had higher white blood cell counts at presentation including myeloid precursors and myeloblasts . They often presented with either unexplained lung infiltrates or hypoxia and lower rates of microbiologically defined infections . Elevated solGMRalpha levels were not associated with decreased relapse-free and overall survival in the AML population . On multivariate analysis, the correlation between elevated solGMRalpha levels and age, M4 and M5 FAB subtypes and decreased numbers of infections persisted . Our study is the first to describe that distinct clinical presentations are associated with aberrant solGMRalpha levels in haematological malignancies. J UOEH, 2003 Mar 1, 25(1), 61 - 77 {Prevention measures against Legionella infection in a circulating hot water bath}; Miyamoto H; For the sake of water conservation, a system for circulating hot water is widely used at public baths in Japan . Recently, large outbreaks of Legionella infection have occurred in public baths in Miyazaki and Kagoshima prefectures . More than three hundred persons were infected with Legionella pneumophila, and eight died . These outbreaks revealed that the Manual of Prevention Measures against Legionella Infection in a Circulating Hot Water Bath, which was published by the Ministry of Health, Labour and Welfare in Japan in 2001, was not fully understood or conformed to by managers of the baths . Microbiological features about legionellae should be fully understood for prevention of Legionella infection in a circulating hot water or spring bath . This review describes the microbiological characteristics of legionellae, their habits in the environment, pathogenesis, symptoms of Legionella infection, and disease outbreaks in Japan . I also describe practical prevention measures to deal with this organism in a circulating hot water or spring bath. Bull Acad Natl Med, 2002, 186(8), 1401 - 9 {Sanitary safety of GMOs used in therapeutics}; Trouvin JH; The recent progress in human therapeutics has been made possible thanks to molecular biology and its use in producing proteins having the same sequence and structure as that of human proteins . The use of GMOs allows production of proteins with high added value in therapeutics, which are of satisfactory quality . GMOs may also be directly administered to patients as gene therapy vectors . However, the use of GMOs in therapeutics must take into consideration some risks, particularly those of microbiological contamination, of neo-antigenicity as well as environmental risks with regard to the way of use of the GMO . Nevertheless, those risks are taken in due consideration in the development of those new medicinal products; solutions have been found to allow their use in therapeutics with a very positive benefit/risk ratio . Medicinal products from biotechnology have permitted considerable therapeutic progress without compromising health security. Ann Pharm Fr, 2003 Mar, 61(2), 103 - 8 {Health security--GMOs in therapeutics}; Trouvin JH; The recent progress in human therapeutics has been made possible thanks to molecular biology and its use in producing proteins having the same sequence and structure as that of human proteins . The use of GMOs allows production of proteins with high added value in therapeutics, which are of satisfactory quality . GMOs may also be directly administered to patients as gene therapy vectors . However, the use of GMOs in therapeutics must take into consideration some risks, particularly those of microbiological contamination, of neo-antigenicity as well as environmental risks with regard to the way of use of the GMO . Nevertheless, those risks are taken in due consideration in the development of these new medicinal products; solutions have been found to allow their use in therapeutics with a very positive benefit/risk ratio . Medicinal products from biotechnology have enabled considerable therapeutic progress without compromising health security. J Biotechnol, 2003 Apr 10, 102(1), 93 - 8 Cometabolic degradation of chlorinated aromatic compounds; Jechorek M et al.; The degradation of chlorobenzene was investigated with the specially chosen strain Methylocystis sp . GB 14 DSM 12955, using 23 ml headspace vials and in a soil column filled with quaternary aquifer material from a depth of 20 m . A long-term experiment was carried out in this column, situated in a mobile test unit at a contaminated location in Bitterfeld (Germany) . Groundwater polluted by chlorobenzene was continuously fed through the column, through which a mixture comprising 4% CH(4) and 96% air was bubbled . Chlorobenzene was oxidized by up to 80% under pure culture conditions in the model experiments and was completely degraded under the mixed culture conditions of the column experiments . Over a period of 4 months, the stability of the biological system was monitored regularly by analyzing the sMMO activity as well as by classical microbiological and molecular biological methods. J Int Acad Periodontol, 2001 Oct, 3(4), 81 - 6 Comparative clinical and microbiological effects of subgingival metronidazole application in adult periodontitis; 12-months results; Buduneli E et al.; The aim of the present study was to evaluate the clinical and microbiological effects of subgingival application of 25% metronidazole dental gel as an adjunct to scaling and root planing (SRP) in the treatment of adult periodontitis . Eighty teeth in 18 patients were evaluated using a split mouth design . The test teeth received SRP and a 25% metronidazole gel applied subgingivally on days 0 and 7 . The control teeth received SRP only . Clinical and microbiological examinations were carried out before treatment and on weeks 1, 3, 7, 13, 26, 38 and 52 of the experimental period . Colony forming units of Porphyromonas gingivalis and Prevotella intermedia / Prevotella nigrescens were determined . Both treatments provided significant improvements in all the clinical and microbiological parameters (P<0.05) . However, none of the differences between the study groups were statistically significant (P > 0.05) . As a conclusion, the present study does not provide evidence in favour of the routine use of adjunctive metronidazole dental gel in the treatment of adult periodontitis. Dtsch Tierarztl Wochenschr, 2003 Feb, 110(2), 65 - 8 {The regional differences of the pH-value in the vagina, cervix, and uterus of cows during interestrus}; Wehrend A et al.; This study aimed to ascertain the pH value of the vagina, cervix, and uterus in cows during interoestrus . Measurements were made with an ambulant, digital pH meter with a flexible probe and a measuring frequency of one value per second . The genital tract (vagina, cervix, uterus) of 50 cows were analyzed with this instrument immediately post mortem . The sexual health of the animals was evaluated via clinical, histological, and microbiological tests . Statistically significant regional differences in the pH value were documented (p < 0.01) . Whereas a decrease was measured between the values for the vagina (6.92 +/- 0.51) and the cervix (6.22 +/- 0.31), increased values were measured in the uterus (6.62 +/- 0.32) . The physiological pH value in the genital tract of the cow should be taken into consideration for the development of new therapeutic measures in terms of the local application of probiotically active bacterial strains. Bull Soc Sci Med Grand Duche Luxemb, 2002, (2), 121 - 34 {Treatment of pneumonia acquired in the community}; Waschbisch T et al.; The community-acquired pneumonia is a common and serious illness . Pneumonia is said to be community acquired if it is contracted outside of hospital environment or if it is diagnosed within the first 48 hours of hospitalisation . The pathogen remains unknown after investigations in around 50% . The patient should initially be treated empirically, based on the likely pathogens according to the patient's risk-factors, underlying diseases, severity of pneumonia and place of therapy . If recent guidelines are compared (American Thoracic Society, British Thoracic Society and the Infectious Disease Advisory Board) there are differences concerning epidemiology, patients classification and the empiric antibiotic treatment . The appearance of resistances and the recent availability of new antibiotics account partially for these differences . In order to avoid further resistances but still achieving an efficient treatment, coherent antibiotic schemes considering local microbiological epidemiology and patients classifications must be applied as proposed by different guidelines. Tunis Med, 2002 Nov, 80(11), 658 - 62 {Optimization of microbiological diagnosis of endocarditis}; Boukadida J; The endocarditis stays a dangerous illness . The positive microbiological diagnosis has a precious contribution for a successful hold in charge of the patient . To optimise the microbiological diagnosis of the endocarditis, essentially it comes back to respect the maximum rules of good practice of the blood cultures and the microbiological cardiac valve exams . During the last decades, techniques of molecular biology came to remedy insufficiencies of the conventional microbiology . We arrange rich microbiological data to guide the therapist while waiting the current microbiological data of the patient. Appl Microbiol Biotechnol, 2003 Feb, 60(6), 696 - 9 Epub 2002 Dec 18. Inducive effect of cresoquinone on microbiological transformation of L-tyrosine to 3,4 dihydroxy phenyl L-alanine by Aspergillus oryzae NG-11(P1); Haq I et al.; The present work describes the inducive effect of cresoquinone on microbiological transformation of L-tyrosine to 3,4 dihydroxy phenyl L-alanine ( L-DOPA) by Aspergillus oryzae NG-11(P1) . Mould mycelium was used for biochemical conversion of L-tyrosine to L-DOPA because tyrosinases, beta-carboxylases and tyrosine hydroxylases are intracellular enzymes . The maximum conversion of L-tyrosine to L-DOPA (0.428 mg/ml) was achieved after 60 min of biochemical reaction . To enhance the production of L-DOPA, cresoquinone was added to the reaction mixture . Best L-DOPA biosynthesis results were observed when the concentration of cresoquinone was 3.5 x 10(-6) M (1.686 mg/ml L-DOPA produced with 1.525 mg/ml consumption of L-tyrosine) . Cresoquinone not only increased enzyme activity but also enhanced cell membrane permeability to facilitate secretion of enzymes into the reaction broth . Comparison of kinetic parameters revealed the ability of the mutant to yield L-DOPA {Y(p/x) {i.e., mg L-DOPA formed (mg cells formed)(-1)} =7.360+/-0.04} . When the culture grown on various cresoquinone levels was monitored for Q(p), Q(s) and q(p) { Q(p): mg L-DOPA produced ml(-1) x h(-1); Q(s): mg substrate consumed ml(-1) x h(-1); q(p): mg L-DOPA formed (mg cells)(-1) h(-1)}, there was significant enhancement ( P<0.025) of these variables. J Nat Prod, 2003 Mar, 66(3), 327 - 31 Biotransformation of the diterpenes epicandicandiol and candicandiol by Mucor plumbeus; Fraga BM et al.; The microbiological transformation of the diterpene epicandicandiol (1) with Mucor plumbeus gave foliol (3), sideritriol (5), and 7beta,16alpha,17,18-tetrahydroxy-ent-kaurane (7), while the incubation of candicandiol (2) gave 7alpha,9beta,18-trihydroxy-ent-kaur-16-ene (10), canditriol (11), and 7alpha,16alpha,17,18-tetrahydroxy-ent-kaurane (12) . Thus, the main difference observed in both feedings, resulting from the spatial change in the orientation of the 7-hydroxyl, from axial in the substrate 1 to equatorial in 2, was the formation of a 3alpha- and a 9beta-hydroxylated derivative, respectively. J Infect Dis, 2003 Apr 1, 187(7), 1097 - 106 Epub 2003 Mar 14. Cardiac valves in patients with Q fever endocarditis: microbiological, molecular, and histologic studies; Lepidi H et al.; The pathologic features of Q fever endocarditis, which is caused by Coxiella burnetii, were histologically evaluated in cardiac valves from 28 patients . We used quantitative image analysis to compare valvular fibrosis, calcifications, vegetati