J Indian Med Assoc, 2002 Jun, 100(6), 372 - 5 A study on the comparison between clinical and microbiological diagnoses of sexually transmitted diseases; Haripriya V et al.; The efficacy of microbiological diagnosis in sexually transmitted diseases (STDs) has been evaluated in comparison with the clinical diagnosis . Amongst the clinical diagnoses of single STDs, syphilis, genital warts, gonorrhoea and herpes genitalis were the predominant ones . Syphilis was the most predominant infection in both the single and mixed STD infections in Chennai . Clinical diagnoses of trichomoniasis, genital chlamydiasis and genital herpes were more accurate and correlated well with laboratory investigations . On the other hand, clinical diagnoses of gonorrhoea, candidiasis and syphilis were less accurate . More over many of these cases, clinically diagnosed as single, infection, were also positive for other STDs in the laboratory investigations . Double infections were clinically diagnosed only in 7 cases as against 11 cases in microbiological tests and one triple infection diagnosed in microbiological tests was diagnosed only as single disease clinically . Therefore, the laboratory/microbiological investigations have been emphasised to have better accuracy of diagnosis of STDs. Eur J Clin Microbiol Infect Dis, 2002 Oct, 21(10), 729 - 35 Epub 2002 Oct 03. Clinical study of an outbreak of Legionnaire's disease in Alcoy, Southeastern Spain; Fernandez JA et al.; The aim of this study was to identify the clinical features of Legionnaires' disease, sudden outbreaks of which demand a quick and flexible clinical approach, particularly with regard to diagnosis and therapy . A prospective and comparative study based on a clinical protocol was performed during an outbreak of Legionnaires' disease in Alcoy, Spain . The outbreak was environmental in origin, linked to cooling towers . Data about epidemiological and clinical features, blood chemistry values, radiological and microbiological findings, and characteristics related to the clinical course of Legionnaires' disease were obtained for 357 patients admitted to hospital with community-acquired pneumonia (177 with Legionella pneumonia) . Patients with Legionnaires' disease were younger (mean age, 65.3+/-16.5 years) and more likely to be smokers compared with patients with other types of pneumonia (28.8% vs . 11.1%; P<0.01) . Moreover, they had not been admitted to any hospital because of pneumonia in the previous year . Patients with Legionnaires' disease had higher fever, more severe headache, and less expectoration as well as lower sodium blood levels (mean, 132.6+/-4.8 mmol/l vs . 135.7 mmol/l; P<0.01) . Radiological studies also showed that fewer patients with Legionnaires' disease had pleural effusion (9% vs . 19.4% of those with non- Legionella pneumonia) . The presence of headache, high fever, hyponatremia, scanty or null expectoration, and current cigarette smoking provides physicians with important clues for a high suspicion of Legionella pneumonia before the results of confirmatory laboratory tests are available. Lancet, 2002 Oct 26, 360(9342), 1287 - 92 Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features; Thwaites GE et al.; BACKGROUND: The diagnosis of tuberculous meningitis is difficult . Discrimination of cases from those of bacterial meningitis by clinical features alone is often impossible, and current laboratory methods remain inadequate or inaccessible in developing countries . We aimed to create a simple diagnostic aid for tuberculous meningitis in adults on the basis of clinical and basic laboratory features . METHODS: We compared the clinical and laboratory features on admission of 251 adults at an infectious disease hospital in Vietnam who satisfied diagnostic criteria for tuberculous (n=143) or bacterial (n=108) meningitis . Features independently predictive of tuberculous meningitis were modelled by multivariate logistic regression to create a diagnostic rule, and by a classification-tree method . The performance of both diagnostic aids was assessed by resubstitution and prospective test data methods . FINDINGS: Five features were predictive of a diagnosis of tuberculous meningitis: age, length of history, white-blood-cell count, total cerebrospinal fluid white-cell count, and cerebrospinal fluid neutrophil proportion . A diagnostic rule developed from these features was 97% sensitive and 91% specific by resubstitution, and 86% sensitive and 79% specific when applied prospectively to a further 42 adults with tuberculous meningitis, and 33 with bacterial meningitis . The corresponding values for the classification tree were 99% and 93% by resubstitution, and 88% and 70% with prospective test data . INTERPRETATION: This study suggests that simple clinical and laboratory data can help in the diagnosis of adults with tuberculous meningitis . Although the usefulness of the diagnostic rule will vary depending on the prevalence of tuberculosis and HIV-1 infection, we suggest it be applied to adults with meningitis and a low cerebrospinal fluid glucose, particularly in settings with limited microbiological resources. Acta Paediatr, 2002, 91(9), 972 - 7; discussion 894-5 Treatment of children with cystic fibrosis: central, local or both? van Koolwijk LM, Uiterwaal CS, van der Laag J, Hoekstra JH, Gulmans VA, van der Ent CK. Owing to a lack of longitudinal studies, the effect of centralization of care on pulmonary function and survival remains unclear . Three different levels of involvement of centralized care in the treatment of paediatric cystic fibrosis patients were compared with regard to longitudinal pulmonary function and nutritional and microbiological status in a 3-y period, and the literature was reviewed on the possible advantages and disadvantages of centralized care . The study included 105 paediatric patients attending the Cystic Fibrosis Centre between January 1997 and January 2001 . Twenty-three patients were treated by local paediatricians according to the protocol of the Centre and were seen only once a year at the Centre, for an annual check-up (local care) . Forty-one patients were treated at the Centre only (centralized care) . The remaining 41 patients were treated in close cooperation between the Centre and local hospitals, with patients visiting the doctors alternately (shared care) . The mean annual changes in pulmonary function and body mass index from all patients, as well as a microbiological survey, were reviewed . No significant differences were found between the three groups for annual changes in FEV1, FVC and body mass index, nor did the review of microbial colonization show any significant differences between the groups . Because the groups in this study were relatively small, the results might have been influenced by lack of power . CONCLUSION: In this relatively small group, no differences in pulmonary function, nutritional status or microbiological colonization between the three levels of involvement of centralized care could be found . This could signify that local paediatricians have a special role in the care for patients with cystic fibrosis, in close cooperation with the specialists at the Centre. Shock, 2002 Nov, 18(5), 476 - 80 Intestinal ischemic preconditioning protects the intestine and reduces bacterial translocation; Aksoyek S et al.; Ischemic preconditioning (IPC) was first demonstrated in the heart, but this protective effect has been also recently described in the intestine . The aim of this study was to determine the effects of intestinal ischemic preconditioning on the morphology of intestine and bacterial translocation . Twenty-four male Wistar rats weighting 250 to 300 g were randomized into three groups . A control group of rats (n = 8) were subjected laparotomy . In an ischemic group (n = 8), laparotomy was performed and the superior mesenteric artery was occluded by an atraumatic clamp for 30 min . In the preconditioned group (n = 8), before the ischemia-reperfusion (I/R) period (as in ischemic group), rats were subjected to an initial 10 min of intestinal ischemia and 10 min of reperfusion . Twenty-four hours later, to evaluate whether the I/R induced intestinal injury and bacterial translocation (BT), tissue and blood samples were collected, and liver, spleen, and mesenteric lymph node specimens were obtained under sterile conditions for microbiological analysis . Samples of ileum were removed for both biochemical and histopathological evaluation . In the I/R group, the incidence of bacteria-isolated mesenteric lymph nodes, spleen, liver, and blood was significantly higher than other groups (P < 0.05) . IPC prevented I/R-induced BT and it significantly reduced the I/R-induced intestinal injury (P < 0.05) . Increased inducible nitric oxide (NO) synthase (iNOS) expression observed on the ileal specimens of the I/R group was found to be prevented by IPC . Our data suggest IPC as a key factor that reduces BT and iNOS activation in intestinal I/R . This is the first study showing that intestinal IPC blocks the cascade of events that causes BT and intestinal injury that may lead to sepsis. J Ind Microbiol Biotechnol, 2002 Nov, 29(5), 243 - 54 Chemical and microbiological changes in laboratory incubations of nitrate amendment "sour" produced waters from three western Canadian oil fields; Eckford RE et al.; Nitrate addition to oil field waters stops the biogenic formation of sulfide because the activities of nitrate-reducing bacteria (NRB) suppress the activities of sulfate-reducing bacteria (SRB) . In general, there are two types of NRB - the heterotrophic NRB and the chemolithotrophic NRB . Within the latter group are the nitrate-reducing, sulfide-oxidizing bacteria (NR-SOB) . To date, no study has specifically addressed the roles of these different NRB in controlling sulfide concentrations in oil field produced waters . This study used different culture media to selectively enumerate heterotrophic NRB and NR-SOB by most probable number (MPN) methods . Produced waters from three sulfide-containing western Canadian oil fields were amended with nitrate as an electron acceptor, but no exogenous electron donor was added to the serum bottle microcosms . Changes in the chemical and microbiological characteristics of the produced waters were monitored during incubation at 21 degrees C . In less than 4 days, the sulfide was removed from the waters from two of the oil fields (designated P and C), whereas nearly 27 days were required for sulfide removal from the water from the third oil field (designated N) . Nitrate addition stimulated large increases in the number of the heterotrophic NRB and NR-SOB in the waters from oil fields P and C, but only the NR-SOB were stimulated in the water from oil field N . These data suggest that stimulation of the heterotrophic NRB is required for rapid removal of sulfide from oil field-produced waters. Sarcoidosis Vasc Diffuse Lung Dis, 2002 Oct, 19(3), 227 - 33 Sarcoidosis of the upper respiratory tract . Selected cases emphasizing diagnostic and therapeutic difficulties; Sharma OP; BACKGROUND: Sarcoidosis of the upper respiratory tract (SURT) is a frequently overlooked and inadequately treated complication of sarcoidosis . AIM: The aim of this descriptive study is to present selected cases of sarcoidosis of the upper respiratory tract depicting diagnostic and therapeutic challenges . METHODS AND RESULTS: Five selected patients who either had an unusual initial presentation or an unusual clinical course were included if they also had long follow up . The diagnosis of SURT was based on the conventional criteria including histological evidence and appropriate microbiological studies . CONCLUSION: These case studies underline problems that may arise when SURT is not recognized early and appropriate and adequate treatment is delayed. Infect Control Hosp Epidemiol, 2002 Oct, 23(10), 615 - 9 Disruption of services in an internal medicine unit due to a nosocomial influenza outbreak; Sartor C et al.; OBJECTIVE: To describe a nosocomial influenza A outbreak, how it was managed, what impact it had on subsequent delivery of health care, and the additional charges attributable to it DESIGN: Prospective cohort study and microbiological investigation . SETTING: One internal medicine unit in an acute care, university-affiliated hospital . PARTICIPANTS: Twenty-three patients and 22 staff members from February 28 to March 6, 1999 . RESULTS: Attack rates were 41% (9 of 22) among patients and 23% (5 of 22) among staff members, with 3 of 14 cases being classified as "certain." The influenza virus isolates were typed as A/SYDNEY/5/97 (H3N2) . The index case was a patient who shared a room with the first nosocomial case . Vaccination rates for influenza virus were 43% (10 of 23) among patients and 36% (8 of 22) among staff members . The outbreak resulted in staff members' taking 14 person-days of sick leave . Furthermore, 8 scheduled admissions were postponed and all emergency admissions were suspended for 11 days . Hospital charges attributable to the influenza outbreak totaled $34,179 and the average extra charge per infected patient was $3,798 . CONCLUSIONS: Nosocomial influenza outbreaks increase charges and alter the quality of care delivered in acute care settings . Strategies for their prevention need to be evaluated in acute care settings. Int J Environ Health Res, 2002 Sep, 12(3), 221 - 33 Deterioration of drinking water quality in the distribution system and gastrointestinal morbidity in a Russian city; Egorov A et al.; Few studies have been conducted in Russia to assess the relationship between drinking water quality and gastrointestinal (GI) infections . In the city of Cherepovets, effluent water at the treatment plant usually meets the country's hygienic standards . To provide protection against secondary water contamination in the distribution system, concentrations of total residual chlorine in effluent water are maintained#10; at levels from 1 to 2 mg x l(-1) . However, residual chlorine concentrations rapidly decline in the distribution system and rechlorination is not practiced . Some areas of the city routinely have very low residual chlorine at taps and little protection against secondary microbiological contamination of water in pipelines . A cross-sectional epidemiological study was conducted in Cherepovets to assess an association between decline in residual chlorine concentrations and risk of GI illness . This study included water quality monitoring and an extensive questionnaire survey of city residents . The results demonstrated a consistent spatial pattern of free chlorine decline in the distribution system . An interquartile range variability in free residual chlorine decline (0.22 mg x l(-1)) was associated with 1.42 (95% confidence interval (CI) = 1.05, 1.91) relative risk of self-reported gastrointestinal illness after control for socioeconomic, hygienic and demographic parameters. J Acquir Immune Defic Syndr, 2002 Oct 1, 31(2), 183 - 7 Efficacy of caspofungin in the treatment of esophageal candidiasis resistant to fluconazole; Kartsonis N et al.; Caspofungin is a new echinocandin drug with comparable in vitro activity against azole-susceptible and -resistant isolates of that could provide a less toxic alternative to amphotericin B for the management of esophageal candidiasis with clinical or laboratory evidence of decreased susceptibility to fluconazole . The authors retrospectively analyzed its efficacy in adults with endoscopically documented esophagitis from four Phase II and III studies using two definitions of resistance to fluconazole: 1) clinically refractory infection based on failure of esophageal symptoms to improve despite at least 1 week of >or=200 mg/d of fluconazole; or 2) microbiologically resistant infection with either "susceptible dose-dependent" or "resistant" isolates based on MICs of 16 to 32 and >or=64 microg fluconazole/mL, respectively . A favorable response required resolution of all symptoms and substantial improvement in endoscopic findings . Seven of 11 patients (64%) who had been clinically refractory to fluconazole had favorable responses to caspofungin . Eleven of 14 patients (79%) whose isolates had decreased susceptibility to fluconazole had favorable responses to caspofungin, including 5 (83%) of 6 patients infected by isolates with MICs of >or=64 microg fluconazole/mL . Caspofungin appeared to be efficacious therapy for some patients with esophageal candidiasis who were clinically refractory to fluconazole or infected by with reduced susceptibility to fluconazole in vitro. J Hosp Infect, 2002 Oct, 52(2), 77 - 80 A UK historical perspective on operating theatre ventilation; Stacey A et al.; As part of the preparation for the report of the Hospital Infection Society Working Party on Infection Control and Operating Theatres, studies published from the UK on the subject of operating theatre ventilation were reviewed . Few have convincingly demonstrated a direct relationship between the microbiological quality of operating theatre air and postoperative wound infection . Nevertheless, the findings from these studies have had a major influence on the development of official UK guidance on the design, performance and testing of ventilation in both conventional and ultraclean operating theatres . J Appl Microbiol, 2002, 93(5), 825 - 34 Quantification of microcystin-producing cyanobacteria and E . coli in water by 5'-nuclease PCR; Foulds IV et al.; AIMS: 5'-Nuclease (real-time, quantitative) PCR methodologies were developed and applied as diagnostic tools for the detection of microcystin-producing cyanobacteria and Escherichia coli in water . METHODS AND RESULTS: PCR was used to detect regions of the lacZ gene in E . coli, and the microcystin synthetase gene in microcystin-producing cyanobacteria . In environmental water samples, natural inhibitors to PCR were effectively removed with a prefiltration step and an EDTA wash . A lower detection limit of 10 cells ml(-1) was obtained with endpoint PCR detection . 5'-Nuclease PCR was used for microbial quantification of 1 ml inoculated water samples . We were able to detect down to three copies of our target genes per sample within about 2 h (post-DNA isolation) for both E . coli and microcystin-producing cyanobacteria . CONCLUSIONS: 5'-Nuclease PCR offers a rapid and sensitive method of bacterial quantification in water samples . SIGNIFICANCE AND IMPACT OF THE STUDY: 5'-Nuclease PCR can be adopted as an effective diagnostic tool for monitoring microbiological water quality, through coliform quantification, and detection of other waterborne microbial pathogens. ILAR J, 2002, 43(4), 244 - 58 Guidelines for the design and statistical analysis of experiments using laboratory animals; Festing MF et al.; For ethical and economic reasons, it is important to design animal experiments well, to analyze the data correctly, and to use the minimum number of animals necessary to achieve the scientific objectives---but not so few as to miss biologically important effects or require unnecessary repetition of experiments . Investigators are urged to consult a statistician at the design stage and are reminded that no experiment should ever be started without a clear idea of how the resulting data are to be analyzed . These guidelines are provided to help biomedical research workers perform their experiments efficiently and analyze their results so that they can extract all useful information from the resulting data . Among the topics discussed are the varying purposes of experiments (e.g., exploratory vs . confirmatory); the experimental unit; the necessity of recording full experimental details (e.g., species, sex, age, microbiological status, strain and source of animals, and husbandry conditions); assigning experimental units to treatments using randomization; other aspects of the experiment (e.g., timing of measurements); using formal experimental designs (e.g., completely randomized and randomized block); estimating the size of the experiment using power and sample size calculations; screening raw data for obvious errors; using the t-test or analysis of variance for parametric analysis; and effective design of graphical data. J Clin Periodontol, 2002 Aug, 29(8), 743 - 9 Local antibiotic therapy guided by microbiological diagnosis; Mombelli A et al.; BACKGROUND: The aim of this study was to determine the distribution patterns of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in periodontitis patients after standard mechanical periodontal therapy, and to evaluate the effect of additional local antibiotic therapy, given to all teeth with cultural evidence of these bacteria . METHODS: 17 patients were included . 852 separate subgingival microbial samples were taken from the mesial and distal aspect of every tooth in 17 subjects at baseline . 46 of these samples, from 10 positive subjects, showed cultural evidence for P . gingivalis . 82 samples, from 5 subjects, were A . actinomycetemcomitans-positive . Three subjects showed no evidence for persistence of A . actinomycetemcomitans or P . gingivalis . In the other 14 subjects, all A . actinomycetemcomitans- or P . gingivalis-positive teeth were treated with tetracycline fibers (ACTISITE(R)) . Sub-gingival microbial samples were again taken from two sites of every tooth, 1 month after fiber removal . 89% of the initially P . gingivalis-positive sites were now negative, but 16 previously negative sites now tested positive . 77% of the initially A . actinomycetemcomitans-positive sites were now negative, but 5 previously negative sites now tested positive . The teeth with persisting P . gingivalis or A . actinomycetemcomitans were again treated with fibers . Two sites of every tooth were once more sampled after 1 month . At this time, 5 subjects still showed cultural evidence of P . gingivalis at a total of 19 sites, and 4 subjects were positive for A . actinomycetemcomitans in a total of 27 sites . These 9 patients were finally submitted to systemic antibiotic therapy (3 x 250 mg metronidazole plus 3 x 375 mg amoxicillin/d for 7 days) . Despite of all efforts, P . gingivalis was again detected 3 months later in isolated sites in 3 subjects, and A . actinomycetemcomitans could be cultivated from one single site . CONCLUSIONS: Therapy with tetracycline fibers guided by microbiological diagnosis effectively reduced P . gingivalis and A . actinomycetemcomitans locally, but was unable to completely eradicate the target organisms . Additional systemic antibiotic therapy further reduced P . gingivalis and A . actinomycetemcomitans . The observed persistence patterns suggest that reemergence of A . actinomycetemcomitans was due to recolonization, whereas the strikingly reproducible local reemergence of P . gingivalis in some sites indicated failed eradication. J Clin Periodontol, 2002 Aug, 29(8), 724 - 35 Antibiotic resistance of subgingival species during and after antibiotic therapy; Feres M et al.; AIM: The purpose of the present investigation was to determine the percentage and identity of antibiotic-resistant species in subgingival plaque and saliva samples from chronic periodontitis patients treated by scaling and root planing followed by orally administered amoxicillin or metronidazole . METHOD: In all, 20 chronic periodontitis patients were selected for study . After clinical and microbiological monitoring, subjects were randomly assigned to receive either orally administered amoxicillin at the dosage of 500 mg, 3 times daily for 14 days or orally administered metronidazole at the dosage of 250 mg, 3 times daily for 14 days . For the antibiotic resistance determinations, subgingival plaque samples were taken from six posterior teeth at baseline, and 90 days; and from two randomly selected teeth at 3, 7 and 14 days during and after antibiotic administration . Samples were plated on enriched blood agar plates with or without either 2 micro g/mL metronidazole or 2 micro g/mL amoxicillin . Colonies were counted at 7 days . Significant differences in percentage of resistant organisms over time were determined by the Quade test . Microbial growth was washed from antibiotic-containing media and the identity of species determined using checkerboard DNA-DNA hybridization . Data were compared with those obtained in a previous study from subjects receiving SRP only or SRP followed by 14 days of orally administered doxycycline . The level of doxycycline used to determine antibiotic resistance in that study was 4 micro g/mL . RESULTS: The mean percentage of resistant isolates increased during antibiotic administration and returned to baseline levels by 90 days post therapy . The mean percentages (+/- SEM) of isolates resistant to 2 micro g/mL metronidazole were 53 +/- 9, 65 +/- 9, 79 +/- 4 and 69 +/- 7 at baseline, 3, 7 and 14 days during antibiotic administration, and 57 +/- 4, 64 +/- 5, 62 +/- 7 and 47 +/- 6 at 3, 7, 14 and 90 days after antibiotic administration . At the same time points, the percentage of resistant isolates to amoxicillin was 0.5 +/- 0.2, 22 +/- 12, 14 +/- 5 and 37 +/- 11 during, and 31 +/- 11, 8 +/- 3, 3 +/- 2 and 3 +/- 0.6 after, administration . Antibiotic-resistant isolates of resistant species detected during or after therapy were also detected prior to therapy . The most prevalent resistant species in the metronidazole-treated group were: A . naeslundii 1, S . constellatus, A . naeslundii 2, S . mitis, S . oralis, A . odontolyticus, S . sanguis, and in the amoxicillin-treated group: S . constellatus, P . nigrescens, E . saburreum, A . naeslundii 1, S . oralis, P . melaninogenica and P . intermedia . CONCLUSIONS: Systemic antibiotic administration transiently increased the percentage of resistant subgingival species, but a major component of subgingival plaque remained sensitive to the agents during their administration . Antibiotic-resistant isolates of resistant species could be detected in samples both prior to and after therapy . However, % antibiotic-resistant isolates returned to baseline levels 90 days after antibiotic administration. J Clin Periodontol, 2002 Aug, 29(8), 710 - 23 Guided tissue regeneration in intrabony defects using an experimental bioresorbable polydioxanon (PDS) membrane . A 24-month split-mouth study; Christgau M et al.; AIM: The comparison of the clinical, radiographic, and microbiological healing results in deep intrabony defects following GTR therapy with two different bioresorbable membranes in a prospective split-mouth design . MATERIAL AND METHODS: 31 pairs of contralateral intrabony defects were randomly treated with either an experimental Polydioxanon (PDS) membrane or a Polylactic acid (PLA) matrix barrier . After 6, 12 and 24 months, healing results were assessed using clinical examinations (REC, PPD, CAL, vertical relative attachment gain V-rAG), quantitative digital subtraction radiography (amount and area of bone density changes), and microbiological analysis . RESULTS: Postoperative membrane exposures occurred in 14 PDS and 2 PLA treated sites . 6, 12 and 24 months p.o., both membranes provided a significant gain in CAL {median values: 6 months (PDS vs . PLA: 3.0 vs . 3.0 mm); 12 and 24 months (PDS vs . PLA: 4.0 vs . 4.0 mm)}, which corresponded to a V-rAG of 57.1% (PDS) vs . 62.5% (PLA) after 24 months . PDS and PLA treated sites revealed significant bone density gain 6, 12 and 24 months after surgery . 38.8% (PDS) vs . 41.8% (PLA) of the initial defect areas showed bone density gain . While the gain in bone density was significantly greater in PDS than in PLA sites, neither CAL gain nor the area of bone density changes revealed significant differences . Microbiological culture revealed similar bacterial loads in PDS and PLA sites during the first 12 months . CONCLUSION: This 24-month study indicates that the PDS and PLA membranes can provide similar favorable regeneration results in deep intrabony periodontal defects, although considerably more postoperative membrane exposures have to be expected in PDS treated sites. Pathol Res Pract, 2002, 198(8), 553 - 8; discussion 559-61 Granulomatous Pneumocystis carinii pneumonia complicating hematopoietic cell transplantation; Gal AA et al.; Pneumocystis carinii pneunonia (PCP) is associated with a wide spectrum of clinical and histopathological presentations . While granulomatous PCP uncommonly occurs in AIDS patients, it is extremely rare in other non-AIDS immunocompromised patients . We identified three patients who developed granulomatous PCP after bone marrow or blood stem cell transplantation . In all cases, fiberoptic bronchoscopy with bronchoalveolar lavage was non-diagnostic, and an open lung biopsy was required for diagnosis . All patients were successfully treated with trimethoprim-sulfamethoxazole . The histological appearance varied from an ill-defined granulomatous pneumonia to well-formed necrotizing granulomas . The typical intraalveolar eosinophilic frothy exudate was absent . Often sparsely distributed, the organisms were detected by GMS and immunohistochemical stains for P . carinii . No other pathogens were identified by additional histochemical stains or by microbiological cultures . Awareness of this unusual granulomatous tissue response to P . carinii and initiation of specific treatment can lead to successful resolution of this potentially lethal infection. J Cataract Refract Surg, 2002 Oct, 28(10), 1882 - 3 Aspergillus niger endophthalmitis after cataract surgery; Brar GS et al.; We report a 65-year-old diabetic woman who developed Aspergillus niger endophthalmitis after cataract surgery . She presented 9 weeks after extracapsular cataract extraction with a black growth covering the cornea and moderate echoes in the vitreous on ultrasonography . After microbiological confirmation of fungal endophthalmitis, the patient received intravitreal amphoterecin B 5 micro g, topical natamycin 5% hourly, atropine 1% 3 times, and oral antifungal therapy . The patient was told the visual prognosis and was advised to have penetrating keratoplasty and vitrectomy, which she refused. Int J Antimicrob Agents, 2002 Sep, 20(3), 165 - 73 Ertapenem monotherapy versus combination therapy with ceftriaxone plus metronidazole for treatment of complicated intra-abdominal infections in adults; Yellin AE et al.; The efficacy and safety of intravenous (IV) ertapenem, 1 and 1.5 g once a day, for treatment of adults with complicated intra-abdominal infection were compared with those of IV ceftriaxone 2 g once a day plus IV metronidazole 500 mg every 8 h . After at least 3 days of IV therapy and satisfactory clinical response, patients could be switched to oral ciprofloxacin plus metronidazole . Fifty-nine patients were randomized to receive ertapenem 1 g and 51 to receive ertapenem 1.5 g; 55 patients were randomized to each comparator group . At the test of cure, 4-6 weeks post therapy, in the 1 g cohort, 84% (26/31) of patients treated with ertapenem and 85% (35/41) with comparator therapy had a favourable clinical and microbiological assessment . Success rates in the 1.5 g cohort were 83% (22/29) and 77% (24/31) in the ertapenem and comparator groups, respectively . Drug-related adverse events were generally similar in both treatment groups . Ertapenem 1 or 1.5 g once a day followed by optional oral therapy appeared similar to combined therapy with ceftriaxone plus metronidazole with the same optional oral switch for treatment of complicated intra-abdominal infections in adults . Although not compared directly in a randomized fashion, the efficacy and safety profiles of ertapenem 1 and 1.5 g appeared comparable . Ertapenem was generally well tolerated and had an overall safety profile similar to ceftriaxone plus metronidazole . Int J Antimicrob Agents, 2002 Sep, 20(3), 153 - 64 A risk analysis framework for the long-term management of antibiotic resistance in food-producing animals; Salisbury JG et al.; In recent years, there has been increasing concern that the use of antibiotics in food-producing animals, particularly their long-term use for growth promotion, contributes to the emergence of antibiotic-resistant bacteria in animals . These resistant bacteria may spread from animals to humans via the food chain . They may also transfer their antibiotic-resistance genes into human pathogenic bacteria, leading to failure of antibiotic treatment for some, possibly life-threatening, human conditions . To assist regulatory decision making, the actual risk to human health from antibiotic use in animals needs to be determined (risk assessment) and the requirements for risk minimisation (risk management and risk communication) determined . We propose a novel method of risk analysis involving risk assessment for three interrelated hazards: the antibiotic (chemical agent), the antibiotic-resistant bacterium (microbiological agent) and the antibiotic-resistance gene (genetic agent) . Risk minimisation may then include control of antibiotic use and/or the reduction of the spread of bacterial infection and/or prevention of transfer of resistance determinants between bacterial populations . Int J Food Microbiol, 2002 Nov 15, 79(1-2), 35 - 45 Preservation of fresh meat with active and modified atmosphere packaging conditions; Skandamis PN et al.; The sensory, microbiological and physicochemical attributes of fresh meat stored at 5 and 15 degrees C were affected by the combined effect of volatile compounds of oregano essential oil and modified atmosphere packaging conditions (40% CO2/30% N2/30% O2, 100% CO2, 80% CO2/20% air, vacuum pack and air) . It was found that the extension of shelf life of meat samples depended on the packaging conditions and augmented in the order: air < vacuum pack < 40% CO2/30% N2/30% O2 < 80% CO2/ 20% air < 100% CO2 . Longer shelf life was observed in samples supplemented with the volatile compounds of oregano essential oil and stored under the same packaging conditions mentioned above . The extension of shelf life may be due to the synergistic effect of volatile compounds of oregano essential oil and the modified atmosphere packaging used on the microbiological and physicochemical characteristics of meat . Indeed, both these hurdles can prolong and delay microbial growth or suppress the final counts of the spoilage microorganisms in comparison with the 'control' samples . The effect of essential oil volatile compounds was even more pronounced on the physicochemical changes of meat samples caused by microbial association . Oregano essential oil delayed glucose and lactate consumption, both indicators of meat spoilage aerobically as well as under 40% CO2/30% N2/30% O2, and 100% CO2 . Finally, changes in other metabolites such as formic acid were also observed. Anat Rec, 2002 Nov 1, 268(3), 180 - 5 Chemical markers for bacteria in extraterrestrial samples; Fox A; Interplanetary missions to collect pristine Martian surface samples for analysis of organic molecules, and to search for evidence of life, are in the planning phases . The only extraterrestrial samples currently on Earth are lunar dust and rocks, brought back by the Apollo (U.S.) and Luna (Soviet Union) missions to the moon, and meteorites . Meteorites are contaminated when they pass through the Earth's atmosphere, and during environmental exposure on Earth . Lunar fines have been stored on Earth for over 30 years under conditions designed to avoid chemical but not microbiological contamination . It has been extremely difficult to draw firm conclusions about the origin of chemicals (including amino acids) in extraterrestrial samples . Of particular concern has been the possibility of bacterial contamination . Recent work using state-of-the-art gas chromatography tandem mass spectrometry (GC-MS/MS) has dramatically lowered the chemical background, allowing a clear demonstration that lunar fines are remarkably different from terrestrial dust in that they generally lack certain chemical markers (muramic acid and 3-hydroxy fatty acids) characteristic of Earth's bacteria . Thus, lunar dust might be used as a negative control, in conjunction with GC-MS/MS analyses, in future analytical studies of lunar dust and meteorites . Such analyses may also be important in studies designed to search for the presence of life on Mars . Extremophiles, 2002 Oct, 6(5), 419 - 25 Epub 2002 Jun 13. Microbial community in acidic hydrothermal waters of volcanically active White Island, New Zealand; Donachie SP et al.; We report the first description of the microbial community in a stream of acidic hydrothermal waters on volcanically active White Island, New Zealand, using both molecular and microbiological methods . alpha- and beta-Proteobacteria, green-sulfur bacteria, and uncultured Firmicutes were identified from the community DNA-based 16s rRNA gene library . The same bacterial groups and the Rhodophyte Cyanidium caldarium were represented in enrichment cultures . C . caldarium, two Firmicutes and an acidophilic alpha-Proteobacterium, Acidiphilium cryptum, were brought into pure culture . Bacteria cultured from the stream grow at pH > or =2, and the Cyanidium grows at pH 0.2. J Agric Food Chem, 2002 Oct 23, 50(22), 6389 - 94 Insecticide formulations based on nicotine oleate stabilized by sodium caseinate; Casanova H et al.; Organic farming and new trends toward the use of safer insecticides for crop protection have created new opportunities for botanical insecticides in the pesticide market . In this study, the botanical insecticide nicotine was formulated as a dispersion (20 vol %) stabilized by sodium caseinate, with nicotine oleate solutions used as the dispersed phase . The formulation showed a phase transition on increasing the nicotine oleate concentration, being an emulsion at 7.5-8.2 wt %, a suspo-emulsion at 8.2-9.7 wt %, and a suspension at 9.7-10.8 wt % . Biological activity, apparent viscosity, dispersion time, and protein surface coverage were dependent on nicotine oleate concentration . The emulsion with 8.2 wt % nicotine oleate and the suspo-emulsion with 8.7 wt % nicotine oleate were found to be the most appropriate formulations for insecticide purposes due to their high bioactivity, low viscosity, and low dispersion time . Nicotine oleate formulations showed good creaming and microbiological stability for at least 4 months without losing their biological activity. J Food Prot, 2002 Oct, 65(10), 1623 - 7 Effects of pulsed electric field processing and storage on the quality and stability of single-strength orange juice; Ayhan Z et al.; The effects of pulsed electric field (PEF) processing on microorganisms in orange juice and on the flavor and color of the juice during storage for 112 days at 4 and 22 degrees C were investigated . Single-strength orange juice was PEF processed at an electric field strength of 35 kV/cm for 59 micros and placed into sterilized glass bottles in a sanitary glove box . PEF-processed orange juice was microbiologically stable at 4 and 22 degrees C for 112 days . PEF processing resulted in significant increases in the hydrocarbons D-limonene, alpha-pinene, myrecene, and valencene (P < or = 0.05) but did not have any effect on octanal, decanal, ethyl butyrate, and linalool . The levels of hydrocarbon compounds did not change at 4 and 22 degrees C in 112 days . Octanal, decanal, ethyl butyrate, and linalool levels significantly decreased in 14 days at 4 degrees C and in 2 days at 22 degrees C . The decrease in these compounds did not have a significant effect on the sensory quality of the orange juice (P > or = 0.05) . The microorganisms in PEF-processed orange juice, along with the flavor and color of the juice, remained stable at 4 degrees C for 112 days. Genome Biol . 2002 Sep 24;3(10):REPORTS4033 . Epub 2002 Sep 24. Viruses in and out; Andrawiss M; A report on the twelfth Congress of Virology, part of 'The world of microbes', the joint meeting of the three divisions of the International Union of Microbiological Societies, Paris, France, 27 July to 1 August 2002 J AOAC Int, 2002 Sep-Oct, 85(5), 1187 - 200 AOAC International methods committee guidelines for validation of qualitative and quantitative food microbiological official methods of analysis; Feldsine P et al.; Responding to a need for a guide for conducting Official Method validation studies of microbiological methods, AOAC utilized the experience of three microbiologists who have been active in the field of method validation . In collaboration, a document was prepared which covered the following areas: terms and their definitions associated with the Official Methods program (e.g., reference methods, alternative methods, and ruggedness testing), protocols and validation requirements for qualitative methods versus those for quantitative methods, the concept of the precollaborative study, ruggedness testing, tests for significant differences, performance indicators, and the approval process . After its preparation, this document was reviewed by the members of the Methods Committee on Microbiology and Extraneous Materials and by members of the Official Methods Board . Herein is presented the approved version of that document. Intensive Care Med, 2002 Oct, 28(10), 1440 - 6 Epub 2002 Aug 17. Direct costs of severe sepsis in three German intensive care units based on retrospective electronic patient record analysis of resource use; Moerer O et al.; OBJECTIVE: To determine the direct costs of severe sepsis patients in German intensive care units (ICUs) . DESIGN: Retrospective electronic data analysis . SETTING: Three adult intensive care units (surgical/medical) in three university hospitals in Germany . PATIENTS: 385 patients identified by standard definitions as suffering from severe sepsis . MEASUREMENTS AND RESULTS: A bottom-up approach was used to determine the direct ICU cost on actual resource use (medication, laboratory tests, microbiological analysis, disposables, and clinical procedures) for patients with severe sepsis . To determine the total direct costs, center-specific personnel and basic bed ("hotel") costs were added to total resources consumed . Average hospital mortality of severely septic patients was 42.6% . Mean ICU length of stay (LOS) was 16.6 days . Survivors stayed on average 4 days longer than nonsurvivors . The mean direct ICU costs of care were 23,297+/-18,631 euros per patient and 1,318 euros per day . In comparison, average daily charges being paid for an ICU patient by the health care system in Germany are 851 euros (based on official statistics) . Nonsurvivors were more expensive than survivors in total direct costs (25,446 vs . 21,984 euros) and in per day direct cost (1,649 vs . 1,162 euros) . Medication makes up the largest part of the direct costs, followed by expenses for personnel . CONCLUSIONS . Patients with severe sepsis have a high ICU mortality rate and long ICU LOS and are substantially expensive to treat . Nonsurviving septic patients are more costly than survivors despite shorter ICU LOS . This is due to higher medication costs indicating increased efforts to keep patients alive. Anal Bioanal Chem, 2002 Oct, 374(3), 421 - 6 Epub 2002 Sep 07. Development of a laser-induced cell lysis system; Dhawan MD et al.; A novel cell lysis system was developed that is based on laser-induced disruption of bacterial and yeast cells . It will find application as a rapid, efficient and clean sample preparation step in bioanalytical detection systems . Using E . coli as our model analyte, we optimized cell lysis with respect to optimal laser wavelength, lowest energy input requirements, RNA release from the cells, and potential protein damage . The optimized system was finally applied to the lysis of four additional microorganisms . All experiments were carried out with about 2000 cells per sample or less . Initially, lysis was determined by the detection of cell survival after laser treatment using standard microbiological techniques, (i.e., cells were grown on nutrient agar plates) . Then, actual release of mRNA from the cells was proven . Wavelengths investigated ranged from 500 nm to 1550 nm . An average power of 100 mW for the lasers was shown to be sufficient to obtain cell lysis at wavelengths above 1000 nm, with optimal wavelengths between 1250 nm and 1550 nm . Since water absorbs energy at those wavelengths, it is assumed that laser exposure results in an instantaneous increase of the cell temperature, which causes rupture of the cell membrane . Second, damage to protein solutions treated under optimized laser-lysis conditions was also studied . Using a pure solution of horseradish peroxidase as a model protein, no loss in enzyme activity was observed . Thus, it was concluded that damage to intracellular proteins is unlikely . Third, RNA release was tested using an E . coli specific RNA biosensor . Release of RNA was not detected from untreated cells, but laser-treated E . coli cells displayed significant RNA release due to laser-induced cell lysis . Finally, lysis of M . luteus, B . subtilis, B . cereus, and S . cerevisiae were investigated under optimized conditions . In all cases, laser-induced lysis of the cells was confirmed by determination of cell survival . Hence, laser-induced cell lysis is an efficient procedure that can be used for sample preparation, without damage to macromolecules, in bioanalytical detection systems for microorganisms . Miniaturized lasers and miniaturized cell-lysis chambers will create a simple, field-usable cell lysis system and allow the application of laser-induced cell lysis in micro Total Analysis Systems. Ann Hematol, 2002 Sep, 81(9), 529 - 31 Epub 2002 Aug 16. Candida arthritis in a patient with chronic myelogenous leukemia (CML) in blastic transformation, unresponsive to fluconazole, but treated effectively with liposomal amphotericin B; Turgut B et al.; Candida arthritis is quite rare and might be caused either by direct intra-articular inoculation of Candida or secondary to hematogeneous seeding of Candida in immunocompromised hosts . Until now less than 50 cases of Candida arthritis have been reported in the literature . We report a case of Candida arthritis, which occurred in a patient with chronic myelogenous leukemia (CML) in blastic transformation . Aggressive chemotherapy and broad-spectrum antibiotics for a prolonged period for febrile neutropenia had been given to the patient . Arthritis of the left knee appeared during the recovery phase of leukopenia . Despite treatment with fluconazole, no clinical or microbiological improvement was obtained . Thus, administration of liposomal amphotericin B was started and after 3 days there was improvement . We can conclude that fluconazole might not be sufficient in some Candida arthritis cases and liposomal amphotericin B might be a good alternative in these resistant cases. Int J Food Microbiol, 2002 Dec 15, 79(3), 175 - 81 Analysing collaborative trials for qualitative microbiological methods: accordance and concordance; Langton SD et al.; In qualitative (detection) food microbiology, the usual measures of repeatability and reproducibility are inapplicable . For such studies, we introduce two new measures: accordance for within laboratory agreement and concordance for between laboratory agreement, and discuss their properties . These measures are based on the probability of finding the same test results for identical test materials within and between laboratories, respectively . The concordance odds ratio is introduced to present their relationship . A method to test whether accordance differs from concordance is discussed. Clin Chest Med, 2002 Sep, 23(3), 603 - 12 Radiology of pulmonary Mycobacterium avium-intracellulare complex; Levin DL; Although the radiographic appearance of pulmonary MAC infection in the immunocompetent host can be varied, there are several generalizations that can be made . The classic radiographic appearance is indistinguishable from that of pulmonary tuberculosis . The classic form is seen most commonly in males and is typically associated with other predisposing diseases, especially chronic obstructive pulmonary disease . Most patients have upper lobe disease with associated pleural thickening . Widespread disease is common, as is cavitation . Pleural effusions and adenopathy are uncommon . The Lady Windermere syndrome is a special form of pulmonary MAC seen primarily in middle-aged and elderly women . The radiographic findings are bronchiectasis and small nodules, predominately located within the middle lobe and lingula . The combination of bronchiectasis involving exclusively, or primarily, the right middle lobe and lingula is highly suggestive of pulmonary MAC, even in the face of negative sputum cultures . Pulmonary infection with MAC in the immunocompromised patient generally reflects a widespread systemic disease . As such, the radiographic appearance is highly variable . Diffuse pulmonary opacities and adenopathy are common features . Plain radiographs are frequently normal despite active pulmonary infection . Regardless of the clinical situation, pulmonary MAC infection is often omitted from the radiographic differential even when the appearance is characteristic . In general, when pulmonary abnormalities are identified that are consistent with a granulomatous infection, pulmonary MAC needs to be considered along with tuberculosis and fungal infection . Especially with pulmonary MAC, radiographic stability over several years does not exclude active disease . The radiographic appearance may be suggestive of the diagnosis of pulmonary MAC, but correlation with the clinical and microbiological data is necessary to confirm the diagnosis. Curr Protein Pept Sci, 2002 Aug, 3(4), 467 - 84 Protein regulators of eicosanoid synthesis: role in inflammation; Homaidan FR et al.; A variety of factors contribute to the complex course of inflammation . Microbiological, immunological and toxic agents can initiate the inflammatory response by activating a variety of humoral and cellular mediators . In the early phase of inflammation, excessive amounts of cytokines and inflammatory mediators are released . These factors activate, in addition to other signaling pathways, the lipid synthesis pathways, which play a crucial role in the pathogenesis of organ dysfunction . Arachidonic acid (AA), the precursor of pro-inflammatory eicosanoids, is released from membrane phospholipids by the action of phospholipase A(2) (PLA(2)), and is metabolized to prostaglandins (PGs) and leukotrienes (LTs) by the action of cyclooxygenase (COX) and lipoxygenase (LO) enzymes, respectively . Disordered activation of PLA(2), LO and COX enzymes have been implicated in many inflammatory diseases . PLA(2) is activated by phospholipase-A(2)-activating protein (PLAP) and LO by 5-lipoxygenase-activating protein (FLAP) . The inducible form of COX-2 enzyme, which is usually not present under basal conditions, is induced in inflammation . In this article the function of these enzymes in eicosanoid synthesis, their regulation, and their implication in inflammatory disorders will be reviewed . The properties, function and regulation of the protein activators PLAP and FLAP will also be discussed. Med Pr, 2002, 53(3), 279 - 81 {Tularemia as a potential weapon of bioterrorists}; Mierzynska D et al.; This paper addresses the issue of using airborne tularemia as a potential biological weapon of terrorists . Because of its extreme infectivity, easy dissemination and substantial pathogenic ability, it may become a dangerous biological agent . An outbreak of acute febrile illness with pneumonia, pleuritis and hilar lymphadenitis in urban healthy populations, regardless of age and gender, should suggest an action of terrorism . The presumptive diagnosis should be based on epidemiological and clinical findings as the final microbiological confirmation may take several weeks . The treatment with aminoglicosides or alternatively doxycycline and ciprofloxacin administered parenterally is recommended . In a mass casualty situation, oral doxycycline and ciprofloxacin are the preferred drugs . Vaccination is recommended only in the laboratory personnel working routinely with Francisella tularensis . Isolation and special precautions are not necessary because the illness is not transmitted from one person to another. Bone Marrow Transplant, 2002 Oct, 30(7), 427 - 31 Continuous infusion of ceftazidime for patients with breast cancer and multiple myeloma receiving high-dose chemotherapy and peripheral blood stem cell transplantation; Egerer G et al.; This prospective study was performed to examine the safety and efficacy of a continuous infusion of ceftazidime in patients who developed febrile neutropenia after high-dose chemotherapy (HDCT) and autologous peripheral blood stem cell transplantation (PBSCT) and to determine if the underlying disease represents a risk factor for infectious complications . From September 1995 to May 2000, 55 patients with breast cancer (BC, group I, 54 females, one male) and 32 patients with multiple myeloma (MM, group II, 10 female, 22 male) were included in this study . The febrile patients received a 2 g intravenous bolus of ceftazidime, followed by a 4 g continuous infusion over 24 h using a portable infusion pump . If the fever persisted for 72 h a glycopeptide antibiotic was added . The median age was 42 years (range 22-59) in group I and 52 years (range 35-63) in group II . Thirty-five BC patients (64%) and 20 MM patients (63%) responded to the monotherapy with ceftazidime . After addition of a glycopeptide antibiotic, an additional 11 BC patients vs 10 MM patients became afebrile . The causes of fever in group I were fever of unknown origin (FUO) in 49 patients, microbiologically documented infection (MDI) in five patients, and clinically documented infection (CDI) in one patient . The causes of fever in group II were FUO in 22 patients, MDI in eight patients and CDI in two patients . Forty-one febrile episodes in BC patients (75%) and 22 episodes in the MM patients (69%) were successfully managed by out-patient treatment, resulting in a saving of an average of 20 days of inpatient care . Significantly more episodes of MDI and CDI occurred in patients with MM (P = 0.05) . The results indicate that BC and MM patients with febrile neutropenia after HDCT and PBSCT can be treated as outpatients with close monitoring to ensure safety . This approach represents a better use of health care resources. Microbiology, 2002 Oct, 148(Pt 10), 2929 - 36 An ex vivo culture model for screening drug activity against in vivo phenotypes of Mycobacterium tuberculosis; Turner DJ et al.; Since the activity of drugs against Mycobacterium tuberculosis grown in microbiological culture can differ from their activity against bacteria present in infected tissues, compounds with optimal activity against in vivo phenotypes may be overlooked in drug-discovery programmes that rely on in vitro screens . The authors have investigated the use of an ex vivo cell-culture model to assess the action of drugs on M . tuberculosis in an environment resembling that encountered during infection . Mycobacterial viability in the ex vivo model was shown to be regulated by the cell-mediated immune system, with growth inhibited by CD4(+) T cells at an early stage of infection in BCG-vaccinated mice, and at a later stage after infection in naive mice . Screening of drugs in the ex vivo model demonstrated a window of pyrazinamide susceptibility that coincides with the onset of the T-cell-mediated immune response in naive or vaccinated mice . It is proposed that pyrazinamide acts on a population of bacteria that are exposed to an acidic environment as a result of immune activation . Clinically, administration of pyrazinamide during the initial phase of treatment reduces the risk of relapse after 6 months, suggesting that the early pyrazinamide-susceptible population may contribute to the later pool of mycobacteria that persist during prolonged chemotherapy. Arh Hig Rada Toksikol, 2002 Jun, 53(2), 135 - 44 Commercial rodent feed as an occasional cause of morbidity and mortality in a rat breeding colony; Varnai VM et al.; In the last fifteen years there were several feed-related outbreaks of morbidity and mortality in the Institute's breeding colony of Wistar rats . The last event took place in April 1999, one month after the use of a new supply of the usual standard rodent feed . Animals did not thrive and manifested generalised oedema, hypoalbuminaemia, elevated liver enzymes, and high mortality . The effect of feed was assessed first by feeding a group of sick females during 14 days with either suspected feed (A-March) or with the earlier supply of feed (A-January) of the same producer . Then a group of healthy male rats Y59 from another breeding colony was fed either suspected feed (A-March) or feed from another producer (feed B) . Although neither chemical nor microbiological deviation in feed analysis had been detected, decreased consumption and slower body weight gain in all animals fed with feed A-March suggested an association between this batch of feed and the increased morbidity in those animals . Eventually, the entire rat colony was put down and replaced with a new breed which was given a new brand of feed. Rhinology, 2002 Sep, 40(3), 154 - 8 Experimental sinusitis in nasally catheterised rabbits; Cetin CB et al.; AIM: The aim of the study was to create an experimental rabbit model for investigating the effects of nasal catheterization on rhinosinus mucosa, bacterial flora and observing the development of bacterial sinusitis . METHODS: Healthy adult white rabbits of either sex and with body weights of 2.5-3 kg were used . Rabbits were randomly separated into two groups; the first group was catheterized by 12 French and the second group was catheterized by 8 French catheters blindly and the non-catheterized left sides were accepted as control . Three randomly chosen rabbits from each group were examined by computerized tomography scans (CT) and sacrified in the first, second and the fourth week of the study . Microbiological and histopathological examinations were performed . RESULTS: In both study groups after the first week of nasal catheterization, opacity or air-fluid level was detected in maxillary sinuses by CT scans, which was significant in group 1 . Inflammation spread by the prolongation of nasal catheterization and rapidly development of sinusitis was observed by thicker catheters' usage . CONCLUSION: In this study, the role of nasal catheterization as a predisposing factor in the development of sinusitis and the increase of sinusitis development risk in relation with the catheterization period and the catheters' thickness was shown. Cytometry, 2002 Oct 1, 49(2), 62 - 9 Assessment of Escherichia coli B with enhanced permeability to fluorochromes for flow cytometric assays of bacterial cell function; Herrera G et al.; BACKGROUND: Flow cytometry has become a choice methodology for microbiological research . However, functional cytometric assays in live bacteria are still limited . This is due, in part, to the cell wall impairing penetration of vital dyes in bacteria, thus imposing permeabilization procedures . These manipulations may affect cell physiology, provoke cell aggregation or lysis, and they are time-consuming . Escherichia coli B strains have been used for mutagenic assays because of an altered lipopolysaccharide that provokes increased membrane permeability . We assessed the use of these strains as possible alternatives for flow cytometric assays to avoid the permeabilization steps . METHODS: Suspensions of E . coli K-12 (strain AB1157) and E . coli B (strain WP2 uvrA/pKM101, denoted as strain IC188) were stained with several fluorochromes, including fluorescein isothiocyanate, propidium iodide, Nile Red, bis-(1,3-dibutylbarbituric acid) trimethine oxonol, hydroethidine, and dihydro-dichlorofluorescein diacetate, under basal conditions and following permeabilization, impairment of membrane potential, inhibition of dye efflux pump, and oxidative stress . Fluorescent staining of both strains was compared by epifluorescence microscopy and flow cytometry . RESULTS: The E . coli B strain IC188 exhibited more efficient staining with vital fluorochromes than the E . coli K-12 strain AB1157 and maintained a similar membrane potential . In addition, IC188 showed higher sensitivity than AB1157 to reveal oxidative stress when challenged with prooxidants . CONCLUSIONS: E . coli B strains may be useful for biochemical and toxicological studies based on flow cytometry and fluorescence microscopy . J Clin Periodontol, 2002 Jul, 29(7), 638 - 44 Comparison of microbial cultivation and a commercial PCR based method for detection of periodontopathogenic species in subgingival plaque samples; Eick S et al.; OBJECTIVES: Microbiological laboratory procedures are involved in diagnosis and therapy control of progressive and refractory forms of periodontitis . In recent years techniques have been developed based on the detection of nucleic acids . The purpose of this study was to validate the commercially available micro-Dent(R) test which employs probes for A . actinomycetemcomitans, P . gingivalis, P . intermedia, B . forsythus and T . denticola . METHODS: 122 plaque samples obtained from periodontal pockets with various depths from 33 early onset periodontitis (EOP) patients and 15 periodontally healthy subjects were analysed by cultivation and the microDent(R) kit . RESULTS: Both cultivation and the nucleic acid based assay showed a positive correlation of pocket depth with the frequency and quantity of periodontopathogenic species . T . denticola was found only in pockets > 4 mm in EOP patients . Comparison of the two methods revealed that the microDent(R) kit identified both P . gingivalis and B . forsythus more often than did the cultivation method . Conclusions: Nucleic acid techniques should replace cultivation methods as gold standard in microbiological diagnosis of progressive periodontitis . The micro-Dent(R) kit can be recommended for microbiological laboratories analysing subgingival plaque samples. Contracept Deliv Syst, 1984 Jan, 5(1), 29 - 45 Scanning electron microscopy of the IUD tail; Spornitz UM et al.; PIP: The surface ultrastructure of the tails of various IUDs (Multiload, Copper 7, Copper T-Device, Nova-T, FDI, Lippes Loop, and Dalkon Shield) was studied with the scanning electron microscope . The parts of the IUD tail exposed to the vaginal, cervical, and uterine milieu showed strikingly different surface characteristics . The surface ultrastructure of these 3 parts is influenced by the duration of use, nature of microbiological contaminants, pregnancy with the IUD in situ, and pelvic inflammatory disease (PID) . Duration of use and PID alter the surface ultrastructure most drastically . In comparing tails of the different IUDs, the IUDs with relatively smooth tails became less rapidly contaminated during the 1st few months of use . The surface ultrastructure of the IUD tail was formed through a coat of material which consists of cellular debris, dead bacteria, mucus, etc . The thickness of the coat was found to be largely dependent on the duration of IUD use . The thicker the coat, the more likely bacteria were found on the intrauterine part of the tail . The possible significance of these findings with respect to the development of PID is discussed . author's modified Eur J Pediatr, 2002 Oct, 161(10), 542 - 6 Epub 2002 Aug 15. Early events in atopy; Van Bever HP; The prevalence of allergic diseases, such as allergic asthma, allergic rhinitis and atopic dermatitis, has increased during the last decade . It is generally accepted that the increased prevalence of allergic diseases is due to a disturbed T-helper lymphocyte (T(h)) T(h1)-T(h2) balance, leading to more expression of T(h2) features . Decreased postnatal microbiological stimulation (i.e . improvements in public health, reduction in family size, increased usage of antibiotics) results in an increased possibility of ongoing postnatal T(h2) reactions . Furthermore, increased postnatal allergen exposure, especially to house dust mite, is known to facilitate the existence of T(h2) features . Therefore, identification of early markers of allergy such as increased total IgE in cord blood offers the possibility to initiate adequate primary prevention in subjects at risk . Primary prevention measures constitute merely of avoidance of early allergen contacts (foods and inhalants) and avoidance of pollution exposure (i.e . passive smoking) . At the moment, insufficient data are available concerning the preventive effect of medication on the development of allergic diseases . However, studies on the early use of cetirizine suggest that the occurrence of asthma can be prevented or delayed in young children suffering from atopic eczema . CONCLUSION: because identification of the atopic newborn is now possible, adequate early prevention can be instigated. Life Sci Space Res, 1979, 17, 99 - 103 Microbiological flora as a function of ice depth in central Antarctica; Abyzov SS et al.; A technique has been developed for obtaining ice samples under sterile conditions for microbiological analyses as a function of ice thicknesses and with a view to clarifying the possibility of long term microbial anabiosis under permafrost conditions . For the first time microbiological studies from the surface down to 312 meters in the Vostok station region have been carried out and the distribution of microorganisms in the strata studied has been clarified . Microorganisms occur rather rarely, and their distribution is of a random character, independent of the depth of sampling . Viable microorganisms have been found in the ice horizons approximately as old as 8-13 thousand years. Integration, 1998 Fall, (57), 10 - 2 Cure: myth or reality? Treatment; Harrington M; PIP: In this address to the 12th World AIDS Conference, Mark Harrington, an AIDS activist from the US presented his perspectives about the obstacles hindering efforts to cure AIDS . Harrington described the progress of his disease as revealed by a series of lymph node biopsies and reported that he successfully began highly active antiretroviral therapy (HAART) 11 years after he was infected . While he was grateful for his success, he expressed disgust that millions of people throughout the world do not have access to HAART . He asked whether those seeking a cure would be satisfied with a clinical or microbiological cure or would hold out for a complete genomic cure and noted that he was satisfied to live with a little provirus as long as his immune system can protect him from dying of AIDS . He then mentioned some of the additional approaches that researchers will take to try to increase the chances of a cure . Harrington expressed disagreement with researchers who urge infected individuals to go on therapy early, pointing out that periods of noncompliance could lead to drug resistance . He called for studies that would weigh the benefits and risks of early intervention and pointed out that a mistaken reliance on therapy has undermined prevention efforts . He also criticized cuts in funding for programs in developed countries and the lack of support offered by developed countries to AIDS programs in the developing countries hardest hit by the epidemic . He concluded by calling for a partnership of science and activism and for increased funding to combat HIV/AIDS . CVI Forum, 1993 Nov, (5), 7 - 8 Immunization in Mongolia: where are the people? Analysing attitude data through ridit schemes. PIP: The attitudes of individuals and populations on various issues are usually assessed through sample surveys . Responses to survey questions are then scaled and combined into a meaningful whole which defines the measured attitude . The applied scales may be of nominal, ordinal, interval, or ratio nature depending upon the degree of sophistication the researcher wants to introduce into the measurement . This paper discusses methods of analysis for categorical variables of the type used in attitude and human behavior research, and recommends adoption of ridit analysis, a technique which has been successfully applied to epidemiological, clinical investigation, laboratory, and microbiological data . The ridit methodology is described after reviewing some general attitude scaling methods and problems of analysis related to them . The ridit method is then applied to a recent study conducted to assess health care service quality in North Carolina . This technique is conceptually and computationally more simple than other conventional statistical methods, and is also distribution-free . Basic requirements and limitations on its use are indicated . Arch AIDS Res, 1992, 6(4), 221 - 46 HIV / STD interactions immunosuppression and future research development; Hafez ES et al.; PIP: Screening for HIV in China began in 1984, with the first AIDS case appearing in 1985 . 305,280 sera were tested as of 1992, of which 379 were seropositive for antibodies to HIV . Of these 379 individuals, there were 4 hemophiliacs identified in 1985, 1 homosexual male, 4 individuals returning from Africa, 365 drug addicts and 2 spouses . 68 foreigners and 1 Chinese hemophiliac from Hong Kong also tested seropositive . Concern is expressed over the psychosomatic trials of infected women who feel unable to discuss their HIV status with family members for fear of influencing their role as primary caregivers and sex partners . Without access to medical therapy and support groups, these women no doubt feel isolated . Non-directive counseling is recommended for seropositive women during pregnancy . AIDS patients have reduced natural killer cell cytotoxicity . Seminal plasma also suppresses several immune responses . The pathogenicity of HIV, however, has yet to be determined . Fatty acid metabolism and Beta-endorphin are discussed in the context of therapeutic approaches . HIV/STD interactions are finally considered with individual attention given to bacterial vaginosis, hepatitis B, Chlamydia trachomatis, Herpes Simplex virus, microbiological contaminants of the vagina bacterial vaginosis, syphilis, mycoplasmas/epididymitis, bacterial prostatitis, and IVF culture media infections . Arch AIDS Res, 1990, 4(1-2), 115 - 35 Prevention of sexual transmission of AIDS / STD by a spermicide containing benzalkonium chloride; Mendez F et al.; PIP: Spermicides widely used in contraception such as nonoxynol-9 (N-9) and benzalkonium chloride (BK) have a preventive effect on the sexual transmission of HIV and STDs . In vitro inactivation of HIV by BK was obtained within 10 minutes of contact at 0.025%-0.08% concentration . The most active of all those tested, N-9, inactivates at 0.05% after 30 minutes . A vaginal pharmaceutical form of BK at 1.2% inactivates at 0.012% (Pasteur Institute, 1987) . HIV survived inside latex condoms but no free HIV-1 survived exposure to the interior of condoms lubricated with BK at .83% (Wainberg, 1988) . In vivo studies were carried out which quantified the preventive power against STDs in a study of 903 cases of high risk women who used a pharmaceutical preparation of BK during a period of 3-6 months . The control group was comprised of high risk women not treated with the BK spermicide . Clinical, gynecological, microbiological, and serological tests were performed every 2 months . A 41.3% reduction (P0.001) in the number of STD cases was observed; however, a consistent use was unrealistic and some positive diagnoses could be related to individual sexual practices (oral, anal) not covered by an intravaginal locally active product . BK is an effective inactivator of HIV, and as such, is a valuable new arm against AIDS . It provides protection against STDs and is safe . author's modified Adv Contracept Deliv Syst, 1988, 4(2-3), 97 - 193 Conception control and HIV/STD infections; Arias E et al.; PIP: The basic clinical aspects of contraception, fertility regulation, family planning, and family health are described as they relate to parameters of human immunodeficiency virus (HIV), AIDS Related Complex (ARC), and sexually transmitted diseases (STD) in man . Special emphasis is placed on: the biology/pathology of HIV; microbiology/immunology of human semen; condoms/spermicides; IUDS and HIV infections; STDs; heterosexual/homosexual transmission of HIV; risk factors/cofactors and HIV; prevention of HIV; clinical manifestations and opportunistic infections; and the integration of family planning programs with STD/HIV services . Human semen contains a wide variety of cellular elements and microbiological contaminants . THe major leukocyte subpopulations in the semen include: granulocytes, monocytes/macrophages, B lymphocytes, helper and suppressor/cytotoxic T lymphocytes, and antibodies . HIV penetrates several types of cells: macrophages, antibody-producing B cells, endothelial cells of blood vessels, and non-neuronal brain cells . Sperm-specific moieties have a high potential of immunogenicity . Condoms have been recommended to HIV carriers, both to prevent sexual transmission of HIV to uninfected sexual partners and to avoid repeated contact with HIV which influences clinical outcome of AIDS . Fluctuations in sales of condoms are due to the removal of IUDs from the American market; homosexual fear of HIV infection; and the discontinuation of oral contraceptive use among older women . The FDA has authorized anti-AIDS benefits in advertising/labelling of condoms . With the use of IUDs, a local infection of susceptible cervical cells from infected semen precedes systemic spread of HIV . Multiple sex partners increase the risk of HIV/STD infections . Further complications may also involve immunopathological interactions among multiple viral infections . With copper IUDs there may be urticarial eruptions and eczematous dermatitis and such cases with exposure of subcutaneous areas of the skin are considered as cofactors for HIV infection . HIV-infected women should avoid pregnancy and be given the highest priority for family planning services . Clin Oral Investig, 2002 Sep, 6(3), 161 - 5 Epub 2002 Aug 16. Contamination level of alginate impressions arriving at a dental laboratory; Sofou A et al.; The contamination level of alginate impressions delivered to a large dental laboratory in Sweden was determined . One hundred and seven consecutive alginate impressions were included during 7 days . Samples were taken and transferred into sterile physiological saline and analysed microbiologically for colony-forming units (cfu) as well as nonhemolytic, alpha-hemolytic, and beta-hemolytic colonies . After sampling, the clinics were contacted and asked to fill in simple questionnaires about their routines of disinfecting impressions . The questionnaire study revealed that about half of the clinics had some kind of disinfection routine, while the others rinsed in running water only . Seventy-two percent of the impressions yielded growth of bacteria, with a median number of 1.3x10(2) cfu . Thirteen per cent of the samples yielded >10(3) cfu, with a maximum number of 3.4x10(4) cfu . The majority of isolates were non- and alpha-hemolytic bacteria . Growth was recorded in 61.3% of disinfected impressions, and the numbers of bacteria in disinfected and nondisinfected impressions were similar . These findings raise the question of whether impressions need to be disinfected or if proper handling and hygienic procedures are sufficient to block the possible route of infection. Nephrol Dial Transplant, 2002 Oct, 17(10), 1814 - 8 Ultrapure dialysis fluid slows loss of residual renal function in new dialysis patients; Schiffl H et al.; BACKGROUND: Residual renal function is beneficial for adequacy of haemodialysis, quality of life and mortality in dialysis patients . Our prospective randomised investigation aimed to analyse the effects of the microbiological quality of dialysis fluid on the course of residual renal function after initiation of haemodialysis . METHODS: Thirty patients starting haemodialysis were randomly assigned to ultrapure or conventional dialysate . During the 24-month study period, creatinine clearance, CRP and IL-6 levels, hydration status, number of hypotensive episodes and blood pressure recordings were assessed every 6 months . RESULTS: Residual renal function declined in both groups during the study period, although there were no statistically significant differences in demographic (age, gender), renal (cause of end-stage renal disease, residual renal function, hypertension, ACE inhibitors) and treatment characteristics (Kt/V urea) at recruitment . The use of mildly contaminated (up to 300 CFU/ml) dialysate resulted in higher CRP and IL-6 levels and more pronounced loss of residual renal function . Multiple regression analysis showed that the microbiological quality of the dialysate is an independent determinant of the loss of residual renal function . CONCLUSIONS: Ultrapure dialysis fluid combined with high-flux synthetic membranes are effective components of renal replacement therapy to slow the loss of residual renal function in haemodialysis patients . These improvements of haemodialysis are desirable, but add to treatment costs. Mikrobiologiia, 2002 Jul-Aug, 71(4), 545 - 9 {Microbiological and biochemical study of lignocompost during succession}; Volchatova IV et al.; The investigation of microbiological succession and changes in the enzymatic activity, temperature, pH, and phytotoxicity of lignin during its composting showed that the addition of a starter culture (a specially developed association of microorganisms) affects degradational succession in the compost pile . The process of composting can be monitored either microbiologically or biochemically, by measuring the activity of some enzymes . The compost is ready for use when the activity of oxidoreductases (particularly polyphenol oxidases) falls and the activity of invertase stabilizes at a certain level. Cad Saude Publica, 2002 Sep-Oct, 18(5), 1401 - 9 {Criteria for definition of environmental contamination indicators related to solid waste from health care facilities: a proposal for evaluation}; Silva AC et al.; The objective of this study was to identify target microorganisms as indicators of environmental contamination . The study evaluates the main environmental aspects and epidemiological chain related to such agents . Microorganisms were selected through key information about microbiological characterization of health care facilities' solid waste and evaluation of risk of infection from discarded sharps . The form of evaluation proposed for criteria adopted in the selection of contamination indicators included prior submission of a structured questionnaire to a network of specialists from the Federal District of Brazil . The specialists' multidisciplinary background, including professionals from the health field and an environmental microbiologist, helped define environmental contamination indicators by consensus . Pathogens such as Mycobacterium tuberculosis and hepatitis A and B viruses were specifically identified as capable of environmental survival or resistance. Chemosphere, 2002 Oct, 49(1), 85 - 90 Trace elements in organs and tissues of striped dolphins (Stenella coeruleoalba) from the Mediterranean sea (Southern Italy); Cardellicchio N et al.; The distribution of metals (Cd, Cu, Zn, Fe, Cr, Pb and Sn) were investigated in various tissues and organs obtained from striped dolphins (Stenella coeruleoalba) stranded along the Apulian coasts (Southern Italy) during April-July 1991 . Metals were determined by atomic absorption spectrophotometry . Metal concentrations were generally high in the liver, and low in brain and melon . Some metals showed organ-specific accumulations: copper, tin and zinc exhibited high concentrations in liver, the highest cadmium concentration was observed in kidney . Pathological, microbiological and parasitological surveys were performed on the animals . It was not possible to relate dolphin death to a specific cause, or to contaminants; however, the accumulation of metals may contribute to certain pathological alterations. Lancet, 2002 Aug 24, 360(9333), 619 - 20 Assessment of lungs rejected for transplantation and implications for donor selection; Ware LB et al.; Present criteria for donor-lung selection exclude more than 85% of lungs . We aimed to establish if potentially suitable lungs are rejected for transplantation . We obtained 29 pairs of rejected lungs and assessed them by physiological, microbiological, and histological methods . Most donor lungs had no or mild pulmonary oedema (24/29 {83%}), intact alveolar fluid clearance (17/23 {74%}), and normal or mildly abnormal histological findings (18/29 {62%}) . When all factors were considered, including microbiological and non-lung donor factors, 12 (41%) of 29 pairs of rejected lungs would have been potentially suitable for transplantation . Our findings emphasise the urgent need for prospective scientific assessment of selection of donors for lung transplantation. Lancet, 2002 Aug 17, 360(9332), 528 - 34 Rifapentine and isoniazid once a week versus rifampicin and isoniazid twice a week for treatment of drug-susceptible pulmonary tuberculosis in HIV-negative patients: a randomised clinical trial; Benator D et al.; BACKGROUND: Rifapentine has a long half-life in serum, which suggests a possible treatment once a week for tuberculosis . We aimed to compare rifapentine and isoniazid once a week with rifampicin and isoniazid twice a week . METHODS: We did a randomised, multicentre, open-label trial in the USA and Canada of HIV-negative people with drug-susceptible pulmonary tuberculosis who had completed 2 months of a 6-month treatment regimen . We randomly allocated patients directly observed treatment with either 600 mg rifapentine plus 900 mg isoniazid once a week or 600 mg rifampicin plus 900 mg isoniazid twice a week . Primary outcome was failure/relapse . Analysis was by intention to treat . FINDINGS: 1004 patients were enrolled (502 per treatment group) . 928 successfully completed treatment, and 803 completed the 2-year 4-month study . Crude rates of failure/relapse were 46/502 (9.2%) in those on rifapentine once a week, and 28/502 (5.6%) in those given rifampicin twice a week (relative risk 1.64, 95% CI 1.04-2.58, p=0.04) . By proportional hazards regression, five characteristics were independently associated with increased risk of failure/relapse: sputum culture positive at 2 months (hazard ratio 2.8, 95% CI 1.7-4.6); cavitation on chest radiography (3.0, 1.6-5.9); being underweight (3.0, 1.8-4.9); bilateral pulmonary involvement (1.8, 1.0-3.1); and being a non-Hispanic white person (1.8, 1.1-3.0) . Adjustment for imbalances in 2-month culture and cavitation diminished the association of treatment group with outcome (1.34; 0.83-2.18; p=0.23) . Of participants without cavitation, rates of failure/relapse were 6/210 (2.9%) in the once a week group and 6/241 (2.5%) in the twice a week group (relative risk 1.15; 95% CI 0.38-3.50; p=0.81) . Rates of adverse events and death were similar in the two treatment groups . INTERPRETATION: Rifapentine once a week is safe and effective for treatment of pulmonary tuberculosis in HIV-negative people without cavitation on chest radiography . Clinical, radiographic, and microbiological data help to identify patients with tuberculosis who are at increased risk of failure or relapse when treated with either regimen. Z Naturforsch {C}, 2002 Jul-Aug, 57(7-8), 654 - 9 Microbial transformation of a beta- and gamma-eudesmols mixture; Maatooq GT; Beta- and gamma-eudesmols mixture was microbiologically transformed by Gibberella suabinetti ATCC 20193 . Seven different eudesmanoidal metabolites (3-9) were isolated and their structures were elucidated by the different spectroscopic techniques . These metabolites are: eudesma-4-en-11-ol-3-one (carissone), eudesma-3-en-2beta, 11-diol, eudesma-4-en-3beta,11-diol, eudesma-4(15)-en-8,11-diol, eudesma-4(15)-en-2a,11-diol (pterocarpol), 1(3)cyclo-eudesma-4(15)-en-11,12-diol and eudesma-4-en-11,15-diol. Dtsch Med Wochenschr, 2002 Sep 20, 127(38), 1947 - 50 {Osteomyelitis of the tibial head caused by Mycobacterium haemophilium in a patient with AIDS}; Gruschke A et al.; HISTORY AND ADMISSION FINDINGS: A 53-year-old man with known HIV infection and AIDS was admitted because of painful swelling at the right knee for 6 weeks . The cause was thought to be osteomyelitis and surgical treatment was planned . INVESTIGATIONS: No causative pathogen was found at curettage and lavage of an abscess at the right medical head of the tibia, but at a subsequent operative revision acid-fast rods were seen and identified as Mycobacterium haemophilum . TREATMENT AND COURSE: A systemic antibiotic, 1 g levofloxacin daily, had been started at the initial abscess operation . 2 weeks later, because swelling of the right knee had recurred with marked local and systemic signs of infection, a second surgical intervention was performed . Afterwards, in view of the histological finding of acid-fast bacteria suggesting tubercular osteomyelitis, the patient was put on combined treatment with 300 mg/d of isoniazid, 1600 mg/d of ethambutol, 2 g/d of pyrazinamide, and 1 g of streptomycin i.m . every other day . After molecular microbiological identification of M . haemophilum the antibiotic treatment was changed to 1600 mg/d of ethambutol, 300 mg/d of rifabutin and 1 g/d of clarithromycin . The operation wound healed well . CONCLUSION: M . haemophilum infection can be lethal in immunodeficient patients if untreated . Although there is no standard treatment, this rare infectious disease responds relatively well to a modified combined tuberculostatic regimen . Special laboratory techniques to identify the specific causative pathogen are therefore of great importance. Rev Clin Esp, 2002 Sep, 202(9), 476 - 84 {Nosocomial bacteremia in the adult patient . Study of associated costs}; Morano Amado LE et al.; OBJECTIVE: Nosocomial infection causes a prolonged hospital stay and an increase in care costs . The objective of this study was to determine the length of stay excess and costs attributable to nosocomial bacteremia . PATIENTS AND METHODS: Retrospective study of clinical records of 148 patients with nosocomial bacteremia during 1996 . A matched case-control study was performed . For matching, the following parameters were used: RDG, year of admission, age 10 years, main diagnosis and number of secondary diagnoses . Costs were determined by excess length of hospital stay and calculating alternative costs . RESULTS: Matching was obtained for 100 cases (67.5%) and cost estimation was performed . Compared with cases, non-matched cases showed differences regarding significant issues for cost, such as hospital stay ( p = 0.01), number of empirical (p = 0.001) or definitive antibiotics (p = 0.03) . The median hospital stay for cases was longer than for controls (35 vs 15.5 days, respectively; p = 0.000) . When only survivor case-control pairs were considered (n = 75), cases remained in hospital for a median of 36 vs 15 days for controls (p = 0.000) . Hospital stay days attributable to nosocomial bacteremia were 19.5 for all matched and 21 for matched survivor cases . Only 76% of cases had stay days attributable to bacteremia . Significant differences between cases and controls included: the mean total costs of admission (p = 0.000), cost of stay (p = 0.001), pharmaceutical expenses (p = 0.000), and cost of microbiological studies (p = 0.000), laboratory work-up (p = 0.001) and radiological studies (p = 0.000) . Hospital stay represented more than 60% of costs, followed by pharmaceutical expenses . Cost differences between bacteremic patients and controls, calculated in function of stay median, was 4.424 euros (p = 0.000) and 4.744 euros (p = 0.000) for alternative costs . Ten cases showed a difference that represented more than half of the total difference . CONCLUSIONS: Nosocomial bacteremia represent a stay prolongation and a significant economical burden . Hospital stay and pharmaceutical expenses accounted for the most part of the associated costs . The differences in costs obtained with both methods were small . Since not all selected cases were matched, there may be an error in the appreciation of the difference between cases and controls. Rocz Panstw Zakl Hig, 2002, 53(2), 141 - 7 {Evaluation of qualitative properties of amaranth (Amaranthus)}; Gajewska R et al.; The work contains results of determination of protein, fat, carbohydrates, water, ash, energy value, B group vitamins (B1, B2, PP, B6) and minerals (Ca, P, Mg, Fe, Na, K, Cu, Mn, Zn, Co, Ni, Cr, Cd, Pb) in three products of amaranth . The nutrients components were determined by general approved analytical methods . Vitamins group B were determined using microbiological methods . Minerals like Ca, Mg, Fe, Na, K, Cu, Mn, Zn, Co, Ni, Cr, Cd and Pb were determined using the flame AAS method . Phosphorus was determined spectrophotometrically as phosphates with ammonium molybdate . Mean percentage content of protein, fat, caborhydrates, water and ash in products of amaranth examined (seeds, meal, expanded seeds "popping") were: 13.5-14.4; 7.1-7.6; 63.8-71.7; 3.0-12.3; 3.1-3.4 respectively; there energy value expressed in Kcal/100 g were 373-412 . Vitamins content in products of amaranth (mg/100 g) were: 0.019-0.029 thiamin; 0.100-0.143 riboflavin; 1.02-1.20 niacinamide and 0.563-0.615 pyridoxin . The levels (mg/100 g) of minerals were as follow: 204-223 Ca; 712-792 P; 8.3-9.7 Fe; 200-235 Mg; 2.9-3.1 Zn; 1.03-1.38 Cu; 3.78-4.54 Mn; 6.30-8.42 Na; 318-337 K; 0.040-0.055 Cr; 0.185-0.292 Ni and 0.045-0.051 Co . Mean contents of cadmium ranged 5-9 micrograms/100 g and lead 27-35 micrograms/100 g in examined products of amaranth. Kidney Int, 2002 Oct, 62(4), 1447 - 53 Heat sterilization of peritoneal dialysis solutions influences ingestive behavior in non-uremic rats; Zheng ZH et al.; BACKGROUND: The appetite inhibitory effect of glucose-based peritoneal dialysis (PD) solutions may be due to glucose as such, or the hyperosmolality of the PD solution, or an effect of glucose degradation products (GDPs) formed in the PD solution during heat sterilization . This was studied in an experimental appetite model in rat . METHODS: The effect of different experimental PD solutions on ingestive behavior was investigated in non-uremic rats equipped with an implanted intraoral (i.o.) cannula through which a 1 mol/L sucrose solution was infused during tests . The amount of intake was recorded at 30 min after rats were infused intraperitoneally (IP) with 30 mL of different solutions . This method allowed an accurate and reproducible analysis of i.o . intake . The experimental PD solutions tested included (1) glucose based PD solutions with different glucose concentrations, sterilized by heat or microbiological filter, (2) glucose- and mannitol-based PD solutions with the same osmolality, sterilized by heat or microbiological filter; and (3) glucose based PD solutions, using different pH values (pH 3.0, pH 5.5 or pH 7.4) during heat sterilization . RESULTS: Following IP infusion of solutions, (1) the i.o . intake was significantly inhibited by glucose based, heat sterilized PD solutions and the degree of appetite suppression was related to the concentration of dialysate glucose in a dose-dependent way; (2) the i.o . intake was significantly less suppressed by filter sterilized than by heat sterilized glucose-based solutions; (3) the i.o . intake was significantly less following the IP infusion of glucose-based than following the mannitol-based heat sterilized solutions; however, i.o . intake did not differ between the glucose-based and mannitol-based filter sterilized solutions; and (4) furthermore, the degree of suppression of i.o . intake induced by glucose-based PD solutions was influenced by the pH value during heat sterilization . The lower the pH of the PD solution during heat sterilization, the higher the i.o . intake . CONCLUSIONS: The IP infusion of glucose-based heat-sterilized PD solutions inhibited food intake in this experimental appetite model, and the degree of suppression depended on the concentration of dialysate glucose and the pH of the solution during heat sterilization . The results suggest that GDPs formed during heat sterilization may exert a more adverse effect than glucose itself on ingestive behavior, and that a reduction of the concentration of GDPs in the PD solution using filter sterilization or a low pH value in the PD solution during heat sterilization may improve food intake. Int J Tuberc Lung Dis, 2002 Sep, 6(9), 831 - 8 An outbreak of Legionnaires' disease in an inner city district: importance of the first 24 hours in the investigation; Jansa JM et al.; OBJECTIVE: To present the main results of the investigation of an outbreak of Legionnaire's disease that occurred in an inner city district of Barcelona between 15 October and 15 November 2000 . METHODS: Epidemiological surveys of patients and environmental investigations were initiated on the day the first five cases were notified . Water samples and smears from cooling tower trays were taken for microbiological analysis . Maps of the distribution of cases and possible contamination foci were elaborated . Incidences were calculated for each census tract . RESULTS: A total of 54 patients related to the outbreak were identified, with a case fatality rate of 5.5% . Incidence rate in the area closest to the cooling tower (6.40/1000) was significantly higher than that of the rest of the neighbourhood (2.23/1.000, RR 2.87, 95%CI 1.37-6.12, P = 0.0035) . Cultures positive for Legionella pneumophila serogroup 1, subtypes Pontiac, Philadelphia or Allentown, were obtained from eight patients . On the 39th day of the investigation it was found that the strain isolated in one of the cooling towers coincided with the serogroup, subtype and molecular profiles identified in clinical samples . CONCLUSIONS: Rapid coordination of clinicians, microbiologists, epidemiologists and environmentalists permitted the source of infection and the affected cases to be correlated within a few days. Int J Tuberc Lung Dis, 2002 Sep, 6(9), 806 - 13 Tuberculosis in children dying with HIV-related lung disease: clinical-pathological correlations; Rennert WP et al.; SETTING: Chris Hani Baragwanath Hospital, Soweto, South Africa . OBJECTIVES: To compare post mortem histological, microbiological and biochemical findings with clinical and radiological data generated ante mortem in children infected with HIV dying from clinical lung disease . METHODS: Post mortem lung and liver biopsies were undertaken on 93 consecutive deaths in children with HIV . Specimens were processed for culture, histology and staining for M . tuberculosis, Pneumocystis carinii pneumonia (PCP) and cytomegalovirus (CMV) . Post mortem diagnoses were compared with clinical and radiological data generated during the final hospitalisation . RESULTS: Tuberculosis (TB) was diagnosed post mortem in four (4.3%) cases; a further 17 (18.2%) patients had been treated empirically for TB before death, and the remaining 72 (77.5%) patients had not been treated for TB . TB was more prevalent in children aged 1 year or older (13.4%) than in younger patients (1.4%) (P < 0.025) . Patients with PCP, CMV pneumonitis or lymphocytic interstitial pneumonitis (LIP) had the same clinical presentation or radiographic appearances as patients with TB . The only features distinguishing patients with TB were older age and ante mortem gastric aspirate cultures positive for M . tuberculosis . CONCLUSION: The diagnosis of TB in children infected with HIV remains difficult . Clinical and radiographic features are shared with other opportunistic diseases . Case identification strategies relying on clinical and radiographic findings lead to overtreatment, particularly in children younger than 1 year of age . Gastric aspirate cultures remain a reliable tool for the identification of infected patients. J Food Prot, 2002 Sep, 65(9), 1447 - 51 Rapid and simple estimation of microbiological quality of raw milk using chromogenic Limulus amoebocyte lysate endpoint assay; Rhee MS et al.; A rapid chromogenic Limulus amoebocyte lysate (LAL) endpoint assay for the enumeration of total mesophilic microbial loads and coliforms was investigated as a means to assess the microbiological quality of raw milk . For experiment 1, raw milk samples (n = 25) were stored in a refrigerator (2 +/- 2 degrees C) and then analyzed at regular intervals (1, 5, 10, and 15 days) . For experiment 2, fresh raw milk samples (n = 50) were tested to determine the utility of the LAL assay for fresh raw milk . The sample was diluted threefold in a 96-well microtiter plate with pyrogen-free water and assayed with a chromogenic LAL kit to find a final reaction point . The LAL results were compared with standard plate counts (SPC) and coliform counts determined by conventional plating methods . The results of the LAL assay were strongly correlated to conventional SPC (r2 = 0.93; n = 100) and were highly correlated to coliforms (r2 = 0.74; n = 100) . A highly significant linear relationship (r2 = 0.82; n = 50) was also observed between the predicted SPC based on the LAL value and the actual SPC . The results of LAL testing were classified into one of seven contamination groups . The data set for SPC was effectively differentiated using the LAL technique (P < 0.01) . The chromogenic LAL assay was found to be a rapid (within 16 min) and simple (not requiring specific instruments) method for monitoring microbial levels in raw milk . This method may be successfully implemented to rapidly determine highly microbial contaminated raw milk (> 3.0 log10 CFU/ml of SPC). Probl Tuberk, 2002, (6), 33 - 7 {Migration of CD4+ and CD8+ lymphocytes into the internal lining of tuberculous pleural empyema and tuberculous caverns during their local sanitation}; Trusov VN et al.; Cytological, immunological, and microbiological findings after sanitation of pulmonary caverns and pleural empyemas were analyzed in 13 patients: 7 with empyemas of residual pleural cavities after surgery for pulmonary tuberculosis and 6 with fibrocavernous pulmonary tuberculosis . It has been found that target sanitation of the intrapulmonary and intrapleural cavities enhances lymphocytic penetration into the internal part of the cavitary wall, infiltrating lymphocytes represent mainly CD4+ cells whose count progressively increases with successful sanitation, as appeared as a significant rise in both the so-called immunoregulatory index (CD4+/CD8+ ratios of 3.4 to 6.1) . A study of the populational composition of lymphocytes promotes an objective evaluation of the magnitude of a specific tuberculous inflammatory process in the wall of the cavity of empyemas and caverns. Anesteziol Reanimatol, 2002 Mar-Apr, (2), 23 - 5 {Possibilities of fiber bronchoscopy in complex diagnosis and treatment of inhalation injuries of the tracheobronchial tree}; Volkov SV et al.; The treatment of patients with burn injuries of the tracheobronchial tree is a pressing problem today, because of rather high prevalence of this injury and high mortality (90%) . Clinical signs during the first 24 h do not allow evaluating the severity of the injury . Based on analysis of case histories of 24 patients, the authors sum up results of complex examinations including fibrobronchoscopy, microbiological, and histological studies . Fibrobronchoscopy precisely showed the degree and extension of airway involvement in burn injuries, while accessory microbiological and histological studies help timely predict the development of pyoseptic complications . Endoscopic methods of therapy promote a more rapid reduction of inflammation and healing of erosive ulcerative involvement of the tracheobronchial mucosa. J Environ Health, 2002 Sep, 65(2), 29 - 36 Where we are in retail food safety, how we got to where we are, and how do we get there? Bryan FL. Food safety has not yet been attained . This is evident from reported foodborne-disease outbreaks, laboratory-confirmed cases of diseases that can be foodborne, estimates of foodborne illness based on surveillance data, and out-of-compliance risk factors . Several activities have had an impact on food safety, but there are limitations in the way each of those activities has been or is being conducted . The activities include foodborne-disease surveillance; food sampling and testing; swabbing and testing of utensils; inspection and enforcement of regulations; use of the Food Code; on-site hazard analyses, on-site monitoring of critical control points and prompt corrective actions; applied research and challenge testing; training of public-health and food regulatory personnel; training of food workers, supervisors, and managers; and education of the public . To attain food safety, we must use common (microbiological) sense and understand the principles of transmission of foodborne-disease etiological agents and their control . A change of attitudes and program focus is necessary. Trop Med Int Health, 2002 Sep, 7(9), 788 - 92 Epidemiological aspects of mycetoma from a retrospective study of 264 cases in West Bengal; Maiti PK et al.; Between 1981 and 2000, 264 cases of mycetoma were diagnosed clinically and microbiologically at Calcutta School of Tropical Medicine . Retrospective analysis of the records revealed that the ratio of actinomycetomas and eumycetomas was 197 : 67; the male to female ratio was 183 : 81 . Ninety-four cases occurred in the 1980s and 170 in 1990s, with significantly more infections of Actinomadura spp . (P < 0.01) and fewer with Nocardia caviae (P < 0.01) during the last decade . Pricking was the most common injury associated with eumycetomas (P < 0.01) . A total of 196 infections were in exposed body parts and 68 in covered areas . The localization of mycetomas differed significantly (P < 0.01) according to sex, incidence of actinomycetomas or eumycetomas, and obvious history of trauma . Exposed area cases were more common among agricultural workers (P < 0.01), while covered area mycetomas were almost always actinomycetomas with a remarkably lower incidence of N . caviae, A . madurae and Madurella grisea infections . The peak age of onset was between 16 and 25 years . The delay of diagnosis for the 80th percentile of cases was around 6 years for cases caused by N . brasiliensis and Streptomyces spp.; 8 years for N . caviae and N . asteroides; and 10 years for M . grisea and Actinomadura spp . From the history of trauma in 130 patients, the 80th percentile incubation period (IP) was calculated for N . brasiliensis, N . caviae and N . asteroides as 3 years; for Actinomadura spp . 7 years and for M . grisea 9 years . The minimum IP for all organisms was around 3 months. Nahrung, 2002 Aug, 46(4), 258 - 69 Controlling organic chemical hazards in food manufacturing: a hazard analysis critical control points (HACCP) approach; Ropkins K et al.; Hazard analysis by critical control points (HACCP) is a systematic approach to the identification, assessment and control of hazards . Effective HACCP requires the consideration of all hazards, i.e., chemical, microbiological and physical . However, to-date most 'in-place' HACCP procedures have tended to focus on the control of microbiological and physical food hazards . In general, the chemical component of HACCP procedures is either ignored or limited to applied chemicals, e.g., food additives and pesticides . In this paper we discuss the application of HACCP to a broader range of chemical hazards, using organic chemical contaminants as examples, and the problems that are likely to arise in the food manufacturing sector . Chemical HACCP procedures are likely to result in many of the advantages previously identified for microbiological HACCP procedures: more effective, efficient and economical than conventional end-point-testing methods . However, the high costs of analytical monitoring of chemical contaminants and a limited understanding of formulation and process optimisation as means of controlling chemical contamination of foods are likely to prevent chemical HACCP becoming as effective as microbiological HACCP. J Fr Ophtalmol, 2002 Jun, 25(6), 590 - 3 {Fungal contamination detection in cornea preservation media}; Rousset A et al.; PURPOSE: Fungi can cause major complications following corneal grafting . In this study we aimed to verify the efficiency of a fungal contamination detection protocol for human corneas in preservation before clinical use . Materials and methods: The 12 most frequently found species of fungi responsible for keratitis and endophthalmitis were inoculated to preservation medium used by most French eye banks . A protocol used by several centers, including a daily visual control, was followed in order to check that it showed the presence of all microorganisms, particularly slow-growing filamentous fungi . RESULTS: Every species was detected in a time from 2 to 4 days . CONCLUSION: This microbiological contamination detection protocol of detection for human corneas in organ culture at +31 degrees C, seems to effectively detect the main agents responsible for fungal contamination. Plant Physiol, 1997 Sep, 115(1), 299 - 309 Distribution of Folate Derivatives and Enzymes for Synthesis of 10-Formyltetrahydrofolate in Cytosolic and Mitochondrial Fractions of Pea Leaves; Chen L et al.; Leaf extracts of 14-d-old pea (Pisum sativum L . cv Homesteader) seedlings were examined for folate derivatives and for 10-formyltetrahydrofolate synthetase (SYN), 5,10-methenyltetrahydrofolate cyclohydrolase (CYC), and 5,10-methylenetetrahydrofolate dehydrogenase (DHY) activities . Microbiological and enzyme assays showed that leaf folates SYN, CYC, and DHY were predominantly cytosolic . Extracts of Percoll gradient-purified mitochondria contained less than 1% of total leaf folate and less that 1% of each enzyme activity . Fractionation of whole-leaf homogenates resulted in the copurification of DHY and CYC (subunit 38 kD) and the isolation of a SYN protein (subunit 66 kD) . Polyclonal antibodies were raised against purified cytosolic DHY-CYC (DHY-CYC-Ab) and cytosolic SYN (SYN-Ab), respectively . Immunoblots showed that DHY-CYC-Ab cross-reacted with a mitochondrial protein band (38 kD) . Two mitochondrial protein bands (subunit Mr = 40,000 and 44,000) cross-reacted with SYN-Ab . Immunoaffinity chromatography (DHY-CYC-Ab as the immobile ligand) indicated that the bulk of mitochondrial SYN activity was not associated with mitochondrial DHY or CYC . When 9-d-old etiolated pea seedlings were exposed to light for up to 3 d, the specific enzyme activities of DHY-CYC in whole-leaf extracts rose 2-fold and more DHY-CYC-Ab cross-reacting protein was detected . In contrast, the specific activity of SYN fell from 5 to 1 {mu}mol min-1 mg-1 protein and less SYN-Ab cross-reacting protein was detected . The data suggest that in pea leaves, the bulk of one-carbon-substituted tetrahydrofolates and enzymes for the generation of 10-formyltetrahydrofolate are extra-mitochondrial. J Am Med Inform Assoc, 2002 Sep-Oct, 9(5), 500 - 8 Basic microbiologic and infection control information to reduce the potential transmission of pathogens to patients via computer hardware; Neely AN et al.; Computer technology from the management of individual patient medical records to the tracking of epidemiologic trends has become an essential part of all aspects of modern medicine . Consequently, computers, including bedside components, point-of-care testing equipment, and handheld computer devices, are increasingly present in patients' rooms . Recent articles have indicated that computer hardware, just as other medical equipment, may act as a reservoir for microorganisms and contribute to the transfer of pathogens to patients . This article presents basic microbiological concepts relative to infection, reviews the present literature concerning possible links between computer contamination and nosocomial colonizations and infections, discusses basic principles for the control of contamination, and provides guidelines for reducing the risk of transfer of microorganisms to susceptible patient populations. Biodegradation, 2002, 13(1), 41 - 52 Assessment of soil contamination--a functional perspective; van Straalen NM; In many industrialized countries the use of land is impeded by soil pollution from a variety of sources . Decisions on clean-up, management or set-aside of contaminated land are based on various considerations, including human health risks, but ecological arguments do not have a strong position in such assessments . This paper analyses why this should be so, and what ecotoxicology and theoretical ecology can improve on the situation . It seems that soil assessment suffers from a fundamental weakness, which relates to the absence of a commonly accepted framework that may act as a reference . Soil contamination can be assessed both from a functional perspective and a structural perspective . The relationship between structure and function in ecosystems is a fundamental question of ecology which receives a lot of attention in recent literature, however, a general concept that may guide ecotoxicological assessments has not yet arisen . On the experimental side, a good deal of progress has been made in the development and standardized use of terrestrial model ecosystems (TME) . In such systems, usually consisting of intact soil columns incubated in the laboratory under conditions allowing plant growth and drainage of water, a compromise is sought between field relevance and experimental manageability . A great variety of measurements can be made on such systems, including microbiological processes and activities, but also activities of the decomposer soil fauna . I propose that these TMEs can be useful instruments in ecological soil quality assessments . In addition a "bioinformatics approach" to the analysis of data obtained in TME experiments is proposed . Soil function should be considered as a multidimensional concept and the various measurements can be considered as indicators, whose combined values define the "normal operating range" of the system . Deviations from the normal operating range indicate that the system is in a condition of stress . It is hoped that more work along this line will improve the prospects for ecological arguments in soil quality assessment. Int J Food Microbiol, 2002 Sep 15, 78(1-2), 57 - 77 Physiological and mathematical aspects in setting criteria for decontamination of foods by physical means; Smelt JP et al.; In heat processing, microbial inactivation is traditionally described as log-linear . As a general rule, the relation between rate of inactivation and temperature is also described as a log-linear relation . The model is also sometimes applied in pressure and in pulsed electric field (PEF) processing . The model has proven its value by the excellent safety record of the last 80 years, but there are many deviations from log-linearity . This could lead to either over-processing or under-processing resulting in safety problems or, more likely, spoilage problems . As there is a need for minimal processing, accurate information of the inactivation kinetics is badly needed . To predict inactivation more precisely, models have been developed that can cope with deviations of linearity . As extremely low probabilities of survival must be predicted, extrapolation is almost always necessary . However, extrapolation is hardly possible without knowledge of the nature of nonlinearity . Therefore, knowledge of the physiology of inactivation is necessary . This paper discusses the physiology of denaturation by heat, high pressure and pulse electric field . After discussi