Gig Sanit, 2001 Jul-Aug, (4), 19 - 21 {Effects of phenoxy carboxylic acid herbicides on plant photosynthetic and soil microbiological activities}; Saniagina NA et al.; Lontrele and cowboy were tested for effects on the photosynthetic activity of amaranthus and the microbiological activity of leached chernozem . The tested herbicides were shown to be beneficial for different changes occurring in the levels of total chlorophyll in the amaranthus leaves and for the leached chernozem to evolve carbon dioxide in different phases of amaranthus growth. J Clin Microbiol, 2001 Sep, 39(9), 3080 - 4 Experimental paratuberculosis in calves following inoculation with a rabbit isolate of Mycobacterium avium subsp . paratuberculosis; Beard PM et al.; The role of wildlife species in the epidemiology of paratuberculosis has been the subject of increased research efforts following the discovery of natural paratuberculosis in free-living rabbits from farms in east Scotland . This paper describes the experimental inoculation of young calves with an isolate of Mycobacterium avium subsp . paratuberculosis recovered from a free-living rabbit . After a 6-month incubation period, all eight calves inoculated with the rabbit isolate had developed histopathological and/or microbiological evidence of M . avium subsp . paratuberculosis infection . Similar results were obtained from a group of calves infected with a bovine isolate of M . avium subsp . paratuberculosis . The virulence of the rabbit isolate for calves demonstrated in this study suggests that rabbits are capable of passing paratuberculosis to domestic ruminants and that wildlife reservoirs of M . avium subsp . paratuberculosis should therefore be considered when formulating control plans for the disease. Commun Dis Public Health, 2001 Jun, 4(2), 141 - 3 Capture recapture as a method of determining the completeness of tuberculosis notifications; Tocque K et al.; Notification of tuberculosis cases is often incomplete but combining data from several sources can provide a more accurate estimate of the number of cases . Data for the city of Liverpool were collected over an eight-year period from three sources: notifications, microbiological records and in-patient discharge coding data . Capture-recapture (CR) techniques were used to estimate the total number (including unreported cases) of tuberculosis cases in the city . By creating a log-linear model from the pattern of case replication between data sets, a model of best fit was created from which the number of cases present in the population, but not identified in any of the data sets, was estimated . False positive diagnoses were found in 67/516 (13%) of notifications and in 65/241 (27%) of in-patient codings . After excluding these, the total combined number of cases from all data sources was 473 . CR methods identified only twelve extra cases (2.5%) making the estimated number of true cases total 485 . Of these, in-patient codings identified 36.3%, microbiological records 56.3% and notifications 92.6% . It was concluded that notification of tuberculosis is very complete in Liverpool . Capture-recapture methods can be used to assess completeness of notification data in other settings. Compend Contin Educ Dent Suppl, 1996, 17(19), S39 - 44 A microbiological and clinical study of the safety and efficacy of baking-soda dentifrices; Zambon JJ et al.; This article reports the results of a study that examined the clinical and microbiological changes associated with regular use of baking-soda dentifrices . Two dentifrice formulations were examined in a 6-month longitudinal study of 101 adult subjects with assessments for plaque, gingival inflammation, and stain at baseline and 3 and 6 months during the active phase of the study, and at 3 months after cessation of product use . One dentifrice contained 52% baking soda and 3% sodium percarbonate (Arm & Hammer PeroxiCare) while the other dentifrice contained 65% baking soda (Arm & Hammer Dental Care) . Both dentifrices resulted in statistically significant reductions in dental plaque, gingival inflammation, and stain at all time periods compared to baseline . Dental plaque and buccal soft-tissue samples were obtained for microbiological analysis from a 50-subject subset . Microbiological assays, including bacterial culture, phase-contrast microscopy, and immunofluorescence microscopy, confirmed the safety of both formulations . Beneficial alterations in dental plaque bacteria were noted, including significant reductions in the levels of Actinomyces species . The data from this study indicate that dentifrices containing high levels of baking soda are clinically effective and microbiologically safe. J Contam Hydrol, 2001 Aug, 50(3-4), 261 - 85 Numerical analysis of biological clogging in two-dimensional sand box experiments; Kildsgaard J et al.; Two-dimensional models for biological clogging and sorptive trace transport were used to study the progress of clogging in a sand box experiment . The sand box had been inoculated with a strip of bacteria and exposed to a continuous injection of nitrate and acetate . Brilliant Blue was regularly injected during the clogging experiment and digital images of the tracer movement had been converted to concentration maps using an image analysis . The calibration of the models to the Brilliant Blue observations shows that Brilliant Blue has a solid biomass dependent sorption that is not compliant with the assumed linear constant Kd behaviour . It is demonstrated that the dimensionality of sand box experiments in comparison to column experiments results in a much lower reduction in hydraulic conductivity (factor of 100) and that the bulk hydraulic conductivity of the sand box decreased only slightly . However, in the central parts of the clogged area, the observations and simulations clearly show a complex picture of flow diverting the injected nutrients around the clogged area as fingers . The calibration of the model demonstrates that the physical and microbiological processes (advection, dispersion, attachment-detachment, growth-decay) are all needed to capture the progress of clogging. Nephrol Dial Transplant, 2001 Sep, 16(9), 1863 - 9 Effects of ultrapure dialysis fluid on nutritional status and inflammatory parameters; Schiffl H et al.; BACKGROUND: Malnutrition and chronic systemic inflammatory response syndrome not only coexist in uraemia, but may also have a bi-directional cause-and-effect relationship . To evaluate the role of dialysate-related cytokine induction in inflammatory response and nutritional status, we conducted a prospective comparison of two dialysis fluids differing in their microbiological quality . METHODS: Forty-eight early haemodialysis patients were assigned to either treatment with conventional (potentially microbiologically contaminated) or on-line produced ultrapure dialysis fluid . Study parameters were bacterial growth, markers of systemic inflammation (C-reactive protein (CRP) and interleukin 6), and parameters of nutritional status (estimated dry weight, upper mid-arm muscle circumference, serum albumin concentration, insulin-like growth factor 1, leptin, and protein catabolic rate) . Patients were followed for 12 months . RESULTS: There were no statistically significant differences in demographic and treatment characteristics, degree of bacterial contamination of the dialysate, markers of systemic inflammation, or parameters of nutritional status among the two treatment groups at recruitment . Changing from conventional to ultrapure dialysis fluid reduced significantly the levels of IL-6 (19+/-3 pg/ml to 13+/-3 pg/ml) and CRP (1.0+/- 0.4 mg/dl to 0.5+/-0.2 mg/dl), and resulted in significant increases in estimated dry body weight, mid-arm muscle circumference, serum albumin concentration, levels of the humoral factors, and in protein catabolic rate after 12 months . Continuous use of conventional dialysis fluid (median 40-60 c.f.u./ml) was not associated with significant alterations in markers of inflammation (IL-6 21+/-4 pg/ml vs 24+/-6 pg/ml, CRP 0.9+/-0.3 mg/dl vs 1.1+/-0.4 mg/dl) or of nutritional status at any time of the study . All differences in systemic inflammation and nutritional parameters observed during the study period (from recruitment to month 12) were significant between the two patient groups . CONCLUSIONS: Cytokine induction by microbiologically contaminated dialysis fluid has a negative impact on nutritional parameters of early haemodialysis patients . The microbiological quality of the dialysis fluid represents an independent determinant of the nutritional status in addition to known factors, such as dose of dialysis and biocompatibility of the dialyser membrane . Ultrapure dialysis fluid adds to the cost of the dialytic treatment, but may improve the nutritional status in long-term haemodialysis patients. Haematologica, 2001 Aug, 86(8), 862 - 70 Infections caused by filamentous fungi in patients with hematologic malignancies . A report of 391 cases by GIMEMA Infection Program; Pagano L et al.; BACKGROUND AND OBJECTIVES: To evaluate the clinical characteristics of patients with hematologic malignancies developing a filamentous fungi infection (FFI) and to define the prognostic factors for their outcome . DESIGN AND METHODS: A retrospective study, conducted on patients admitted to 14 Hematology divisions of tertiary care or university hospitals, participating in the GIMEMA Infection Program, over a ten-year period (1988-1997) . The study included patients with hematological malignancies and a histologically and/or microbiologically proven or probable FFI . RESULTS: We included 391 patients (male/female: 262/129, median age 49 years) with hematologic malignancies (225 acute myeloid leukemia, 67 acute lymphocytic leukemia, 30 chronic myeloid leukemia, 22 non-Hodgkin's lymphoma, 12 myelodysplastic syndrome, 10 aplastic anemia, 7 Hodgkin's disease, 8 chronic lymphocytic leukemia, 5 multiple myeloma, and 5 hairy cell leukemia) who developed a proven FFI . Eighty percent of the patients had been neutropenic for an average of 14 days before the infection, and 71% had an absolute neutrophil count lower than 0.5 x 10(9)/L at the time of FFI diagnosis . The primary sites of infection were: lungs (85%), nose and paranasal sinus (10%), and other sites (5%) . The diagnosis was made while still alive in 310 patients (79%), and at autopsy in the remaining 81 patients (21%) . Chest X-ray was diagnostic in 77% of patients with pulmonary FFI, while computed tomography (CT) scan of the thorax was positive in 95% of cases . A significant diagnostic advantage for CT scan was observed in 145 patients who had both a chest X-ray and CT scan . Aspergillus was identified as the cause of FFI in 296 patients, Mucorales in 45 patients, Fusarium in 6 patients and other filamentous fungi species in 4 patients, while in a further 40 patients no agent was identifiable . The overall mortality rate three months after the diagnosis of FFI was 74%, and fungal infection had been the cause of death in 51% of patients . INTERPRETATION AND CONCLUSIONS: Our retrospective study shows that FFI still remains a life-threatening complication in neutropenic patients . Despite appropriate treatment, half of the patients die due to this complication . The use of glucocorticoids and recovery from neutropenia are the most important prognostic factors . Mucorales infections are associated with a significantly poorer prognosis than those due to Aspergillus spp. Thromb Haemost, 2001 Aug, 86(2), 543 - 9 Early inhibition of activated fibrinolysis predicts microbial infection, shock and mortality in febrile medical patients; Raaphorst J et al.; To evaluate the contribution of an imbalance between coagulation activation and fibinolysis activation and inhibition to morbidity and mortality in sepsis, we determined in medical hospitalized patients at inclusion (day 0) for fever (temperature above 38.0 degrees C axillary or 38.3 degrees C rectally), and daily thereafter for two days, circulating thrombin-antithrombin III (TAT) complexes, plasmin-alpha2-antiplasmin (PAP) complexes (day 0 only), tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and interleukin (IL)-6, the latter as a marker of the inflammatory host response . Study variables were 1) positive microbiological results for specimens from local sites associated with a clinical infection, positive blood cultures (including parasitemia) or both, within 7 days after inclusion, 2) development of shock, i.e . systolic blood pressure <90 mmHg or a reduction of 40 mmHg from baseline within 7 days after inclusion, and 3) death related to febrile illness within 28 days after inclusion . The peak plasma levels of TAT complexes were elevated in 44% and the PAP complexes in all patients . The t-PA and PAI-1 levels were elevated in 74 and 94% of patients, respectively . Values for TAT and PAP did not differ among subgroups, while peak t-PA and IL-6 levels were higher in patients with positive microbiological results, developing shock or ultimately dying than in those without the complications (p<0.005) . Peak PAI-1 levels were elevated in patients developing shock and ultimate death versus those with an uncomplicated course (p <0.05) . Peak IL-6 related to PAI-1 and t-PA levels, which interrelated . Patients with elevated TAT levels had increased plasma levels of IL-6, PAP, PAI-1 and t-PA versus those with normal TAT (p <0.05) . Our data indicate that inhibition of activated fibrinolysis, which may partly depend on both cytokinemia and activation of coagulation, predicts microbial infection, septic shock and mortality of febrile medical patients . This suggests an early pathogenic role of inhibition of activated fibrinolysis in the downhill course of serious microbial infection. Br J Ophthalmol, 2001 Sep, 85(9), 1070 - 4 Treatment of fungal keratitis by penetrating keratoplasty; Xie L et al.; AIM: To study the use of penetrating keratoplasty (PKP) for the treatment of severe fungal keratitis that could not be cured by antifungal medication . METHODS: A retrospective analysis of 108 cases of severe fungal keratitis in which PKP was performed served as the basis for this study . Fungal keratitis was diagnosed by KOH staining of corneal scrapings or by confocal microscopic imaging of the cornea . All patients received a combination of topical and oral antifungal medicines without steroids as the first course of therapy . Patients whose corneal infection was not cured or in whom the infection progressed during antifungal treatment were given a PKP . After surgery, the patients continued to receive antifungal therapy with gradual tapering of the dose over a 1-2 month period . Cyclosporine was used to prevent graft rejection beginning 2 weeks after PKP . Topical steroid only was administered to the patient whose donor graft was over 8.5 mm and with a heavy iris inflammation 2 weeks after PKP . The surgical specimens were used for microbiological evaluation and examined histopathologically . The patients were followed for 6-24 months after PKP . Graft rejection, clarity of the graft, visual acuity, and surgical complications were recorded . RESULTS: Corneal grafts in 86 eyes (79.6%) remained clear during follow up . There was no recurrence of fungal infection and the visual acuity ranged from 40/200 to 20/20 . Complications in some patients included recurrent fungal infection in eight eyes (7.4%), corneal graft rejection in 32 eyes (29.6%), secondary glaucoma in two eyes (1.9%), and five eyes (4.6%) developed cataracts . 98 of 108 of the recipient corneas had PAS positive fungal hyphae in tissue sections; 97 of 108 were culture positive for various fungi, including Fusarium (63), Aspergillus (14), Candida (9), Penicillium (4), and seven cases in which septate hyphae were seen but identification of the organism was not conclusive . CONCLUSIONS: PKP is an effective treatment for fungal keratitis that does not respond to antifungal medication . Early surgical intervention before the disease becomes advanced is recommended . It is critical that the surgical procedure remove the infected tissue in its entirety in order to effect a cure. Paediatr Perinat Epidemiol, 2001 Jul, 15 Suppl 2, 90 - 103 Identification of biological/biochemical marker(s) for preterm delivery; Thorsen P et al.; Fetal and neonatal mortality and morbidity rates are strongly associated with gestational age for delivery: the risk for poor outcome increases as gestational age decreases . Attempts to predict preterm delivery (PTD, spontaneous delivery before 37 weeks' gestation) have been largely unsuccessful, and rates of PTD have not improved in recent decades . More recently, the reported associations between infections in pregnancy and PTD suggest preventive initiatives that could be taken . The overall objective of the current study is to assess whether specific markers of infection (primarily interleukin (IL) 1beta, tumour necrosis factor (TNF) alpha, IL-6, and IL-10) obtained from maternal blood during pregnancy, alone or in combination with other risk factors for PTD, permit identification of women at risk for spontaneous PTD . To achieve this objective, data are obtained from two Danish prospective cohort studies involving serial collection of maternal blood samples, newborn cord blood samples, and relevant confounders and other risk factors for PTD . The first study consists of a completed Danish regional cohort of 3000 pregnant women enrolled in a study of microbiological causes of PTD, upon which a nested case-control study of PTD in 84 cases and 400 controls has been performed . The second study is a nested case-control study of 675 PTD cases (equally divided into three gestational age categories of 24-29 weeks' gestation, 30-33 weeks' gestation, and 34-36 weeks' gestation) and 675 controls drawn from the ongoing Danish National Birth Cohort study of 100 000 pregnant women enrolled during 1997-2001 . The second study will provide the opportunity to refine and retest hypotheses from the first study, as well as to explore new hypotheses . Our preliminary work suggests that a single predictive marker effectively accounting for a large proportion of PTD is unlikely to be found . Rather, a search for multiple markers indicative of the multifactorial aetiology of PTD is likely to be more successful . Knowledge gained from the proposed studies will be implemented in a third, clinical intervention study against PTD . The first phase of the clinical intervention study will be to establish a risk-assessment model based on the "best" combination of biological/biochemical measures and other factors associated with PTD in order to identify pregnant women at very high risk of PTD . The second phase will be to apply an intervention model of tailored obstetric care to the very high-risk pregnant women for PTD identified in phase one . The intervention will be carried out against each specific risk factor associated with PTD identified for the individual . The aim is to reduce the risk for PTD attributed to the combination of risk factors included in the clinical intervention study. Infect Control Hosp Epidemiol, 2001 Jun, 22(6), 363 - 9 HACCP and food hygiene in hospitals: knowledge, attitudes, and practices of food-services staff in Calabria, Italy . Collaborative Group; Angelillo IF et al.; OBJECTIVES: To determine adherence to Hazard Analysis and Critical Control Points (HACCP) methods and to evaluate knowledge, attitudes, and practices of food-services staff with regard to food hygiene in hospitals . DESIGN: A survey . PARTICIPANTS: Hospital medical directors and food-services staff of 36 hospitals in Calabria, Italy . METHODS: A questionnaire about hospital characteristics, food-services organization, and measures and procedures for the control and prevention of foodborne diseases was sent to medical directors; a questionnaire about demographic and practice characteristics, knowledge, attitudes, and behaviors about control and prevention of foodborne diseases was sent to food-services staff . Multiple logistic regression analysis was performed . RESULTS: Only 54% of the 27 responding hospitals were using the HACCP system and, of those using HACCP, 79% adopted a food-hygiene-practice manual; more than one half already had developed written procedures for food storage, personal hygiene, cleaning and disinfection; one half or less performed microbiological assessment of foods and surfaces . Of the 290 food-services staff who responded, 78.8% were aware of the five leading foodborne pathogens; this knowledge was significantly higher among those with a higher educational level and those who worked in hospitals that had implemented the HACCP system . Younger staff and those who had attended continuing educational courses about food hygiene and hospital foodborne diseases had a significantly higher knowledge of safe temperatures for food storage . A positive attitude toward foodborne-diseases prevention was reported by the great majority, and it was significantly higher in older respondents and in those working in hospitals with a lower number of beds . Only 54.9% of those involved in touching or serving unwrapped raw or cooked foods routinely used gloves during this activity; this practice was significantly greater among younger respondents and in those working in hospitals using HACCP . CONCLUSION: Full implementation of the HACCP system and infection control policies in hospital food services is needed. Akush Ginekol (Sofiia), 2001, 41(1), 9 - 11 {Modern treatment of vaginal mycosis in adolescence}; Sirakov M et al.; The aim of the study is to determine the effectiveness of the single per oral application of 200 mg Fungolon (Fluconazolum) in adolescent girls with proven Candida spp . Vaginal infection . MATERIAL AND METHODS: A prospective, case control study in 50 girls, aged 9 to 18 years, was performed . Patients were recruited in the outpatient Clinic of Paediatric and Adolescent Gynecology at the University Hospital "Majchin dom", Sofia, Bulgaria . They suffered from vaginal discharge and/or pruritus of the external genitalia . Candida spp . Was proven in all of the microbiological investigation performed . The treatment with Fungolon was performed per os, in single dose of 200 mg . RESULTS: The complaints and Candida in the vaginal smear (controlled 1 week after the treatment) disappeared in 43 of 50 patients (86%) treated . No effect was observed in 7 girls (14%) . A reinfection with Candida was observed in 6 of the 38 patients (16%) at the second week after the treatment . The typisation of the resistant to Fungolon Candida shown predominance of Candida glabrata . There were no side effects registered during the Fungolon treatment . CONCLUSION: The treatment of Candida spp . Vaginal infection in adolescent girls by a single per oral application of 200 mg Fungolon (Fluconazolum) is very convenient and efficient . It gives a prompt effect (the complaints disappear in one or two days), high percentage of healed patients (86%), with absence of side effects . The usage of Fungolon should be highly recommended for treatment of vaginal mycoses in puberty and adolescence. Biomaterials, 2001 Sep, 22(18), 2481 - 7 Association of vancomycin and calcium phosphate by dynamic compaction: in vitro characterization and microbiological activity; Gautier H et al.; Dynamic compaction has rarely been used to produce drug-delivery devices in granule form . This report considered four processes associating vancomycin and compared dynamic compaction with wet granulation, a classical method . In the wet granulation study, vancomycin was associated with biphasic calcium-phosphate (BCP) granules either by adsorption or incorporation with a new granulation . In the dynamic compaction study, BCP powder was compacted at 1.1, 1.5 and 1.9 MPa . The compacts obtained were crushed and sieved (200-500 microm), and the vancomycin solution was adsorbed on the resulting granules . After crushing and sieving, the compaction of BCP and vancomycin powders produced vancomycin-loaded granules . In each study, 4.76% of vancomycin was associated with BCP . Granules were characterized in terms of porosity, vancomycin release and vancomycin biological activity . Physicochemical studies of BCP and vancomycin showed their structural integrity after dynamic compaction, which prolonged vancomycin release time from 1 to 6 days . However, a microbiological assay indicated that vancomycin had been altered since only 27.7% was found to be active. J Med Primatol, 2001 Jun, 30(3), 185 - 7 Spontaneous Waterhouse-Friderichsen syndrome in a gang-housed baboon; Cary M et al.; Waterhouse-Friderichsen syndrome can cause acute death in the baboon without specific signs . Furthermore, this syndrome could result from stress-related intestinal permeability changes that allow macromolecules and/or microbiological entities to enter the systemic circulation . The resulting sepsis could cause adrenocortical insufficiency, hypotension and shock leading to death. Intensive Care Med, 2001 Aug, 27(8), 1269 - 73 Detection of bacteraemia in critically ill patients using 16S rDNA polymerase chain reaction and DNA sequencing; Sleigh J et al.; OBJECTIVE: To confirm the sensitivity of the polymerase chain reaction (PCR) technique (versus blood cultures) and to gain a better understanding of the incidence of true- and false-positive results when using this technique . DESIGN: Observational study . SETTING: Fourteen-bed, level 3 intensive care unit . PATIENTS: Hundred twenty-six critically ill adult patients . Hundred ninety-seven blood culture and PCR samples taken as clinically indicated for suspected sepsis, according to routine ICU protocol . MEASUREMENTS AND RESULTS: The PCR product (16SrDNA: 341F-1195R) was sequenced and compared with a database of known species (Genebank) to identify the bacterial nucleic acid . The PCR or blood culture result was classified as a true-positive if there was other microbiological or clinical supporting evidence. Eur Respir J, 2001 Jul, 18(1), 243 - 5 Acute lung injury associated with 5-fluorouracil and oxaliplatinum combined chemotherapy; Trisolini R et al.; Diarrhoea, T-CD4+ lymphopenia and bilateral patchy pulmonary infiltrates developed in a male 60 yrs of age, who was treated with oxaliplatinum and 5-fluorouracil for unresectable rectum carcinoma . The findings from transbronchial lung biopsy and bronchoalveolar lavage (BAL) were consistent with an organizing diffuse alveolar damage pattern . Once extensive microbiological studies proved negative, corticosteroids were given and a complete remission of clinical and radiological abnormalities was achieved . It is concluded that the aforementioned pathological manifestations were due to chemotherapy and included a pulmonary adverse reaction, a feature never previously associated with oxaliplatinum and 5-fluorouracil regimens. Vestn Otorinolaringol, 2001, (3), 18 - 22 {Pathogenesis and treatment of chronic purulent otitis media and its complications: immunological aspects}; Talyshinskii AM et al.; Clinicoimmunological, microbiological and cytological examinations were made in 96 patients with otitis media purulenta chronica (OMPC) and otogenic intracranial complications . It was found that in different clinical forms of OMPC nonspecific defense and immunity indices vary . In OMPC and chronic purulent mesotympanitis the indices change insignificantly . In chronic purulent epitympanitis and otogenic intracranial complications there was suppression in T-cell immunity and nonspecific defense . Middle ear secretion contained less SIgA and lysozyme, blood contained more amount of IgA and IgM and less of IgG . Deficiency of general and local defense antiinfectious mechanisms shows significance of immune and nonspecific resistance in transformation of ear inflammation into chronic phase and development of complications . Alterations in immunity, nonspecific defense and tympanic cavity depend on the causative agent of OMPC . Association of St . aureus with gramnegative flora or anaerobic infection cause the greatest immune deficiency . Temporal bone surgery and standard treatment for 21 days fail to eradicate initial immune disorders in the blood and middle ear . Thymalin immunocorrection improves nonspecific defense and immunity, attenuates inflammation and stimulates reparative processes in the trepanation wound of the ear. Probl Tuberk, 2001, (3), 56 - 8 {Detection of Mycobacterium tuberculosis by different methods}; Skriagina EM et al.; Comparative assessment of the sensitivity of detection of Mycobacteria tuberculosis by using bacterioscopy after Ziehl-Nilsen, the cultural study on the Finn II yolk medium and Middlebrook 7H11 agar medium, and polymerase chain reaction indicated that a complex microbiological study with all available laboratory methods should be used. Rev Belge Med Dent, 2001, 56(1), 35 - 61 {Incidence and primary prevention of complications related to the placement of dental implants}; Torelli S et al.; Despite high success rate with endosseous titanium implants, failures inevitably occur . At an early stage, lack of primary stability, surgical trauma, peroperative contamination and occlusal overload seem to be the most important causes of implant failure . Many authors have reported that implant failures after primary healing and osseointegration are mainly due to peri-implant infection and/or excessive occlusal stress . Like periodontal disease, peri-implant inflammatory lesions develop as a result of plaque accumulation and exhibit similar clinical and microbiological signs as encountered for periodontitis . Clinicians should therefore enforce preventive measures to decrease the prevalence of such causative agents . Therapeutic attempts should have their rationale in the restoration of a biomechanical and/or host-bacterial equilibrium . The major limitation at this point seems to be the detection of a pathological process . Aside from clinical evaluation, the interpretation of radiographic images is one of the most frequently applied diagnostic procedures in patients with osseointegrated implants . Post-therapeutic maintenance care is an integral part of the entire implant treatment approach. FEMS Microbiol Lett, 2001 Aug 7, 202(1), 25 - 30 Fimbria-mediated bacterial adhesion to human oral epithelium; Vitkov L et al.; Oral mucosa biopsies and saliva samples from 12 individuals were processed for transmission (TEM) and scanning (SEM) electron microscopy with and without ruthenium red staining . Additionally performed microbiological estimations indicated in all bacteriological samples a facultative pathogenic flora . SEM and TEM investigation showed a diverse bacterial flora attached to the mucosal surface . Fimbriae comprising the glycocalyx and enabling bacterial attachment to the epithelial cells could be clearly visualised by ruthenium red . The only mode of bacterial attachment to the oral mucosa detected in the present investigation was fimbria-mediated adhesion and co-adhesion . The fimbria-mediated adhesion enables the bacterial persistence in the oral cavity and is the first step in the bacterial colonisation process. CLAO J, 2001 Jul, 27(3), 166 - 8 Fungal ring infiltrates in disposable contact lens wearers; Salierno AL et al.; PURPOSE: To report two cases of ring infiltrates in disposable contact lens wearers resembling Acanthamoeba keratitis but later identified as fungus . METHODS: We report two patients with histories of disposable soft contact lens use, who, on initial presentation, were found to have corneal ring infiltrates and were treated for presumed Acanthamoeba keratitis . Microbiological studies, which included Gram stain and Gomori methenamine silver stain, as well as blood agar, chocolate agar, thioglycolate broth, Sabouraud agar, nonnutrient agar with Escherichia coli overlay, and Lowenstein-Jensen plates, were performed . RESULTS: Microbiological studies revealed fungi in both cases . CONCLUSIONS: Fungal keratitis is an uncommon complication of disposable soft contact lens use, but it should be considered in the differential diagnosis of corneal ring infiltrates. Dtsch Tierarztl Wochenschr, 2001 Jul, 108(7), 297 - 302 {Perspectives of veterinary science--from the viewpoint of consumer health protection}; Hildebrandt G; Concerning the causal chain "healthy animal--healthy food--healthy man" there's no doubt that mainly veterinarians are responsible for a safe preharvest area . In the food processing sector, of which economical importance is increasing in inverse proportion to agricultural activity of developed nations, the veterinarians must win through against many other professions . In this competition the specific veterinarian competence to prevent or to control microbiological, parasitological and some chemical hazards should be used . Therefore scientific work in veterinary public health has to concentrate on risk management . Additionally to developing methods for rapid and/or discriminative determination of causative agents the implementation of integrated quality assurance systems is needed in future according to the spirit of "intelligent" food hygiene. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2001 Aug, 92(2), 208 - 14 A new bacterial species associated with failed endodontic treatment: identification and description of Actinomyces radicidentis; Kalfas S et al.; OBJECTIVE: This report describes 2 endodontic patients who had persistent signs and symptoms after conventional root canal treatment . The aim of this study was to determine what microorganisms were present in the root canals of the teeth with failed endodontic therapy . STUDY DESIGN: After removal of the root fillings, the canals were sampled by advanced microbiological techniques and the isolates were characterized by various tests . RESULTS: Bacteria, which grew in pure cultures, were isolated in each case . The bacteria were similar to each other and were classified as Actinomyces on the basis of phylogenic and phenotypic evidence . The bacteria were different from others within the genus, thus warranting designation as a new species, Actinomyces radicidentis . CONCLUSIONS: The 2 cases of endodontic failure were infected with A radicidentis, a new Actinomyces species . This bacterium joins a restricted group of other microorganisms that have been associated with failure of root canal treatment. Eur J Nucl Med, 2001 Jul, 28(7), 822 - 30 The efficacy of technetium-99m ciprofloxacin (Infecton) imaging in suspected orthopaedic infection: a comparison with sequential bone/gallium imaging; Yapar Z et al.; Technetium-99m ciprofloxacin (Infecton) has recently become established as a new radiopharmaceutical for the imaging of infection . This study was performed to determine the value of Infecton imaging in demonstrating orthopaedic infection and to compare the results with bone/gallium imaging . Twenty-two patients (12 female, 10 male; mean age 51.7+/-16.8 years) with suspected orthopaedic infective conditions were included in the study . The patients underwent three scintigraphic studies in the following sequence: 740 MBq 99mTc-methylene diphosphonate (MDP) three-phase bone scintigraphy; at least 2 days later, 370 MBq Infecton scan at 1-4 h; and finally, 185 MBq gallium-67 scintigraphy . 67Ga imaging could not be performed on four patients . All images were blindly interpreted by two independent observers . The final diagnosis was made by consensus when the readings were different . Interpretation of the early and late Infecton images was made separately, with visual findings being classified according to a four-grade scale (0, +, ++, +++) . Images graded 0 and +, and also those regions which showed a decrease in uptake grade on late images as compared with early images, were classified as negative for infection; grades ++ and +++ were classified as positive . Bone/gallium images were considered positive when the images were spatially incongruent or when gallium uptake was more intense than that of 99mTc-MDP . The diagnosis was confirmed by intraoperative microbiological or histological findings, or by the presence of gross purulence . The sensitivity of Infecton imaging was found to be 85%, the specificity 92% and the accuracy 88%, as compared to figures of 78%, 100% and 90%, respectively, for bone/gallium imaging . Although the two modalities showed a similar clinical yield, the easy availability of Infecton and the short investigation time make Infecton imaging the better option for the detection of orthopaedic infection. Fed Regist, 2000 Dec 12, 65(239), 77497 - 9 Revision to requirements for licensed Anti-Human Globulin and Blood Grouping Reagents . Food and Drug Administration, HHS . Direct final rule. {Differences between tuberculous spondylitis and brucellar spondylitis} Calvo Romero JM, Ramos Salado JL, Garcia de la Llana F, Bureo Dacal JC, Bureo Dacal P, Perez Miranda M. Servicio de Medicina Interna, Hospital Regional Universitario Infanta Cristina, BadajozOBJECTIVE: To identify potential differences in the clinical and laboratory characteristics between tuberculous spondylitis (TS) and brucellar spondylitis (BS) . PATIENTS AND METHODS: Retrospective study of patients with TS and BS diagnosed in our hospital between january 1992 and december 1998 . RESULTS: TS was diagnosed in 17 patients and BS in 10 patients . In our series, a higher delay in the diagnosis (27.9 +/- 24.6 vs . 16 +/- 5.6 weeks, p = 0.02) was found in TS . There was a higher frequency, but without stadistic significance, of immunosuppression, one or several paravertebral or epidural abscesses, spinal cord compression, anemia and an elevated erythrocyte sedimentation rate in TS, and a higher frequency of fever/febricule and residual vertebral pain in BS . Lumbar location was the most frequent in both groups (58.8% in TS and 70% in BS) . CONCLUSIONS: It is possible that there were some differences in the clinical and laboratory characteristics between TS and BS which may be an aid in the differential diagnosis of both entities and orient the empirical treatment in these cases without a definitive microbiological diagnosis or while awaiting the diagnostic confirmation. Ned Tijdschr Geneeskd, 2001 Jul 28, 145(30), 1471 - 3 {Six-month old girl with an anaphylactic reaction to rice flour, a rare food allergy}; Klein SK et al.; A 6-month-old girl had been admitted three times due to the sudden onset of respiratory and gastrointestinal symptoms, paleness and a reduced level of consciousness . Various laboratory tests (including allergy tests) as well as microbiological and radiological investigations did not establish the cause . Only when it was noticed that the incidents followed a change of diet, did it became obvious that a reaction to food components was the underlying cause . A provocation test revealed an anaphylactic reaction to rice flour . Food allergy is a widespread problem within paediatrics; rice flour appears to be hypoallergenic, but can lead to immunological responses. Acta Pol Pharm, 2001 Mar-Apr, 58(2), 93 - 6 Elaboration of HPLC method for biotin determination in multiple vitamin drugs and comparison with microbiological method; Klaczkow G et al.; We were searching for optimal analytical conditions for the biotin determination by the HPLC method with detection at the wavelength 200 nm in multiple vitamin drugs . Statistical parameters of the HPLC method and the microbiological method of the biotin determination, were compared. Int J Tuberc Lung Dis, 2001 Aug, 5(8), 763 - 8 Mycobacterium tuberculosis bacteremia in a university hospital; Esteban J et al.; SETTING: Patients with blood cultures positive for Mycobacterium tuberculosis between 1988 and 1999 . OBJECTIVE: To study the clinical and microbiological characteristics of patients with tuberculous bacteremia, including data about evolution and management . DESIGN: Retrospective review of the clinical charts and microbiological records of patients with culture-proven tuberculous bacteremia between 1988-1999 . RESULTS: During the study period, 19 patients with culture-proven M . tuberculosis bacteremia were detected (1.42 isolates/patient, 4.7% of all patients with blood cultures for mycobacteria) . Four patients were non-infected with the human immunodeficiency virus and 15 were HIV-infected . In four patients blood was the only positive sample . Five patients were diagnosed simultaneously with tuberculosis and HIV infection . Only 13 had a temperature higher than 37.5 degrees C . Most patients had symptoms or signs of respiratory tract involvement, and 11 patients died (10 from tuberculosis) . The average time for detection of positive blood cultures was 33.25 days for lysis-centrifugation cultures and 26.46 days for BACTEC cultures . The incidence of M . tuberculosis bacteremia remained stable during the study period . CONCLUSIONS: Although blood cultures are useful for definitive diagnosis of disseminated tuberculosis, the long incubation times made them of limited usefulness in the clinical management of patients . Mortality remains high in these patients. Probl Tuberk, 2001, (2), 18 - 20 {Components of monitoring drug resistance of tuberculosis agent in the evaluation of effectiveness of the national tuberculosis control program}; Popov SA et al.; The authors analyzed the changes and pattern of drug-resistance in tuberculosis pathogen by using the reports of over 700 microbiological laboratories of tuberculosis control service in Russia in the past 20 years (1979-1998), which yielded a monitoring system for drug resistance in the pathogen in this country . Seven underlying informational blocks were identified . These included more than 20 different quantitative and qualitative parameters covering the characteristics of a patient and the pathogen and regionally environmental and epidemiological indices . Analysis of the data on the united northern, west-northern, and Baltic regions is given as an example of successful use of the monitoring system. Mycoses, 2001, 44(5), 125 - 35 Fluconazole vs . amphotericin B for the management of candidaemia in adults: a meta-analysis; Kontoyiannis DP et al.; The incidence of bloodstream infections caused by Candida species is rising . Few published studies have compared the efficacy of fluconazole with that of amphotericin B . We performed a meta-analysis of the prospective studies that compared fluconazole and amphotericin B for the treatment of candidaemia in adults . Data on total mortality, candidaemia-attributable mortality, efficacy, microbiological failure, and toxicity were extracted from eligible studies . All studies appeared homogeneous with respect to the outcome measures . Most patients were at relatively low risk for death as evidenced by the low average physiologic score and the lack of intense immunosuppression . The odds ratios (OR) of treatment with amphotericin B versus fluconazole and 95% confidence intervals (CI) were as follows: total mortality (OR, 1.06; CI, 0.89-1.25), candidaemia-attributable mortality (OR, 1.0; CI, 0.70-1.45), clinical response (OR, 1.14; CI, 0.93-1.39) and microbiological failure according to all Candida species (OR, 0.99; CI, 0.78-1.26) . A trend favouring amphotericin B was seen in mycological eradication of non-albicans Candida species (OR, 0.70; CI, 0.47-1.06) . Finally, amphotericin B was more toxic than fluconazole (OR, 2.94; CI, 2.14-4.4) . In conclusion, fluconazole is as efficacious and less toxic than amphotericin B in stable, not severely immunosuppressed candidaemic patients at low risk for death . However, fluconazole may be less effective than amphotericin B in candidaemias caused by some non-albicans Candida species. Acta Clin Belg, 2001 May-Jun, 56(3), 187 - 90 Streptobacillus moniliformis: case report and review of the literature; Frans J et al.; Streptobacillus moniliformis is one of the causes of rat bite fever . The clinical and microbiological diagnosis of this rare infectious disease is often quite problematic . Penicillin, in sufficiently high dosis, is the treatment of choice and leads to a prompt resolution of the infection, whereas lack of treatment leads to a 13% mortality rate . As far as we know, this paper reports the first human isolate in Belgium. Khirurgiia (Sofiia), 2000, 56(2), 20 - 3 {Bacterial translocation from the gastrointestinal tract: catalyst of multiple organ dysfunction syndrome}; Khinev S et al.; The abnormal colonization of gastrointestinal tract (GIT), the loss of the intestinal barrier function, the bacterial translocation (BT) are signs of intestinal insufficiency which are supposed to be involved in the pathogenesis of MODS . This worsens the condition or leads to lethal outcome in patients after major abdominal surgery in ICU . The goal of this investigation was to consider the scientific and clinical evidence for the BT role in the pathogenesis of MODS and to present evidence about the advantages and the efficiency of antibiotic combination Amikacin plus Clindamycin as a new therapeutic strategy for the improvement of the outcome in patients with MODS and sepsis . To that purpose patients with diffuse peritonitis of different origin were analyzed . After surgery some patients were left with laparostomy . This gave the possibility for revisions and lavages of the abdominal cavity and for taking material for microbiological analyses . The patients were grouped into two subgroups according to antibiotic treatment: 1st group--combination of usually used antibiotics; 2nd group--Amikacin plus Clindamycin . The second group patients showed good tolerance to this antibiotic combination and good therapeutic effect. Clin Imaging, 2001 Mar-Apr, 25(2), 110 - 3 MR diffusion-weighted imaging of kidney: differentiation between hydronephrosis and pyonephrosis; Chan JH et al.; The objective of the study was to evaluate the capability and reliability of the magnetic resonance (MR) diffusion-weighted imaging (DWI) in differentiation between hydronephrosis and pyonephrosis . Single-shot echoplanar MR diffusion-weighted imaging was performed in 12 patients who had dilatation of the renal pelvis and calyces detected by ultrasonography (US) . Microbiological tests confirmed that there were four cases of pyonephrosis and eight cases of hydronephrosis . Signal intensities of the collecting (pelvicalyceal) systems on the diffusion-weighted images and apparent diffusion coefficient (ADC) maps were noted . ADC values of the pelvicalyceal system in all patients were computed and compared using Student's t test . On diffusion-weighted images, the pelvicalyceal system of the hydronephrotic kidney was hypointense while the pelvicalyceal system of the pyonephrotic kidney was markedly hyperintense . The mean ADCs of the hydronephrotic and pyonephrotic renal pelvis were 2.98 +/- 0.65 x 10(-3) and 0.64 +/- 0.35 x 10(-3) mm(2)/s, respectively . The extremely low ADC of the renal pelvis of the pyonephrotic kidney accounted for its signal hyperintensity on diffusion-weighted images as well as signal hypointensity on ADC maps . In conclusion, the MR diffusion-weighted imaging may be a reliable tool to differentiate pyonephrosis from hydronephrosis. Farmaco, 2001 May-Jul, 56(5-7), 475 - 82 Pharmaco-toxicological screening of commercially available Italian natural mineral waters; Evandri MG et al.; The consumption of natural mineral water has increased enormously during the past few years, yet doubts are arising about the real utility of using such water instead of ordinary drinking water (tap water) . Mineral water's 'special' mineral composition might have properties favourable to health, which should be assessed by clinical and pharmacological analyses . A comparative pharmaco-toxicological study was performed on 14 commercially available Italian natural mineral waters with a wide range of mineral content . The waters were microbiologically analysed and the Allium cepa test done; in addition, Irwin, charcoal meal and diuresis tests were also performed on laboratory animals . No toxicological signs were recorded at the Allium cepa assay for any but the water with the highest mineral content . The diuretic effect was comparable to that of control tap water . Waters with high magnesium content significantly enhanced intestinal motility while at the Irwin test none of the water samples evoked behavioural changes . All the tested samples were microbiologically pure . In conclusion, mineral water can be an alternative to aqueduct water in places where the latter comes from superficial water and has to be subjected to hard potabilisation techniques; water from the 'Acqua Marcia' aqueduct (control) was found to have characteristics comparable to the mineral waters studied. J Craniofac Surg, 2001 Jul, 12(4), 362 - 8 Postoperative infections in craniofacial reconstructive procedures; Fialkov JA et al.; The rate of, and possible risk factors for, postoperative craniofacial infection is unclear . To investigate this problem, we reviewed 349 cases of craniofacial skeletal procedures performed from 1996 to 1999 at our institution . Infection rate was determined and correlated with the use of implants, operative site, and cause of deformity . The inclusion criteria consisted of all procedures requiring autologous or prosthetic implantation in craniofacial skeletal sites, as well as all procedures involving bone or cartilage resection, osteotomies, debridement, reduction and/or fixation . Procedures that did not involve bone or cartilage surgery were excluded . The criteria for diagnosis of infection included clinical confirmation and one or more of 1) intravenous or oral antibiotic treatment outside of the prophylactic surgical regimen; 2) surgical intervention for drainage, irrigation, and or debridement; and 3) microbiological confirmation . Among the 280 surgical cases that fit the inclusion criteria and had complete records, there were 23 cases of postoperative infection (8.2%) . The most common site for postoperative infection was the mandible (infection rate = 16.7%) . Multiple logistic regression analysis revealed gunshot wound to be the most significant predictor of postoperative infection . Additionally, porous polyethylene implantation through a transoral route was correlated with a significant risk of postoperative infection. J Antimicrob Chemother, 2001 Aug, 48(2), 303 - 10 Use of fluconazole in daily practice: still room for improvement; Natsch S et al.; One hundred courses of fluconazole treatment in a university hospital and 81 courses in a non-university teaching hospital have been analysed in a prospective audit to evaluate prescribing practices . The quality of treatments was assessed by an infectious disease specialist and a pharmacist according to standard guidelines . In the non-university hospital, prescribed dosages were lower than in the university hospital, and often below the recommended dose . Mean duration of treatment for oesophageal candidosis and disseminated infections was considerably shorter in the non-university hospital compared with the university hospital, and often judged too short . Microbiological samples were examined in 75% of the cases in both hospitals . The expert reviewers agreed with the indication to use fluconazole in 58-100% of cases in the university hospital and 42-80% in the non-university hospital, depending on the type of infection . There did not appear to be a major problem with inappropriate use of fluconazole . However, important issues for improvement could be identified, such as increasing the dosage and duration of treatment in cases of serious infections, and withholding treatment from patients with colonization rather than infection. Arch Bronconeumol, 2001 Jul-Aug, 37(7), 286 - 8 {Acute interstitial pneumonia: favorable outcome with steroid therapy}; Anton E et al.; We report the case of a 65-year-old man with no history of respiratory disease who came to the emergency room complaining of fever, cough, yellowish sputum and increasing dyspnea of one week's duration . Severe respiratory insufficiency was evident upon examination and a chest film showed diffuse pulmonary infiltrates . Microbiological tests were negative . Lung biopsy gave evidence consistent with diffuse alveolar damage in organizing phase . Evolution of symptoms and blood gases was good after corticosteroid treatment was begun, although pulmonary fibrosis was still evident in a follow-up radiograph. Endocr Pathol, 2001 Spring, 12(1), 87 - 91 Isolated Pneumocystis carinii infection of adrenal glands causing Addison's disease in a non-immunocompromised adult; Agarwal J et al.; Pneumocystis carinii is primarily an opportunistic pathogen infecting patients with AIDS and other immunocompromised patients, and ordinarily does not affect immunocompetent persons . We report isolated P . carinii infection of bilateral adrenal glands in a non-immunocompromised adult male, leading to fatal Addisonian crisis . Diagnosis of P . carinii was established on the basis of cytopathology and microbiological tests, using conventional staining techniques and direct immunofluorescence on ultrasound-guided fine needle aspirates and trucut needle biopsy specimen from adrenal glands . P . carinii pneumonia and other fungal infections of the adrenal glands were excluded by appropriate tests . Absence of HIV infection was established by negative ELISA for HIV I and II antibodies and Western blot analysis at the time of presentation and 45 d later . Normal blood total leukocyte and CD4 lymphocyte counts and IgG and IgA levels confirmed the immunocompetent status of the patient . The patient improved with anti-Pneumocystis treatment and corticosteroid replacement, but succumbed to an episode of Addisonian crisis triggered by a diarrheal illness. Nuklearmedizin, 2001 Jun, 40(3), 75 - 9 {Antigranulocyte scintigraphy of septic loosening of hip endoprosthesis: effect of different methods of analysis}; Klett R et al.; AIM: Diagnosis of infection with help of antigranulocyte scintigraphy near body stem is difficult because of contemporary visualisation of bone marrow . Therefore, we investigated, whether it is possible to improve the accuracy in diagnosing septic loosening of hip endoprosthesis by changing the analyzing methods . METHODS: In 28 patients, the results of a visual interpretation of late scan, a visual interpretation and a quantitative interpretation of time-activity-course were compared . These results were verified by histology respectively microbiology . RESULTS: Histological and microbiological verification found 14 septic loosening and 14 aseptic loosening of the hip prothesis . Therefore, sensitivity, specificity, negative and positive predictive value for the visual interpretation of late scan were 0.86, 0.57, 0.80 and 0.67 . For visual and quantitative interpretation of time-activity-course we found 0.86, 0.79, 0.85 and 0.80 respectively 1, 0.93, 1, 0.93 . For interobserver agreement we found kappa coefficients of 0.28 +/- 0.2 for visual interpretation of late scan, 0.48 +/- 0.17 for visual interpretation and 1.0 +/- 0 for quantitative interpretation of time-activity-course . CONCLUSION: In all investigated values quantitative interpretation of time-activity-course was superior to the other analyzing methods . Therefore, antigranulocyte scintigraphy for septic loosening of hip endoprosthesis should be interpreted quantitatively. Br J Haematol, 2001 Jul, 114(1), 93 - 8 Clinical significance of Aspergillus fungaemia in patients with haematological malignancies and invasive aspergillosis; Girmenia C et al.; The clinical significance of Aspergillus fungaemia in the setting of a deep-seated aspergillosis has not been clearly established . Among 107 microbiologically documented Aspergillus infections in patients with haematological diseases observed over a 17-year period, blood cultures grew Aspergillus species from 10 cases . Aspergillus fungaemia was documented in 9 out of 89 (10.1%) patients with pulmonary aspergillosis at a median of 5 d from the onset of clinical signs of infection, and in one patient with central venous catheter focal infection . Five (50%) patients died as a result of fungal infection a median of 12 d (range 4--48) from the documentation of Aspergillus fungaemia . A comparison between cases of invasive aspergillosis with or without fungaemia showed that fungaemic patients were similar to those without positive blood cultures regarding clinical presentation, risk factors, clinical course and outcome . The diagnostic role of Aspergillus fungaemia in the setting of a deep-seated infection is limited because blood cultures become positive when a microbiological or clinical diagnosis of aspergillosis has already been performed . Aspergillus fungaemia does not necessarily seem to be correlated with a disseminated infection or a poorer prognosis. Poult Sci, 2001 Jul, 80(7), 988 - 96 Physicochemical and microbiological properties of selected rice flour-based batters for fried chicken drumsticks; Mukprasirt A et al.; Rice flour-based batter (RFBB) formulations for chicken drumstick coating were developed as an alternative for traditional wheat flour-based batter (WFBB) . Physicochemical properties and storage stability of selected RFBB were evaluated and compared to WFBB . Batter pickup of RFBB formulated in combination with oxidized corn starch and methylcellulose (MC) was not significantly different from that of WFBB . In contrast, batters with only rice and corn flour (60:40% flour weight) exhibited significantly higher pickup . Rice flour batter with 15% oxidized corn starch had the lowest batter pickup . All RFBB exhibited (P < 0.05) lower oil absorption than WFBB . The TBA values of RFBB and WFBB increased (P < 0.05) with increased frozen storage time at -40 C for 90 d . The RFBB with MC exhibited the lowest TBA values, whereas WFBB had the highest values . Microstructural analysis revealed that freezing caused structural deterioration of all batters, but the RFBB with MC exhibited less freezing tolerance than other samples . The total plate counts of immediately fried or frozen fried chicken stored for 90 d were less than 1 log cfu/g sample . The RFBB with 5% oxidized corn starch and MC can replace WFBB on fried drumsticks . Additionally, RFBB results in a healthier product due to lower fat absorption. Mar Pollut Bull, 2001 Jun, 42(6), 425 - 32 Managing coastal bathing water quality: the contribution of microbiology and epidemiology; Efstratiou MA; The EU Bathing Water Directive with a life of 25 years (EEC, 1976) has contributed significantly to the improvement of the quality of coastal recreational waters throughout Europe and has successfully protected public health . Improvement of the standards of living and general public demands has made it necessary to consider updating it (EU, 1994) introducing important changes in microbiological parameters . Measurement of microbial pollution is of primary importance to this new proposal, as is to the regulatory schemes introduced by the very recent 'Annapolis Protocol' (WHO/US EPA, 1999) . This report discusses the microbiological aspects of the health-related management of bathing seawater in the context of the scientific information available from epidemiological and microbiological studies. Clin Exp Med, 2001 Mar, 1(1), 61 - 6 The effects of pentoxifylline treatment on bacterial translocation after hemorrhagic shock in rats; Koyluoglu G et al.; Bacterial translocation is thought to be responsible for infectious complications after hemorrhagic shock . The aim of this study was to investigate the effects of pentoxifylline treatment on bacterial translocation in animals subjected to hemorrhagic shock . Thirty-one Wistar albino rats (280-360 g) were divided into three groups: sham (n=10), shock (n=11), and shock-pentoxifylline (n=10) . Blood was not withdrawn from sham rats . Shock rats were subjected to 30 min of shock followed by reinfusion of shed blood . Shock/pentoxifylline rats received pentoxifylline after reinfusion of shed blood . After hemorrhage and reinfusion (24 h), the mesenteric lymph nodes, liver, spleen, and blood samples were evaluated using quantitative microbiological techniques, and the numbers of colony-forming units were compared between groups . Cecum was removed to evaluate the bacterial population . Ileum and cecum were examined histologically . The incidence of bacterial translocation was higher in the shocked rats (63%) than in the sham shock rats (10%) . Pentoxifylline reduced the incidence of shock-induced bacterial translocation to 0% . Cecal bacterial levels were significantly higher in the shock rats than in the sham and shock/pentoxifylline rats . The histological damage caused by hemorrhagic shock was prevented by pentoxifylline treatment . In conclusion, the hemorrhagic shock triggered translocation of bacteria to the mesenteric lymph nodes, spleen, liver, and blood of rats . Pentoxifylline treatment just after shed blood transfusion significantly attenuated this phenomenon. Arch Dis Child, 2001 Aug, 85(2), 125 - 31 Nationwide study of haemolytic uraemic syndrome: clinical, microbiological, and epidemiological features; Elliott EJ et al.; AIMS: To establish the incidence and aetiology of haemolytic uraemic syndrome (HUS) in Australia and compare clinical and microbial characteristics of sporadic and outbreak cases . METHODS: National active surveillance through the Australian Paediatric Surveillance Unit with monthly case notification from paediatricians, July 1994 to June 1998 . Children under 15 years presenting with microangiopathic haemolytic anaemia, thrombocytopenia, and acute renal impairment were identified . RESULTS: Ninety eight cases were identified (incidence 0.64 per 10(5) children <15 years/annum and 1.35 per 10(5) children <5 years/annum) . Eighty four were associated with diarrhoea (64 sporadic, 20 constituting an outbreak) and 14 were atypical . Shiga toxin producing Escherichia coli (STEC) O111:H- was the most common isolate in sporadic HUS and caused the outbreak . However O111:H- isolates from outbreak and sporadic cases differed in phage type and subtyping by DNA electrophoresis . STEC isolates from sporadic cases included O26:H-, O113:H21, O130:H11, OR:H9, O157:H-, ONT:H7, and ONT:H- . STEC O157:H7 was not isolated from any case . Only O111:H- isolates produced both Shiga toxins 1 and 2 and possessed genes encoding E coli attaching and effacing gene (intimin) and enterohemolysin . Outbreak cases had worse gastrointestinal and renal disease at presentation and more extrarenal complications . CONCLUSIONS: Linking national surveillance with a specialised laboratory service allowed estimation of HUS incidence and provided information on its aetiology . In contrast to North America, Japan, and the British Isles, STEC O157:H7 is rare in Australia; however, non-O157:H7 STEC cause severe disease including outbreaks . Disease severity in outbreak cases may relate to yet unidentified virulence factors of the O111:H- strain isolated. J Craniomaxillofac Surg, 2001 Apr, 29(2), 111 - 7 Purulent pansinusitis, orbital cellulitis and rhinogenic intracranial complications; Eufinger H et al.; OBJECTIVES: Acute pansinusitis is rarely seen in the maxillofacial surgery field, but often occurs in combination with orbital and intracranial involvement . Clinically this entity is of great importance, since it represents a severe disease with possibly disastrous consequences . PATIENTS: Aetiology, diagnosis and therapy of acute pansinusitis and its complications were analysed in 36 patients treated surgically from 1987 to 1996 . RESULTS: Eighteen patients were aged between 3 and 21-years-old . Only eight suffered from pure pansinusitis, and three of an isolated purulent orbital infection . Of these 25 patients 20 had (pan-)sinusitis with orbital, three with intracranial, and two with both orbital and intracranial complications . Intracranial involvement included meningitis, empyema and brain abscess . Aetiology was rhinogenic in 26, odontogenic in six patients, and traumatic in two cases . Radiological work-up included conventional radiographs and CT in most cases, MRI was only used with special indications . Microbiological examination detected single or multiple species of micro-organisms with equal frequency . If multiple species were found, infection was mostly aerobic/anaerobic in combination . CONCLUSION: These purulent processes, frequently seen in young patients, require immediate surgical intervention and drainage with elimination of the cause of the disease if possible . Cooperation with other specialities is essential depending on the spread of the disease . In spite of the threatening acute symptoms, severe courses of disease or permanent defects should be avoidable. Water Sci Technol, 2001, 43(12), 9 - 18 Setting microbiological water quality standards for sea bathing--a critical evaluation; Mugglestone MA et al.; The World Health Organization (WHO) recently produced draft guidelines for safe recreational water environments . The microbiological standards proposed in the guidelines are expected to overestimate the degree of water quality required to provide given levels of public health protection . The WHO standards were obtained by means of a risk assessment which featured a dose-response model derived from a series of randomised controlled trials . The trials have many strengths but biases and problems with statistical analysis are likely to have led to over-estimation of the risks from bathing in the dose-response model . In addition, the WHO risk assessment failed to consider the effects of uncertainty and variability in risk estimates and sensitivity to model assumptions . Improved standards could be obtained by extending the risk assessment to examine these effects and by incorporating a suitably revised dose-response model. Water Sci Technol, 2001, 43(12), 39 - 48 A new analytical tool to assess health risks associated with the virological quality of drinking water (EMIRA study); Gofti-Laroche L et al.; This work assessed the risks associated with the virological quality of tapwater using a molecular analytical tool manageable in a field survey . It combined a daily epidemiological follow-up of digestive morbidity among a panel of volunteers and a microbiological surveillance of drinking water . RT-PCR was used for detection of enterovirus, rotavirus and astrovirus . 712 cases of acute digestive conditions occurred in the 544 volunteers . 38% (9/24) raw water and 23% (10/44) tap water samples were positive for at least one virus marker with 9/10 positive tap water samples complying with bacterial criteria . No statistically significant association was found between the presence of viral markers and observed incidence of digestive morbidity . However, when an outbreak occurred, enterovirus and rotavirus RNA was detected in the corresponding stored tap water samples . Sequencing of the amplified fragments showed that the rotavirus detected was of bovine origin . This work demonstrated that enteric virus markers were common in tapwater of the study communities (characterised by a vulnerable raw water) despite absence of bacterial indicators . Tangential ultrafiltration coupled to RT-PCR allowed a simultaneous and fast detection of the study viruses from environmental samples . This process is a promising tool usable for virological water surveillance, in as much the corresponding know-how is transferred to the field professionals. Public Health, 2001 Jul, 115(4), 301 - 5 Quantitative microbial monitoring in a dental office; Cellini L et al.; The aim of this study was to evaluate the environmental pollution before and after dental procedures (during one year) in a dental office in which a system of air filtration was effective and suitable procedures of microbial controls were routinely applied for instruments and small surfaces . The air contamination was evaluated during one year by the 'plate' method (Air Microbial Index, AMI) in each room of the dental office following a bimonthly monitoring program . Nutrient agar plates were exposed, in monitored areas for 1 h for each control time and incubated at 37 degrees C for 2 days . The number of viable cells was expressed as colony forming units per plate per hour (CFU/plate/h) . During the observation year, the quantitative analysis of the microbiological levels in the operative areas was always within acceptable values . In fact, a range from 4-18 CFU/plate/h was found as the mean of AMI in each controlled room . In particular, the aerosol pollution following dental procedures did not significantly modify AMI values compared with AMI values recorded before dental procedures . Data presented here demonstrate that the combined use of effective infection control procedures and a system of air filtration can be efficacious in reducing airborne environmental contamination in a dental office and emphasise the use of an inexpensive method such as AMI to verify the environmental bacterial pollution. Tuberculosis (Edinb), 2001, 81(1-2), 79 - 86 Pathogenesis of tuberculosis in cattle; Neill SD et al.; There has been a renewed interest in the pathogenesis of bovine tuberculosis in many countries, in an attempt to understand better its transmission, to improve diagnosis and assess the potential of vaccination . This paper, which overviews current knowledge of aspects of the pathogenesis of bovine tuberculosis, draws from studies of field cases and experimental infections and highlights deficiencies in current understanding . The pathogenesis of bovine tuberculosis has not received the same level of attention as with human tuberculosis, and in many instances, the processes involved in bovine tuberculosis have been drawn from studies of human tuberculosis or from small animal models of infection . This paper however, considers the successful emulation of naturally acquired tuberculosis using experimental cattle models and identifies the complex and integrated nature of microbiological, immunological and pathological events involved . Current understanding of the initiation of infection, immune responses, and subsequent pathology, which can vary significantly in individual animals are discussed . Whilst there are aspects of M . bovis that still remain elusive to scientific investigation, further studies on the pathogenesis of bovine tuberculosis are advocated as necessary to provide a better scientific basis on which to review control and eradication strategies, which are currently less than effective in many regions . Gastroenterol Hepatol, 2001 Jun-Jul, 24(6), 297 - 9 {Vulvar lymphedema: unusual manifestation of metastatic Crohn's disease}; Bel Pla S et al.; Cutaneous-mucosal lesions constitute one of the most frequent extraintestinal manifestations of Crohn's disease and in some cases may be the first symptom of intestinal disease . We describe the case of a 45-year-old female patient who sought medical help for genital tumefaction of 20 years' evolution . For the previous 15 years, she had been experiencing digestive symptomatology attributed to irritable bowel syndrome . Two months before the consultation, and coinciding with aggravation of the condition, the patient had been diagnosed with colonic Crohn's disease . Skin biopsy of the labia minora revealed sarcoid granulomas . The results of microbiological studies (staining for microorganisms and cultures) were negative . A diagnosis of metastatic vulvar Crohn's disease was made and, treatment with metronidazole was started, which improved the genital edema after 2 months . Genital lymphedema is an exceptionally rare manifestation of metastatic Crohn's disease that may appear several years before intestinal symptomatology develops . Treatment with metronidazole seems to be a good therapeutic option. Pest Manag Sci, 2001 Apr, 57(4), 351 - 9 Quantification of acetochlor degradation in the unsaturated zone using two novel in situ field techniques: comparisons with laboratory-generated data and implications for groundwater risk assessments; Mills MS et al.; Degradation of the herbicide acetochlor in the unsaturated zone was quantified using two unique in situ field techniques . The DT50 values generated at two different sites on surface soil and two subsoil depths using these techniques were compared with values generated under aerobic laboratory-incubation conditions (typically 20 degrees C, 40% maximum water holding capacity) . Additionally, laboratory-degradation data were generated on surface and subsoils from four other sites . All subsoils were treated with acetochlor at 5% of the surface soil application rate . Acetochlor degradation in both field- and laboratory-incubated subsoils was rapid and often exceeded surface soil rates . Field and laboratory DT50 values from all sites ranged from 2 to 88 days in subsoil, compared with a range of 1 to 18 days in surface soils . The DT50 results from in situ field techniques were comparable with those generated from laboratory incubations in the same soils, confirming the validity of performing laboratory-based degradation studies to determine pesticide DT50 values in subsoils . Microbiological characterisation of selected soils revealed that subsoils had a viable and active population, although direct counts of bacteria were consistently lower in subsoil (10(8)-10(9) g-1 dry soil) compared with surface soils (10(10) g-1 dry soil) . The leaching models used to perform groundwater risk assessments (e.g . PELMO, PESTLA, MACRO-DB, PRZM and the FOCUS EU leaching scenarios) have provision for inclusion of subsoil degradation rates . However, conservative default estimates are typically used, as no other alternative is available . Results presented here show that these default values may significantly underestimate true subsoil degradation contributions, and therefore not accurately predict pesticide concentrations in groundwater . The degradation data generated for acetochlor were applied to the mathematical model PELMO to demonstrate the importance of the inclusion of subsoil degradation data in groundwater risk assessment models and thereby in the registration of pesticides in Europe. Dtsch Med Wochenschr, 2001 Jun 22, 126(25-26), 750 - 3 {Cerebral tuberculosis in a patient with Sharp's syndrome.}; Gaul C et al.; HISTORY AND ADMISSION DIAGNOSIS: A 57-year-old female patient with fever and impaired consciousness was admitted to the department of neurology after her first epileptic seizure . She had a 9-year history of mixed connective tissue disease (MCTD, Sharp's syndrome) predominantly presenting with pulmonary symptoms and destructive arthritis . Endoprothetic surgery had to be performed several times and she was given long-term immunosuppressive therapy . INVESTIGATIONS: Cerebrospinal fluid analysis showed pleocytosis (59/mm3), high protein concentration (2540 mg/l) and low glucose level (31 mg/dl) compared to blood glucose level (122 mg/dl) the indicating possible tuberculous meningoencephalitis . DIAGNOSIS, TREATMENT AND COURSE: Tuberculostatic therapy was initiated, but despite extensive testing Mycobacterium tuberculosis could initially not be detected by microscopy, culture or amplification techniques (TMA; transcription mediated amplification) . Clinical response to antituberculous therapy was poor and the patient developed cerebral ischaemia and hydrocephalus . Because of earlier histological findings from the synovialectomy showing epitheloid cell granuloma a knee joint specimen from a wound drainage was tested and extracerebral tuberculosis was finally confirmed by mycobacterial culture so that tuberculosis as the reason for the meningoencephalitis became highly probable . Despite slight improvements the patient still had hemiparesis and lethargy as neurological sequalae at the end of therapy . CONCLUSION: The case demonstrates the difficulties in the diagnosis of tuberculosis in patients with signs and symptoms similar for those caused by other multisystemic diseases . When tuberculous meningitis is considered, therapy should be initiated even in cases with negative microbiological tests because of severe consequences when treatment is delayed. Minerva Urol Nefrol, 2001 Jun, 53(2), 61 - 3 {Microbiological evaluation of two different disinfection protocols of a new hemodialysis monitor with an ultrafilter}; Vallero A et al.; BACKGROUND: Hemodialysis monitors represent a frequent site for bacterial contamination . METHODS: Two different disinfection protocols on a new device (Formula(R), Bellco) have been compared: only chemical or chemical plus heat disinfection by means of CFU, and LAL test . The endotoxin removing capacity of ultrafilter was tested with varying lipopolysaccharide concentrations . RESULTS: Similar results were obtained with heat disinfection compared to chemical disinfection (CFU and LAL test) . The LAL test (chromogenic and gel-clot) showed that the ultrafilter performance decreased with use and was significant after 200 operating hours . CONCLUSIONS: Heat disinfection between dialysis shifts and chemical disinfection at the end of the day exclude bacterial contamination of the monitor as well as chemical disinfection; LAL test is a useful and simple tool to assess the ultrafilters performance in each Center. Fresenius J Anal Chem, 2001 Jun, 370(2-3), 270 - 4 NH4NO3 extractable trace element contents of soil samples prepared for proficiency testing--a stability study; Traub H et al.; In view of its intended use as a sample for proficiency testing or as a reference material the stability of the extractable trace element contents of a soil from an irrigation field was tested using the extraction with 1 mol/L ammonium nitrate solution according to DIN 19730 . Therefore, changes of the extractability of sterilized and non sterilized soil samples stored at different temperatures were evaluated over a period of 18 months . Sets of bottles were kept at -20 degrees C, +4 degrees C, about +20 degrees C and +40 degrees C, respectively . The NH4NO3 extractable contents of Cd, Cr, Cu, Ni, Pb and Zn were determined immediately after bottling and then after 3, 6, 12 and 18 months with ICP-AES or ETAAS . Appropriate storage conditions are of utmost importance to prevent deterioration of soil samples prepared for the determination of NH4NO3 extractable trace element contents . Temperatures above +20 degrees C must be avoided . The observed changes in the extractability of the metals (especially for Cr and Cu) most likely could be related to thermal degradation of the organic matter of the soil . There is no need to sterilize dry soil samples, because microbiological activity in soils with a low moisture content appears to be negligible with regard to trace element mobilization. Gastroenterol Clin Biol, 2001 Apr, 25(4), 425 - 8 {Crohn's disease complicated by multiple and recurrent aseptic splenic abscesses}; Coat N et al.; We report a case of multiple aseptic splenic abscesses occurring in a woman with Crohn's disease for three years . All microbiological samples were negative . The diagnosis was suspected on abdominal echography and CT scan and confirmed on histologic examination of the splenectomy specimen . The evolution was marked by recurrence of fever and inflammatory syndrome, associated to transitory morphological abnormalities of the accessory spleen . Aseptic splenic abscesses recurrence was suspected . This case allows us to consider aseptic splenic abscesses as an extra-intestinal manifestation and not as a splenic localisation of Crohn's disease. Enferm Infecc Microbiol Clin, 2001 May, 19(5), 211 - 8 {Cefotaxime, twenty years later . Observational study in critically ill patients}; Alvarez-Lerma F et al.; OBJECTIVE: Afer twenty years of commercial availability of cefotaxime, the objective of this study was to know the reasons and modes of use, administration dosage as well as its effectiveness and tolerance in critically ill patients admitted to Intensive Care Units (ICU) in our country . DESIGN: Open, prospective, observational, multicenter study . SUBJECTS: All patients who had cefotaxime administered in monotherapy or in combination with other antibiotics were included as cases in this study . RESULTS: A total of 624 patients were included in 44 ICUs (average 14 cases) . Cefotaxime was indicated for therapy of 274 community-acquired infections (43.9%), 194 prophylaxis (31.1%), and 156 nosocomial infections (25.0%) . Both community-acquired pneumonia (149, 34.7%) and mechanical ventilation associated pneumonia (62, 14.4%) predominated, followed by trachebronchitis (60, 13.9%) and central nervous system infections (42, 9.8%) . Over half of infections (222, 51.6%) presented as systemic inflammatory response syndrome (SIRS), 133 (30.9%) as severe sepsis, and 75 (17.4%) as septic shock.In 374 (87.0%) out of the 430 cases of infection treatment, cefotaxime wan prescribed on an empirical basis and in 150 of them (40.1%) a further confirmation of the causative agent was obtained . In 120 (27.9%) cases, cefotaxime was administered as monotherapy and in the remaining cases in association with one or more antibiotics.The use of cefotaxime as prophylaxis was evaluated as failure in 31 (16.0%) of the cases, whereas in treatment it was considered as failure in 98 (22.8%) of the 430 cases, 51 community-acquired infections, 27 (27.3%) of ICU-acquired infections, and 20 (35.1%) nosocomial infections acquired outside the ICU.In 127 (29.5%) of the 430 infection treatments the initial treatment was changed . The reasons for the change included clinical failure (36, 28.3%), recovery of an uncovered pathogen with the antibiotic (40, 31.5%), emergence of multi-resistant pathogens (28, 22.0%), to decrease the therapeutic spectrum (7, 5.5%), and other reasons (16) . Cefotoxime was also changed in 21 (6.0%) of the 194 cases in which it was used as prophylaxis.In 32 (5.1%) patients 37 adverse effects were noted which were associated with a possible or likely use of cefotaxime . Most notably, diarrhoea in 15 (2.4%) occasions and skin rash in 6 cases (1.0%) . CONCLUSIONS: Cefotaxime is still one of the therapies of choice for community-acquired and nosocomial infections as well as in different prophylactic modes . It is mostly used on an empirical basis and associated with other antibiotics . Clinical and microbiological efficiency is high whereas adverse effects related to its use have been scarce. Arch Pediatr, 2001 Jun, 8(6), 577 - 83 {Chronic recurrent multifocal osteomyelitis in children: report of 17 cases}; Coinde E et al.; Chronic recurrent multifocal osteitis (OCRM) is a rare condition in children, of unknown aetiology, which may be misdiagnosed as osteomyelitis, arthritis or tumour . PATIENTS AND METHODS: We present a retrospective multicentric study of 17 patients (five boys and 12 girls) with an average follow-up of 7.5 years (six months-25 years) . RESULTS: A spectrum of presenting features is possible, ranging from bone lesions alone to lesions combined with arthritis, palmoplantar pustulosis or psoriasis . The diagnosis was delayed from two weeks to five years . Roentgenographic evaluation was often normal at the beginning of the disease or showed nonspecific bone reactions . Radioisotope bone scans assisted in establishing the diagnosis and in identifying lesions that were initially clinically silent . Bone biopsies were performed in seven cases . Histopathological examination showed only mild inflammatory nonspecific changes . Microbiological cultures were always negative . Treatments were different according to the evolution of the disease and the hospital . There was no response to antibiotics in seven patients . The response to nonsteroidal anti-inflammatory agents and steroids was moderate and often transient . Salazopyrine and pamidronate treatment used in two patients allowed a durable remission . We lost sight of four patients, pain persisted in three in spite of treatment, it disappeared in two with treatment, mild pain persisted in five without treatment and remission occurred in three without treatment . CONCLUSION: This study clarifies the clinical and radiologic features of chronic recurrent multifocal osteomyelitis . The recognition of this rare entity is often delayed and difficulties in patient management sometimes emerge from its usual protracted course. Crit Care Med, 2001 Jul, 29(7 Suppl), S109 - 16 Epidemiology of sepsis: an update; Angus DC et al.; OBJECTIVE: We review the case definition, occurrence, and outcome of sepsis . We discuss whether the epidemiology of sepsis has changed over time and discuss issues important to our understanding of sepsis . DATA SOURCES: Literature review . DATA SUMMARY: Our understanding of the epidemiology of sepsis is hampered by the lack of a reliable case definition . Inconsistent application of sepsis definition criteria contributes to confusion and variability in the literature . Variability in the time course of sepsis also introduces difficulty . The Centers for Disease Control estimated an incidence of 73.6 per 100,000 population in 1979, rising to 175.9 per 100,000 in 1989 . However, this study was of septicemia, not severe sepsis . There are several hospital-based studies of the occurrence of severe sepsis, defined using the American College of Chest Physicians/Society of Critical Care Medicine consensus criteria . These studies reported variable hospital and intensive care unit (ICU) occurrence rates, ranging from 2% to 11% of all hospital or ICU admissions . Most of these data are from academic, tertiary care centers, which limits generalizability . More population-based studies are required to better delineate the incidence and risk factors of sepsis in the general population . Hospital mortality from sepsis has ranged from 25% to 80% over the last few decades . Although mortality may be lower in recent years, sepsis is clearly still a very serious condition . Achieving a better understanding of whether the mortality rate for sepsis is falling, however, is confounded by the lack of a uniform definition . Risk factors for adverse outcome include the degree of physiologic derangement, organ dysfunction, underlying illness, site of infection, and microbiological etiology . We do not know, however, the factors that predict response to new therapies . This dilemma has led researchers to explore whether markers of the inflammatory cascade might be more specific for sepsis, more accurate for risk prediction, or more useful for predicting response to therapy . However, there as yet is no equivalent of the CPK-MB for acute myocardial infarction . Whether we will find such a marker as we develop a greater understanding of the genetic control of the inflammatory cascade is uncertain but promising . One might assume intuitively that the epidemiology of sepsis is changing . For example, the number of patients being treated in ICUs has increased over time, the technologies used in the ICU have changed, and the choice and the use of antibiotics have changed . Predisposing factors, such as chemotherapeutic regimens, have also changed, and there have been marked changes in antibiotic resistance . Furthermore, there have been wide changes in the microbiological etiologies of diseases such as pneumonia and acute exacerbations of chronic bronchitis . However, lacking good case definitions and true incidence studies, we can only make inferences about whether the epidemiology of sepsis is truly changing . CONCLUSION: Many studies have documented many aspects of the epidemiology of sepsis . However, the composite picture they provide, although rich in many aspects, remains incomplete and emphasizes the heterogeneity of the condition . Unfortunately, few population-based prospective cohort studies exist that allow us to accurately delineate the risk factors for sepsis, its course, and its outcome . To place new information, such as the role of genetic predisposition, in the correct context, it is essential that such studies be conducted. Scand J Gastroenterol, 2001 Jul, 36(7), 701 - 5 Helicobacter pylori and iron deficiency anaemia in children; Ashorn M et al.; BACKGROUND: Both iron deficiency anaemia and Helicobacter pylori infection are rare in developed countries . A possible connection has been suggested between these two diseases and our aim was to define the clinical picture and to study the effect of bacterial eradication in H . pylori colonized children with severe anaemia . METHODS: Eight children with iron deficiency anaemia refractory to iron supplementation were examined with gastroscopy because of suspicion of H . pylori infection . Anaemia was treated with oral ferrous sulphate . Two patients needed blood transfusions . Eradication therapy was given either with combination of colloidal bismuth subcitrate and metronidazole or with omeprazole, clarithromycin and amoxycillin . Eradication was confirmed by urea breath test 4 weeks post-treatment . RESULTS: H . pylori infection was confirmed histologically and microbiologically in all children, who also presented with chronic, active gastritis . Bacteria were successfully eradicated in 7/8 patients . Correction of haemoglobin values was observed post-treatment, iron stores still being deficient at control in 4/8 children . CONCLUSIONS: Our results suggest that H . pylori might have a role in causing iron deficiency anaemia in school-age children . Screening for H . pylori should be extended to cover those patients with other clinical manifestations than symptoms from gastrointestinal tract. J Am Coll Nutr, 2001 Jun, 20(3), 247 - 54 Iron and folate in fortified cereals; Whittaker P et al.; BACKGROUND: Fortification of cereal-grain products was introduced in 1941 when iron and three vitamins were added to flour and bread . Ready-to-eat cereals were fortified at about the same time . These fortifications have contributed to increased dietary iron intake and reductions in iron deficiency anemia in the US . In 1996, FDA finalized rules for fortification of specific enriched cereal-grain products with folic acid . This measure was instituted to increase the folate intakes of women of child-bearing age and thereby reduce the risk of having a pregnancy affected with a neural tube birth defect . However, with recent increases in fortification, public health officials in the US are concemed that excess intake of specific nutrients such as iron and folic acid may result in toxic manifestations . OBJECTIVE: Our objective was to measure iron and total folate content in breakfast cereals and compare assay to label values for % Daily Value . We also determined by weight the amount of a ready-to-eat breakfast cereal adults would eat and compared this to the labeled serving size, for which the reference amount for this cereal per eating occasion was 1 cup or 30 g . DESIGN: Twenty-nine breakfast cereals were analyzed for iron content using the bathophenanthroline reaction . Twenty-eight cereals were analyzed for total folate, utilizing a microbiological assay with tri-enzyme digestion . Serving size quantities were estimated in seventy-two adults who regularly ate breakfast cereal and were asked to fill a 16 or 22 cm round bowl with the amount of cereal that they would consume for breakfast . RESULTS: When the labeled value was compared to the assayed value for iron content 21 of the 29 breakfast cereals were 120% or more of the label value and 8 cereals were 150% or more of the label value . Overall, analyzed values for iron ranged from 80% to 190% of label values . Analyzed values for folate ranged from 98% to 320% of label values . For 14 of 28 cereals, analyzed values exceeded label declarations by more than 150% . Bran-containing cereals contained the highest amounts of folate relative to their label declarations . The median analyzed serving size for the breakfast cereal was 47 g for females, 61 g for males with a combined median of 56 g as compared to the label value of 30 g . CONCLUSIONS: Analyzed values of iron and folic acid in breakfast cereals were considerably higher than labeled values . For adults, the amount of cereal actually consumed was approximately 200% of the labeled serving size . When the quantity of cereal consumed is more than the labeled serving size and when the levels of iron and folate are higher than declared, the intake of both will be significantly greater than the labeled values . It will be important to continue monitoring serum ferritin and folate levels in NHANES IV, since daily consumption of breakfast cereals may contribute to excessive intakes of iron and folate. Lett Appl Microbiol, 2001 Jul, 33(1), 31 - 5 Development of a rapid method for the detection of verocytotoxin-producing Escherichia coli (VTEC); Bettelheim KA; AIMS: The object of this study was to adapt a new test kit to achieve the rapid identification of verocytotoxin-producing Escherichia coli (VTEC) . METHODS AND RESULTS: The kit, which is based on reversed passive latex agglutination (RPLA), was combined with a method for identifying heat-labile enterotoxin-producing E . coli (LT-ETEC) . An answer can thereby be obtained within a single working day . Over 200 strains, both VTEC and non-VTEC, of human and animal origin, belonging to a variety of serotypes were tested in this new rapid technique . Apart from three false-positive results, all other strains gave the correct answer by this rapid method . CONCLUSION: The method should enable the diagnosis of these important human pathogens to be made rapidly by most microbiological laboratories, and permit appropriate actions to be taken rapidly and therefore more effectively. J Clin Periodontol, 2001 Aug, 28(8), 782 - 9 Subantimicrobial dose doxycycline as an adjunct to scaling and root planing: post-treatment effects; Caton JG et al.; BACKGROUND/OBJECTIVE: Subantimicrobial dose doxycycline (SDD 20 mg bid) plus scaling and root planing (SRP) significantly improved clinical attachment level (CAL) and reduced probing depth (PD) compared with placebo plus SRP in a double-blind, placebo-controlled, multicenter study of patients with adult periodontitis (AP) . In a study conducted as a follow-up, the post-treatment effects of SDD were assessed in patients who completed the SRP study . METHODS: The SRP study was a 9-month, active-treatment study and the follow-up was a 3-month, no-treatment study . In the SRP study, tooth sites in qualifying quadrants were scaled and root planed and patients were randomized to receive twice daily SDD 20 mg or placebo . In the follow-up, patients received no study drug; investigators and patients remained blinded to the previous treatment group assignments . Efficacy measures included the change in CAL and PD from baseline values determined at the start of the SRP study in tooth sites stratified by baseline PD (i.e., 0-3 mm, 4-6 mm, > or =7 mm) . Safety was evaluated using adverse event data and the results of clinical laboratory tests, oral pathology examinations, and microbiological assessments . RESULTS: Within each disease stratum, the incremental improvements in PD and CAL demonstrated in the SDD group over 9 months of active treatment were maintained through 3 additional months of no treatment . Treatment cessation did not result in an accelerated regression of periodontal health . No differences in the incidence of adverse events (including those related to infection) or laboratory or microbiological parameters were noted between the SDD group and the placebo group . CONCLUSIONS: The administration of SDD 20 mg bid for a period of up to 9 months is not associated with rebound effects or delayed or negative after-effects for a 3-month period after cessation of therapy. J Clin Periodontol, 2001 Aug, 28(8), 741 - 5 On the symmetry of periodontal disease; Mombelli A et al.; BACKGROUND, AIM: Symmetry is a common feature of biological systems, and can be observed in multiple aspects of the human body . The purpose of this study was to estimate the impact of symmetry on variance observed in intraoral topographic distribution patterns of chronic periodontitis . METHOD: This analysis was performed on a data set from 56 subjects, including clinical and microbiological variables, recorded at the mesial and distal aspect of every tooth in the entire dentition . The impact of contralateral conditions was determined on the level of the site, the tooth, and the quadrant . RESULTS: Significant correlations were detected between probing depths, recession, attachment levels, total cultivable bacterial counts and the plaque index recorded on the right and left side on all levels of analysis . The odds for bleeding on sampling, as well as for the presence of P . intermedia/nigrescens and A . actinomycetemcomitans increased significantly if the respective contralateral site was positive for the same parameter . In combining ipsilateral and contralateral parameters into the analysis it could be shown in several instances that this contralateral effect was stronger than the impact of other, ipsilateral factors . As an example, the odds for bleeding on sampling increased up to 10 fold if the contralateral site was bleeding, whereas the ipsilateral total cultivable count, determined at the same site, explained less than 30% of the variation in the bleeding tendency . CONCLUSION: These findings support the view that the development of periodontal disease in any site cannot be explained by the influence of local detrimental factors alone. J Appl Microbiol, 2001 Jul, 91(1), 22 - 8 The influence of packaging methodology on the microbiological and fatty acid profiles of refrigerated African catfish fillets; Anelich LE et al.; AIMS: The shelf-life of refrigerated catfish fillets was determined at 2 degrees C, to simulate retail conditions, using two types of packaging materials, vacuum packing (VP) and oxygen permeable packaging (OPP) . METHODS AND RESULTS: Representative samples (n=5) from both types of packaging methods were drawn at random every 2 d until a microbiological count of 106 cfu g-1 was reached . Samples were pooled and screened microbiologically using standard methods . Fatty acid analyses of total lipids, neutral lipid, glycolipid and phospholipid fractions were also conducted, to determine at which point the fish was regarded as spoiled and which packaging method provided a longer shelf-life . OPP limits storage to a maximum of 4 d (aerobic plate count of 8.2 x 105 cfu g-1), whereas VP extends the shelf-life of the fillets to between 6 and 8 d (aerobic plate count of 9.2 x 104 cfu g-1 and 1.66 x 106 cfu g-1, respectively) . Similarly, coliform counts increased with time; however, packaging material had no statistical influence thereon . CONCLUSION: Until d 13, when the experiment was terminated, no deterioration in lipid composition of the various fractions was noted . SIGNIFICANCE AND IMPACT OF THE STUDY: An extended shelf-life microbiologically-speaking, for potential processors, could thus be obtained by using VP instead of OPP. Acta Paediatr, 2001 Jun, 90(6), 605 - 10 The efficacy of bismuth subsalicylate in the treatment of acute diarrhoea and the prevention of persistent diarrhoea; Chowdhury HR et al.; A controlled, randomized, double-blind study in Bangladeshi children (ages 4-36 mo) with acute diarrhoea was undertaken to determine whether bismuth subsalicylate (BSS) would prevent the development of persistent diarrhoea (PD) in young children . The children were randomized to two groups: 226 were given liquid oral BSS, (as Pepto-Bismol), 100 mg/kg/d for 5 d; 225 were given placebo of identical appearance . On admission to the study, the two groups were comparable both clinically and microbiologically . Rotavirus was found in 56% of all the children, and enterotoxigenic E . coli in 31% of a subsample studied . Children treated with BSS had less severe and less prolonged illness than those treated with placebo (p = 0.057) . There was, however, no difference in the development of PD between the two groups (8% and 11%) . Unexpectedly, patients treated with BSS gained significantly more weight (2.3%) than those treated with placebo (0.5%; p < 0.001) during the course of the study . No toxicity of BSS was detected . Conclusion: Treatment with BSS had a modest therapeutic effect on acute diarrhoea, as has been previously demonstrated, but with no suggestion of a therapeutic effect on the prevention of persistent diarrhoea in this group of patients. Clin Infect Dis, 2001 Aug 1, 33(3), 376 - 7 Epub 2001 Jul 05. Food irradiation: a public health challenge for the 21st century; Steele JH; Although the United States food supply is generally considered one of the safest in the world, foodborne illnesses remain a concern . Each year, millions of Americans become ill and as many as 5000 die from foodborne infections . The United States Department of Agriculture estimates that medical treatment and productivity losses associated with foodborne illnesses cost as much as $37 billion annually . Irradiation, which involves exposing food briefly to radiant energy, can reduce or eliminate microorganisms that contaminate food or cause spoilage . So far, only limited quantities of irradiated foods--spices, herbs, dry vegetable seasonings, and some fresh fruits, vegetables, and poultry--have been available in the United States . Major purchasers are health care and food service establishments . The World Health Organization reviewed 500 studies and concluded that food irradiation poses no toxicological, microbiological, or nutritional problems . In more than 40 years, there have been no accidents in North America involving transport of the types of radioactive isotopes used for irradiation. Boll Soc Ital Biol Sper, 1999 Jul-Aug, 75(7-8), 39 - 45 Histological analysis and staining techniques modified and verified on ancient mummified tissues to study microorganism infestations; Boano R et al.; The purpose of this work is to give a brief account of the possibility to estimate the preservation of human mummified tissues using histological analysis . This method can be useful to identify injuries and to plan qualified conservative actions on ancient human remains . Some preliminary results are presented here regarding the study on 16 ancient mummies from the Egyptian Museum of Turin . Samples of mummified tissues were taken without damaging the remains; they were hydrated again and dyed with histological techniques which were specifically modified and verified in same cases . Our research identifies some agents (biological and chemical) that appear to be responsible, among others, of mummified tissue destruction . The microscopic examination reveals features that might refer to fungal and bacterial infestation . Using special staining methods on seried sections we were able to suspect, at least in one case, the presence of biologically active forms . Microbiological assays confirm the vitality of fungi . Histological tissue analysis can then be useful to guide any conservative intervention for preservation and protection of the integrity of biological remains from museum collections. Clin Microbiol Rev, 2001 Jul, 14(3), 561 - 83 Whipple's disease and "Tropheryma whippelii"; Dutly F et al.; Whipple's disease is a rare bacterial infection that may involve any organ system in the body . It occurs primarily in Caucasian males older than 40 years . The gastrointestinal tract is the most frequently involved organ, with manifestations such as abdominal pain, malabsorption syndrome with diarrhea, and weight loss . Other signs include low-grade fever, lymphadenopathy, skin hyperpigmentation, endocarditis, pleuritis, seronegative arthritis, uveitis, spondylodiscitis, and neurological manifestations, and these signs may occur in the absence of gastrointestinal manifestations . Due to the wide variability of manifestations, clinical diagnosis is very difficult and is often made only years or even decades after the initial symptoms have appeared . Trimethoprim-sulfamethoxazole for at least 1 year is usually considered adequate to eradicate the infection . The microbiological diagnosis of this insidious disease is rendered difficult by the virtual lack of culture and serodiagnostic methods . It is usually based on the demonstration of periodic acid-Schiff-positive particles in infected tissues and/or the presence of bacteria with an unusual trilaminar cell wall ultrastructure by electron microscopy . Recently, the Whipple bacteria have been characterized at the molecular level by amplification of their 16S rRNA gene(s) . Phylogenetic analysis of these sequences revealed a new bacterial species related to the actinomycete branch which was named "Tropheryma whippelli." Based on its unique 16S ribosomal DNA (rDNA) sequence, species-specific primers were selected for the detection of the organism in clinical specimens by PCR . This technique is currently used as one of the standard methods for establishing the diagnosis of Whipple's disease . Specific and broad-spectrum PCR amplifications mainly but not exclusively from extraintestinal specimens have significantly improved diagnosis, being more sensitive than histopathologic analysis . However, "T . whippelii" DNA has also been found in persons without clinical and histological evidence of Whipple's disease . It is unclear whether these patients are true asymptomatic carriers or whether differences in virulence exist among strains of "T . whippelii" that might account for the variable clinical manifestations . So far, six different "T . whippelii" subtypes have been found by analysis of their 16S-23S rDNA spacer region . Further studies of the pathogen "T . whippelii" as well as the host immune response are needed to fully understand this fascinating disease . The recent cultivation of the organisms is a promising major step in this direction. Int J Gynaecol Obstet, 2001 Jul, 74(1), 35 - 43 Efficacy of 7-day treatment with metronidazole+miconazole (Neo-Penotran) - a triple-active pessary for the treatment of single and mixed vaginal infections; Ozyurt E et al.; OBJECTIVE: To evaluate the efficacy of Neo-Penotran pessaries (metronidazole 500 mg + miconazole nitrate 100 mg) in candidal, bacterial and trichomonal vaginitis and in mixed vaginal infections . METHOD: Ninety-seven patients with clinical diagnosis of vaginitis entered this open, non-comparative study . Each patient inserted one pessary twice daily for 7 days . Gynecological and microbiological assessments were carried out before, and 8-10/21-23 days after the start of treatment . RESULTS: Vaginitis symptoms were resolved in 91% of the 74 patients evaluated, and improved in a further 7% . Microbiological cure rates were 97.3% for trichomonal, 86.6% for bacterial and 81% for candidal vaginitis . Recurrence rates were 2.7, 3.8 and 16.1%, respectively . Overall microbiological cure rate for mixed infections was 86%, with 93% for trichomonal+bacterial, and 73% for bacterial+candidal vaginitis . In two out of three cases with trichomonal+bacterial+candidal infection, the microorganisms were eradicated completely . CONCLUSION: Neo-Penotran provides immediate and effective treatment for vaginitis, irrespective of single or multiple infection, even when the diagnosis may be uncertain. Clin Oral Implants Res, 1998 Dec, 9(6), 357 - 64 In vivo early plaque formation on pure titanium and ceramic abutments: a comparative microbiological and SEM analysis; Rasperini G et al.; A lack of information exists about the influence of different implant abutment materials on bacterial colonization and its role in the development of perimplantar infections . In order to study these aspects, removable acrylic devices, harboring samples of titanium and novel ceramic abutments (Nobel Biocare) were adapted to the molar-premolar region in 2 mandibular quadrants of 4 volunteers . Samples of each material were collected at 6 and 24 h, 7 and 14 days . Samples were observed by scanning electron microscopy and bacterial counts were made by means of ATP detection and direct plate count . The electron micrographs demonstrated that the bacteria colonization was already present after 6 h of presence in the oral cavity . After 24 h, both the materials were covered by several layers of bacterial cells . No differences in microbial colonization were observed between titanium and ceramic samples . The microbiological analysis confirmed the presence of relevant amounts of microbial cells on the tested samples . The maximum of colonization was achieved after 24 h in the oral cavity and the bacterial counts remained constant over the 14 day period . No significant differences were observed between the two materials analyzed in this study . In addition, ATP-bioluminescence technology was demonstrated to be a suitable system to evaluate bacterial colonization in the oral cavity. J Org Chem, 2001 Jan 26, 66(2), 538 - 43 Microbiological transformations . 47 . A step toward a green chemistry preparation of enantiopure (S)-2-, -3-, and -4-pyridyloxirane via an epoxide hydrolase catalyzed kinetic resolution; Genzel Y et al.; The biocatalyzed hydrolytic kinetic resolution of 2-, 3-, and 4-pyridyloxirane by the Aspergillus niger epoxide hydrolase (EH) has been explored . This was used to perform a gram scale preparation of these epoxides of (S) absolute configuration using a process performed at a concentration as high as 10 g/L (82 mM) . All three epoxides have been obtained in a nearly enantiopure form (ee > 98%) . Interestingly, it was shown that this biotransformation could be achieved using plain water instead of buffer solution, an important improvement as far as downstream processing of an eventual industrial process is concerned . Neither of these substrates could be obtained in reasonable enantiomeric purity and yield using the nowadays most efficient metal-based catalysts. Transpl Infect Dis, 2000 Jun, 2(2), 80 - 7 Microbiological diagnosis of invasive fungal infections in transplant recipients; Verweij PE et al.; Invasive fungal infections remain an important cause of morbidity and mortality in transplant recipients . Since conventional diagnostic tools such as culture lack sensitivity and specificity, alternative diagnostic assays have been developed . Among the most promising techniques are the detection of fungal DNA and serology . Fungal DNA can be detected with high sensitivity and specificity when performed with specimens from sterile sites such as blood . Polymerase chain reaction (PCR) assays can be used to detect a broad range of fungal pathogens and combined with species identification . Multicenter diagnostic studies are needed to establish the diagnostic value of PCR but lack of standardization hampers such studies . The serodiagnosis of invasive fungal infections has become an important tool in the management of invasive fungal infections . Especially the detection of circulating galactomannan has been shown to be a sensitive marker for invasive aspergillosis . Both serology and PCR can be used to monitor the response to antifungal therapy . The optimal use of non-culture-based methods is in prospective screening of patients at high risk . Since the incidence of disease greatly influences the positive predictive value, screening should take place only in those patients at very high risk for invasive fungal disease. Transpl Infect Dis, 2000 Mar, 2(1), 15 - 21 Safety and efficacy of granulocyte colony-stimulating factor in kidney and liver transpl