Analysis of a Temporal Cluster of Shigella Boydii Isolates in Mpumalanga; South Africa; November to December 2007

Background: Shigellosis is a global human health problem. The disease is most prevalent in developing countries with poor access to safe potable water and sanitation. Shigella boydii is of particular epidemiological importance in developing nations such as African and Asian countries. In the present study; we report on the analysis of a temporal cluster of 29 S. boydii serotype 2 strains; isolated in the Mpumalanga Province of South Africa (SA) over the period of November to December 2007. Methodology: Bacteria were identified as S. boydii using standard microbiological identification techniques and serotyped using commercially available antisera. Susceptibility testing to antimicrobial agents was determined by the Etest. Genotypic relatedness of strains was investigated by pulsed-field gel electrophoresis (PFGE) analysis of digested genomic DNA. Results: The cluster of 29 isolates revealed comparable antimicrobial susceptibility profiles; while dendrogram analysis of PFGE patterns showed that the cluster of isolates grouped together and could clearly be differentiated from a random selection of unrelated S. boydii serotype 2 strains. Our data has strongly suggested that this cluster of isolates may share a common ancestry. However; this cannot be substantiated by epidemiological data because a detailed epidemiological investigation was not conducted. Conclusions: We have documented the first cluster of S. boydii infection in SA. Due to the lack of adequate epidemiological investigation; we cannot emphatically state that an outbreak had occurred. However; we do hypothesis that this was an outbreak for which a waterborne source cannot be excluded. This study has highlighted the urgent need for timely and appropriate systems of epidemiological investigation of all suspected outbreaks of disease in developing countries

Evaluation of Anti-Inflammatory; Antinociceptive and Antipyretic Effects of Methanol Extract of Cleome Chelidonii

The methanol extract of Cleome chelidonii whole plant was investigated for its anti-inflammatory; antinociceptive and antipyretic activities at the doses of 50; 100 and 200 mg/kg of body weight. The experimental paradigms used were carrageenan-induced pedal edema for anti-inflammatory activity; acetic acid-induced writhing and hot plate methods to assess antinociceptive activity and yeast-induced hyperpyrexia to evaluate the antipyretic activity. In acute phase inflammation; at dose of 200 mg/kg of body weight after 3 hours treatment with methanol extract of C. chelidonii in carrageenan showed a maximum inhibition of 54.6(P 0.05) when compared with standard drug aspirin (10 mg/kg); which showed decreased formation of granuloma tissue by 60.6(P 0.01). The methanol extract possesses significant (P 0.05) antinociceptive activity in both paradigms. In rats a significant (P 0.01) reduction in hyperpyrexia was also produced by the extract. This study exhibits that the methanol extract of entire plant of C. chelidonii possesses anti-inflammatory; antinociceptive and antipyretic activities

Video assisted thoracoscopic surgery at the Queen Elizabeth Hospital Barbados / Cirugía toracoscópica asistida por video en el Hospital Queen Elizabeth de Barbados

Video assisted thoracoscopic surgery (VATS) is now an established technique for diagnostic and therapeutic intervention in patients with thoracic pathology at the Queen Elizabeth Hospital (QEH). This article reviews the experience with 50 patients over the period May 1996 to February 2003, looking at various factors and outcomes in an attempt to ascertain the viability of this procedure at this institution. It serves as a follow-up article to the publication of the initial experience in 1999 (1). There were 24 males and 26 females included in the study. Video assisted thoracoscopic surgery was used for diagnosis in 27 cases (54), therapeutic indication in 17 cases (34) and as both a diagnostic and therapeutic modality in six cases (12). In 92of cases, the operations were completed thoracoscopically with a conversion rate of 8. The morbidity and mortality rates were 18and 2respectively. Video assisted thoracoscopic surgery is an effective tool for the treatment and investigation of selected thoracic pathology at the QEH with complications and mortality rates comparable to other institutions (2, 3).

La cirugía toracoscópica asistida por video (CTAV) es ya una técnica establecida para el diagnóstico y la intervención terapéutica de pacientes con patologías toráxicas en el Hospital Queen Elizabeth. Este articulo pasa revista a nuestra experiencia con 50 pacientes en el transcurso del período de mayo de 1996 a febrero de 2003, prestando atención a varios factores y resultados en un intento por corroborar la viabilidad de ese procedimiento en nuestra institución. El trabajo sirve como un artículo de seguimiento a la publicación de nuestra experiencia en el año 1999(1). El estudio abarcó 24 hombres y 26 mujeres. La CTAV se usó para el diagnóstico en 27 casos (54%), como indicación terapéutica en 17 casos (34%), tanto en la modalidad de diagnóstico como en la terapéutica en seis casos (12%). En el 92% de los casos, las operaciones fueron completadas toracoscópicamente con una tasa de conversión de 8%. Las tasas de morbilidad y mortalidad fueron 18% y 2% respectivamente. La CTAV resultó ser un instrumento efectivo para el tratamiento y la investigación de patologías toráxicas seleccionadas en nuestra institución, con complicaciones y tasas de mortalidad comparables a la de otras (2) (3).

Antimicrobial use in paediatric wards of teaching hospitals in Bangladesh.

To ascertain the pattern of antimicrobial use and to assess its appropriateness a 4-month prospective study was conducted from January through April 1998 in paediatric wards of five selected medical college hospitals in Bangladesh. The hospitals were selected by simple random technique. Every patient in the paediatric wards of the selected hospitals who was being treated with antimicrobials during the data collection period was considered for the study. The treatment charts of 2171 admitted paediatric patients were reviewed. Pneumonia and diarrhoea were the two most common infectious diseases among them. The most commonly used antimicrobials were ampicillin, gentamicin, amoxicillin, cloxacillin and ceftriaxone. The majority of the admitted paediatric patients (56.1%) included in this study received two or more antimicrobials in combination for their treatment. The percentages of appropriate antimicrobial treatment of pneumonia, and diarrhoea were 57.1% and 67.8% respectively across the hospitals. The evident of high percentages of inappropriate antimicrobial treatment for the most common infectious diseases suggested the need for intervention to improve antimicrobial use in hospitals.

The concept of noise sensitivity: implications for noise control.

The term "noise sensitivity" is frequently used in many areas of noise research. However, it can be used to describe several different effects and it can be measured in different ways. In noise surveys, noise sensitivity refers to the fact that individuals differ in the annoyance produced by different sources of noise. Noise sensitivity can be viewed as an independent variable, which may be directly related to outcomes such as health status, or it can be conceptualized as a factor that modifies or mediates the effects of noise exposure on the outcome measure. Noise sensitivity is highly correlated with the general trait negative affectivity, a measure of the extent to which individuals perceive or report negative features of their environment or self. Indeed, few studies have demonstrated effects of noise sensitivity that are independent of negative affectivity. This implies that it is most appropriate to examine general indicators of reported sensitivity rather than a noise-specific measure. Noise sensitivity can also be considered in terms of physiological reactivity to noise sources. Such effects are often only weakly associated with self-reports of noise sensitivity. Habituation to noise is also an important topic to consider and again this appears to be largely independent of self-reported noise sensitivity. Overall, it would appear that it is important to distinguish between subjective reports of noise sensitivity and objective indicators. Different factors will modify these two aspects of noise sensitivity and this implies that different strategies are needed to influence them. Such effects must be taken into consideration when one considers whether control should be targeted at the community in general, or whether it should also cover the most sensitive individuals.

Sulbactam-cefoperazona en el tratamiento de la neumonía nosocomial / Sulbactam-cefoperazone in the treatment of the nosocomial pneumonia

Investigadores de 8 centros a nivel nacional evaluaron la eficacia y seguridad de la combinación sulbactan/cefoperazona (SBT/CPZ)m, en un estudio abierto en 51 pacientes hospitalizados (29 M, 22 F), con edades comprendidas entre 12-90 años con el diagnóstico (en base a historia clínica, hallazgos radiológicos y/o bacteriológicos) de neumonía nosocomial (NN). La combinación fue administrada como monoterapia en una dosis diaria de 4,76g (rango 39g) entre 1-14 días (X=9,94 días). De los 51 pacientes, 47 fueron evaluados para eficacia clínica; se obtuvo curación en 41 (87,2 por ciento), falla en 5 (10,6 por ciento) y recaída en 1(2 por ciento). Veintidos pacientes se incluyeron para evaluación de eficacia bacteriológica, ocurriendo erradicación en 19 (86 por ciento) y persistencia en 3 (14 por ciento) siendo estos: K.pneumoniae, P.aeruginosa + E.cloacae y P.aeruginosa + S.coagulasa negativa, los cuales respondieron al agregar amikacina. El 88 por ciento de los gérmenes aislados fueron Gram negativos. Como efecto adverso se reportó dispepsia en un paciente. Cinco pacientes muerieron, dos de ellos relacionados con la infección y tres por otras causas. Los resultados permiten concluir que la combinación SBT/CPZ usada como monoterapia constituye una alternativa apropiada para el tratamiento de neumonía nosocomial

Occupational carbamate pesticide intoxication in three farm workers: implications and significance for occupational health in Jamaica

The importance of occupational health practice principles in the delivery of health care to the working population is stressed by the authors' management of the an incident of occupational pesticide poisoning. The clinical management of the patients involved, as well as the occupational and environmental health management of that incident, is discussed. An illustrative case report is used to describe an occurrence of carbofuran pesticide poisoning in three female farm workers in Jamaica. This report highlights the implications and significance of this incident in terms of sensitivity of the medical profession to similar occupational health problems

A new tool for continuous detection of the presence of triatomine bugs, vectors of Chagas disease, in rural households

Ante la necesidad de contar con un dispositivo sencillo pero sensible para detectar triatominos domiciliarios y como parte del conjunto de actividades de vigilancia de la transmisión de la Enfermedad de Chagas en áreas rurales, mediante investigaciones realizadas en el INDIECH, se desarrolló un nuevo tipo de caja de cartulina denominado sensor María. La caja de cartulina rígida de 40x22x2cm, está abierta en ambos costados y en su extremo inferior, para permitir la libre entrada y salida de las vinchucas. En su interior contiene una cartulina blanda absorbente plegada en acordeón que posee una serie de orificios verticales a través de los cuales los insectos pueden desplazarse. El sensor María fue instalado dentro de los dormitorios de 38 viviendas en Amamá, Departamento de Moreno, y en 19 casas de Gramilla, Departamento de Gramilla, ambos de la provincia de Santiago del Estero. Estas localidadess no habían sido rociadas nunca con insecticidas, pero en Gramilla la densidad de vinchucas era inferior a la correspondiente a Amamá. En ambas localidades se comparó la sensibilidad de los sensores María para detectar la presencia de vinchucas en las casas, con la colecta manual de insectos por el método hora/hombre, correspondiente a un esfuerzo de 1 hora/hombre/casa utilizando movilizadores químicos. Dicha colecta manual se realizó al final de cada experimento que se prolongó por 30 días en Amamá y por 90 días en Gramilla. En Amamá los sensores María detectaron un 71% de casas infestadas mientras que por captura manual se registró un 79% de casas positivas. Los sensores detectaron el 90% de las viviendas de alta infestación por la presencia de evidencias (exuvias, huevos, rastros de materia fecal) y el 55% de ellas por la presencia de vinchucas vivas. En las casas de baja infestación, un 75% de los dormitorios tenían evidencias en los sensores y en un 30% de ellas se hallaron vinchucas vivas...

Mobilization of hypothalamus acetylcholinesterase from bound to soluble fraction by electrical stimulation of the rabbit sciatic nerve

La estimulación elétrica del nervio ciático del conejo produce un aumento significativo del porcentaje de actividad de acetilcolinesterasa (AChE) soluble del hipotálamo; aumenta en forma no significativa estadísticamente en el tálamo y no produce inigún cambio en el tallo cerebral. Este aumento de la actividad de AChE souble probablemente representa la movilización de la enzima desde el reticulo endoplásmico liso y rugoso hacia el citoplasma neuronal producto de la activación del sistema nervioso central evocado por la estimulación del nervio ciático

Increase of acetylcholinesterase activity of the cerebrospinal fluid of the rabbit after sciatic nerve stimulation, its blockade by atropine

El líquido cefalorraquideo (LCR) extraído de la cisterna magna del conejo anestesiado con pentobarbital posee actividad de acetilcolinesterasa (AChE). La estimulación eléctrica del nervio ciático aumentó la actividad de AChE del LCR y este efecto fue antagonizado fuertemente por la administración sistémica previa de sulfato de atropina (3 mg/kg) y no por la administración de metilnitrato de atropina (3 mg/kg). Durante los experimentos, la presión del LCR y la presión sanguínea sufrieron cambios despreciables; y la barrera hematoencefálica permaneció estable porque no se detectó azul de Evans en el tejido nervioso ni en el LCR. No se detectaron cambios en la acti-actividad de la LDH del LCR después de la estimulación del nervio ciático. En conclusión, el aumento de activdad de la AChE del LCR inducido por la estimulación nerviosa periférica parece estar mediado por un mecanismo colinérgico central