The incidence of psychotic disorders in the Republic of Ireland: a systematic review.

OBJECTIVES: Despite a substantial epidemiological literature on the incidence of psychotic disorders in Ireland, no systematic review has previously been undertaken. Such evidence can help inform understanding of need for psychosis care. METHODS: We conducted a prospectively registered systematic review (PROSPERO: CRD42021245891) following PRISMA guidelines. We searched four databases (Medline, PsycInfo, Web of Science, Embase) for papers containing incidence data on non-organic psychotic disorders, in people 16-64 years, published between 1950 and 2021 in the general adult population. We conducted duplicate screening, risk of bias assessments, and extracted data to a standardised template. We undertook a narrative synthesis for each major diagnostic outcome. Random effects meta-analyses were conducted for comparisons with ≥5 incidence rates. RESULTS: Our search yielded 1975 non-duplicate citations, of which 23 met inclusion criteria, containing incidence data ascertained between 1974 and 2016 (median study quality: 5/8; interquartile range: 4-6). Incidence of all psychotic disorders (N = 4 studies) varied from 22.0 (95%CI: 17.3-28.0) in Dublin to 34.1 per 100,000 person-years (95%CI: 31.0-37.5) in Cavan and Monaghan. The pooled incidence of schizophrenia (N = 6 studies, N = 8 settings) was 20.0 per 100,000 person-years, though with imprecision around this estimate (95%CI: 10.6-37.5; I2: 97.6%). Higher rates of most outcomes were observed in men. There was consistent evidence of raised rates in more deprived and fragmented social environments, but no clear pattern by rural-urban status. CONCLUSIONS: Patterns of incidence of psychotic disorders in Ireland are broadly consistent with the wider literature from the Global North. Findings could help identify populations at higher risk of psychosis in Ireland.

Planar Crack Approach to Evaluate the Flexural Strength of Fiber-Reinforced Concrete Sections.

This article describes a model based on concepts of Fracture Mechanics to evaluate the flexural strength of fiber-reinforced concrete (FRC) sections. The model covers the need by structural engineers to have tools that allow, in a simple way, the designing of FRC sections and avoiding complex calculations through finite elements. It consists of an analytical method that models FRC post-cracking behavior with a cohesive linear softening law (σ - w). We use a compatibility equation based on the planar crack hypothesis, i.e., the assumption that the crack surfaces remain plane throughout the fracture process, which was recently proven true using digital image correlation. Non-cracked concrete bulk follows a stress-strain law (σ - ε) combined with the Bernoulli-Navier assumption. We define a brittleness number derived from non-dimensional analyses, which includes the beam size and the softening characteristics. We show that this parameter is key to determining the FRC flexural strength, characterizing fiber-reinforced concrete, and reproducing the size-effect of sections in flexure. Moreover, we propose an expression to calculate the flexural strength of FRC as a function of the cited brittleness number. The model also gives the ratio between the residual strength in service conditions and the flexural strength. Model results show a good agreement with tests in the scientific literature. Finally, we also analyze the brittle-ductile transition in FRC sections.

Factors affecting the outcome of adult patients with Methicillin-resistant Staphylococcus aureus and Non- Methicillin resistant Staphylococcus aureus pneumonia: A retrospective, cross-sectional cohort study

@#<p style="text-align: justify;"><strong>Introduction:</strong> Pneumonia continues to be a leading cause of morbidity and mortality worldwide. Locally, pneumonia is the 3rd cause of death (2016). Currently, one of the concerns is the rise of resistant microorganisms particularly MRSA. Knowledge regarding MRSA pneumonia is mostly from international data. This study aims to determine the factors that may affect the outcome of MRSA and non-MRSA pneumonia as well as describe the susceptibility patterns of its etiologic agents.</p><p style="text-align: justify;"><strong>Methods:</strong> This is a retrospective, cross-sectional cohort study. The setting is a tertiary government hospital. The target subjects are patients 18 y/o and above, with bacteriologically-confirmed pneumonia, and were admitted in 2017.</p><p style="text-align: justify;"><strong>Results:</strong> The results revealed a high rate of MRSA pneumonia (88.2%), most are community-acquired (90%), and factors associated with mortality were: male, Type 2 DM, smoking history, radiographic findings of congestion, and significant difference was noted. For Non-MRSA pneumonia factors associated with mortality were: erythrocytosis, kidney and liver disease, cancer, previous cerebrovascular disease, previous admission (ARMMC), number of comorbidities, findings of altered sensorium, chest retractions, DBP ? 60 mmHg, radiographic findings of pulmonary congestion, and classification of CAP-MR. Morbidity factors included: anemia, trauma, multiple comorbidities, radiographic findings of bilateral infiltrates, unilateral/bilateral consolidation, unilateral/bilateral minimal pleural effusion, subcutaneous emphysema, congestion, and infection with multiple bacteria. The first antibiogram for the institution revealed a poor susceptibility pattern for the usually used empiric treatment.</p><p style="text-align: justify;"><strong>Conclusion:</strong> This study reveals a high rate of MRSA pneumonia, with several factors associated with its mortality. In terms of morbidity, no significant difference was noted from the variables measured. For Non-MRSA pneumonia which is seen in the majority of the subjects, several factors associated with mortality were noted and unlike MRSA pneumonia the morbidity is affected by the presence of anemia, trauma, multiple comorbidities, etc.<br />The antibiogram showed a poor susceptibility to the usually used empiric treatment.</p>

Quantitative proteomic analysis in symptomatic and asymptomatic apical periodontitis.

AIM: To quantitatively and qualitatively compare the host proteomic profile in samples of symptomatic and asymptomatic apical periodontitis (AP) using nano-liquid chromatography-electron spray tandem mass spectrometry. METHODOLOGY: Samples were obtained from 18 patients with radiographically evident AP, divided into symptomatic and asymptomatic groups (nine per group) according to clinical characteristics. After sample collection, protein extraction, purification and quantification of the samples were performed, which were analysed by reverse-phase liquid chromatography coupled to mass spectrometry. Label-free quantitative proteomic analysis was performed by Protein Lynx Global Service software. Differences in expression of proteins between the groups were calculated using the Monte Carlo algorithm, considering P < 0.05 for down-regulated proteins and 1 - P > 0.95 for up-regulated proteins. Proteins were identified with the embedded ion accounting algorithm in the software and a search of the Homo sapiens UniProt database. RESULTS: A total of 853 individual human proteins were identified. In the quantitative analysis, common proteins to both groups accounted for 143 proteins. Differences in expression between groups resulted in 51 up-regulated proteins (1 - P > 0.95) in the symptomatic group, including alpha-1-antitrypsin, protein S100-A8, myeloperoxidase, peroxiredoxin and lactotransferrin. This group also had 43 down-regulated proteins (P < 0.05), comprising immunoglobulin, neutrophil defensin, pyruvate kinase and alpha-enolase. The qualitative analysis considered only the exclusive proteins of each group. For the symptomatic group, 318 complete proteins and 29 fragments were identified, such as dedicator of cytokinesis protein, intersectin, prostaglandin, phospholipase DDHD2 and superoxide dismutase. For the asymptomatic group, 326 complete proteins and 37 fragments were identified, including azurocidin, C-reactive protein, collagen alpha, cathepsin, heat shock and laminin. CONCLUSIONS: Quantitative differences in the expression of common proteins in cases of symptomatic and asymptomatic AP were found, which were mostly related to host immune response in both groups. Exclusive proteins in the symptomatic group were mainly related to the host response to the presence of viruses in endodontic infections, oxidative stress and proteolytic enzymes. The results provide a basis for a better understanding of cellular and molecular pathways involved in AP, establishing specific proteomic profiles for symptomatic and asymptomatic conditions.

Indicators for the assessment of social resilience in flood-affected communities - A text mining-based methodology.

This work turns the social resilience concept into a practical and tangible set of dimensions and indicators for social resilience assessment. It further provides an analysis of the social resilience concept in the context of flood risk governance. Floods are a worldwide recurring phenomenon that causes severe social, economic and environmental losses. In the context of global change, it is very difficult to accurately predict extreme events that may increase disaster frequency; hence the implementation of social resilience is essential to lessen the losses. Indeed, the right balance between natural and social factors and indicators is yet to be found. Social resilience has been debated extensively for decades, both in scientific and political contexts. It has been a concern in disaster risk reduction and risk governance fields, both of which have strived to implement it. The enlarged conceptual discussion regarding this topic has resulted in some indicator-based assessments that hardly reflect the conceptual discussion developed so far. These indicator-based approaches still lack accurate inclusion of social dynamics and the capacity to learn from experience. In order to contribute to a comprehensive approach (concept and methods) for assessing social resilience to floods, the evolutionary resilience concept (Davoudi, Simin; Shaw, Keith; Haider, L. Jamila; Quilnlan, Allyson E; Petterson, Garry D.; Wilkinson, Cathy; Fünfgeld, Hartmut; McEvoy, Darryn; Porter, 2012) was considered as a reference in this work, as it can include dimensions that are difficult to evaluate (non-static time and learning-capacity in multi-dimensional systems). This work addresses the challenge of a conceptual overview of social resilience to include key factors and indicators. Our methodology uses text mining, experts' surveys and bibliography reviews to generate an indicators database. The contribution of this article to the scientific debate on social resilience assessment is twofold. First, the key-concepts, words and expressions in this field are identified, which provides the basis to build a comprehensive and coherent analytical framework. Secondly, an original indicators database is proposed in line with that framework. The results of a text mining-based methodology and an online survey, involving experts from different countries, show that four of the six dimensions of the indicators database refer to social aspects of risks (Individuals, Society, Governance, and Built Environment), while the remaining two refer to the Environment and Disaster. The results obtained so far suggest the need for a next step aiming to validate the dimensions and the indicators of this database through its application to real case studies.

Biocompatibility, induction of mineralization and antimicrobial activity of experimental intracanal pastes based on glass and glass-ceramic materials.

AIM: To evaluate the biocompatibility, induction of mineralization and antimicrobial activity of experimental intracanal pastes based on two glass and glass-ceramic materials. Calcium hydroxide (Ca(OH)2 ) paste was used as the positive control. METHODOLOGY: The glass-ceramic powder [two-phased Biosilicate (BS-2P)] and F18 bioactive glass were mixed with distilled water (ratio 2 : 1), inserted in polyethylene tubes and implanted in the subcutaneous tissues of 16 rats. Empty tubes were used as negative control. After 7 and 30 days (n = 8), the rats were euthanized for haematoxylin-eosin, von Kossa, polarized light and osteopontin (OPN) immunolabeling analysis. Direct contact tests using a suspension of each paste were performed with Enterococcus faecalis planktonic cells to evaluate antimicrobial activity (24 h of contact), in a pilot study. The number of CFU mL-1 was calculated for each group. The antimicrobial analysis data were submitted to one-way anova and Tukey tests, whilst biocompatibility and immunohistochemical data were submitted to the Kruskal-Wallis and Dunn tests (P < 0.05). RESULTS: Most specimens of the control, BS-2P and Ca(OH)2 groups were associated with moderate inflammation seven days following implantation, whilst F18 was associated with moderate to severe inflammation, without differences amongst the groups (P > 0.05). At 30 days, most specimens of control, F18 and BS-2P groups had mild inflammation, whilst Ca(OH)2 had mild to moderate inflammation; however, no differences were determined amongst the groups (P > 0.05). The fibrous capsule was thick at 7 days, becoming thin at 30 days. All pastes induced von Kossa-positive structures and were birefringent to polarized light. At seven days, the BS-2P group had significantly more OPN immunolabeling compared to the control and Ca(OH)2 groups (P < 0.05). At 30 days, the F18 group had significantly more OPN immunolabeling compared to the control and Ca(OH)2 groups (P < 0.05). All pastes reduced the total number of E. faecalis; however, the reduction was only significant when comparing BS-2P and Ca(OH)2 groups to the control (P < 0.05). Only calcium hydroxide eliminated E. faecalis. CONCLUSIONS: Experimental BS-2P and F18 pastes were biocompatible, stimulated biomineralization and induced significant OPN immunolabeling compared to Ca(OH)2 . Only the BS-2P paste demonstrated antimicrobial activity comparable to Ca(OH)2 .

Normal force distribution and posture of a hand pressing on a flat surface.

Hand strength data are needed to understand and predict hand postures and finger loads while placing the hand on an object or surface. This study aims to analyze the effect of hand posture and surface orientation on hand force while pressing a flat surface. Twelve participants, 6 females and 6 males ages 19-25, performed three exertions (100%, 30% and 10% MVC- Maximum Voluntary Contraction) perpendicular to a plate in 4 angles (-45°, 0°, 45° and 90° with respect to the horizontal plane) at elbow height. Exertions involved pushing in two postures: (1) whole hand and (2) constrained to only using the fingertips. Inter-digit joint angles were recorded to map hand and finger motions and estimate joint moments for each condition. Participants exerted twice the force when pushing with whole hand vs. fingertips. 72-75% of the total force was exerted over the base of the palm, while only 11-13% with the thumb for exertions at 90°, 45° or 0° plate angles. Males maximum force for pushing at 0°, 45° and 90° plates averaged 49% higher than females for the whole hand and 62% for the fingertips (p < 0.01). There was no significant sex difference (p > 0.05) for the -45° plate. Thumb joint loads were generally higher than the other individual fingers (p < 0.05) in all % MVC and accounted for 12% of total force during whole hand exertions. On average, joint moments were 30% higher during fingertip conditions vs. whole hand. Thumb and finger joint moment magnitudes when pushing the plate at 100% MVC indicated that Metacarpophalangeal (MCP) joint moments were higher (p < 0.05) than Distal Interphalangeal joints (DIP) and Proximal Interphalangeal joints (PIP) under whole hand and fingertips conditions.

Antibiotic prescription for endodontic infections: a survey of Brazilian Endodontists.

AIM: To investigate antibiotic prescribing habits reported by Brazilian endodontists in specific clinical situations. METHODOLOGY: Brazilian endodontists (n = 13 853) were invited to answer an online questionnaire. The questionnaire consisted of two parts: the first part contained personal data such as age, gender, years of experience and location of endodontic practice; the second part included questions regarding their behaviour when prescribing antibiotics in dental practice. The subjects provided their registration number in the Regional Council of Dentistry (RCD) to prevent duplication of data. Data were collected and analysed by SPSS 17.0 (SPSS, Inc., Chicago, IL, USA). Chi-square and Fisher's exact tests were used to test the significance of possible associations (P < 0.05). RESULTS: From the 13 853 questionnaires, a total of 615 were answered (4.44%). The first-choice antibiotic was amoxicillin (81.5%), followed by amoxicillin + clavulanic acid (30.7%). For acute apical abscesses with intra- and extraoral diffuse swelling, fever and trismus, 90.1% reported they would prescribe antibiotics, whilst 88.1% reported they would prescribe antibiotics even without extraoral swelling, fever and trismus, and 20.5% would prescribe antibiotics in cases of chronic apical periodontitis, and sinus tract. The first-choice antibiotics varied by age of dentist (P < 0.001) and time elapsed since their endodontic graduation (P = 0.001). CONCLUSIONS: Many endodontists reported prescribing antibiotics in situations where they would not be indicated. Likewise, the general administration of antibiotics was longer in duration than necessary, reinforcing the need of continuous education regarding the use of antibiotics.

Impacts of climate and land use changes on the hydrological and erosion processes of two contrasting Mediterranean catchments.

The impacts of climate and land use changes on streamflow and sediment export were evaluated for a humid (São Lourenço) and a dry (Guadalupe) Mediterranean catchment, using the SWAT model. SWAT was able to produce viable streamflow and sediment export simulations for both catchments, which provided a baseline for investigating climate and land use changes under the A1B and B1 emission scenarios for 2071-2100. Compared to the baseline scenario (1971-2000), climate change scenarios showed a decrease in annual rainfall for both catchments (humid: -12%; dry: -8%), together with strong increases in rainfall during winter. Land use changes were derived from a socio-economic storyline in which traditional agriculture is replaced by more profitable land uses (i.e. corn and commercial forestry at the humid site; sunflower at the dry site). Climate change projections showed a decrease in streamflow for both catchments, whereas sediment export decreased only for the São Lourenço catchment. Land use changes resulted in an increase in streamflow, but the erosive response differed between catchments. The combination of climate and land use change scenarios led to a reduction in streamflow for both catchments, suggesting a domain of the climatic response. As for sediments, contrasting results were observed for the humid (A1B: -29%; B1: -22%) and dry catchment (A1B: +222%; B1: +5%), which is mainly due to differences in the present-day and forecasted vegetation types. The results highlight the importance of climate-induced land-use change impacts, which could be similar to or more severe than the direct impacts of climate change alone.

Microbiological profile and antimicrobial susceptibility pattern of infected root canals associated with periapical abscesses.

The aim of this investigation was to identify microorganisms from root canals with periapical abscesses and assess the susceptibility of specific anaerobic bacteria to selected antimicrobials and their ß-lactamase production. Sixty root canals were microbiologically investigated. The susceptibility of Anaerococcus prevotii, Fusobacterium necrophorum, F. nucleatum, Parvimonas micra, and Prevotella intermedia/nigrescens to antimicrobials was evaluated with the Etest, whereas ß-lactamase production was assessed with nitrocefin. A total of 287 different bacterial strains were recovered, including 201 strict anaerobes. The most frequently strict isolated anaerobes were A. prevotii, P. micra, and F. necrophorum. The selected bacteria were susceptible to all the tested antibiotics, except A. prevotii and Fusobacterium species to azithromycin and erythromycin, as well as A. prevotii and F. necrophorum to metronidazole. None of the microorganisms produced ß-lactamase. Gram-positive anaerobic bacteria predominated in the root canals with periapical abscesses. All microorganisms tested were susceptible to benzylpenicillin, amoxicillin, amoxicillin + clavulanate, cefaclor, and clindamycin, producing no ß-lactamase.

Recuperación funcional tras fractura de cadera en una población anciana, medida con el índice de Barthel / Use of the Barthel Index to measure functional recovery in an elderly population after hip fracture

Objetivo. Analizar el grado de recuperación funcional de una serie de pacientes afectados de una fractura de cadera (FC),a los 6 y 12 meses tras la fractura, usando el índice de Barthel (IB) como instrumento de medida. Material y métodos. Estudio longitudinal prospectivo no intervencionista sobre 246 pacientes mayores de 65 años que acudieron a nuestro centro tras sufrir una FC por un traumatismo de baja energía. Se determinó su edad, sexo, nivel socioeconómico, grado de independencia funcional (IB) tanto previo como a los 6 y 12 meses, y su destino al alta (domicilio, residencia privada o un hospital de crónicos concertado con la consejería) y su mortalidad a los 6 y 12 meses. Resultados. Las mujeres constituyeron el 71,5% de los casos con una edad media de 81 años. El IB medio previo a la FC fue de 77 puntos. El 70% de los pacientes deambulaban antes de la fractura. De éstos, sólo el 48% que sufrió una FC intracapsular y el 39% de los que sufrieron una FC extracapsular volvieron a caminar a la finalización del estudio (12 meses). En 35 pacientes se desestimó el tratamiento quirúrgico por causas médicas o negativa familiar. Conclusiones. Los pacientes con edad extrema, demencia, bajos niveles de formación académica, institucionalizados en centros de crónicos y no operados presentaron peor IB a los 6 y 12 meses. El estado neurológico aceptable, acudir a control en la consulta externa, el cuidado familiar y unos niveles altos de hemoglobina preoperatoria se han relacionado con una mejor la recuperación funcional en estos pacientes (AU)

Purpose. To determine how many patients were able to return to their previous independence status after a hip fracture, using the Barthel Index Scale to measure it. Materials and methods. An observational, prospective longitudinal study of 246 patients over 65 diagnosed with hip fracture. We determined age, sex, type of fracture and treatment, cultural, and economical status, independence level before and after the fracture, and mortality over 12 months. Results. Of the 246 patients studied, 71.5% were women, and the mean age was 81 years. The Barthel Index Scale before the fracture was 77. Seventy per cent of the patients were capable of walking before the fracture, but only 48% with intracapsular, and 39% with extracapsular hip fracture, reached their previous walking capability. Thirty five patients underwent nonsurgical treatment. Conclusions. We found that advanced age, dementia, lower education levels, residence-dependent patients, and those who did not have surgical treatment, had lower levels on the Barthel Index Scale at 6 and 12 months. On the other hand, the absence of neurological diseases, attending follow-up clinics, good family care, and high haemoglobin levels prior to the fracture seemed to lead to a better functional recovery (AU)

Complex dorsal metacarpophalangeal joint dislocation caused by interosseous tendon entrapment: case report.

We report a patient with open complex, dorsal metacarpophalangeal joint dislocation of the index finger with interposition of the first dorsal interosseous tendon and the transverse ligament of the palmar aponeurosis. To our knowledge, entrapment of the first dorsal interosseous tendon has not been reported to be the cause of irreducible dislocation of the metacarpophalangeal joint.

Bacterial examination of endodontic infections by clonal analysis in concert with denaturing high-performance liquid chromatography.

BACKGROUND/AIMS: The aim of this study was to examine the diversity of bacterial species in the infected root canals of teeth associated with endodontic abscesses by cloning and sequencing techniques in concert with denaturing high-performance liquid chromatography. METHODS: Samples collected from five infected root canals were subjected to polymerase chain reaction (PCR) with universal 16S ribosomal DNA primers. Products of these PCRs were cloned and sequenced. Denaturing high-performance liquid chromatography (DHPLC) was used as a screening method to reduce the number of clones necessary for DNA sequencing. RESULTS: All samples were positive for the presence of bacteria and a range of 7-13 different bacteria were found per root canal sample. In total, 48 different oral clones were detected among the five root canal samples. Olsenella profusa was the only species present in all samples. Porphyromonas gingivalis, Dialister pneumosintes, Dialister invisus, Lachnospiraceae oral clone, Staphylococcus aureus, Pseudoramibacter alactolyticus, Peptostreptococcus micros and Enterococcus faecalis were found in two of the five samples. The majority of the taxa were present in only one sample, for example Tannerella forsythia, Shuttleworthia satelles and Filifactor alocis. Some facultative anaerobes that are frequently isolated from endodontic infections such as E. faecalis, Streptococcus anginosus and Lactobacillus spp. were also found in this study. CONCLUSION: Clonal analysis of the microflora associated with endodontic infections revealed a wide diversity of oral species.

Regulation of transthyretin by thyroid hormones in fish.

Transthyretin (TTR) is a thyroid hormone-binding protein (THBP) which in its tetrameric form transports thyroid hormones (THs), thyroxine (T(4)) and triiodothyronine (T(3)) in the blood of vertebrates. The principal site of production of TTR is the liver but in the sea bream TTR mRNA is also present in the heart, intestine and brain. The regulation of TTR is unstudied in fish and the normal circulating level of this THBP is unknown. The aim of the present study was to establish factors which regulate TTR production in fish. As a first step a number of tools were generated; sea bream recombinant TTR (sbrTTR) and specific sbrTTR antisera which were used to establish an ELISA (enzyme-linked immunosorbent assay) for measuring TTR plasma levels. Subsequently, an experiment was conducted to determine the influence of THs on TTR production. Circulating physiological levels of TTR in sea bream determined by ELISA are approximately 3.8microgml(-1). Administration of T(3) and T(4) to sea bream significantly increased (p<0.001 and p<0.005, respectively) the concentration of circulating TTR ( approximately or = 11.5microgml(-1)) in relation to control fish, but did not change gene transcription in the liver. Methimazol (MMI) an antithyroid agent, failed to significantly reduce circulating THs below control levels but significantly increased (p<0.005) plasma TTR levels (approximately or = 10.8microgml(-1)) and decreased (p<0.05) transcription in the liver. Future studies will aim to elucidate in more detail these regulatory pathways.

Incidence and antimicrobial susceptibility of Porphyromonas gingivalis isolated from mixed endodontic infections.

AIM: To investigate the prevalence of Porphyromonas gingivalis in root canals of infected teeth with periapical abscesses and to investigate the antimicrobial susceptibility of this species to some frequently prescribed antibiotics. METHODOLOGY: Samples were obtained from 70 root canals of abscessed teeth. Microbial sampling, isolation and bacterial identification were accomplished using appropriate culture methods for anaerobic species. The antimicrobial susceptibility of the 20 strains of P. gingivalis isolated was determined by using the E-test. The antimicrobial agents tested were amoxicillin, amoxicillin + clavulanate, azythromycin, benzylpenicillin, cephaclor, clindamycin, erythromycin, metronidazole and tetracycline. RESULTS: A total of 352 individual strains, belonging to 69 different species, were isolated. Eighty three percent of the strains were strict anaerobes and 47.5% of the isolated bacteria were Gram-negative. Porphyromonas gingivalis was found in 20 root canals and was most frequently found in symptomatic cases. Statistically, the presence of P. gingivalis was related to purulent exudates and pain on palpation (both P < 0.05). All P. gingivalis strains were sensitive to amoxicillin, amoxicillin + clavulanate, cephaclor, clindamycin, benzylpenicyllin, metronidazole and tetracycline. The lowest range of minimum inhibitory concentration (MIC) (0.026-0.125 microg mL(-1)) was observed against amoxicillin + clavulanate and clindamycin. The lowest MIC 90 was observed against clindamycin (0.064 microg mL(-1)). One strain was resistant to erythromycin and eight strains were resistant to azythromycin. CONCLUSION: Porphyromonas gingivalis pathogen is isolated with frequency from root canals of infected teeth with periapical abscesses. Amoxicillin, as well as amoxicillin-clavulanic acid and benzylpenicillin were effective against P. gingivalis.

Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia and Prevotella nigrescens in endodontic lesions detected by culture and by PCR.

he aim of this study was to investigate the presence of four black-pigmented bacteria, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia and Prevotella nigrescens, in endodontic infections by culture and polymerase chain reaction (PCR) analyses. Microbial samples were obtained from 50 teeth with untreated necrotic pulps (primary infection) and from 50 teeth with failing endodontic treatment (secondary infection). Microbiological strict anaerobic techniques were used for serial dilution, plating, incubation, and identification. For PCR detection, the samples were analyzed using species-specific primers of 16S rDNA and the downstream intergenic spacer region. Culture and PCR detected the test species in 13/100 and 50/100 of the study teeth, respectively. The organisms were cultured from 11/50 (22%) of primarily infected root canal samples and from 2/50 (4%) of secondary root canal samples. PCR detection identified the target species in 32/50 (64%) and 18/50 (36%) of primary and secondary infections, respectively. P. gingivalis was rarely isolated by culture methods (1%), but was the most frequently identified test species by PCR (38%). Similarly, P. endodontalis was not recovered by culture from any tooth studied, but was detected by PCR in 25% of the sampled teeth. PCR-based identification also showed higher detection rates of P. intermedia (33%) and P. nigrescens (22%) than culture (13%). In conclusion, P. gingivalis, P. endodontalis, P. intermedia, and P. nigrescens were identified more frequently in teeth with necrotic pulp than in teeth with failing endodontic treatment. Also, a higher frequency of black-pigmented species was detected by PCR than by culture.

Microbiological analysis of infected root canals from symptomatic and asymptomatic teeth with periapical periodontitis and the antimicrobial susceptibility of some isolated anaerobic bacteria.

The purpose of the present study was to investigate the correlation between the composition of the bacterial flora isolated from infected root canals of teeth with apical periodontitis with the presence of clinical signs and symptoms, and to test the antibiotic susceptibility of five anaerobic bacteria mostly commonly found in the root canals of symptomatic teeth against various substances using the E-test. Microbial samples were taken from 48 root canals, 29 symptomatic and 19 asymptomatic, using adequate techniques. A total of 218 cultivable isolates were recovered from 48 different microbial species and 19 different genera. Root canals from symptomatic teeth harbored more obligate anaerobes and a bigger number of bacterial species than the asymptomatic teeth. More than 70% of the bacterial isolates were strict anaerobes. Statistical analysis used a Pearson Chi-squared test or a one-sided Fisher's Exact test as appropriate. Suggested relationships were found between specific microorganisms, especially gram-negative anaerobes, and the presence of spontaneous or previous pain, tenderness to percussion, pain on palpation and swelling amoxicillin, amoxicillin + clavulanate and cephaclor were effective against all the strains tested. The lowest susceptibility rate was presented by Prevotella intermedia/nigrescens against Penicillin G. Our results suggested that specific bacteria are associated with endodontic symptoms of infected teeth with periapical periodontitis and the majority of the anaerobic bacterial species tested were susceptible to all antibiotics studied.

Hydrolysis of surfactant-associated phosphatidylcholine by mammalian secretory phospholipases A2.

Hydrolysis of surfactant-associated phospholipids by secretory phospholipases A2 is an important potential mechanism for surfactant dysfunction in inflammatory lung diseases. In these conditions, airway secretory phospholipase A2 (sPLA2) activity is increased, but the type of sPLA2 and its impact on surfactant function are not well understood. We examined in vitro the effect of multiple secretory phospholipases A2 on surfactant, including their ability to 1) release free fatty acids, 2) release lysophospholipids, and 3) increase the minimum surface tension (gammamin) on a pulsating bubble surfactometer. Natural porcine surfactant and Survanta were exposed to mammalian group I (recombinant porcine pancreatic) and group II (recombinant human) secretory phospholipases A2. Our results demonstrate that mammalian group I sPLA2 hydrolyzes phosphatidylcholine (PC), producing free fatty acids and lysophosphatidylcholine, and increases gammamin. In contrast, mammalian group II sPLA2 demonstrates limited hydrolysis of PC and does not increase gammamin. Group I and group II secretory phospholipases A2 from snake venom hydrolyze PC and inhibit surfactant function. In summary, mammalian secretory phospholipases A2 from groups I and II differ significantly from each other and from snake venom in their ability to hydrolyze surfactant-associated PC.

La ultrasonografía como método diagnóstico en traumatismos y heridas abdominales / Ultrasonography as diagnostic method in abdominal trauma and wounds

Los traumatismos abdominales constituyen un problema de salud pública. El diagnóstico precoz de las lesiones intrabdominales incide directamente sobre la sobrevida de los enfermos. Practicamos el examen ultrasonográfico del abdomen en 35 pacientes que ingresaron al Hospital Militar "Dr. Carlos Arvelo" de Caracas durante los años 1987 y 1988. Encontramos que el líquido libre en la capacidad abdominal y los hematomas intraparenquimatosos fueron los hallazgos más frecuentes, seguidos por los hematomas retroperitoneales. La correlación entre los hallazgos ultrasonográficos y la evolución de los pacientes fue positiva en el 100% de los casos, tanto para aquéllos en quienes el estudio fue normal, cuya evolución clínica fue satisfactoria, como para los que requieron intervención quirúrgica. Consideramos que el examen ultrasonográfico del abdomen, practicado por personal entrenado y con experiencia, puede aportar en forma rápida información de gran utilidad para el manejo de pacientes con traumatismos abdominales y constituye por tanto, una exploración de primera línea en estos casos