Enumeration of Campylobacter spp. on the surface and within chicken breast fillets.

AIM: To investigate how many Campylobacter bacteria are present on the surface and inside chicken breast fillets, with a focus on generating data distributions which can be used in risk assessments for this pathogen-commodity combination. METHODS AND RESULTS: We analysed 100 fresh retail chicken breast fillets (skinless and deboned) by means of a rinse sample for surface and 55 fillets for internal pathogen contamination using 10 g meat and a most probable number technique. Prevalence was 87% on the surface and 20% in the deep tissue. The mean number of Campylobacter on the surface of the fillets was 1903 CFU, with a median of 537 CFU and a maximum of 38,905 CFU. Campylobacter counts inside the tissue were <1 CFU g(-1) meat (mean = 0.24 CFU, median = 0.15 CFU, maximum = 0.74 CFU). In addition, we investigated the influence of the type of package on the occurrence of the pathogen. Data provide an indication of less favourable conditions for survival of the pathogen on chicken meat packed under a modified atmosphere of carbon dioxide in nitrogen, in comparison with ambient air or vacuumed packages. CONCLUSIONS: Given the high numbers of the pathogen on the chicken meat surface in comparison with low levels of internal contamination, it can be concluded that cross-contamination during the preparation of contaminated chicken is a more important pathway for consumers' exposure to Campylobacter than the consumption of undercooked meat. SIGNIFICANCE AND IMPACT OF THE STUDY: The detailed quantitative data on the occurrence of C. jejuni and C. coli on the surface and inside chicken meat presented here can be useful for future probabilistic exposure assessments.

Analysis of gyrA mutations in quinolone-resistant and -susceptible Campylobacter jejuni isolates from retail poultry and human clinical isolates by non-radioactive single-strand conformation polymorphism analysis and DNA sequencing.

AIMS: The aims of this study were to characterize the molecular variations in the quinolone resistance-determining region (QRDR) of gyrA among quinolone-resistant and -susceptible Campylobacter jejuni isolates originating from foods of animal origin and human infections and to evaluate the suitability of the single-strand conformation polymorphism (SSCP) method as a screening method for molecular characterization of fluoroquinolone resistance. METHODS AND RESULTS: Alterations in QRDR of gyrA from 182 C. jejuni isolates were determined by nonradioisotopic SSCP analysis and direct sequencing. A total of 13 types of nucleic acid sequence combinations within the QRDR of the gyrA gene resulted in 11 different SSCP patterns. All nalidixic acid resistant strains possessed nucleotide substitution at either codon Thr-86 or Asp-90. Silent mutations were detected additionally. Thr-86 to Ile mutation was detected in all 139 ciprofloxacin resistant strains, which showed cross-resistance to nalidixic acid. CONCLUSIONS: The SSCP method is suitable for a molecular screening of quinolone resistant C. jejuni isolates and in combination with DNA sequencing suitable to detect genetic variations of the QRDR of gyrA. SIGNIFICANCE AND IMPACT OF STUDY: This study provides data of the genetic variations of the QRDR of gyrA from C. jejuni isolates of foods and human beings.

Involving family members in cancer care: focus group considerations of patients and oncological providers.

Family members are an integral part of a patient's cancer care from the moment the diagnosis is delivered to the conclusion of treatment. Family members bring with them a range of emotional reactions, interpersonal dynamics and expectations for the care the patient receives. This study is part of a multi-institutional project to continue to improve the process of cancer care. In this study, 19 focus groups (11 patient and 8 provider) were conducted concerning issues related to doctor-patient communication in eight cancer centers in the United States. The content of the conversations was analyzed and thematic categories emerged that highlight the various strengths and difficulties associated with family involvement. The focus groups' comments support the need for explicit conversations between professional caregivers, patients and their loved ones, in order to negotiate the expectations and needs of each team member. Implications for clinical practice and strategies for working with family members are offered.

Predictors of missed appointments for psychiatric consultations in a primary care clinic.

OBJECTIVE: The purpose of the study was to determine predictors of missed appointments for psychiatric consultations among patients in a general medical clinic. METHODS: The charts of 180 patients consecutively referred for psychiatric consultations at a university-affiliated primary care clinic were reviewed. Ninety patients missed appointments for these consultations. Parametric and nonparametric tests were used to compare patients who missed and did not miss appointments on demographic and clinical variables, as well as measures related to patients' interactions with the clinic and the referring clinician. RESULTS: Logistic regression analysis revealed three significant predictors of missed appointments. Patients with mild distress and those with significant resistance to seeing a psychiatrist were more likely to miss appointments, as were those who had to wait longer between the referral and the appointment date. CONCLUSIONS: The results suggest that shortening the wait for a psychiatric consultation, reserving consultation for more severe cases, and working to reduce patients' resistance to consultation will reduce the number of missed appointments.

Biliary excretion of tetroxoprim in man.

The biliary excretion of tetroxoprim (TXP) was studied in 10 patients with T-tube drainage. A mean biliary peak of 32.56 +/- 7.69 micrograms/ml was observed 2-3 h after a single oral dose of 200 mg. The biliary elimination rate constant (kb) of TXP was found to be 0;056 (h-1), indicating a longer elimination from the bile than from the central blood compartment. Taking into account the TXP serum levels, following the same oral dose as reported in the literature, concentration factors of 6-8 can be calculated in the bile.