Horizontal transmission of antimicrobial resistance genes from E. coli to Serratia spp. in minced meat using a gfp tagged plasmid.

The transmission of antimicrobial resistance genes from enteric bacteria from the animal reservoir to indigenous bacteria in meat is a serious concern, as it can contribute to human exposure to antimicrobial resistance genes. The aim of this study was to investigate plasmid-mediated horizontal transfer of antimicrobial resistance genes from Escherichia coli to indigenous environmental bacteria in minced pork stored at 10 and 37 °C. E. coli MG1555 containing a gfp-tagged plasmid carrying tetracycline, kanamycin and streptomycin resistance genes was used as the donor with the indigenous bacteria in minced pork acting as potential recipients. The results demonstrated that enteric members of the pork meat microbiota were able to receive gfp-plasmids from the E. coli donor strain at both 10 and 37 °C. The majority of transconjugants were identified as Serratia spp. through sequencing of their 16S rRNA genes. This indicates that environmental Serratia spp. and other Enterobacteriaceae may play a role as carrier of antimicrobial resistance genes through the meat production chain to the consumer.

Cross and co resistance among Danish porcine E. coli isolates.

Cross and co-resistance to antimicrobials are presented for 765 Danish Escherichia coli isolates of porcine origin from 2009 to 2013. All isolates and data originate from the DANMAP surveillance but have not previously been used to describe the occurrence of cross and co- resistance. Data presented here clearly indicate the ability of low classified antimicrobials as ampicillin to uphold resistance to critical important antimicrobials for human treatment.

Growth potential of exponential- and stationary-phase Salmonella Typhimurium during sausage fermentation.

Raw meat for sausage production can be contaminated with Salmonella. For technical reasons, meat is often frozen prior to mincing but it is unknown how growth of Salmonella in meat prior to freezing affects its growth potential during sausage fermentation. We investigated survival of exponential- and stationary-phase Salmonella Typhimurium (DT12 and DTU292) during freezing at -18°C and their subsequent growth potential during 72h sausage fermentation at 25°C. After 0, 7 and >35d of frozen storage, sausage batters were prepared with NaCl (3%) and NaNO2 (0, 100ppm) and fermented with and without starter culture. With no starter culture, both strains grew in both growth phases. In general, a functional starter culture abolished S. Typhimurium growth independent of growth phase and we concluded that ensuring correct fermentation is important for sausage safety. However, despite efficient fermentation, sporadic growth of exponential-phase cells of S. Typhimurium was observed drawing attention to the handling and storage of sausage meat.

[Evaluation of a none sequential smoking cessation programme in rehabilitation centres]. / Überprüfung eines nicht sequenziell aufgebauten Tabakentwöhnungsprogramms in Rehabilitationskliniken.

AIMS: The present study aims at developing and evaluating a non-sequential smoking cessa-ti-on programme for in-patient rehabilitation centres. The new programme challenges the standard phased approach with the stages motivation, quit day, stabilisation. METHODS: A prospective multi-centre study is conducted with quasi experimental control group design. The newly developed smoking cessation programme (intervention group, IG) is compared against the treatment-as-usual (control group, CG) of participating rehabilitation centres. Data from 850 smokers in 19 in-patient rehabilitation centres are analysed. RESULTS: The process evaluation of the non-sequential programme shows good acceptance among trainers and patients and easy implementation in the rehabilitation setting. Abstinence rates at the end of treatment are comparable for the IG (19.1%) and the CG (17.9%). The amount of cigarettes smoked among remaining smokers also reduced to a comparable degree in both groups. Patients in the IG showed significant improvement with regard to stages of change and self-efficacy. CONCLUSIONS: The non-sequential smoking cessation programme is accepted and can be implemented in an in-patient rehabilitation setting. With regard to major outcome criteria, the programme is comparable to treatment-as-usual. Secondary outcome criteria and satisfaction ratings favour the new programme. Due to a low-threshold access to smoking cessation, the non-sequential approach offers a structural advantage.

[A psychosocial training program for elderly patients with age-related macular degeneration: findings of a pilot evaluation study]. / Ein psychosoziales Trainingsprogramm für ältere Menschen mit altersabhängiger Makuladegeneration: Befunde einer Pilot-Evaluationsstudie.

The purpose of this work was to develop and evaluate a psychosocial intervention aimed to improve quality of life of AMD patients. A total of 22 outpatients (age 62 to 80 years) treated in the University Eye Clinic in Heidelberg were divided into an intervention group (n=14) and a comparison group without intervention (n=8). The intervention program was based on six modules carried out in five weekly group sessions. These modules included: (1) progressive muscle relaxation, (2) exchange of disease-related experiences, (3) connection between thought, emotion, and behavior, (4) activation of available resources, (5) general problem solving skills and (6) information exchange. Pre-post assessment addressed a set of standardized emotional and behavioral outcome measures. Findings revealed that the intervention group showed improvement or prevention of additional loss in emotional as well as in behavioral outcomes, while the comparison group did not. Results are interpreted as initial evidence that the developed program is able to improve the quality of life in patients suffering from AMD.

Chicken juice, a food-based model system suitable to study survival of Campylobacter jejuni.

AIMS: The purpose of this study was to develop a food-based model system that resembles the environment that Campylobacter jejuni experiences on raw poultry products and use this model system to investigate growth and survival of the bacterium. METHODS AND RESULTS: Chicken juice was collected from frozen chickens and subsequently cleared by centrifugation and subjected to sterile filtration. At low temperatures (5 and 10 degrees C) C. jejuni NCTC11168 remained viable in chicken juice for a remarkably longer period of time than in the reference medium BHI. When exposed to heat stress (48 degrees C) C. jejuni NCTC11168 also showed increased viability in chicken juice compared with the reference medium. Furthermore, agar plates made with chicken juice supported growth of four clinical isolates of C. jejuni and a C. jejuni strain obtained from chicken at both 37 and 42 degrees C. CONCLUSIONS: Our work shows that minimal processed and sterilized chicken juice is an ideal environment for survival of C. jejuni and that it is useful as a food-based model system. SIGNIFICANCE AND IMPACT OF THE STUDY: The developed model system may contribute to the understanding of C. jejuni viability on poultry products and can be instrumental in the development of alternative preservation strategies.

Metabolic and cardiopulmonary responses to acute progressive resistive exercise in a person with C4 spinal cord injury.

STUDY DESIGN: Single-subject (female, 38 years of age) case. OBJECTIVES: To describe metabolic and cardiopulmonary responses to progressive resistive exercise in an individual with C4 ASIA A tetraplegia, and to review the relationship between level of spinal cord injury (SCI) and exercise responses. SETTING: Large, urban mid-western city rehabilitation hospital in United States of America. METHODS: Bilateral shoulder elevation/depression (shoulder shrug) exercise with two different resistances (0.7 kg/shoulder, 1.4 kg/shoulder) at two different frequencies (20 min., 40 min.), for 2 min per bout, deployed in a discontinuous protocol. RESULTS: Compared to rest heart rate (HR), exercise HR increased the greatest (13 bpm) for the 1.4 kg resistance at 40 min. and the least (6 bpm) during the 0.7 kg at 20 min. Blood pressure (BP) response was lower than resting BP for all four exercise conditions with the lowest (74/56 mmHg) at 1.4 kg at 40 min. Oxygen uptake was highest (4.6 ml.kg(-1) min(-1)) during 1.4 kg at 20 min and V(E) was greatest (18.2 L/min) during 1.4 kg at 40 min. Rate of perceived exertion (RPE) was the highest (17) during the 1.4 kg at 40 min. CONCLUSIONS: Progressive resistance exercise provoked intense perceived physical effort, but only small metabolic and cardiopulmonary increases in a person with C4 SCI. Exercise recommended at a 'somewhat hard' intensity should avoid significant hypotension and still impressively increase oxygen uptake and ventilation compared to rest. An inverse relation between level of injury and aerobic responses may extend rostrally to the C4 level.

The effects of massage therapy alone and in combination with other complementary therapies on immune system measures and quality of life in human immunodeficiency virus.

OBJECTIVES: Determine effects of massage therapy alone and in combination with exercise or stress management-biofeedback treatment on enumerative immune measures, and quality of life in moderately immunocompromised human immunodeficiency virus (HIV) subjects. DESIGN: Randomized prospective controlled trial with 42 subjects randomly assigned to one of three treatment groups or a control group receiving standard care and intervention over a 12-week period. SETTING: Academic medical center. SUBJECTS: Forty-two (42) subjects with HIV infection (40 males; 2 females; aged 27-50 years) met eligibility requirements of CD4+ lymphocyte cell count greater than 200 cells per microliter; no present or recent signs or symptoms of acquired immunodeficiency syndrome (AIDS), and were not hospitalized. INTERVENTIONS: A 45-minute overall body massage once per week; similar massage and supervised aerobic exercise 2 other days per week; similar massage and biofeedback stress management once per week; control receiving standard treatment. OUTCOME MEASURES: Changes in peripheral blood levels of CD4+ lymphocytes, CD8+ lymphocytes, CD4+/CD8+ lymphocyte ratio and natural killer cells; six dimension quality-of-life assessment. RESULTS: No significant changes (p > 0.05) were found in any enumerative immune measure. Significant (p < 0.05) differences for quality-of-life assessment were in health care utilization and health perceptions, favoring massage and stress management compared to massage only and controls. CONCLUSIONS: Massage administered once per week to HIV-infected persons does not enhance immune measures. Massage combined with stress management favorably alters health perceptions and leads to less utilization of health care resources. This suggests that HIV-infected persons receiving massage and stress management would tend to not overutilize health care services, thus possibly reducing health care costs.

Workplace risk factors for cancer in the German rubber industry: Part 1. Mortality from respiratory cancers.

OBJECTIVES: To determine the cancer specific mortality by work area among active and retired male workers in the German rubber industry. METHODS: A cohort of 11,663 male German workers was followed up for mortality from 1 January 1981 to 31 December 1991. Cohort members were classified as active (n = 7536) or retired (n = 4127) as of 1 January 1981 and had been employed for at least one year in one of five study plants producing tyres or technical rubber goods. Work histories were reconstructed with routinely documented "cost centre codes" which were classified into six categories: I preparation of materials; II production of technical rubber goods; III production of tyres; IV storage and dispatch; V maintenance; and VI others. Standardised mortality ratios (SMRs) adjusted for age and calendar year and 95% confidence intervals (95% CIs), stratified by work area (employment in respective work area for at least one year) and time related variables (year of hire, lagged years of employment in work area), were calculated from national reference rates. RESULTS: SMRs for laryngeal cancer were highest in work area I (SMR 253; 95% CI 93 to 551) and were significant among workers who were employed for > 10 years in this work area (SMR 330; 95% CI 107 to 779). Increased mortality rates from lung cancer were identified in work areas I (SMR 162; 95% CI 129 to 202), II (SMR 134; 95% CI 109 to 163), and V (SMR 131; 95% CI 102 to 167). Mortality from pleural cancer was increased in all six work areas, and significant excesses were found in work areas I (SMR 448; 95% CI 122 to 1146), II (SMR 505; 95% CI 202 to 1040), and V (SMR 554; 95% CI 179 to 1290). CONCLUSION: A causal relation between the excess of pleural cancer and exposure to asbestos among rubber workers is plausible and likely. In this study, the pattern of excess of lung cancer parallels the pattern of excess of pleural cancer. This points to asbestos as one risk factor for the excess deaths from lung cancer among rubber workers. The study provides further evidence for an increased mortality from laryngeal cancer among workers in the rubber industry, particularly in work area I.

Cancer mortality among workers in the German rubber industry: 1981-91.

OBJECTIVES: To determine the cancer specific mortality of active and retired workers of the German rubber industry with emphasis on cancer sites which have been associated with the rubber industry in previous studies. METHODS: A cohort of 11,663 German men was followed up for mortality from 1 January 1981 to 31 December 1991. Cohort members were active (n = 7536) or retired (n = 4127) at the beginning of the study, and had been employed for at least one year in one of five study plants producing types or general rubber goods. Vital status was ascertained for 99.7% of the cohort members, and cause of death found for 96.8% of the 2719 decedents. Age and calendar year adjusted standardised mortality ratios (SMR) and 95% confidence intervals (95% CI) were calculated overall from national reference rates and stratified by year of hire and by years since hire. RESULTS: Mortalities from all causes (SMR 108; 95% CI 104-112) and all cancers (SMR 111; 95% CI 103-119) were significantly increased in the study cohort. Significant excesses in the mortalities from lung cancer (SMR 130; 95% CI 115-147) and pleural cancer (SMR 401; 95% CI 234-642) were identified. SMRs higher than 100 were found for cancers of the pharynx (SMR 144; 95% CI 76-246), oesophagus (SMR 120; 95% CI 74-183), stomach (SMR 110; 95% CI 86-139), rectum (SMR 123; 95% CI 86-170), larynx (SMR 129; 95% CI 69-221), prostate (SMR 108; 95% CI 84-136), and bladder (SMR 124; 95% CI 86-172), as well as for leukaemia (SMR 148; 95% CI 99-213). Mortalities from liver cancer, brain cancer, and lymphoma were lower than expected. CONCLUSIONS: Mortalities from cancer of several sites previously associated with the rubber industry were also increased among workers of the German rubber industry. Results of the stratified analyses are consistent with a role of occupational exposure in the aetiology of some of these cancers.

Analysis of lymph nodes for polyethylene particles in patients who have had a primary joint replacement.

Polarized light microscopy has been used for more than forty years to identify polyethylene particles in histological specimens; however, few investigators have assessed the specificity of this technique. We examined specimens from dissected lymph nodes for the presence of strongly birefringent particles resembling polyethylene. Twenty-seven patients had dissection of lymph nodes after a total joint replacement (Group 1), and a control group of eighteen patients had dissection of lymph nodes before a total joint replacement (Group 2). Specimens from both groups of lymph nodes were examined under plain and polarized light. The presence of strongly birefringent particulate debris was graded from 0 to 4. Twenty-one (78 per cent) of the twenty-seven patients in Group 1 and eight of the eighteen patients in Group 2 had strongly birefringent particles in the lymph nodes. Our results demonstrate that, in the assessment of the systemic dissemination of polyethylene in the lymphoreticular system, polarized light microscopy has important limitations. More refined techniques employing polarized light and other methods of physical and chemical analysis may be necessary to identify polyethylene particles accurately within the lymphoreticular system and periprosthetic tissue.

[Historical cohort study in the German rubber industry: goals, study design and data collection]. / Historische Kohortenstudie in der deutschen Kautschukindustrie: Zielsetzung, Studiendesign und Erhebungsverfahren.

A historical cohort study is carried out to investigate occupational hazards in the German rubber industry since 1991. We present and discuss the study objectives and study design features such as cohort definition, assessment of occupational exposure and selection of the reference population. Cohort enumeration, assessment of vital status and cause of death ascertainment are described. With approximately 2,800 deaths throughout the observation period 1981 to 1991 it will be possible also to study the occupational etiology of rare diseases.

Supervised exercise training improves cardiopulmonary fitness in HIV-infected persons.

We attempted to measure cardiopulmonary effects, CD4 counts, and perceived sense of well-being in 25 individuals moderately to severely immunocompromised from HIV infection (mean entry CD4 count = 144.microliters-1) before and after a 24-wk program of exercise training. Only six subjects completed the 24-wk program. All six showed evidence of a training effect. Statistically significant improvements were seen in maximal oxygen consumption (VO2max), oxygen pulse, and minute ventilation. Submaximal exercise performance improved significantly by 12 wk in the 10 individuals available for testing: decreases were seen in heart rate, rate pressure product, and rate of perceived exertion. White blood cell counts and T-lymphocyte subsets were stable at 12 and 24 wk in the subjects available for testing. High depression/anxiety scores on a mental health inventory (General Health Questionnaire) correlated with low CD4 counts. Scores did not correlate with compliance with the exercise program. There was a trend (P < 0.10) for scores to improve over time among those individuals who attended > or = 80% of scheduled exercise sessions. We conclude that exercise training is feasible and beneficial for some HIV-infected individuals.

Poliomyelitis and the post-polio syndrome: exercise capacities and adaptation--current research, future directions, and widespread applicability.

Poliomyelitis is an acute viral disease that attacks the brain and the ventral horn of the spinal cord. Damage to the lower motor neurons usually results in atrophy and weakness of muscle groups, perhaps paralysis and possibly deformity. A second type, bulbar poliomyelitis, infects the medulla oblongata and may result in dysfunction of the swallowing mechanism along with respiratory and circulatory distress. Minor forms of poliomyelitis result in fever, sore throat, headache, and upper body stiffness, but leave no significant atrophy or paralysis. The purpose of this paper is to review post-polio syndrome (PPS) as well as the effect of exercise on the symptoms and morphologic adaptations to PPS and where future research efforts should be directed. The most common features of PPS for over 350,000 afflicted survivors include general fatigue, weakness, and joint/muscle pain. The primary reasons for these symptoms include 1) destruction of the anterior horn cells by the polio virus, leaving fewer motor neurons to induce muscle contraction; 2) unaffected motor unit enlargement by reinnervation through terminal sprouting; and 3) defective transmission at the neuromuscular junction secondary to failure of terminal axonal sprout. Acute responses to resistive exercise suggest significant muscle strength decrements in the knee extensors compared with similar aged people without polio. However, limited training investigation indicates significant strength increases for the knee extensors following at least 6 wk of training. Acute aerobic responses also differ significantly from those observed in aged-matched control subjects. Chronic aerobic responses to limited training studies suggest significant elevations in maximal oxygen uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

Adherence to exercise interventions in the treatment of hypercholesterolemia.

The goals of this study were to determine the rate of adherence to exercise treatment of hypercholesterolemia and to identify personality and demographic factors associated with adherence. Of the 31 subjects entering the 26-week program, 12 attended 80% or more of the scheduled sessions. Adherence was positively associated with the perceived seriousness of hypercholesterolemia, the expectation of benefit from treatment, and depressed feelings of helplessness and hopelessness. Negative associations were identified between adherence and the perception of health status being under the control of chance or of powerful others. Older subjects were more likely to be adherers at 8 and 16 weeks but not at 26 weeks.

[Epidemiology of risks in the workplace]. / Epidemiologie der Risiken am Arbeitsplatz.

Epidemiologic studies of occupationally exposed subjects allow to detect diseases caused by the work environment and to identify hazardous exposures. They provide the basis for preventive measures and workers compensation. Occupational epidemiology traditionally emphasized the study of work related cancer. Long latency periods for the development of most cancers and limited information about the exposure history of the study subjects are problems for all study types. The specific advantages and limitations of different study designs are discussed. Research strategies in occupational epidemiology are demonstrated using as an example two studies from the American tire and rubber industry. The specific contributions of a historical cohort study and a nested case-control study, concerning the association between lymphosarcoma and exposure to solvents, are discussed. Experiences and first results from a historical cohort study in the German rubber industry are reported. Future research in occupational epidemiology should concentrate more on the study of work related morbidity such as musculoskeletal disorders, hearing loss, accidents and the influence of the work environment on the mental and physical well being. Modern research methods such as prospective cohort studies or workforce monitoring should be used more often. Prospective cohort studies provide quantitatively and qualitatively more precise information about exposures and potential confounders, e.g. cigarette smoking or alcohol consumption, than traditional study methods. The promising perspectives of biological markers warrant further research. The situation of occupational epidemiology in Germany can only be improved if all concerned parties and institutions realize the importance of occupational epidemiology. Laws concerning data confidentiality which seriously hamper epidemiologic research must be modified.

The Toledo Exercise and Diet Study. Results at 26 weeks.

This study was designed to test whether an exercise program is additive to diet counseling in lowering elevated blood cholesterol levels. From a screened population of 1024 subjects, we randomized 66 predominantly female subjects to two intervention groups: diet counseling and diet counseling with exercise. Subjects were selected who had elevated levels of serum low-density lipoprotein cholesterol, an average or low fitness level, and a diet high in saturated fat and cholesterol. After 26 weeks of intervention, 51 subjects exhibited significant decreases in serum levels of cholesterol, high-density lipoprotein cholesterol, triglycerides, and low-density lipoprotein cholesterol. The addition of exercise to diet counseling resulted in improved aerobic capacity, losses of body fat and weight, and further nonsignificant decreases in serum cholesterol and low-density lipoprotein cholesterol levels. Since these results differ from data acquired in individuals with normal to borderline serum cholesterol levels, further studies appear indicated in hypercholesterolemic subjects, especially in women.

Stimulated secretion of pro-opiomelanocortin-related peptides in hypothalamic cells.

UNLABELLED: Although it has been suggested pro-opiomelanocortin (POMC) related peptides in brain may be neurotransmitters or neuromodulators, little is known about their secretion from neurons because it is difficult to study neurosecretion with an in vivo model. To demonstrate the possibility that POMC peptides may be neuroregulators which can be secreted in response to specific stimuli, we studied the secretion of immunoreactive (IR-) adrenocorticotropin (ACTH) and IR-beta-endorphin from dissociated hypothalamic cells during potassium-induced depolarization. Significant increments (p less than 0.025) in secretion of IR-ACTH (267%) and IR-beta-endorphin (88-172%) over basal secretion were stimulated by 60 mM KCl in the presence of calcium. CONCLUSION: Stimulated secretion of POMC peptides from hypothalamic cells by potassium and calcium follows classical neurosecretory mechanisms and suggests these neuropeptides could be neuroregulators in brain.