Faecal carriage of extended-spectrum beta-lactamase-producing bacteria in the community.

We determined the faecal carriage of extended-spectrum beta-lactamase-(ESBL)-producing bacteria in the community in Saudi Arabia. A total of 716 faecal specimens (from 505 healthy individuals and 211 community outpatients) were screened for ESBL using the double-disk synergy test and confirmed by the Clinical Laboratory Standards Institute combined disk method. We found 91 (12.7%) isolates were ESBL-producers. Of these, 87 (95.6%) were Escherichia coli and 4 (4.4%) Klebsiella pneumoniae. A similar rate of faecal carriage of ESBL-producers was demonstrated in community outpatients and healthy individuals: 62 (12.3%) healthy persons and 29 (13.7%) outpatients. We conclude that the community could be a reservoir of these ESBL-producing bacteria and enzymes.

Faecal carriage of extended-spectrum beta-lactamase-producing bacteria in the community

We determined the faecal carriage of extended-spectrum beta-lactamase-[ESBL]-producing bacteria in the community in Saudi Arabia. A total of 716 faecal specimens [from 505 healthy individuals and 211 community outpatients] were screened for ESBL using the double-disk synergy test and confirmed by the Clinical Laboratory Standards Institute combined disk method. We found 91 [12.7%] isolates were ESBL-producers. Of these, 87 [95.6%] were Escherichia coli and 4 [4.4%] Klebsiella pneumoniae. A similar rate of faecal carriage of ESBL-producers was demonstrated in community outpatients and healthy individuals: 62 [12.3%] healthy persons and 29 [13.7%] outpatients. We conclude that the community could be a reservoir of these ESBL-producing bacteria and enzymes

Modified double-disc test for detection of extended-spectrum beta-lactamases in Escherichia coli and Klebsiella pneumoniae.

This study evaluates the performance of a modified double-disc test (MDDT) for the detection of extended-spectrum beta-lactamases (ESBLs) in clinical isolates of Escherichia coli and Klebsiella pneumoniae. Ninety-six isolates of E. coli and 40 K. pneumoniae are studied for ESBL production by the National Committee for Clinical Laboratory Standards (NCCLS) combination disc tests and MDDT A total of 112 (82%) isolates (80 [83%] E. coli, 32 [80%] K. pneumoniae) were positive for ESBL by MDDT compared to 102 (75%; 72 [75%] E. coli and 30 [75%] K. pneumoniae) by the NCCLS method. In 10 (7.4%) isolates, ESBLs were detected only by MDDT Twenty-four (17.6%) isolates were negative for ESBL by both methods. The protocol described in this study provides a more sensitive approach than does the NCCLS method for ESBL detection in E. coli and K. pneumoniae.

Accelerated detection of extended-spectrum beta-lactamases in clinical isolates of Enterobacteriaceae.

A prospective study is carried out to evaluate the performance of a protocol for the accelerated detection of extended-spectrum beta-lactamases (ESBLs) in clinical isolates of Escherichia coli, Klebsiella pneumoniae and other Gram-negative bacteria. A modified double-disc test (MDDT) is incorporated in a Gram-negative template for routine susceptibility testing. The MDDT identified accurately ESBLs in all isolates subsequently confirmed as ESBL-producers by the standard Clinical Laboratory Standards Institute (CLSI) combined disc method. Of 1213 isolates tested, 98 (8%) were positive for ESBLs by MDDT and 95 (7.8%) were positive by the CLSI method. ESBLs were detected in 48 (7.8%) E. coli, 21 (8%) K. pneumoniae, 12 (5.8%) Proteus mirabilis, 13 (18.8%) Providencia stuartii and four (6.8%) Enterobacter cloacae isolates. Time required for ESBL detection by the MDDT method was one day. The protocol described provides a simple, rapid and low-cost method for early detection of ESBLs in Gram-negative bacteria.

HPLC-DAD-ESIMS analysis of phenolic compounds in nectarines, peaches, and plums.

The phenolic compounds of 25 peach, nectarine, and plum cultivars were studied and quantified by HPLC-DAD-ESIMS. Hydroxycinnamates, procyanidins, flavonols, and anthocyanins were detected and quantified. White and yellow flesh nectarines and peaches, and yellow and red plums, were analyzed at two different maturity stages with consideration of both peel and flesh tissues. HPLC-MS analyses allowed the identification of procyanidin dimers of the B- and A-types, as well as the presence of procyanidin trimers in plums. As a general rule, the peel tissues contained higher amounts of phenolics, and anthocyanins and flavonols were almost exclusively located in this tissue. No clear differences in the phenolic content of nectarines and peaches were detected or between white flesh and yellow flesh cultivars. There was no clear trend in phenolic content with ripening of the different cultivars. Some cultivars, however, had a very high phenolic content. For example, the white flesh nectarine cultivar Brite Pearl (350-460 mg/kg hydroxycinnamates and 430-550 mg/kg procyanidins in flesh) and the yellow flesh cv. Red Jim (180-190 mg/kg hydroxycinnamates and 210-330 mg/kg procyanidins in flesh), contained 10 times more phenolics than cultivars such as Fire Pearl (38-50 mg/kg hydroxycinnamates and 23-30 mg/kg procyanidins in flesh). Among white flesh peaches, cultivars Snow King (300-320 mg/kg hydroxycinnamates and 660-695 mg/kg procyanidins in flesh) and Snow Giant (125-130 mg/kg hydroxycinnamates and 520-540 mg/kg procyanidins in flesh) showed the highest content. The plum cultivars Black Beaut and Angeleno were especially rich in phenolics.

The effect of ecological parameters on the distribution of snail vectors of schistosomiasis.

The infestation of the water courses showed 32.5% for Biomphalaria alexandrina and 8.75% for Bulinus truncatus. Ecological parameters, showed non significant variations in the water courses harbouring snail vectors and those free from snails except for conductivity in the habitats harbouring B. truncatus. This variation was more highly significant (p<0.001). Of the examined sites, 11.25% were harbouring B. alexandrina and Lymnaea natalenesis living together and 5% of the sites were harbouring B. truncatus and Physa acuta snails. Snail vectors were distributed with different degrees with aquatic plants reflecting the degree of species preference plants for snails' life.

Antioxidant activity of pomegranate juice and its relationship with phenolic composition and processing.

The antioxidant activity of pomegranate juices was evaluated by four different methods (ABTS, DPPH, DMPD, and FRAP) and compared to those of red wine and a green tea infusion. Commercial pomegranate juices showed an antioxidant activity (18-20 TEAC) three times higher than those of red wine and green tea (6-8 TEAC). The activity was higher in commercial juices extracted from whole pomegranates than in experimental juices obtained from the arils only (12-14 TEAC). HPLC-DAD and HPLC-MS analyses of the juices revealed that commercial juices contained the pomegranate tannin punicalagin (1500-1900 mg/L) while only traces of this compound were detected in the experimental juice obtained from arils in the laboratory. This shows that pomegranate industrial processing extracts some of the hydrolyzable tannins present in the fruit rind. This could account for the higher antioxidant activity of commercial juices compared to the experimental ones. In addition, anthocyanins, ellagic acid derivatives, and hydrolyzable tannins were detected and quantified in the pomegranate juices.

Influence of production, handling, and storage on phytonutrient content of foods.

The goals of agricultural production have traditionally been to try to accommodate needs for: 1) adequate and reliable yields to provide a sufficient food supply in a growing world; 2) food safety; 3) taste; 4) convenience; 5) profit; and 6) variety. Alternative strategies to enhance any of these outcomes are typically evaluated as to their probable effects on the key outcome: yield. However, with the burgeoning consumer interest in foods that optimize health, attention is shifting from concerns over quantity alone to concerns over the constituents of foods that may promote health, and thus to the agricultural practices that will protect, and perhaps enhance these constituents of the food supply. This shift in focus requires new thinking and new strategies across all segments of the food production system. This paper summarizes selected aspects of crop production that are pivotal to the nutrient value of foods for human consumption and suggests some strategies for establishing a new research and production paradigm that will embrace nutrient quality among the priorities of agricultural research.

Costs and benefits of varicella screening and vaccination for healthcare workers at a general hospital.

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Should we routinely check for hepatitis B and C in patients with lichen planus or cutaneous vasculitis?

The study aimed to determine the prevalence of HBs-Ag and anti-HCV antibodies in a group of 43 patients with lichen planus and 19 patients with cutaneous vasculitis versus 30 controls. The results showed that 12 [27.9%] patients with lichen planus were positive for HBs-Ag, 9 [20.9%] were positive for anti-HCV antibodies and 3 [7%] were positive for both. In cutaneous vasculitis patients, 3 [15.8%] were HBs-Ag-positive, 7 [36.8%] were anti-HCV-positive and 3 [15.8%] were positive for both. In the control group, 8 [26.7%] were HBs-Ag positive, 3 [10%] were anti-HCV-positive and 1 [3.3%] was positive for both. These values were not statistically significant

The safety of intraoperative lumbar subarachnoid drainage for acutely ruptured intracranial aneurysm: technical note.

Recently, some concern has arisen regarding the safety of intraoperative spinal drainage for brain relaxation in aneurysm surgery, due to anecdotal association with both aneurysmal rebleeding and increases in symptomatic vasospasm. To address these concerns, we reviewed our experience with frequent spinal drainage and early surgery in 432 consecutive cases of surgically treated aneurysmal subarachnoid hemorrhage. Unless contraindicated by mass effect or associated pathology, all grade I-III patients referred within 14 days were treated with spinal drainage at surgery. In this cohort (n = 314), there were no cases of meningitis or nerve root injury. Only one case of intraoperative rebleeding could be associated with spinal drain placement (0.3%). In grade IV-V patients, 47% required preoperative ventriculostomy, and 11% were ineligible for spinal drainage due to mass effect. There were, however, no complications related to spinal drainage in the remaining 23 patients. Permanently-shunted hydrocephalus (8%) and symptomatic vasospasm (19%) were infrequent overall. When analyzed by grade, spinal drains were generally associated with equal or reduced incidence of these developments when compared to patients without spinal drainage. We conclude that brain relaxation can be safely and effectively obtained using intraoperative spinal drains during early aneurysm surgery.

Ergoloids and ischaemic strokes; efficacy and mechanism of action.

In this double-blind, randomized study the efficacy of the ergoloid compounds, co-dergocrine mesylate and nicergoline, in the rehabilitation of patients with ischaemic stroke was investigated. A group of 30 patients was treated daily with 60 mg nicergoline, orally, and a second group of 27 patients was given 1.8-6 mg co-dergocrine mesylate, orally or intramuscularly, daily (depending on the time since the initial ischaemic insult) for 6 months. Outcome measures included: motoricity index (limb function); Sandoz Clinical Assessment Geriatric (SCAG) scale; psychometric tests to assess functions such as attention, psychomotor performance, perception and sensory and short-term memory; conventional and computerized electroencephalography; and P300 and reaction time measures. The results showed improvements in some aspects such as limb function (P < 0.05), SCAG score (P < 0.01) and some electrophysiological parameters (P < 0.01) after treatment with both drugs. Though statistically significant most of the changes were not large. The efficacy of both drugs was qualitatively similar. The quantitative difference in some aspects in favour of nicergoline could be attributed to differences in the mechanisms of action of the two drugs, although it is also possible that the difference may reflect the dosages used. Nootropic drugs may induce a condition that facilitates the effects of cognitive training.

Cardiac dysrhythmias during nasal surgery--a comparison with lignocaine-adrenaline and prilocaine-octapressin during halothane anaesthesia.

The incidence of cardiac dysrhythmias and adequacy of haemostasis during nasal surgery under deep halothane anaesthesia were studied following nasal infiltration with 10 ml of either 1.5% lignocaine with adrenaline 1:200,000 or prilocaine 1.5% with octapressin 0.03 IU per ml. There was a significant difference in the incidence of cardiac dysrhythmias between patients given octapressin 2% and patients given adrenaline infiltration (18%) p greater than 0.01. Adequate haemostasis was observed in 84% of patients who received octapressin with no adverse effects compared to 94% of the group which received adrenaline (p greater than 0.01). We suggest for the use of lignocaine-adrenaline during halothane anaesthesia that adequate ventilation is assured, deep halothane anaesthesia given, the infiltration delayed 10 minutes after tracheal intubation, the rate of injection adjusted to 10 ml in a 10-minute period and a total dose of adrenaline does not exceed 0.6 microgram/kg.

Modified atmosphere packaging of fruits and vegetables.

Modified atmospheres (MA), i.e., elevated concentrations of carbon dioxide and reduced levels of oxygen and ethylene, can be useful supplements to provide optimum temperature and relative humidity in maintaining the quality of fresh fruits and vegetables after harvest. MA benefits include reduced respiration, ethylene production, and sensitivity to ethylene; retarded softening and compositional changes; alleviation of certain physiological disorders; and reduced decay. Subjecting fresh produce to too low an oxygen concentration and/or to too high a carbon dioxide level can result in MA stress, which is manifested by accelerated deterioration. Packaging fresh produce in polymeric films can result in a commodity-generated MA. Atmosphere modification within such packages depends on film permeability, commodity respiration rate and gas diffusion characteristics, and initial free volume and atmospheric composition within the package. Temperature, relative humidity, and air movement around the package can influence the permeability of the film. Temperature also affects the metabolic activity of the commodity and consequently the rate of attaining the desired MA. All these factors must be considered in developing a mathematical model for selecting the most suitable film for each commodity.

Effects of Elevated CO(2) Concentrations on Glycolysis in Intact ;Bartlett' Pear Fruit.

Mature intact ;Bartlett' pear fruit (Pyrus communis L.) were stored under a continuous flow of air or air + 10% CO(2) for 4 days at 20 degrees C. Fruit kept under elevated CO(2) concentrations exhibited reduced respiration (O(2) consumption) and ethylene evolution rates, and remained firmer and greener than fruit stored in air. Protein content, fructose 1,6-bisphosphate levels, and ATP:phosphofructokinase and PPi:phosphofructokinase activities declined, while levels of fructose 6-phosphate and fructose 2,6-bisphosphate increased in fruit exposed to air + 10% CO(2). These results are discussed in light of a possible inhibitory effect of CO(2) at the site of action of both phosphofructokinases in the glycolytic pathway, which could account, at least in part, for the observed reduction in respiration.