Prevalence and risk factors for gonococcal infection in Reunion Island.

OBJECTIVE: To determine the prevalence and risk factors for gonococcal infection, and the resistance profile of Neisseria gonorrhoeae (NG) in Reunion Island. PATIENTS AND METHODS: All patients who visited the four sexually transmitted infection (STI) clinics of Reunion Island between January 2017 and December 2018 were screened by multiplex polymerase chain reaction. Data on patient characteristics were collected using a self-administered questionnaire (reason for screening, marital status, risk-taking behaviors, place of birth, employment status, type of health care coverage, sexual orientation, number of sexual partners, occurrence of extra-marital relationships, history of STIs, and symptomatology. Precarity was defined as being unemployed and/or receiving universal health insurance). RESULTS: The prevalence of NG (n=4289) in the screened population was 2.8% (95% CI [2.3-3.3]). Minors were especially at-risk (4.4% (95% CI [2.6-7])) and especially girls (5.6% (95% CI [3.2-8.9])). The prevalence observed in the homosexual population was 4.0% [2.6-5.9]. Gonococcal infection was asymptomatic in 56 (69%) patients. For all infection sites, the main risk factors were male minors (P=0.019), individuals living in conditions of precarity (P=0.023), individuals co-infected with chlamydia (P<0.001) or syphilis (P<0.001), and individuals of foreign origin (P=0.006). No NG strain was resistant to ceftriaxone. Strains were resistant to penicillin G, ciprofloxacin, and azithromycin in 22% (20/91), 38% (35/91), and 1% (1/91) of cases, respectively. CONCLUSION: The prevalence of NG in patients visiting STI clinics in Reunion Island is particularly high among minors. Prevention programs targeting this population should be reinforced and screening should be facilitated in school settings.

Stability study of a nisin/natamycin blend by LC-MS.

Nisin and natamycin are natural preservatives used in a broad range of food products. In the present study, the stability of an aqueous nisin/natamycin blend (pH 4.0) for the beverage market was tested at room temperature (22 °C) under dark conditions by means of liquid chromatography. Both an HPLC-UV and a UPLC-MS method were developed to monitor the concentration of natamycin and nisin, respectively. After 6 months at room temperature (22 °C) under dark conditions, the nisin/natamycin blend (pH 4.0) still contained 85% of the original amount of nisin and 95% of natamycin. Even after 1 year, 50% of nisin and 90% of natamycin remained in the formulation. The resulting degradation products were studied by means of high resolution mass spectrometry. For both nisin and natamycin, degradation products originating from hydration (natamycin + H2O; nisin + H2O) and oxidation reactions (natamycin + O; nisin + O; nisin + 2O) were observed.

On-line monitoring of chemical reactions by using bench-top nuclear magnetic resonance spectroscopy.

Real-time nuclear magnetic resonance (NMR) spectroscopy measurements carried out with a bench-top system installed next to the reactor inside the fume hood of the chemistry laboratory are presented. To test the system for on-line monitoring, a transfer hydrogenation reaction was studied by continuously pumping the reaction mixture from the reactor to the magnet and back in a closed loop. In addition to improving the time resolution provided by standard sampling methods, the use of such a flow setup eliminates the need for sample preparation. Owing to the progress in terms of field homogeneity and sensitivity now available with compact NMR spectrometers, small molecules dissolved at concentrations on the order of 1 mmol L(-1) can be characterized in single-scan measurements with 1 Hz resolution. Owing to the reduced field strength of compact low-field systems compared to that of conventional high-field magnets, the overlap in the spectrum of different NMR signals is a typical situation. The data processing required to obtain concentrations in the presence of signal overlap are discussed in detail, methods such as plain integration and line-fitting approaches are compared, and the accuracy of each method is determined. The kinetic rates measured for different catalytic concentrations show good agreement with those obtained with gas chromatography as a reference analytical method. Finally, as the measurements are performed under continuous flow conditions, the experimental setup and the flow parameters are optimized to maximize time resolution and signal-to-noise ratio.

Perirectal sepsis after rubber band ligation of haemorrhoids : a case report.

Rubber band ligation (Barron ligation, RBL) is a widely used method for the treatment of symptomatic -haemorrhoids. In general, it is considered as a safe, effective and easily performed way of treating second and third -degree haemorrhoids. Perineal and pelvic sepsis was already known to be a rare, but possible complication after stapled haemorrhoidopexy. However, there have been some reports of severe sepsis after rubber band ligation as well. We -present a patient who was treated twice for haemorrhoids with rubber band ligation and attended the emergency department 10 days later. He was diagnosed with perirectal sepsis and aggressive antibiotic treatment was the first attempt of treatment. Because of further deterioration under medical therapy, our patient required extensive surgery.

Enantioselective high-performance liquid chromatographic separation of N-methyloxycarbonyl unsaturated amino acids on macrocyclic glycopeptide stationary phases.

This paper describes the enantiomeric resolution of a series of unsaturated N-methyloxycarbonyl-alpha-H-alpha-amino acids (N-MOC-alpha-amino acids) on macrocyclic glycopeptide stationary phases by means of high-performance liquid chromatography (HPLC). Three types of glycopeptide phases, i.e. Chirobiotic T, V and R, were evaluated in both reversed-phase (RP) and polar ionic mode (PIM). The best results in terms of enantioselectivity and resolution were obtained on Chirobiotic R phase, with the PIM mobile phase giving the highest resolution per min. Investigation of the pH of the reversed-phase mobile phase in the pH range 4.1-5.9 showed little effect on enantioselectivity. The method was applied for monitoring the conversion and product enantiomeric excess of an enzymatic hydrolysis reaction using N-MOC-alpha-H-alpha-amino acid esters as substrate.

High-performance liquid chromatographic determination of alpha-aminonitrile enantiomers after derivatization with o-phthalaldehyde and chiral thiols.

o-Phthalaldehyde in combination with chiral thiols is described as a chiral reagent for the resolution of the enantiomers of alpha-H-alpha-aminonitriles and alpha-alkyl-alpha-aminonitriles. Separation of the resulting diastereomers was carried out by reversed-phase chromatography and the derivatives were detected at UV 340 nm. The identity of the diastereomeric derivatives was confirmed by LC-MS. Among the chiral thiols tested, N-acetyl-D-penicillamine and beta-mercaptoisobutyric acid gave the best resolution for the alpha-aminonitriles studied. For quantitative enantiomeric excess determination, beta-mercaptoisobutyric acid was chosen as this thiol could be obtained in high enantiomeric purity from a commercial source. The rate of the reaction of various alpha-aminonitriles with o-phthalaldehyde and beta-mercaptoisobutyric acid was studied. The accuracy of the method was investigated by a comparison of theoretical and measured enantiomeric excess.

Design and synthesis of fluorescent beta-cyclodextrins for the enantioselective sensing of alpha-amino acids.

Fluorescent monofunctionalized beta-cyclodextrins bearing a copper(II) binding side arm and a dansyl group (CD-NH-AA-CH(2)CH(2)NH-DNS) were designed as enantioselective sensors for unmodified alpha-amino acids. The side arm was derived from amino acid synthons (AA = L- and D-phenylalanine (1 and 2), L- and D-phenylglycine (3 and 4), L-proline (5), and L-cyclohexylglycine (6)) and was chosen in order to contain an amide, an amine, and a sulphonamide group. Enantioselectivity was evaluated by addition of copper(II) complexes of D- or L-valine and D- or L-proline. Chiral discrimination in the fluorescence response was observed in all cases, due to a ligand exchange process. The best conditions for these experiments were found to be the use of an excess (10:1) of the copper complex. The cyclodextrin 4 containing a D-phenylglycine unit was found to be poorly enantioselective, as found for 2, suggesting that the best design can be obtained by using L-amino acids. All L-amino acid containing cyclodextrins showed good enantioselectivities, some of which were higher than those already reported for 1. Other analytes related to amino acids were studied using cyclodextrins 1 and 3. Enantiomers of alpha,alpha-disubstituted amino acids, N-methylamino acids, and amino acid amides were found to be discriminated, while beta-phenylalanine and other molecules bearing a poor anchoring group at the alpha-carbon gave poor enantioselectivity. On the basis of the present data a model for the recognition process, based on the formation of ternary diastereomeric complexes, is proposed.

Comparative evaluation of four detectors in the high-performance liquid chromatographic analysis of chiral nonaromatic alcohols.

A comparative evaluation of ultraviolet, polarimetric, refractive index, and evaporative light-scattering detection coupled with high-performance liquid chromatography has been developed for the separation and quantitation of the enantiomers of chiral nonaromatic alcohols, some of which are intermediates in the synthesis of chiral drugs. (R,S)-3-tert-butylamino-1,2-propanediol; (R,S)-glycidol; and (R,S)-1-(4-morpholino)-2-octanol are selected as model compounds in order to compare the detection sensitivity and the linearity of the response with the four detectors. Separation of the enantiomers is performed using chiral stationary phases in normal-phase liquid chromatography. A one-day validation is achieved for (S)-3-tert-butylamino-1,2-propanediol with each detector, and limits of quantitation are determined for the three compounds. Advantages and limitations of the four detectors are discussed.

Determination of the enantiomers of 3-tert.-butylamino-1,2-propanediol by high-performance liquid chromatography coupled to evaporative light scattering detection.

A method for the separation and quantitation of the enantiomers of 3-tert.-butylamino-1,2-propanediol by high-performance liquid chromatography and evaporative light scattering detection has been developed. Separation of the enantiomers was performed in normal-phase liquid chromatography on a Chiralpak AS chiral stationary phase. The influence of the gas nature, gas pressure and temperature of the drift tube of the evaporative light scattering detector on the detection sensitivity was investigated. The method was validated in terms of linearity, limit of quantitation, accuracy and precision. The enantiomeric excess of (S)-3-tert.-butylamino-1,2-propanediol, used for the industrial synthesis of (S)-timolol, was measured from 0 to 94%.

Factors influencing corpus argyrophil cell density and hyperplasia in reflux esophagitis patients treated with antisecretory drugs and controls.

A cross sectional study was designed to elucidate the factors influencing the argyrophil cell population in patients with gastroesophageal reflux disease treated with omeprazole (N = 201) or H2-receptor antagonists (N = 118) and in control patients (N = 215). Fasting gastrinemia and Helicobacter pylori serology were determined. Gastritis, Helicobacter pylori infection, and argyrophil cell density and hyperplasia were evaluated in gastric biopsies. The argyrophil cell density was higher in both treatment groups than in controls (P = 0.002 and P = 0.051), whereas argyrophil cell hyperplasia was similar in the three groups. According to multivariate analysis, positive Helicobacter pylori serology was an independent parameter that decreased both density and grade of hyperplasia of argyrophil cells. Female gender and hypergastrinemia were independent factors increasing argyrophil cell density and hyperplasia, whereas antisecretory therapy, age and active gastritis were not. In addition, atrophic gastritis independently increased argyrophil cell hyperplasia. The prevalence of atrophic gastritis was significantly higher in Helicobacter pylori-positive than in negative patients and lower in the patients treated long-term with omeprazole than in the other groups.

[Gastroprotective effect of an antacid coating agent in rats. Role of endogenous prostaglandins, capsaicin-sensitive afferents neurons and nitric oxide]. / Etude de l'effect gastroprotecteur d'un pansement antiacide chez le rat. Rôle des prostaglandines endogènes, des neurones afférents sensibles à la capsaïcine et du monoxyde d'azote.

UNLABELLED: The aims of this study were: a) to demonstrate the gastroprotective effect of the antacid and mucosal coating agent Gastralgine (aluminium hydroxide and glycinate, magnesium trisilicate and simeticone) against ethanol- and indomethacin-induced gastric injury in the rat; b) to investigate whether gastroprotection elicited by this agent involves stimulation of capsaicin sensitive afferent neurons and activation of the nitric oxide system. METHODS: Rats received intragastrically 2 mL of the antacid or distilled water followed 1 hr later by 2 mL of 100% ethanol ig or 30 mg of indomethacin sc. The surface of ethanol-induced lesions and the length of indomethacin-induced lesions were measured. The role of afferent neurons and endogenous nitric oxide in the prevention of ethanol-induced gastric damage was determined using respectively capsaicin and the inhibitor of nitric oxide biosynthesis, NG-nitro-L-arginine. RESULTS: The antacid and mucosal coating agent significantly reduced the area of macroscopic lesions induced by ethanol and the length of lesions induced by indomethacin. Both functional ablation of afferent nerves and inhibition of nitric oxide synthesis significantly increased ethanol-induced gastric injury but failed to reverse the gastroprotective effect of the antacid against 100% ethanol. CONCLUSIONS: The antacid and mucosal coating agent Gastralgine has a gastroprotective effect against ethanol- and indomethacin-induced injury in the rat. This property does not involve stimulation of capsaicin sensitive afferent neurons or synthesis of endogenous nitric oxide.

Thermospray liquid chromatography/mass spectrometry study of diastereomeric isoindole derivatives of amino acids and amino acid amides.

A thermospray liquid chromatography/mass spectrometry (TSP-LC/MS) method is described for determination of the enantiomeric excess of alpha-amino acids and alpha-amino acid amides as their o-phthalaldehyde/N-acetyl-L-cysteine (OPA/NAC) derivatives. The source temperature is an important factor in optimizing the sensitivity of the TSP-LC/MS analysis, whereas the repeller voltage is of minor importance. On-column mass spectra were acquired for the OPA/NAC derivatives of several alpha-amino acids and alpha-amino acid amides. For the main fragment ions, mass spectra fragmentation pathways are proposed. The applicability of the method is demonstrated by means of the enantiomeric excess determination of valine in a sample from an enzymatic hydrolysis experiment. Using single ion monitoring, the detection limit of D-valine in the presence of excess L-valine is 10 pmol. The present TSP-LC/MS method is useful for validating the results obtained from LC/UV or LC/fluorescence methods for the enantiomeric excess determination of alpha-amino acids and alpha-amino acid amides.

Determination of biocatalyst consumption in an aminopeptidase process using automated sample preparation and high-performance liquid chromatography.

A rapid and sensitive method has been developed for the determination of the biocatalyst consumption in the chemo-enzymic production of optically pure natural and synthetic alpha-H-amino acids. It is based on automated sample preparation from an enzymic reaction mixture, reversed-phase high-performance liquid chromatographic separation, post-column reaction and fluorimetric detection. The assay procedure has been applied to the enzymic conversion of racemic norvaline amide into L-norvaline, catalysed by an L-specific aminopeptidase from Pseudomonas putida. Both norvaline amide and norvaline can be analysed in a single assay in the low nanogram range. The method yields reproducible results and requires 30 min from the time of sampling the enzymic reaction mixture to quantitation. The reaction mixture is automatically sampled and analysed several times during the course of the reaction. With the results obtained a conversion curve can be constructed from which the exact biocatalyst consumption can be calculated. By adaptation of the mobile phase, the method can also be applied to other amino acid amides used as substrates in the aminopeptidase reaction.

Prevention by aluminium phosphate of gastric lesions induced by ethanol in the rat: role of endogenous prostaglandins and sulfhydryls.

This study was designed to demonstrate the cytoprotective effect of an antacid containing aluminium phosphate (Phosphalugel) against ethanol-induced gastric injury in the rat and to determine whether this cytoprotective effect is mediated by endogenous prostaglandins and sulfhydryls. We have quantitatively evaluated gastric mucosal lesions using macroscopic and histological techniques one hour after ethanol administration. Two ml of aluminium phosphate given orally one hour before administration of 2 ml of 100% ethanol significantly (p less than 0.01) reduced the area of macroscopic lesions induced by ethanol (3.3 +/- 0.9%) when compared to distilled water (20 +/- 4.8%). The histological study showed that aluminium phosphate prevented deep tissue necrosis. However, it did not protect surface epithelial cells against ethanol injury. Pretreatment with indomethacin, 5 mg/kg sc one hour before aluminium phosphate, slightly but significantly (p less than 0.05) reduced the cytoprotective effect of aluminium phosphate. Macroscopic lesions occupied 4.3 +/- 0.94% and 1.88 +/- 0.41% of total mucosal area in indomethacin group and in vehicle group, respectively. On the other hand, the sulfhydryl blocker, N-ethyl-maleimide, 10 mg/kg sc, given one hour before aluminium phosphate, completely abolished the cytoprotective effect of aluminium phosphate (32.92 +/- 4.85% in N-ethyl-maleimide group versus 3.78 +/- 1.41% in vehicle group; p less than 0.01). These results show that aluminium phosphate has a cytoprotective effect against ethanol injury in the rat. This property appears to be mediated by both endogenous prostaglandins and sulfhydryls.

The efficacy of estrus detection and fertility following synchronization with PGF2a or synchro - mate- B in Zebu cattle.

Two experiments were carried out to assess the efficacy of estrus detection and fertility in Zebu cattle after synchronization with prostaglandin F2a or a progestagen. The first experiment compared estrus detection rates and fertility following insemination in 42 cows previously synchronized with either 25 mg of PGF2a or with a 6 mg of Norgestomet implant plus 5 mg i.m. of estradiol valerate (SMB). Differences were observed in the percentage of cows detected in estrus (54 vs 95%, respectively, P < 0.05), but not in fertility at the first synchronized estrus (26 vs 15%), nor in the detection rate and fertility at the subsequent estrous period (38 v 47%). The second experiment evaluated the efficacy of estrus detection at different time intervals in 30 cows, comparing estrus synchronized with PGF2a with the subsequent estrous period. The observation periods were continuous, day and night, for 100 h both after PGF2a treatment and from Day 18 of the treatment cycle (Period 1). In addition, the animals were administered PGF2a again on Day 10 of the second cycle and observed continuously from 0600 to 1800 h, and from Day 18 of the treatment cycle (Period 2). Finally, the same treatment regimen was used except that the observation was between 0600 to 0700 h and 1800 to 1900 h (Period 3). No differences were obtained in the percentage of cows detected in estrus in the synchronized and nonsynchronized groups (average 75%); however, accuracy in the detection of estrus in Period 3 differed in the nonsynchronized and synchronized estrus groups by 40% (P < 0.05) compared with the other two, more intense observation periods.

Protective effect of low dose of enprostil against gastric blood loss induced by aspirin in man.

This study tested the efficacy of enprostil given both at potent antisecretory (35 micrograms twice daily) and weak antisecretory (7 micrograms twice daily) doses in preventing aspirin-induced gastric blood loss measured chemically in gastric washings in 10 volunteers. Aspirin (500 mg four times a day) increased gastric blood loss compared with placebo (p less than 0.001). When enprostil was given in addition to aspirin, gastric blood loss was not significantly different from basal value. The pH of gastric washings was significantly increased by the large but not by the low dose of enprostil compared with placebo. The two doses of enprostil were equally efficacious, suggesting a mucosal protective effect of enprostil independent of acid inhibition.

Determination of the enantiomers of alpha-amino acids and alpha-amino acid amides by high-performance liquid chromatography with a chiral mobile phase.

A high-performance liquid chromatographic method for the enantiomeric analysis of a mixture of an alpha-amino acid and the corresponding acid amide is described. Reversed-phase chromatography with copper(II) acetate and N,N-di-n-propyl-L-alanine in the mobile phase are used for the separation. For Val and Val-NH2, several parameters affecting retention and enantioselectivity were investigated. The results indicate that by manipulation of pH, ionic strength, temperature, concentration of CuII, N,N-di-n-propyl-L-alanine and ion-pairing reagent, good control of enantiomeric separation can be achieved. For alpha-amino acid amides a mechanism is proposed which may account for the retention and enantioselectivity. Examples of enantiomeric analysis of mixtures of alpha-amino acids and alpha-amino acid amides with aliphatic, aromatic and polar side-chains are given. The method can be used for the control of the enantiomeric purity of alpha-amino acids and the corresponding acid amides obtained by enantioselective synthesis.

[Results of weight-loss treatment at a hospital. Significance of the administration of triiodothyronine in small doses during a protein diet]. / Résultats de cures amaigrissantes en milieu hospitalier. Intérêt de l'administration de triiodothyronine à petites doses au cours de la diète protidique.

We report the short-term effects of very-low-calorie liquid formula diet (n = 51) and of 600 Kcalories diet (n = 13) in patients who were hospitalized during 3 weeks. Weight loss averaged 278 +/- 14 g/day (m +/- SEM). It was slightly higher with the very-low-calorie liquid formula diet (293 +/- 21 g vs 242 +/- 25 g, N.S.). Individual weight-loss was unpredictable and highly variable; it ranged from 62 to 636 g/day. During the very-low-calorie formula diet, the expected low T3 syndrome was observed and 12 patients were given T3 (25 micrograms during the second week and 50 micrograms during the third week). These rather small doses corrected T3 values, but lowered total and free T4 levels. T3 administration did not modify the magnitude of weight loss in our patients.