What is the role of Ewingella americana in humans? A case report in a healthy 4-year-old girl.

BACKGROUND: Ewingella americana (Ea) is a Gram-negative, lactose-fermenting, oxidase-negative and catalase-positive bacterium that was first described in 1983 as a new genus and species in the family Enterobacteriaceae. It is not known whether Ea is a true pathogen or simply an opportunistic infectious agent, as most of the cases have been described in patients at risk. CASE PRESENTATION: A 4-year-old girl described here was hospitalized due to a productive cough over the previous 3 weeks and a fever > 38 °C associated with tachypnea over the previous 2 days. Her familial and personal medical histories were negative for relevant diseases, including respiratory infections. At admission, she was febrile (axillary temperature 39.2 °C) and had dyspnea with retractions, grunting and nasal flaring. A chest examination revealed fine crackling rales in the left upper field associated with bilateral wheezing. A chest X-ray revealed segmental consolidation of the lingula of the left lung. Laboratory tests revealed leukocytosis (15.,800 white blood cells/mm3 with 50.3% neutrophils), a slight increase in serum C-reactive protein (11.9 mg/L) and normal procalcitonin values (< 0.12 ng/mL). A nasopharyngeal swab culture did not reveal viral or bacterial respiratory pathogens, including atypical bacteria. A blood culture revealed the presence of a Gram-negative, lactose-fermenting rod that was oxidase negative and catalase positive. The isolate was identified by means of the VITEK®2 identification system (bioMérieux, Firenze, Italy) as Ea. This identification was confirmed by sequencing the 16 s ribosomal deoxyribonucleic acid (rDNA). The pathogen was sensitive to aminoglycoside, fluoroquinolones, carbapenems, cefotaxime, and ceftazidime but was intermediate against sulfametoxazole/trimethoprim and resistant to amoxicillin-clavulanic acid, fosfomycin, and oxacillin. The child was immediately treated orally with amoxicillin-clavulanic acid and erythromycin. Based on the results of a blood culture and sensitivity tests, the amoxicillin-clavulanic acid medication was stopped after 3 days. Erythromycin was continued for a total of 10 days, and the child was discharged after 3 days in the hospital. Follow-up visit 1 month later did not reveal any respiratory problems. CONCLUSION: This case shows that Ea infections in healthy subjects are mild even in pediatric age, and the need for antibiotic therapy is debated. Cases occurring in subjects with underlying chronic disease can be significantly more complicated and require appropriate antibiotic therapy.

Dismorfia muscular, imagen corporal y conductas alimentarias en dos poblaciones masculinas / Muscle dysmorphia, body image and eating behaviors in two male populations

Background: Muscle dysmorphia or vigorexia is a disorder in which a person becomes obsessed with the idea that he or she is not muscular enough. Aim: To assess physical exercise, eating behaviors and the presence of muscle dysmorphia among weightlifters and medical students. Subjects and Methods: Cross sectional evaluation of 88 male weightlifters aged 27 ± 7 years and 84 male medical students aged 22 ± 1 year was made. Eating behaviors were evaluated using the Eating Attitudes Test (EAT-40) and the Eating Disorders Inventory (EDI). The perception of body image was assessed using the Graduate Hannover Scale (GHS). Results: Prevalence of muscle dysmorphia among weightlifters was 13.6 percent. Both groups did not differ in body dissatisfaction. Interest in appearance among weightlifters was significantly higher than in students and ranged significantly higher in EAT-40 and EDI (p < 0.001). Other sports were practiced with the same frequency by weightlifters and students. Weightlifters expended more time than students exercising to improve their appearance (p < 0.005). Forty two percent of weightlifters with muscle dysmorphia displayed abuse of anabolics and 67 percent used other substances to improve their performance (p < 0.005). Conclusions: The presence of muscle dysmorphia among weightlifters was confirmed. They were dissatisfied with their body image and more concerned with their physical appearance than those without muscle dysmorphia and/or students. Their anabolic abuse rate was high. Our findings were similar to those reported in the international literature.

[Muscle dysmorphia, body image and eating behaviors in two male populations]. / Dismorfia muscular, imagen corporal y conductas alimentarias en dos poblaciones masculinas.

BACKGROUND: Muscle dysmorphia or vigorexia is a disorder in which a person becomes obsessed with the idea that he or she is not muscular enough. AIM: To assess physical exercise, eating behaviors and the presence of muscle dysmorphia among weightlifters and medical students. SUBJECTS AND METHODS: Cross sectional evaluation of 88 male weightlifters aged 27 ± 7 years and 84 male medical students aged 22 ± 1 year was made. Eating behaviors were evaluated using the Eating Attitudes Test (EAT-40) and the Eating Disorders Inventory (EDI). The perception of body image was assessed using the Graduate Hannover Scale (GHS). RESULTS: Prevalence of muscle dysmorphia among weightlifters was 13.6%. Both groups did not differ in body dissatisfaction. Interest in appearance among weightlifters was significantly higher than in students and ranged significantly higher in EAT-40 and EDI (p < 0.001). Other sports were practiced with the same frequency by weightlifters and students. Weightlifters expended more time than students exercising to improve their appearance (p < 0.005). Forty two percent of weightlifters with muscle dysmorphia displayed abuse of anabolics and 67% used other substances to improve their performance (p < 0.005). CONCLUSIONS: The presence of muscle dysmorphia among weightlifters was confirmed. They were dissatisfied with their body image and more concerned with their physical appearance than those without muscle dysmorphia and/or students. Their anabolic abuse rate was high. Our findings were similar to those reported in the international literature.

Reducing effect of Salvia miltiorrhiza extracts on alcohol intake: influence of vehicle.

A previous study demonstrated that an extract of Salvia miltiorrhiza, a medicinal herb highly valued in Chinese folk medicine for the treatment of different pathologies, including insomnia, was capable of reducing voluntary alcohol intake in selectively bred Sardinian alcohol-preferring (sP) rats. The present study was designed to evaluate the suitability of different emulsifying, suspending agents and solvents as vehicles through which Salvia miltiorrhiza extracts can exert their reducing effect on alcohol intake. A single dose (100 mg/kg) of a standardised extract of Salvia miltiorrhiza was dissolved in either pure Polysorbate 80, arachis oil, PEG 400, or Polyoxyl 35 castor oil, or suspended in 0.5% CMC in water, and administered acutely by gavage to sP rats. A significant and specific reduction in alcohol intake was recorded only in rats treated with the combination of Polysorbate 80 plus the Salvia miltiorrhiza extract. A further experiment demonstrated that the ability of the combination of Polysorbate 80 in water plus the Salvia miltiorrhiza extract to decrease alcohol intake was dependent upon the concentration of Polysorbate 80. The results of the present study demonstrate that Polysorbate 80 is a proper vehicle for unravelling the reducing effect of Salvia miltiorrhiza extracts on alcohol intake. The ability of Polysorbate 80 to form micelles with the active ingredient(s) of the Salvia miltiorrhiza may explain these results. They may also offer relevant information for pharmaceutical preparation of Salvia miltiorrhiza extract to be used in future clinical trials.