Prevalence of Neisseria meningitidis carriers in the school population of Catalonia, Spain

The aim of this study was to determine the prevalence of healthy Neisseria meningitidis pharyngeal carriers in a representative sample of the Catalonian school population, as well as its associated factors. The sample was divided into age groups: < or = 5, 6-7 and 13-14 years old. Parents were given a questionnaire to collect information on sociodemographic and epidemiological variables. Oropharyngeal swabs were collected with a cotton-tipped swab in an Amies transport medium and cultured on Thayer Martin plates at 35 degrees C in 5% CO2. The isolates were serogrouped and sero/subtyped. Of the 1406 children studied, 75 (5.34%) meningococcal carriers were detected: 63 B (4.5%), 9 non groupable (0.7%), 2 29E (0.1%) and 1X (0.07%). No serogroup C meningococci were found in this study, probably due to the high A+C vaccination coverage of up to 68.9% in children 6-7 years old. Bivariate analysis identified six statistically significant risk factors for meningococcal carriage: increasing age, recent upper respiratory tract infection, previous antibiotic treatment, number of students in the class, size of the classroom and social class. Multivariate analysis found that only age and previous antibiotic treatment remained statistically significant when the other factors were controlled.

[Etiology of enteritis in a university general hospital in Barcelona (1992-1995)]

BACKGROUND

The aim of the study was to describe the etiology of enteropathogenic agents over a four-year period (1992-1995) in a University Hospital in Barcelona.

METHODS

We studied 12,793 stool samples, 4519 were obtained from patients under 15 years and 8274 were obtained from patients over 14 years. The specimens were examined for bacteriological, parasitological and virological enteropathogens.

RESULTS

In 3380 specimens of 12,793 stool samples studied were identified an enteropathogen (26.4%). Polymicrobial associations were observed in the 6.8% of the cases. Pathogens were identified in 45% of children samples and 16.3% of adults samples. The etiological enteritis agents more frequently detected in the paediatric patients were Campylobacter (13.5%), rotavirus (11.3%) and Salmonella (10.2%); and Salmonella (4.9%), Campylobacter (3.1%) and Giardia intestinalis (2.1%) in adults. Cryptosporidium (13.5%) was the most frequent cause of gastrointestinal tract infections in HIV-infected subjects. In the children with stools positives, the presence of red and white blood cells were more frequent than the adults with stools positives (73% versus 26.6%).

CONCLUSIONS

The enteropathogenic agents such as Campylobacter, Salmonella, and Giardia were the most frequent cause of gastroenteritis in our environment. In the children, rotavirus infections predominated during the cold months. The most frequent cause of gastroenteritis in HIV-infected patients was Cryptosporidium followed by Campylobacter.

[Traumatic asphyxia and continuous venovenous hemofiltration. Report of a case]

A 32-year-old man was admitted with traumatic asphyxia, with aspiration to the bronchi after being buried under sand. The condition progressed to respiratory distress syndrome and systemic inflammatory response. Because ventilatory and hemodynamic deterioration was rapid and severe, in spite of mechanical ventilation and vasoactive drugs, we instated early continuous arteriovenous hemofiltration, which also allowed us to meet the patient's full nutritional needs. We believe that the patient's very satisfactory progress can be attributed to the early use of this procedure, along with appropriate specific treatment.

[Evaluation of chromogenic medium CPS ID2 (bioMérieux) in urine cultures]

BACKGROUND

The aim of the study was to evaluate the chromogenic agar plate CPS ID2 (bioMérieux) and determine its cost-benefit ratio.

METHODS

A total of 2,193 urinary sediments were processed. The urine culture was carried out in CPS ID2 agar and in cystine-lactose electrolyte deficient (CLED) agar, when needed. Identification of the microorganisms was performed following standard microbiologic procedures through biochemical tests prepared in our laboratory. The identification, from CPS ID2 agar, by direct detection in medium of four metabolic activities: beta-glucuronidase, beta-glucosidase, deaminase, and indol production, was performed following to manufacturer's instructions.

RESULTS

A total of 289 urine cultures were positive, 18 were negative and 34 were contaminated samples. The identification, directly performed from the colonies detected in CPS ID2 agar, was correct in 96% of 166 Escherichia coli, in 92% of 24 Proteus mirabilis and in 97% of 38 enterococci. CPS ID2 agar exhibited 94% and 100% sensitivity and specificity, respectively in E. coli identification, 92% and 100% in P. mirabilis and 97% and 99% in Enterococcus. The use of this new media, CPS ID2, in our laboratory, implies a budgetary increment. However, if commercial galleries are used for routine identification, the cost will be reduced using this new media.

CONCLUSIONS

The CPS ID2 agar allows the isolation and direct identification of the most frequent urinary tract pathogens: E. coli, P. mirabilis and Enterococcus in primary isolation medium. Using this medium, bacteriologists will be able to save time and reagents when identifying the most common uropathogens. Furthermore, the use of this medium would reduce costs in some laboratories.

US and color Doppler imaging of ocular and orbital disease in the pediatric age group

Ultrasonography (US) is a rapid, accurate, noninvasive method of evaluating ocular and orbital disease. A wide spectrum of pediatric ocular and orbital disorders can be demonstrated with US: ocular congenital malformations, vitreoretinal disorders, primary and metastatic ocular and orbital neoplasms, inflammatory and congestive disease (focal or systemic), cystic disease, trauma, and foreign bodies. US may be the method of choice for studying ocular congenital anomalies and vitreoretinal disorders owing to its high definition and noninvasiveness. In ocular neoplasms, US demonstrates the morphology of the lesion, its solid or liquid nature, and the presence of calcifications. Its use is limited when the tumor extends outside the globe; computed tomography (CT) or magnetic resonance (MR) imaging must then be performed. In ocular trauma, US precisely demonstrates the presence of hemorrhage, retinal and choroidal detachment, and foreign bodies. CT and MR imaging are superior in evaluation of orbital disease. Color Doppler US often allows differential diagnosis of vascular, inflammatory, and neoplastic disease.

Effect of kappa-casein split peptides on platelet aggregation and on thrombus formation in the guinea-pig

An undecapeptide (residues 106-116 of cow kappa-casein) is known to inhibit human platelet aggregation and fibrinogen binding through inhibition of the interaction between the fibrinogen gamma-chain C-terminus and alphaIIbbeta3. This was due to structural homologies with the fibrinogen gamma-chain C-terminal dodecapeptide. We have therefore compared in this work the in vitro anti-aggregating activity of kappa-casein split peptides and their in vivo potential antithrombotic activity in a model of arterial thrombosis triggered by laser-induced intimal injury in the guinea-pig. Caseinoglycopeptide (residues 106-169), the undecapeptide (residues 106-116) and the pentapeptide KNQDK (residues 112-116) from cow kappa-casein, were anti-aggregating peptides and exerted a significant antithrombotic activity in the guinea-pig. Caseinoglycopeptides from three species (cow, ewe and human) were also antithrombotic and the most potent being the human one. The antithrombotic activity was achieved in vivo for doses less than the one suspected from in vitro data and for which, ex vivo platelet aggregation was not decreased. In conclusion, the relative involvement of the fibrinogen gamma-chain C-terminal dodecapeptide could be much more important in in vivo thrombosis process than in in vitro platelet aggregation. Its specificity and activity in vivo unveiled an interesting potential way for inhibition of arterial thrombosis if alternative molecular presentation (i.e. peptidomimetics) and alternative route (i.e. per os) can be developed.

Characterization of an antithrombotic peptide from kappa-casein in newborn plasma after milk ingestion

Bovine and human kappa-caseinoglycopeptides, two antithrombotic peptides derived from the corresponding kappa-caseins, were detected in physiologically active concentrations in the plasma of 5-d-old newborn infants after ingestion of cow's-milk-based formula or human milk respectively. It is suggested that these two bioactive peptides are released from milk proteins during digestion.

In search of a correlation between the electron affinity and the radiosensitizing activity of some glyoxylic compounds

The electron affinity of some glyoxylic compounds with radiosensitizing properties was evaluated using different approaches. The half-wave reduction potentials were measured by polarography, and the molecular structures in solution were determined by NMR spectroscopy. The electron affinity of the unhydrated and hydrated molecules was theoretically evaluated by means of a semi-empirical quantum mechanical procedure, the MNDO. The possible correlations between these values and the radiosensitizing efficiency of these glyoxylic compounds is discussed.

Kinetic study of the enzyme NADPH cytochrome-C (P-450) reductase: non-Michaelian behaviour

1. Contrary to what has been accepted until now, the enzyme exhibits non-Michaelian kinetics both against NADPH and against cytochrome-c as substrates; deviations were detected that have led to the proposition of a rate equation of minimum degree 2:2. 2. A general mechanism is proposed that includes, apart from the binding of the enzyme to NADPH, the formation of an enzyme-cytochrome-c complex, both routes leading to the formation of a ternary-complex NADPH-enzyme-acceptor. 3. From the latter, a series of intermediate steps finally leads to the release of the enzyme in conditions to start a new catalytic cycle. 4. Application of the King-Altman method to this mechanism yields a kinetic equation of degree 2:2 with respect to the cytochrome-c and NADPH, in accordance with our experimental results.

The non-Michaelian action of thrombin on peptide p-nitroanilide substrates

1. v([S]) kinetic data were obtained for the hydrolysis of the chromogenic substrates H-D-Phe-L-Pip-L-Arg-pNA (S-2238), H-D-Ile-L-Pro-L-Arg-pNA (S-2288), Tos-Gly-L-Pro-L-Arg-pNA (Tos-Ch-TH) and Cbz-Gly-L-Pro-L-Arg-pNA (Cbz-Ch-TH) by native human thrombin under different experimental conditions (Pip is pipecolyl, pNA is p-nitroanilide, Tos is tosyl and Cbz is benzyloxycarbonyl). 2. The data were fitted to rational functions of order 1:1, 2:2 and 3:3 by using non-linear regression. Discrimination between equations of different degree was made using the F-test. 3. In all, 24 curves were fitted. In 17 cases degree 2:2 was significantly better than degree 1:1 at a confidence level of 95%. In no case was any further significant improvement found with functions of degree 3:3. 3. Our results allow us to assert that native human thrombin is an enzyme that does not allow Michaelian kinetic behaviour when acting on chromogenic substrates. Instead, the empirically obtained steady-state data require mechanisms whose rate equation is at least of degree 2:2.

Kinetic study of the inhibition of the amidolytic activity of thrombin by benzamidine and N-dansyl-(p-guanidino)-phenylalanine-piperidide (I-2581)

1. v([I]) data were obtained for the hydrolysis of the chromogenic substrate H-D-Phe-L-Pip-L-Arg-pNA (S-2238) by native human thrombin in the presence of the synthetic inhibitors Benzamidine and N-dansyl-(p-guanidino)-phenylalanine-piperidide (I-2581). v([S]) data were also obtained in the absence and presence of fixed concentrations of each of the inhibitors. 2. Analysis of the kinetic data was based on the numerical fitting to rate equations of the polynomial quotient type of degree n:m using nonlinear regression methods. The discrimination between rate equations with different degrees was performed by application of the statistical F test. 3. Of eight v([I]) curves fitted, in six cases it was found that degree 1:2 was significantly better than degree 1:1 at a confidence level of 95% or higher; in no case was a significant improvement found with rate equations with a higher number of parameters. For the v([S]) data, of eleven curves fitted it was found that in nine cases degree 2:2 significantly improved degree 1:1 at confidence levels 99% and in one case at a level of 95%; no significant improvement was found with rate equations of higher degree for these data either. 4. Our findings allow us to propose that inhibition of the amidolytic activity of native human thrombin by benzamidine and I-2581 may be accounted for by mechanisms whose v([I]) rate equation will be a minimum of degree 1:2, thus implying a pure inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)

Measurement of infarct size in acute canine myocardial infarction by single-photon emission computed tomography with technetium-99m pyrophosphate

The location and extent of myocardial infarction (MI) are important predictors of patient course. The current study tests the hypothesis that MI size could be measured accurately using rotating gamma camera single-photon emission computed tomography ( SPECT ) and technetium-99m pyrophosphate (PPi) and that the accuracy of these measurements was independent of MI location and transmural or nontransmural distribution. SPECT was performed in 38 dogs 48 hours after ligation of the left anterior descending coronary artery (14 dogs) or left circumflex coronary artery (LC) (24 dogs) at the mid-level or below. Projection images were corrected for center-of-rotation and field nonuniformity and processed with a 1-dimensional low-pass filter to diminish rib activity. Sixteen 0.5-cm-thick transverse sections, including the entire left ventricle, were reconstructed by filtered backprojection , low-pass filtered, contrast enhanced and processed with a 3-dimensional boundary enhancement operator. The boundary of PPi uptake in each slice was marked automatically using an algorithm that combined a directional derivative and a threshold, and required continuity of the boundary in 3 dimensions. The total number of volume elements that showed abnormal tracer uptake were summed, corrected to absolute volume, and multiplied by the specific weight of cardiac muscle. Scintigraphic MI weight was compared with pathologic MI weight. There was an excellent correlation between scintigraphic and pathologic MI weight. The poorer correlation for nontransmural compared with transmural MIs is most likely a function of size alone, since MIs that weighed less than 10 g (n = 12, range 1.3 to 9.5 g), both transmural and nontransmural, showed a similar correlation: S = 1.07 X P + 0.56 (r = 0.81, standard error of the slope = 0.245).(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of inotropic and chronotropic stimuli on acute myocardial ischemic injury. III. Influence of basal heart rate

The influence of basal heart rate (HR) on the effects of inotropic (dobutamine infusion) and chronotropic (atrial pacing) stimuli during acute myocardial ischemia was assessed by measurement of intramural carbon dioxide partial pressure (PCO2) in open-chest dogs undergoing transient 10-minute left anterior descending coronary artery occlusions. In protocol I, in 5 dogs anesthetized with pentobarbital alone, HR increased from 153 +/- 10 to 182 +/- 7 beats/min between experimental coronary occlusions, but the increase in ischemic zone intramural carbon dioxide tension (delta PmCO2) was not altered by this significant increase in HR. In protocols II to V, dogs were anesthetized with combinations of morphine, thiamylal and pentobarbital and had a basal average HR of 81 beats/min. Atrial pacing in protocol II (13 dogs) increased HR from 76 +/- 21 to 134 +/- 19 beats/min (p less than 0.001); left ventricular (LV) myocardial oxygen consumption (MVO2) rose from 3.9 +/- 1.6 to 4.9 +/- 1.4 ml/min/100 g (p less than 0.05), and delta PmCO2 rose from 42 +/- 14 to 50 +/- 15 mm Hg (p less than 0.01), indicating more severe ischemic injury during the second experimental coronary occlusion. In protocol III, 11 dogs received 20 micrograms/kg/min of dobutamine before the second experimental occlusion, which significantly (p less than 0.02) increased HR, LV dP/dt and MVO2; delta PmCO2 increased from 46 +/- 13 to 63 +/- 18 mm Hg (p less than 0.01). The 7 dogs in protocol IV received 3.9 +/- 1.9 micrograms/kg/min of dobutamine, titrated such that HR was unchanged (84 +/- 10 vs 81 +/- 15 beats/min), but LV dP/dt increased by 92% (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

A mechanism for fibrin monomer aggregation based on a kinetic study

A kinetic study was carried out of the aggregation of fibrin monomers under different reaction conditions. At either acid or base pH values, second-order kinetic processes were observed throughout the concentration range studied. At neutral pH (6.8 less than or equal to pH less than or equal to 7.3) the kinetics were of second order at fibrin monomer concentrations of less than 0.3-0.4 mg/ml, while at higher concentrations they changed to first order. Both the second order rate constants and the opacity of the fibrin gels are highly dependent on pH, ionic strength, the concentration of calcium ions and on temperature. A three-step reaction mechanism is proposed for the aggregation of fibrin monomers to explain the kinetic behaviour observed in the different reaction media.