The impact of different housing systems on egg safety and quality

A move from conventional cages to either an enriched cage or a noncage system may affect the safety or quality, or both, of the eggs laid by hens raised in this new environment. The safety of the eggs may be altered either microbiologically through contamination of internal contents with Salmonella enterica serovar Enteritidis (Salmonella Enteritidis) or other pathogens, or both, or chemically due to contamination of internal contents with dioxins, pesticides, or heavy metals. Quality may be affected through changes in the integrity of the shell, yolk, or albumen along with changes in function, composition, or nutrition. Season, hen breed, flock age, and flock disease-vaccination status also interact to affect egg safety and quality and must be taken into account. An understanding of these different effects is prudent before any large-scale move to an alternative housing system is undertaken.

Phase I clinical trial and pharmacokinetics of intravesical mitomycin C in dogs with localized transitional cell carcinoma of the urinary bladder

BACKGROUND

Transitional cell carcinoma (TCC) is the most common cancer of the urinary tract in dogs. The most frequent cause of death is urinary obstruction from the primary tumor. Standard medical therapy for TCC is only partially effective.

HYPOTHESIS/OBJECTIVES

Intravesical administration of mitomycin C (MMC) in dogs with invasive TCC will result in antitumor activity against the primary tumor and minimal systemic drug absorption.

ANIMALS

Thirteen privately owned dogs with naturally occurring, histopathologically diagnosed TCC of the urinary bladder.

METHODS

A prospective phase I trial was performed. MMC was given intravesically (600 μg/mL initial concentration) for 1 h/d for 2 consecutive days each month. The MMC concentration was escalated to a maximum of 800 μg/mL in groups of 3 dogs until the maximum tolerated dose (MTD) was determined. Serum assays for MMC were performed to determine the extent of systemic absorption of the MMC.

RESULTS

The MTD of MMC based on local toxicoses was 700 μg/mL (1-h dwell time, 2 consecutive days). In addition, 2 dogs had severe myelosuppression and appeared to have systemic absorption of MMC. Five dogs had partial remission, and 7 dogs had stable disease.

CONCLUSIONS

Intravesical MMC has antitumor activity in dogs with invasive TCC. Further study is needed to determine the cause of the myelosuppression associated with MMC administration, and to develop strategies to minimize this risk.

Modified pressure imaging for egg crack detection and resulting egg quality

Cracks in the shell surface compromise the primary barrier for external microbial contamination of the egg. Microcracks are very small cracks in the shell surface that are difficult to detect by human graders. New technology has been developed that uses modified pressure and imaging to detect microcracks in eggs. Research has shown the system to have an accuracy of 99.6% in detecting both cracked and intact eggs. A study was undertaken to determine if quality differences existed between modified pressure imaged and control eggs during extended cold storage. Three replicates were conducted with eggs stored at 4 degrees C for 5 wk with weekly quality testing. The physical quality factors monitored were Haugh units, albumen height, egg weight, shell strength, vitelline membrane strength and elasticity, and whole egg total solids. All measurements were conducted on individual eggs (12/treatments per replicate) each week with the exception of whole egg solids, which were determined from 3 pools (4 eggs each)/treatment per replicate each week. Percentage of whole egg total solids was the only significant difference (P < 0.05) between treatments (23.65% modified pressure imaged and 23.47% control). There was a significant difference (P < 0.05) for egg weight between replicates (60.82, 58.02, and 60.58 g for replicates 1, 2, and 3, respectively). Therefore, imaging eggs in the modified pressure system for microcrack detection did not alter egg quality during extended cold storage. Utilizing the modified pressure crack detection technology would result in fewer cracked eggs reaching the consumer, consequently enhancing food safety without affecting product quality.

Physical quality and composition of retail shell eggs

There are a number of specialty shell eggs available to consumers in the US retail market. A survey consisting of white and brown large shell eggs with various production and nutritional differences (traditional, cage-free, free-roaming, pasteurized, nutritionally enhanced, and fertile) was conducted to determine if physical quality and compositional differences exist. Identical brands of eggs were purchased from the same retail outlets on 3 occasions (replicates) in a single city. The average range of time from processing to purchase for all eggs was 7.67 to 25.33 d, with traditional white eggs in retail having the shortest time. Haugh unit values ranged from 66.67 (cage-free, docosahexaenoic acid, and n-3 enhanced) to 84.42 (traditional white). Albumen height followed a similar pattern. Egg weight was greater for brown eggs (61.12 vs. 58.85 g). Brown eggs also had greater static compression shell strength than white eggs (4,130.61 vs. 3,690.31 g force). Vitelline membrane strength was greatest for traditional brown eggs (2.24 g force). Percentage of total solids and crude fat was greatest in the cage-free, n-3-enhanced white eggs (25.07 and 11.71%, respectively). Although significant differences were found between white and brown shell eggs and production methods, average values for quality attributes varied without one egg type consistently maintaining the highest or lowest values.

Airborne gamma survey of the historic Sleisbeck mine area in the Northern Territory, Australia, and its use for site rehabilitation planning

An airborne gamma-survey provided information about the extent of radioactive contamination around the historic Sleisbeck mine. Quickbird satellite data were acquired to relate airborne measurements to land cover features. Enhanced equivalent uranium (eU) levels were found to be confined to the mine and low grade waste rock dumps. The average terrestrial background radiation dose rate estimated from the airborne gamma survey data was 0.10-0.14 microGy h(-1) while the area around the mine exhibited a maximum of approximately 2.3 microGy h(-1), but measurements on the ground indicate that this maximum is exceeded in some localized areas. Rehabilitation of the site is likely to result in a threefold reduction in radiation doses to people accessing the area.

Childhood outcomes after prescription of antibiotics to pregnant women with preterm rupture of the membranes: 7-year follow-up of the ORACLE I trial

BACKGROUND

The ORACLE I trial compared the use of erythromycin and/or amoxicillin-clavulanate (co-amoxiclav) with that of placebo for women with preterm rupture of the membranes without overt signs of clinical infection, by use of a factorial randomised design. The aim of the present study--the ORACLE Children Study I--was to determine the long-term effects on children of these interventions.

METHODS

We assessed children at age 7 years born to the 4148 women who had completed the ORACLE I trial and who were eligible for follow-up with a structured parental questionnaire to assess the child's health status. Functional impairment was defined as the presence of any level of functional impairment (severe, moderate, or mild) derived from the mark III Multi-Attribute Health Status classification system. Educational outcomes were assessed with national curriculum test results for children resident in England.

FINDINGS

Outcome was determined for 3298 (75%) eligible children. There was no difference in the proportion of children with any functional impairment after prescription of erythromycin, with or without co-amoxiclav, compared with those born to mothers who received no erythromycin (594 [38.3%] of 1551 children vs 655 [40.4%] of 1620; odds ratio 0.91, 95% CI 0.79-1.05) or after prescription of co-amoxiclav, with or without erythromycin, compared with those born to mothers who received no co-amoxiclav (645 [40.6%] of 1587 vs 604 [38.1%] of 1584; 1.11, 0.96-1.28). Neither antibiotic had a significant effect on the overall level of behavioural difficulties experienced, on specific medical conditions, or on the proportions of children achieving each level in reading, writing, or mathematics at key stage one.

INTERPRETATION

The prescription of antibiotics for women with preterm rupture of the membranes seems to have little effect on the health of children at 7 years of age.

FUNDING

UK Medical Research Council.

Childhood outcomes after prescription of antibiotics to pregnant women with spontaneous preterm labour: 7-year follow-up of the ORACLE II trial

BACKGROUND

The ORACLE II trial compared the use of erythromycin and/or amoxicillin-clavulanate (co-amoxiclav) with that of placebo for women in spontaneous preterm labour and intact membranes, without overt signs of clinical infection, by use of a factorial randomised design. The aim of the present study--the ORACLE Children Study II--was to determine the long-term effects on children after exposure to antibiotics in this clinical situation.

METHODS

We assessed children at age 7 years born to the 4221 women who had completed the ORACLE II study and who were eligible for follow-up with a structured parental questionnaire to assess the child's health status. Functional impairment was defined as the presence of any level of functional impairment (severe, moderate, or mild) derived from the mark III Multi-Attribute Health Status classification system. Educational outcomes were assessed with national curriculum test results for children resident in England.

FINDINGS

Outcome was determined for 3196 (71%) eligible children. Overall, a greater proportion of children whose mothers had been prescribed erythromycin, with or without co-amoxiclav, had any functional impairment than did those whose mothers had received no erythromycin (658 [42.3%] of 1554 children vs 574 [38.3%] of 1498; odds ratio 1.18, 95% CI 1.02-1.37). Co-amoxiclav (with or without erythromycin) had no effect on the proportion of children with any functional impairment, compared with receipt of no co-amoxiclav (624 [40.7%] of 1523 vs 608 [40.0%] of 1520; 1.03, 0.89-1.19). No effects were seen with either antibiotic on the number of deaths, other medical conditions, behavioural patterns, or educational attainment. However, more children whose mothers had received erythromycin or co-amoxiclav developed cerebral palsy than did those born to mothers who received no erythromycin or no co-amoxiclav, respectively (erythromycin: 53 [3.3%] of 1611 vs 27 [1.7%] of 1562, 1.93, 1.21-3.09; co-amoxiclav: 50 [3.2%] of 1587 vs 30 [1.9%] of 1586, 1.69, 1.07-2.67). The number needed to harm with erythromycin was 64 (95% CI 37-209) and with co-amoxiclav 79 (42-591).

INTERPRETATION

The prescription of erythromycin for women in spontaneous preterm labour with intact membranes was associated with an increase in functional impairment among their children at 7 years of age. The risk of cerebral palsy was increased by either antibiotic, although the overall risk of this condition was low.

FUNDING

UK Medical Research Council.

Estimating the effect of lung collapse and pulmonary shunt on gas exchange during breath-hold diving: the Scholander and Kooyman legacy

We developed a mathematical model to investigate the effect of lung compression and collapse (pulmonary shunt) on the uptake and removal of O(2), CO(2) and N(2) in blood and tissue of breath-hold diving mammals. We investigated the consequences of pressure (diving depth) and respiratory volume on pulmonary shunt and gas exchange as pressure compressed the alveoli. The model showed good agreement with previous studies of measured arterial O(2) tensions (Pa(O)(2)) from freely diving Weddell seals and measured arterial and venous N(2) tensions from captive elephant seals compressed in a hyperbaric chamber. Pulmonary compression resulted in a rapid spike in Pa(O)(2) and arterial CO(2) tension, followed by cyclical variation with a periodicity determined by Q(tot). The model showed that changes in diving lung volume are an efficient behavioural means to adjust the extent of gas exchange with depth. Differing models of lung compression and collapse depth caused major differences in blood and tissue N(2) estimates. Our integrated modelling approach contradicted predictions from simple models, and emphasised the complex nature of physiological interactions between circulation, lung compression and gas exchange. Overall, our work suggests the need for caution in interpretation of previous model results based on assumed collapse depths and all-or-nothing lung collapse models.

Enterobacteriaceae and related organisms isolated from shell eggs collected during commercial processing

In the United States, commercial shell eggs are washed and graded before retail. Since passage of the Egg Products Inspection Act in 1971, processing guidelines have been set to ensure that external and internal characteristics are maintained. However, less is known about how commercial processing affects the safety of shell eggs. To identify enteric bacteria entering plants and persisting throughout processing, eggs were collected from 3 US commercial shell egg-processing plants on 3 separate visits. On each plant visit, 12 eggs were collected from each of 12 sites along the processing line: accumulator, prewash rinse, first washer, second washer, sanitizer rinse, dryer, oiler, check detection/scales, 2 egg grader/packer head lanes, rewash belt entrance, and rewash belt exit. Each egg was sampled by a rinse technique, and the rinsate was plated onto violet red bile glucose agar with overlay for the detection and enumeration of Enterobacteriaceae. From each plate, up to 5 colonies were randomly selected and isolated for identification to genus or species by using biochemical tests. Several genera and species were detected at each of the 3 plants. Sites from which the greatest numbers of isolates were identified were those collected from eggs during preprocessing (accumulator, prewash rinse) or from eggs judged as dirty (rewash belt entrance or exit). Sites yielding the smallest number of isolates were those during or at the end of processing. Escherichia coli and Enterobacter spp. were isolated from each of the 9 plant visits. Other genera isolated from at least 1 of the 3 plants included Cedecea, Citrobacter, Erwinia, Hafnia, Klebsiella, Kluyvera, Leclercia, Morganella, Proteus, Providencia, Rahnella, Salmonella, and Serratia. Non-Enterobacteriaceae isolated and identified included Aeromonas, Chryseomonas, Listonella, Pseudomonas, Sphingobacterium, Vibrio, and Xanthomonas. All of the genera and species were recovered less frequently from fully processed eggs than from unwashed eggs, indicating that shell eggs are less contaminated with bacteria as a result of commercial washing procedures.

Identification of yeasts isolated from commercial shell eggs stored at refrigerated temperatures

Yeasts and molds can grow on or in eggs, causing spoilage. Washed and unwashed eggs (treatments) were collected aseptically on three separate days (replications) from a commercial processing facility and stored for 10 weeks at 4 degrees C. Ten eggs from each treatment were sampled weekly (110 eggs per treatment per replication). Yeasts and molds were enumerated from external shell rinses by plating onto acidified potato dextrose agar. Yeast colonies were picked randomly and stored for subsequent identification by gas chromatographic analysis of fatty acid methyl esters using the MIDI Microbial Identification System. Of 688 isolates analyzed, 380 were identified to genus or species. Genera identified by this method included Candida, Cryptococcus, Hansenula, Hyphopichia, Metschnikowia, Rhodotorula, Sporobolomyces, and Torulaspora. Candida spp. accounted for 84.5% (321 of 380) of the isolate identifications. Candida famata was the most prevalent species (n = 120), followed by Candida lusitaniae (n = 38). A group of 20 isolates was subjected to molecular or biochemical analyses for comparison with the MIDI results. Biochemical tests were performed using automatic and mini systems. Results of biochemical tests and ribosomal DNA sequencing were in agreement for 11 of the isolates, but only 7 of the 20 MIDI-identified isolates were in agreement with the sequencing results. C. famata, an anamorph of Debaryomyces hansenii var. hansenii, was the most commonly identified isolate by all methods. These data indicate that there was limited correlation between results obtained with the MIDI system and the information obtained from molecular databases. However, both systems were able to correctly identify C. famata, the species most often isolated throughout egg storage.

Enhanced suppression of hormonal and metabolic responses to stress by application of combined spinal-epidural and general anaesthesia compared with combined spinal general anaesthesia during colorectal surgery

The aim of the study was to determine the impact of combined spinal-epidural and general anesthesia (CSEGA) on the suppression of the hormonal and metabolic response to surgical stress and to compare it with the technique of combined spinal and general anesthesia (CSGA). Sixteen patients referred for elective colorectal surgery randomly divided into two groups on the basis of anesthesia (CSEGA and CSGA). Mean arterial blood pressure, heart rate, haemoglobin saturation, serum glucose, serum cortisol and urinary catecholamines (adrenaline, noradrenaline and dopamine) were determined at four distinct peri-operative time points. During the peri-operative period the overall haemodynamic and respiratory functions in patients that received CSEGA were superior compared to those in patients that received CSGA. Biochemical analysis revealed that in the sera of patients that received CSEGA the concentration of both glucose and cortisol was elevated to a lesser degree than that observed in the sera of patients that received CSGA. Furthermore, a significant reduction in post-operative urinary catecholamine (adrenaline and noradrenaline) excretion was apparent in the CSEGA group. We conclude that CSEGA is a more suitable form of combined anaesthesia for colorectal surgery with a clear advantage of a blunted surgery-mediated neuro-endocrine stress response.

Storage effects on dielectric properties of eggs from 10 to 1800 MHz

The dielectric constant and loss factor of egg albumen and egg yolk over the frequency range from 10 to 1800 MHz were measured at 24 degrees C at weekly intervals during 5-wk storage at 15 degrees C. Moisture and ash contents of albumen and yolk, as well as Haugh unit and yolk index, were also measured. The dielectric constant and loss factor of albumen were higher than those of yolk. Linear relationships were evident between the log of frequency, below about 1000 MHz, and the log of loss factor of albumen as well as that of yolk. The dielectric constants of albumen and yolk at 10 MHz were lower than those of fresh albumen and yolk when eggs were stored at 15 degrees C for 1 wk. However, after 2 wk in storage these dielectric constants rose and remained at higher levels for the rest of the 5-wk period. At frequencies of 100 MHz and higher, the dielectric constant was essentially constant during the entire storage period. Storage had much less influence on the loss factor of either albumen or yolk. In general, the moisture content and ash content of albumen and yolk decreased slightly as eggs aged. The moisture content of yolk increased somewhat with storage, and there was a corresponding decrease in albumen moisture content. The freshness qualities, Haugh unit and yolk index, also decreased as eggs aged. No obvious correlation between dielectric properties and moisture content, ash content, Haugh unit, or yolk index was observed.

To what extent might N2 limit dive performance in king penguins?

A mathematical model was used to explore if elevated levels of N2, and risk of decompression sickness (DCS), could limit dive performance (duration and depth) in king penguins (Aptenodytes patagonicus). The model allowed prediction of blood and tissue (central circulation, muscle, brain and fat) N2 tensions (P(N2)) based on different cardiac outputs and blood flow distributions. Estimated mixed venous P(N2) agreed with values observed during forced dives in a compression chamber used to validate the assumptions of the model. During bouts of foraging dives, estimated mixed venous and tissue P(N2) increased as the bout progressed. Estimated mean maximum mixed venous P(N2) upon return to the surface after a dive was 4.56+/-0.18 atmospheres absolute (ATA; range: 4.37-4.78 ATA). This is equivalent to N2 levels causing a 50% DCS incidence in terrestrial animals of similar mass. Bout termination events were not associated with extreme mixed venous N2 levels. Fat P(N2) was positively correlated with bout duration and the highest estimated fat P(N2) occurred at the end of a dive bout. The model suggested that short and shallow dives occurring between dive bouts help to reduce supersaturation and thereby DCS risk. Furthermore, adipose tissue could also help reduce DCS risk during the first few dives in a bout by functioning as a sink to buffer extreme levels of N2.

Use of evidence in economic decision models: practical issues and methodological challenges

This paper outlines the current 'state of play' regarding the use of evidence in decision modelling and highlights both practical issues and methodological challenges related to identifying, combining and reporting evidence to inform decision model parameters and structure. Based on discussions at two MRC HSRC-funded workshops consisting of 37 experts from a range of disciplines (i.e. decision-makers, health economists, information specialists, operations researchers and statisticians), it aims to derive a multi-disciplinary standpoint on the appropriate use of evidence in economic decision models and, where applicable, offer some suggestions for good modelling practice. Gaps in the established methodology knowledge base are identified for future research.

A comparison of sevoflurane-fentanyl and neuroleptic anaesthesia for laparoscopic cholecystectomy of mildly obese patients

The current study was formulated to evaluate the advantages and disadvantages of sevoflurane-fentanyl and neuroleptic anaesthesia for laparoscopic cholecystectomy surgery of mildly obese patients. Laparoscopic cholecystectomy was performed using either sevoflurane-fentanyl or neuroleptic anaesthesia. Intra-operative haemodynamic stability, surgical duration, awakening time, severity of post-operative pain and hormonal stress parameters (serum and urinary cortisol, serum insulinlike growth factor and serum insulin) were determined. The duration of both surgery and patient hospitalisation were similar in both study groups. Patients that received sevoflurane-fentanyl exhibited a significantly shorter awakening time compared to neuroleptic anaesthesia. In addition, the same group of patients had less post-operative complications (nausea, vomiting, urinary retention and respiratory insufficiency) despite more abdominal pain. The severity of postoperative pain and the requirement of additional analgesia (up to 12 hours post-surgery) were greater in patients that received sevoflurane-fentanyl. The serum and urinary cortisol concentrations were significantly increased in post-operative patients that received neuroleptic anaesthesia whereas the insulin-like growth factor-I concentration in both study groups significantly decreased post-operatively. Our results clearly show that neuroleptic anaesthesia attenuates the stress response to laparoscopic cholecystectomy to a lesser extent than sevoflurane-fentanyl. The latter anaesthesia is recommended for laparoscopic cholecystectomy of mildly obese patients.

Adult mesenchymal stem cells: differentiation potential and therapeutic applications

Adult mesenchymal stem cells (MSCs) are a population of multipotent cells found primarily in the bone marrow. They have long been known to be capable of osteogenic, adipogenic and chondrogenic differentiation and are currently the subject of a number of trials to assess their potential use in the clinic. Recently, the plasticity of these cells has come under close scrutiny as it has been suggested that they may have a differentiation potential beyond the mesenchymal lineage. Myogenic and in particular cardiomyogenic potential has been shown in vitro. MSCs have also been shown to have the ability to form neural cells both in vitro and in vivo, although the molecular mechanisms underlying these apparent transdifferentiation events are yet to be elucidated. We describe here the cellular characteristics and differentiation potential of MSCs, which represent a promising stem cell population for future applications in regenerative medicine.

Pathogen prevalence and microbial levels associated with restricted shell eggs

Restricted shell eggs that do not meet quality standards for retail but maintain acceptable quality for inclusion in further processed eggs are often diverted to further processing. A study was conducted to characterize the microbiological populations present on and in these eggs. On a single day, restricted eggs were collected from three shell egg processing plants a total of three times (replicates). Six shells or egg contents were combined to create a pool. Ten pools of shells and contents were formed for each plant per replicate. Shells and membranes were macerated in 60 ml of diluent. Contents were stomacher blended to form a homogeneous mixture. Total aerobic microorganisms and Enterobacteriaceae were enumerated. The prevalence of Salmonella, Campylobacter, and Listeria was determined by cultural methods. Average aerobic counts were 4.3 log CFU/ml for the shells and 2.0 log CFU/ml for the contents. There were plant x replicate differences for both (P < 0.05 and P < 0.01, respectively). The average Enterobacteriaceae level associated with the shell was 2.4 log CFU/ml and less than 0.1 log CFU/ml for the egg contents, with 36.7% of the samples being positive. One shell sample (0.5% of total samples) was Campylobacter positive. Two shell samples (1.1% of total samples) were Salmonella positive. Twenty-one percent of samples were positive for Listeria (33 shells and 5 contents). Although current pasteurization guidelines are based on Salmonella lethality, the results of this study reiterate the need to revisit the guidelines to determine the effectiveness for other pathogenic species.

Effects of Genetic Selection on Behavioral Profiles of Single Comb White Leghorn Hens Through Two Production Cycles

Four layer genetic stocks consisting of 3 Ottawa control strains (5, 7, and 10) and a commercial laying stock (CCS) were utilized to evaluate potential changes in behavioral profiles due to the effects of genetic selection through 2 production cycles. The Ottawa strains were started as random bred strains from the crosses of several popular commercial layers in 1950, 1959, and 1972, and the commercial strain used herein was from calendar year 1993, and its ancestors were involved in the formation of all of the random bred strains. The behavior study utilized 2 replicates from each strain that contained 4 cages, 6 hens/cage, for a total of 192 hens. Behavioral observations were recorded on 2 consecutive days beginning at 22 wk of age and every 28 d thereafter during the first production cycle, the molt period, and the second production cycle through 90 wk of age and periodic feather and Hansen's test scores recorded. Behavior profiles were similar between the control strains and the CCS, indicating that long-term genetic selection by commercial egg-type breeding firms to enhance production parameters has had no impact on laying strain behavior patterns. Appetitive behaviors were not affected by strain. During the molt, hens had reduced (P < 0.05) feeding and drinking frequencies in comparison with those observed during the first and second cycles. The data indicated that hens pecked inedible objects at a greater (P < 0.0001) frequency during the first cycle and molt than during the second cycle. Fearfulness scores were only influenced by production phase with the molt having the highest (P < 0.01) score of 3.46. Strain or production phase did not influence the frequency of aggressive and submissive acts.

Botulinum Toxin B Is Not an Effective Treatment of Refractory Overactive Bladder

OBJECTIVES

To determine the efficacy and safety of botulinum toxin-B (BTX-B) in two groups of patients with urodynamically proven idiopathic detrusor overactivity (IDO) or neurogenic DO (NDO) refractory to conservative treatment.

METHODS

This was a nonrandomized, prospective study. We diluted 5000 U of BTX-B in 20 mL of normal saline and injected it at 20 sites around the bladder, avoiding the trigone. The data collected at recruitment and 10 and 26 weeks postoperatively included number of incontinent episodes, frequency, and nocturia, King's Health Questionnaire score, and the urodynamic parameters of volume at the first overactive contraction and maximal cystometric capacity.

RESULTS

A total of 25 patients were recruited, 20 with IDO and 5 with NDO. Only 7 patients, all with IDO, reported symptomatic improvement at the 10-week assessment. The symptoms had returned in these 7 patients at a median of 136 days (range 106 to 151) after injection. Of the remaining 20 patients, 16 (13 with IDO and 3 with NDO) thought an initial improvement had occurred but it had worn off or was wearing off by the first assessment. Two patients (both with NDO) reported no improvement.

CONCLUSIONS

BTX-B had a limited duration of action, with most of its symptomatically beneficial effects wearing off by 10 weeks in most of our patients. The short duration of action for BTX-B suggests it is unlikely to gain widespread use in the treatment of DO.

The anti-oxidative defence system in the isolated rat uterus during spontaneous rhythmic activity

Possible interactions between nitric oxide donors, reactive oxygen species and anti-oxidative defence enzymes led us to determine the activities of anti-oxidative defence enzymes in isolated uterine smooth muscle before and after spontaneous rhythmic activity ex vivo. For our experiments we used isolated uteri from female Wistar rats. Our results showed an increase in total superoxide dismutase (SOD) and Mn SOD activities in uterine smooth muscle after spontaneous contractions when compared with nonexercised uterine smooth muscle. The activity of catalase (CAT) and glutathione preoxidase (GSH-Px) were also increased. No statistically significant changes in the activities of glutathione reductase (GR) and CuZn SOD were found. It is known that an organism's anti-oxidative defence system (guarding against excessive reactive oxygen species generation) requires balanced increments in its individual anti-oxidative enzyme activities rather than increases in the activity of only some enzymes without increases in others. Thus, we may conclude that some adaptive responses are found in exercised uterine smooth muscle but are not complete. Therefore, our results indicate that changes in anti-oxidative enzyme activities may influence the results of the examination of substances ex vivo.

The influence of laparoscopic and open surgery on the concentration and structural modifications of insulin-like growth factor binding protein 3 in the human circulation

Insulin-like growth factor binding protein 3 (IGFBP-3) is the most abundant insulin-like growth factor binding protein in the circulation. The aim of the present work was to investigate the influence of surgery (laparoscopy and open) on the concentration and carbohydrate content of IGFBP-3. The concentration of IGFBP-3 was measured using an immunoradiometric assay (IRMA), its protein profile was characterised using immunoblotting and its sialic acid content was examined by means of Sambucus nigra agglutinin (SNA) affinity chromatography. The concentration of IGFBP-3 was significantly (p < 0.001) lower in preoperative patients compared with healthy subjects. Only patients that underwent open surgery showed a further significant decrease in the concentration of IGFBP-3. Immunoblotting detected two intact IGFBP-3 isoforms, as well as proteolytic fragments. SNA-affinity chromatography showed that in patients that underwent surgery the ratio between the two IGFBP-3 glycoforms was lower than the ratio in healthy subjects. Patients with gallbladder inflammation that underwent laparoscopy had an increased percentage of specifically bound IGFBP-3 to SNA compared with healthy subjects. Our conclusion is that open surgery decreased the level of IGFBP-3 compared with laparoscopy, whereas patients with gallbladder inflammation that underwent laparoscopy had an increased content of sialic acid in IGFBP-3.

Antimicrobial Resistance in Salmonella and Escherichia coli Isolated from Commercial Shell Eggs

The development of antimicrobial resistance in bacteria has become a global problem. Isolates of Salmonella and Escherichia coli recovered from shell egg samples, collected at 3 commercial plants, were analyzed for resistance to 16 antimicrobial agents (n=990). Eggs were sampled by rinsing in a saline solution. Pooled samples were preenriched in buffered peptone water and then selectively isolated using standard broths and agars. Salmonella-positive isolates were serogrouped immunologically before being serotyped. Enterobacteriaceae were enumerated from individual samples using violet red bile glucose agar plates. Escherichia coli were identified biochemically from presumptive Enterobacteriaceae isolates. Salmonella and generic E. coli antimicrobial-susceptibility testing was conducted using a semiautomated broth microdilution system. More resistance was observed in the Salmonella isolates (n=41) than in the E. coli isolates (n=194). Salmonella Typhimurium was the most prevalent (69.0%) serotype and demonstrated the greatest multiple resistance. Salmonella Kentucky, the least prevalent (5.0%) serotype recovered, was the most susceptible. Although 34.1% of the Salmonella serotypes were susceptible to all antimicrobial agents, 60.1% were resistant to 11 or more compounds. Many Salmonella isolates exhibited resistance to tetracycline (63.4%), nalidixic acid (63.4%), and streptomycin (61.0%). Most E. coli isolates (73.2%) were susceptible to all antimicrobial drugs. Many E. coli isolates exhibited resistance to tetracycline (29.9%), streptomycin (6.2%), and gentamicin (3.1%). Only 1% of the E. coli isolates were resistant to 4 antimicrobial agents. These data indicate that shell eggs can harbor resistant foodborne and commensal bacteria; among Salmonella isolates, resistance was serotype-dependent.

Meta-analysis of mortality and cancer incidence among workers in the synthetic rubber-producing industry

Production of synthetic rubber involves exposure to several potentially harmful chemicals. The authors carried out a systematic review and meta-analysis of cohort studies of workers in the rubber-producing industry. Data were obtained from computerized literature searches of several databases from their inception through December 2003. The reference lists of identified articles were inspected for further relevant articles. The authors conducted random-effects meta-analyses of log standardized mortality ratios (SMRs)/standardized incidence ratios. Heterogeneity between study results was explored through subgroup analyses and meta-regression on cohort demographic factors and study quality indicators. The authors identified 36 published articles reporting information on 31 different cohort groups. The meta-SMR was 0.86 (95% confidence interval (CI): 0.82, 0.91) for all-cause mortality (28 cohorts) and 0.94 (95% CI: 0.89, 1.01) for all malignant neoplasms (27 cohorts). Heterogeneity was observed for these endpoints and for the majority of disease-specific outcomes. Statistically significant excesses were observed for diabetes (meta-SMR=1.36, 95% CI: 1.17, 1.59) (five cohorts) and leukemia (meta-SMR=1.21, 95% CI: 1.03, 1.43) (16 cohorts), the latter particularly for persons working exclusively in nontire manufacturing (meta-SMR=1.70, 95% CI: 1.14, 2.54) (four cohorts). Excesses highlighted in previous narrative reviews were not substantiated. Interpretation of these results is complicated by substantial unexplainable heterogeneity; small excesses in specific mortality outcomes may have been disguised by the healthy worker effect.