Modification by analgesics of the susceptibility to antibiotics in Serratia marcescens

The influence of analgesics at low concentrations on permeability and beta-lactamase expression have been studied "in vitro". The effect of these drugs on major outer membrane proteins and the lipopolysaccharide was evaluated. Acetylsalicylate and paracetamol induced modifications in susceptibility to a large variety of antibiotics when tested at therapeutic concentrations. The results suggested that when analgesics and antibiotics are administered simultaneously, the interaction between both kinds of drugs can alter the response of microorganisms to antibiotics.

[Eosinophilic pustular folliculitis in acquired immunodeficiency syndrome. Report of 6 cases]

Eosinophilic pustulous foliculitis (EPF) is a rare dermatosis which has been reported in association with the human immunodeficiency virus infection. Six patients infected with HIV are reported with advanced disease in whom the diagnosis of EPF was made. All patients has a highly pruritic follicular papular rash. In all cases the pathology study revealed a mixed inflammatory infiltrate with predominance of eosinophils at the infundibulum of the pilous folliculi. Two patients had eosinophilia in peripheral blood. Therapy with antihistaminic agents and topical corticosteroids was ineffective in all cases. A favourable therapeutic response was achieved with phototherapy associated with the topic application of disodium cromoglycate 4%.

Disseminated cytomegalovirus infection in an immunocompetent adult successfully treated with ganciclovir

We report the case of a previously healthy man who suffered a disseminated cytomegalovirus infection. He presented with prolonged fever, weight loss of 8 kg, anicteric hepatitis, upper digestive tract bleeding from gastric ulcers, acute polyneuritis and bilateral retinitis. Immunodeficiency was not detected either during admission or during a 3-year follow-up period. The patient was treated with ganciclovir (5 mg/kg BID) during 4 weeks with a favourable clinical outcome. To our knowledge, this is the first reported case with such characteristics.

Detection of adenoviruses and enteroviruses in polluted waters by nested PCR amplification

A procedure has been developed for the rapid detection of enteroviruses and adenoviruses in environmental samples. Several systems for virus concentration and extraction of nucleic acid were tested by adding adenovirus type 2 and poliovirus type 1 to different sewage samples. The most promising method for virus recovery involved the concentration of viruses by centrifugation and elution of the virus pellets by treatment with 0.25 N glycine buffer, pH 9.5. Nucleic acid extraction by adsorption of RNA and DNA to silica particles was the most efficient. One aliquot of the extracted nucleic acids was used for a nested two-step PCR, with specific primers for all adenoviruses; and another aliquot was used to synthesize cDNA for a nested two-step PCR with specific primers for further detection of seeded polioviruses or all enteroviruses in the river water and sewage samples. The specificity and sensitivity were evaluated, and 24 different enterovirus strains and the 47 human adenovirus serotypes were recognized by the primers used. The sensitivity was estimated to be between 1 and 10 virus particles for each of the species tested. Twenty-five samples of sewage and polluted river water were analyzed and showed a much higher number of positive isolates by nested PCR than by tissue culture analysis. The PCR-based detection of enteroviruses and adenoviruses shows good results as an indicator of possible viral contamination in environmental wastewater.

Tuberculous pulmonary gangrene: report of a case and review

Pulmonary gangrene is an uncommon but life-threatening complication of bacterial pneumonia. Only four cases of pulmonary gangrene due to Mycobacterium tuberculosis have been described to date; another case of pulmonary gangrene was attributed to unidentified mycobacteria. We report a fetal case of tuberculous pulmonary gangrene (TPG) and review the literature on this infection. To our knowledge this is the first case of TPG documented by thoracic computed tomographic scanning. Radiological features of pulmonary gangrene are distinctive, and identification of pulmonary parenchyma in the mass on computed tomography may be considered as pathognomonic. Analysis of the six cases revealed that most of the patients were aged, and one-half of them were alcohol abusers. Right-upper-lobe involvement predominated. When performed, sputum smears disclosed acid-fast bacilli. M. tuberculosis was cultured from sputum or pathologic material in five of the six cases. Four patients (66.7%) died. Four of six patients with TPG received antituberculous therapy, and two of them survived; no patient underwent surgical intervention. Although surgical management has been successfully employed in cases of bacterial pulmonary gangrene, TPG has always been treated with medical therapy alone. In spite of administration of antituberculous therapy, mortality is high.

[Value of ultrasonography in the early diagnosis of hepatocellular carcinoma]

The size and the treatment of 135 hepatocellular carcinomas (HCC) has been analyzed, comparing patients diagnosed by a US screening program (group 1) and these diagnosed outside this program (group 2) to determine whether US screening on patients with chronic liver disease is able to diagnose (HCC) at an early stage. alpha-fetoprotein levels above 500 U/ml were considered as diagnostic. Twenty (46.5%) out of 43 patients from group 1 showed a HCC < 5 cm. vs. 14/92 (15.2%) in group 2 (p = 0.001). Only 5.9% of the HCC < 5 cm. showed AFP > 500 U/ml. vs. 29.7% of the advanced HCC (p = 0.003). 88.3% of patients of group 1 vs. 63% of group 2 received specific treatment for HCC (p = 0.002). By means of US screening it is possible to diagnose HCC of smaller size and more susceptible to treatment. AFP is not useful in the early diagnosis of HCC.

Outer membrane proteins from Serratia marcescens

The outer membrane proteins (OMPs) of several strains of Serratia marcescens have been studied by sodium dodecyl sulphate - urea - polyacrylamide gel electrophoresis. Four major OMPs, named Omp1, Omp2, Omp3, and OmpA (42, 40, 39, and 37 kDa, respectively), have been visualized. The relative proportions of Omp2 and Omp3 depend on cultural conditions (temperature of incubation, osmolarity, and nutrient availability).

Influence of different upper age limits on the "Years of Potential Life Lost" index

The use of 65, 70 or 75 years as upper age limits for the "Years of Potential Life Lost" index (YPLL) could influence the relative importance assigned to different causes of premature death. Data from a representative year (1987) in Catalonia (Spain), show that health priorities and comparability among studies are not affected by the use of these upper age limits.

[Thyroid lymphoma: a clinico-pathological study]

Five cases of primary lymphoma of the thyroid followed at our hospital during the last decade are reviewed. The clinical and pathological characteristics are analysed and the therapeutical approach described. The age at the diagnosis ranged between 26 and 76 years, with a female versus male predominance (4 out of 5 cases). The commonest clinical feature at presentation was goiter of rapid growth accompanied by compressive symptoms. The pathologic study showed a centrocytic-centroblastic pattern in 3 cases and an immunoblastic lymphoma in the other 2 cases. Associated Hashimoto's thyroiditis was found in 4 of the patients, and extra-thyroid extension in 2 cases. An immunohistochemical study with different cell membrane markers was performed. The treatment included surgery alone in one case, chemotherapy in one case and radiotherapy in another; combined treatment (surgery plus radiotherapy) was performed in two cases. At present the average follow up period is 4.5 years with a patient having died of an unrelated cause among the five cases.

Maternal and developmental toxicity of low doses of cytosine arabinoside in mice

1-beta-D-Arabinofuranosylcytosine (Ara-C), an effective drug for the treatment of leukemia and breast cancer, was evaluated for developmental toxicity in pregnant Swiss mice. Ara-C was administered by intraperitoneal injection on gestational days 6-15 at doses of 0, 0.5, 2, and 8 mg/kg/day. Maternal observations included clinical signs, body weight change, food consumption, and gross evaluation of organs and uterine contents at necropsy (day 18). Live fetuses were examined for external, visceral, and skeletal alterations. Maternal toxicity was observed at 2 and 8 mg/kg/day, as evidenced by a significant decrease in body weight gain and food consumption during the treatment period. Significantly increased early and late resorptions and reduced number of live fetuses per liter as well as decreased fetal body weight were observed at 8 mg/kg/day. At 2 mg/kg/day, the incidence of cleft palate, renoureteral agenesis or hypoplasia, and poly- or oligodactyly was significantly increased, whereas fetal weight was reduced at 0.5 mg/kg/day. Thus, the developmental no-observed-adverse-effect-level (NOAEL) of Ara-C in the pregnant mouse is lower than 0.5 mg/kg/day, while the NOAEL for maternal toxicity is 0.5 mg/kg/day. We believe that exposure to this agent ought to be avoided during organogenesis.

Sister-chromatid exchanges (SCE) induced by p-dichlorobenzene in cultured human lymphocytes

We have investigated the ability of p-dichlorobenzene (p-DCB) to induce sister-chromatid exchanges (SCE) in cultured human lymphocytes. From our results we can conclude that p-DCB was able to induce a cytotoxic effect, measured as a decrease in third and second metaphases, together with an increase of SCEs.

[The analysis of mortality in urban areas]

BACKGROUND

To investigate health status inequalities in small urban areas, using mortality differences between districts of Reus (pop. 85000), Spain.

METHODS

For the period 1986-1988, data from the Civil Register and from death certificates issued indicated 1521 valid cases. Infant mortality, adjusted mortality indices (AMI) and years of potential life lost (YPLL) were calculated for the 17 groups of cause-of-death based on the International Classification of Diseases and Preventable Causes of Death. Both indicators (AMI and YPLL) were studied for each district and for the city as a whole. The exact confidence limits for the Standard Mortality Ratio were calculated.

RESULTS

Although AMI and YPLL gave results that were quantitatively very different, districts IV and VIII consistently had the worst indices while districts II and VI had the best.

CONCLUSION

Archive data over a period of several years together with exact calculation methods, can demonstrate inequalities in health or in socioeconomic conditions even in small areas. These methods may also be useful in delineating different urban living areas.

Induction of mitotic micronuclei by the pyrethroid insecticide fenvalerate in cultured human lymphocytes

The pyrethroid insecticide fenvalerate was tested for its ability to induce mitotic micronuclei in cytokinesis-block cells of cultured human peripheral blood lymphocytes at concentrations ranging from 10 to 50 micrograms/ml. We observed that fenvalerate induces a significant increase in the frequency of micronuclei, indicating clastogenic and/or aneugenic activity. Our results complement previous data on the genotoxicity of this compound in human lymphocytes.

Sister chromatid exchange in lymphocytes of agricultural workers exposed to pesticides

Sister chromatid exchange (SCE) was studied in the lymphocytes of 27 agricultural workers occupationally exposed to several pesticides and 28 matched controls from el Maresme, an agricultural area near Barcelona. Comparison between both groups with the t-test did not reveal significant differences. These negative findings suggest that, possibly, the exposure level is too low to increase SCE in human lymphocytes in vivo. Our results indicate that smokers, both the workers and the controls, had a higher SCE frequency than non-smokers, in agreement with previous data reported by different authors.

Mitotic arrest induced by fenvalerate in human lymphocyte cultures

The pyrethroid insecticide fenvalerate was tested for its ability to induce C-mitosis in cultured human peripheral blood lymphocytes at concentrations ranging from 2-50 micrograms/ml. We observed a significant increase in C-mitotic figures, indicating that this compound was effective in producing disturbance of spindle function.

Analysis of cytogenetic damage induced in cultured human lymphocytes by the pyrethroid insecticides cypermethrin and fenvalerate

Two pyrethroid insecticides, cypermethrin and fenvalerate, were tested for their ability to induce chromosome structural aberrations and sister chromatid exchanges in cultured human peripheral blood lymphocytes. Fenvalerate, but not cypermethrin, increased the frequencies of chromosome-type aberrations and sister chromatid exchanges. In addition, both pyrethroids affected the cell cycle causing a decrease in the proliferative rate index at concentrations greater than 10 micrograms/ml.

Reactogenicity and antigenicity of rhesus rotavirus vaccine (MMU-18006) in newborn infants in Venezuela

The reactogenicity and antigenicity of the rhesus rotavirus vaccine, strain MMU18006, developed at the Laboratory of Infectious Diseases (National Institute of Allergy and Infectious Diseases, National Institutes of Health) were examined in a double blind, placebo-controlled study of 40 newborn infants in Caracas, Venezuela. The children were observed for the first few days after birth in the hospital nursery and by home visits for 10 days after vaccination to detect any adverse reactions. No reactions could be attributed to the vaccine. Serologic responses to the vaccine were evaluated in paired sera obtained at birth (cord blood) and 4 weeks after vaccination. Serologic responses to the vaccine were not observed by complement fixation, neutralization or a rhesus rotavirus VP7 epitope-specific competition assay. However, such responses were found in 9 of 14 tested infants by an immunoglobulin A-specific enzyme-linked immunosorbent assay. Seventeen of the 20 vaccinees also shed rhesus rotavirus vaccine in stool during the postvaccination period.