Diagnosing a diagnostic study--lipase/amylase ratio.
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Amylases↗
Biomedical subjects
D Castro
Publications and source records attributed to D Castro.
Comparison of epidemiological markers of Salmonella strains isolated from different sources in Spain.
A comparative study of the phage types, antimicrobial susceptibility patterns, and plasmid profiles of 171 strains of Salmonella isolated from food, epidemic outbreaks, and water-contaminated environments as well as sporadic human isolates was carried out to determine the most adequate marker in epidemiological investigations. Typing based on the plasmid profiles appears to be the most effective method for grouping strains with the same serotype obtained from a single outbreak and from environmental sources. However, none of the three markers tested allow us total discrimination and identification of related strains from a common source for epidemiological tracing. Therefore, the combined use of the three methods is necessary for determining whether common source isolates are related.
Bacterial Typing Techniques↗
Development and application of a new scheme of phages for typing and differentiating Salmonella strains from different sources.
A set of 25 phages for typing and differentiating Salmonella strains from different origins (food, water, and disease outbreaks) is described. All the strains were typeable by use of the phages, whereas by the serological method more than 5% of the strains could not be classified. By using the phage typing scheme, 75 phage types were established, and all the results were reproducible 1 and 6 months later. Some phages were serotype and serogroup specific, which may be useful in additional tests for the identification of strains of some Salmonella serotypes. In addition, the strains responsible for an outbreak possessed the same phage type, which implies the potential epidemiological use of these phages.
Bacteriophage Typing↗
The effect of disinfectants on perforated gloves.
Three types of gloves, 'Biogel', 'Regent Dispo Surgical' gloves and Ansell gammex were perforated, and contaminated with Escherichia coli or Pseudomonas aeruginosa as test organisms applied either to the hand or the glove surface. The glove surface was decontaminated with alcoholic chlorhexidine ('Hibisol'), methylated spirit, or soap and water. The experiments were performed in triplicate on three separate days. The experiments were designed to study the ability of the three disinfection methods to reduce the bacterial count of 10(6) colony forming units (cfu) ml-1 (applied to perforated gloves or hands) sufficiently to permit the re-use of such gloves for non-sterile ward procedures. The best method of disinfection was using alcoholic chlorhexidine which not only reduced glove surface carriage but also reduced transfer of bacteria to the hands through the perforation in the gloves. Soap and water was the least effective. Escherichia coli was more easily removed than P. aeruginosa. We recommend that non-sterile ward procedures may be carried out even after gloves have been perforated provided alcoholic chlorhexidine is used between each procedure to reduce cross-infection between patients.
Chlorhexidine↗
Plasmid associated virulence properties of environmental isolates of Aeromonas hydrophila.
The plasmid profiles, and their association with antimicrobial resistance, of 60 strains of Aeromonas hydrophila isolated from fish, shellfish and water were investigated. Only two strains were susceptible to all the antimicrobial agents tested; the highest incidences of resistance were to tetracycline (96.7%), prystanamycin (93.3%), ampicillin (91.7%) and cephalothin (91.7%). Forty strains harboured one or more plasmids and the plasmid profile most frequently detected (15%) was the association of three small plasmids of 4.2, 3.2 and 2.8 Mda. Curing experiments indicated that the plasmid-free derivative strains simultaneously lost their resistance determinants to tobramycin, neomycin, gentamicin and kanamycin. More than 90% of the strains tested produced siderophores and displayed haemolytic activity. However, the relationship between these virulence characters and the presence of plasmids was different; in 74.5% of the strains there was siderophore production and plasmids were detectable, whereas only 60% of the strains simultaneously possessed plasmids and haemolytic activity.
Aeromonas hydrophila↗
Perineural extension of squamous cell carcinoma.
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Adult↗
[Psychological aspects of treatment compliance in the insulin- dependent diabetic child].
Cognitions (conceptual constructs) concerning treatment and compliance with treatment were investigated in 39 children with insulin-dependent diabetes mellitus (mean age, 13.8 +/- 3.0 years; duration of diabetes mellitus, 5.1 +/- 3.2 years). A structured interview and a scale exploring diabetes-related cognitions were administered to each child. Results were as follows: the complexity of treatment of IDDM was perceived as the main obstacle to compliance by 90% of subjects; despite adequate knowledge of the prescribed treatment regimen, the children had created a mental representation of what their treatment should be and were highly compliant to this subjective construction. Most of the complex elements of therapy (urine and blood glucose monitoring, diet) were partly eliminated, with the child developing an idiosyncratic therapeutic regimen with which he or she complied scrupulously. The impact of patient education could be improved by taking this tendency towards simplification into account and by working out with the child the most acceptable regimen capable of ensuring optimal metabolic control.
Adolescent↗
Viability of Salmonella spp and indicator microorganisms in seawater using membrane diffusion chambers.
Diffusion chambers with polycarbonate membrane-filter side walls were used to study the comparative survival of fecal indicators (Escherichia coli and Streptococcus faecalis) and enteric pathogens (Salmonella enteritidis, S. postdam, S. typhimurium, S. london and S. infantis) in natural seawater. It was observed that the percentages of sublethal injury increased with exposure to the marine environment, and that these environmental injuries depended on the microorganism considered. A large proportion of cells lost their ability to produce colonies on the selective media, but retained this capability on a nonselective medium. All microorganisms showed low survival percentages (less than 11%) after 48 hrs of exposure to seawater, but there is not a high difference among the microbial species studied. The results obtained in the present study showed that there were no differences in the survival rates between the serotypes of Salmonella tested. Moreover, Salmonella spp exhibited a similar persistence to E. coli in the marine environment.
Diffusion Chambers, Culture↗
Antibiotic resistance of Salmonella strains isolated from natural polluted waters.
Resistance to 14 antibiotics was tested in 270 Salmonella strains isolated from different aquatic environments. All the strains were sensitive to nalidixic acid (30 micrograms) and cephalothin (30 micrograms) but more than 90% were resistant to tetracycline (30 micrograms). The percentage of strains resistant to other antimicrobial substances depended on the antibiotic and on the isolation source. Twenty-four resistance patterns were recorded in strains isolated from three environmental sources. The only multi-resistance detected in the three ecosystems was that of sulphadiazine and tetracycline (about 20%). The serotypes most frequently detected with multi-resistance to different antibiotics were Salmonella typhimurium and Salm. blockley.
Drug Resistance, Microbial↗
[Urachal cyst. Current status of the problem].
Attention is focussed on urachal cysts, an uncommon disease entity recognized in 1 out of 5,000 autopsies performed in children. Two male patients, aged 47 and 30 years are described herein. Ultrasonography is considered to be necessary for diagnosing this disease. Treatment by complete removal of the cyst is advocated while others suggest the possibility of a more aggressive approach: removal combined with resection of a bladder anuria to avoid recurrence or development of a carcinoma.
Adult↗
[Personalities and chronic glaucoma].
This survey has investigated the occurence of psychopathological affections and their relationship with compliance in open angle glaucomatous patients. Three groups have been considered: 48 severe glaucomas, 37 early glaucomas and 48 control patients, under treatment for other ophthalmological affections. These groups have taken a psychiatric interview, compliance evaluating scale and psychological assessment (inducling: Vocabulaire Binois Pichot, Cattel's 16 Personality Factors and Autoanalyse, Thematic Aperception Test and the Rorschach Test analysed through Exner's Synthetic System). Anxiety personality and disoders are more frequent in the glaucomatous group than the control or early (P = 0.0156). Patients in the early group appeared to be most compliant. Personality structure play a role in the acceptance of the disease and in the degree of cooperation with treatment. Maximal compliance is observed at the beginning of the disease. Personality scales show that glaucomatous patients have difficulties in coping with aggressive pulsions and tend to react to affect loaded situations by a defensive or avoiding attitude.
Adult↗
[Reference intervals of hematologic parameters in the elderly].
Red blood cell counts, haemoglobin, haematocrit, MCV, MCH, MCHC, RDW, platelet count, plateletcrit, platelet distribution width, white blood cell count, white cell differential count (absolute and per cent) and serum iron were studied in 167 people (96 women and 71 men) aged between 60 and 89 years. Significant differences between both sexes were found for all values except RDW, platelet count and percent differential count of white cells. The intervals comprising the central 95% of each values were calculated. In the time of the analysis, only haemoglobin concentration in men showed significant decrease with ageing, although inverse correlation with age was observed for haemoglobin, red cell count and haematocrit in men, and for platelet count in women.
Age Factors↗
The value of adnexal sonographic findings in the diagnosis of ectopic pregnancy.
A prospective study of 383 patients with suspected ectopic pregnancy was carried out at Yale-New Haven Hospital to determine the value of adnexal sonographic findings in the diagnosis of ectopic pregnancy. In patients with adnexal sonographic results and human chorionic gonadotropin titers less than 6000 mIU/ml (n = 220), the presence of a noncystic mass had a positive predictive value of 83%, and the presence of a cystic mass had a positive predictive value of 35%. The combination of a noncystic mass and fluid in the cul-de-sac (found in 22% of all patients with ectopic gestations) was the best predictor of an ectopic pregnancy with a 94% positive predictive value. It is suggested that the demonstration of a non-cystic mass, alone or in the presence of fluid in the cul-de-sac, be used as an indication for diagnostic laparoscopy.
Abortion, Spontaneous↗
[Multilocular cyst of the kidney with double ureter].
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Female↗
[Evaluation of 10 years of surgical treatment for decubitus ulcer].
The authors report a series of 67 patients presenting with 103 decubitus ulcers, treated between 1969 and 1977, and with a follow-up of one year or more. The majority of the patients were paraplegics, other etiologies being present in smaller numbers and raising different problems. They first studied the importance of the pre-and post-operative treatment. This was followed by study of the importance of different surgical techniques for each of the three localizations (sacral, ischial and trochanteric). They demonstrated the absolute need for surgical management, especially with paraplegic patients. Surgery alone allows rapid healing with a high success rate. While it does not, however, preclude any possibility of recurrence (whatever the technique used), it does at least allow the patient to live a normal life. The authors further emphasize the importance of the preoperative treatment, using the nutripump, and the postoperative treatment, using the pulsating air bed (in preference to the water bed). They consider the nutripump to be the most important breakthrough in this field, in recent years. As regards the different localizations, they consider muscle or musculocutaneous flaps to be the treatment of choice for ischial ulcers, but stress the need for wide ischiectomy and the excision of the bursa. In their experience, insufficient excision is a source of failure, even if the flap is good. Similarly, musculocutaneous flaps offer the best solution for trochanteric ulcers, but again, only accompanied by excision of the bursa. Recognition of coxofemoral arthritis is also essential, and no flap will take until this has been remedied. In the case of sacral ulcers, however, they prefer large rotation skin flaps, which allow further advancement in the event of recurrence. The association of two or three ulcers makes surgical management imperative because of the frequently severe undermining of the patient's general state of health. The treatment of two locations in a single stage is always preferable whenever it is feasible.
Adolescent↗
Genetic mapping of Vibrio cholerae enterotoxin structural genes.
The structural genes which constitute the cholera toxin operon, ctxAB, were genetically mapped in the Vibrio cholerae El Tor strain RV79. This strain of V. cholerae contains two copies of the ctx operon located on a 7-kilobase-pair tandemly duplicated region. We began by isolating a vibriophage VcA1 insertion mutation in one of the two ctxA genes located in this region. The mutant carrying this ctxA::VcA1 insertion, DC24, was converted to a VcA1-facilitated donor by introduction of the conjugal plasmid pSJ15, which carries an inserted copy of a defective VcA1-like prophage. The donor characteristics of DC24(pSJ15) indicated that the ctxA::VcA1 insertion mutation was near the trp region of the V. cholerae chromosome. Subsequent RV79 three-factor crosses were performed between VcA1-facilitated donors and recipient strains carrying one of two structural gene mutations in ctx, either delta ctxA23P Kmr or delta ctx-7922. The former was constructed by an in vivo marker exchange procedure and could be scored either by its kanamycin resistance phenotype or by its lack of DNA sequences homologous to the ctxA region. The delta ctx-7922 mutation is a total deletion of both ctx copies of strain RV79. The three-factor cross data strongly suggest that the two ctx loci of RV79 map between the nal and his genes of V. cholerae in the trp nal his linkage group. Physical analysis and heterologous crosses between an RV79 El Tor donor and a 569B classical recipient indicates that one of the two 569B ctx operon copies maps in the same region as the RV79 ctx loci (i.e., linked to nal). Together with previously published observations, these data show that the ctx structural genes are not closely linked to other genes known to affect toxin production in V. cholerae.
Cholera Toxin↗
[10 years' experience with surgical treatment of decubitus ulcers].
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Adolescent↗
A new method of dosimetry-a study of comparative laser-induced tissue damage.
The use of lasers in medicine and surgery has increased slowly-its effectiveness based on trial-and-error clinical experience. Very little comprehensive data has been published that scientifically presents dosage, energy, absorption, and comparisons between types of lasers. Our laboratory has developed a method for taking the guesswork out of laser dosage using scientific data to optimize therapy and give reproducible responses. Experiments were conducted using an argon laser, a neodymium: YAG laser, and a broad-band infrared light source. This preliminary study uses a beam scan technique, which for the first time permits accurate measurement of the laser intensity incident on tissue. Therefore, this protocol allows the standardization of dosage measurements with good experimental reproducibility in biological models. By using this accurate method of measuring the intensity delivered to pigskin, we are able to reproduce for the first time similar histological damage with the different energy sources.
Animals↗