Fifty-two patients with American cutaneous leishmaniasis (ACL) from the Pacific coast of Ecuador were treated topically with an ointment containing 15% paramomycin (PR) and 12% methylbenzethonium chloride (MBCL) in vaselinum album (white soft paraffin; white petrolatum). After 20 applications (over 10 or 20 d) all lesions showed complete epithelialization within the first 100 d. Five patients developed new lesions during the one year observation period; 2 of these were probably reinfections. Considering all 5 cases as treatment failures, the healing rates were: 72% after 50 d, 90% after 100 d, and 85% after 360 d. In a separate study in the same area, a group of 23 patients was left without treatment for 3 months. Only 9% of the untreated patients healed spontaneously after 50 d. Growth of the lesion, inflammation and pain were observed at the beginning of treatment. After treatment, most lesions healed rapidly without scars. The drug was well accepted by the patients and was easy to administer under tropical field conditions.

Administration, Cutaneous↗

PubMedDate not supplied

[Experiences of the German public health service with the implementation of a new infections disease control act--results of focus group discussions].

The new infectious disease control act (IDCA) enacted in 2001 has resulted in far-reaching structural and organisational changes in German public health service (PHS) especially in respect of the surveillance of notifiable diseases. We conducted focus group discussions with 54 employees of the PHS from 14 German states (Länder) in order to investigate how implementation has been received and what could be improved further. Four focus group discussions each based on an identical agenda were performed with 13 or 14 participants. The contributions were taken down during the discussions and later entered into a data base and encoded. Encoding was summarised in 9 subject headings. It became clear that the implementation of the IDCA was mostly well accepted and the support by state departments and the Robert Koch-Institute, the Federal Public Health institution, was well received. However, especially introduction of a mandatory instruction of food handlers caused some initial difficulties. Concerning the list of notifiable diseases some diseases had been omitted whereas some were considered dispensable. Overall the insufficient staffing of local health departments was criticised. A major portion of the identified problems has in the meanwhile been solved; for others, solutions are under way. Some of the problems, however, would only be solvable by modification of the IDCA. Overall the focus group discussions were a useful tool to adapt the design of the surveillance system to the needs of local health departments.

Communicable Disease Control↗

PubMedDate not supplied

Eggs, serum lipids, emotional stress, and blood pressure in medical students.

Emotional stress that occurred as a result of anticipation and participation in final exams did not change mean serum total cholesterol or high density lipoprotein cholesterol significantly in 26 male students who had eaten two eggs daily while maintaining a controlled diet for 12 wk. These same men continued to maintain a controlled diet but abstained from eating eggs for 12 wk which resulted in a statistically significant lower total cholesterol level at the end of 6 wk and on the day of final exams at the end of 12 wk. Mean values for high-density lipoprotein cholesterol in abstainers were significantly reduced at the end of 6 wk, but did not change further by 12 wk. Mean serum triglycerides values were variable. Blood pressures were not changed significantly.

Adult↗

PubMedDate not supplied

Design and applications of sensitive enzyme immunoassays specific for clostridial enoate reductases.

Rabbit antisera raised against purified enoate reductase from Clostridium tyrobutyricum (DSM 1460) and horse-radish peroxidase-conjugated staphylococcal protein A or anti-rabbit immunoglobulin G, respectively, were used to develop enzyme immunoassays. Sensitivity limits of the assay are about 250 pg antigen if the enzyme immunoassays are performed on membrane filters and examined visually, and 20 pg for tests in aqueous solution with spectrophotometrical evaluation. The procedures were applied for dot and Western blots as well as colony lifts. Immunological distances between enoate reductases from different clostridia were determined and the amounts of antigen present in bacterial crude extracts were estimated. In crude extracts of C. thermoaceticum a protein of approximately the size of the enoate reductase and its subunits from C. tyrobutyricum was immunologically detected. Gel filtration chromatography of identically pretreated crude extracts from C. thermoaceticum and C. tyrobutyricum produced immunological signals at similar molecular weights and revealed a lesser tendency of the presumed thermophilic enoate reductase from C. thermoaceticum to disintegrate into its subunits and fragments as compared to its mesophilic counterpart.

Clostridium↗