Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MICROORGANISMS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed1972

The erythrasma microorganism in situ: studies using the skin surface biopsy technique.

The skin surface biopsy technique has been used to investigate the erythrasma organism in situ in the stratum corneum in 11 patients. Staining by PAS and Gram stain showed the presence of a large number of organisms arranged haphazardly in some areas and in microcolonies in others. With the scanning electron microscope it was possible to see that smooth filamentous chains of microorganisms had penetrated horn cells and caused disturbance of the surface structure of these cells.Enzyme histochemical tests showed that the erythrasma microorganism possessed a strong reactivity for NAD diaphorase and other mitochondrial enzymes. The reactivity was focal confirming a complex subcellular organization of organelles. It is suggested that the erythrasma microorganism secretes a mucopolysaccharide sheath in some circumstances.

Adult↗
PubMed2000

Intrauterine infection and spontaneous midgestation abortion: is the spectrum of microorganisms similar to that in preterm labor?

OBJECTIVE: To determine whether microorganisms associated with intrauterine infection and preterm labor play a contributing role in midgestation abortion. METHODS: A 4 year retrospective review of spontaneous midgestation abortions for which autopsy and microbiological cultures of placental and fetal tissue were performed was conducted for a tertiary obstetrics hospital, which included a regional referral service for perinatal and fetal pathology. One hundred twenty-nine spontaneously delivered, nonmacerated, midgestation fetuses or stillbirths (of between 16 and 26 weeks' gestation) and placentas were examined and cultured for aerobic and anaerobic bacteria, yeasts, and genital mycoplasmas. RESULTS: Microorganisms were recovered in 85 (66%) cases (57% placentas, 49% fetuses). Among the culture positive cases, 81% had histological chorioamnionitis, 28% fetal pneumonitis, 38% clinical signs of infection, and 62% ruptured membranes at the time of miscarriage. These differed significantly from culture-negative cases (44%, 5%, 13%, and 34%, respectively). Group B streptococcus (GBS) was the most significant pathogen, recovered in 21 cases, 13 as the sole isolate, 94% with chorioamnionitis, and 47% in women with intact membranes. Escherichia coli and Ureaplasma urealyticum (22 and 24 cases, respectively) occurred mostly as mixed infections, with ruptured membranes. GBS, MU urealyticum, and Streptococcus anginosus group were individually associated with chorioamnionitis, Bacteroides/Prevotella and S. anginosus with fetal pneumonitis. The spectrum of microorganisms was similar to that in preterm labor at later gestations; however, GBS appeared to be the most significant pathogen in midgestation miscarriage, especially with intact membranes. CONCLUSIONS: Unsuspected intrauterine infection underlies many spontaneous midgestation abortions. GBS is a key pathogen in this setting.

Abortion, Spontaneous↗
PubMed1988

Exposure to microorganisms, airway inflammatory changes and immune reactions in asymptomatic dairy farmers. Bronchoalveolar lavage evidence of macrophage activation and permeability changes in the airways.

Lung function, bronchial reactivity, serum antibody levels, bronchoalveolar lavage (BAL) fluid and the magnitude of exposure to airborne microorganisms during farm work were studied in 10 healthy farmers with no respiratory symptoms. Lung function and bronchial reactivity were not altered. An increase in the amount of antibodies against several microorganisms could be demonstrated but precipitating antibodies were observed only in two subjects. In the BAL fluid the nonsmoking farmers had elevated proportion of lymphocytes and elevated levels of albumin, fibronectin and angiotensin-converting enzyme while the levels of hyaluronan and procollagen III N-terminal peptide were within normal limits. The lung function, bronchial reactivity, serum antibody levels and BAL findings were not correlated with the exposure to airborne microorganisms. We conclude that healthy farmers, exposed to mold dust, may exhibit signs of alveolitis including albumin leakage, accumulation of inflammatory cells and alveolar macrophage activation.

Adult↗
PubMedDate not supplied

Organic acids and anaerobic microorganisms in the contents of the cholesteatoma sac.

Organic acids in the contents of the cholesteatoma sac from 28 cases were studied by gas chromatographic technique. Five volatile fatty acids (acetate, propionate, isobutyrate, butyrate and isovalerate) and lactate were detected in large amounts, which may lower the pH of the cholesteatoma content. These acids were considered to be derived from products of anaerobic microorganisms. Therefore, the contents from 12 cases were cultured anaerobically in a glove box. Obligate microorganisms were identified in 92% of the cases and Peptococcus, Bacteroides, and Clostridium species were frequently isolated. In vitro, such obligate anaerobes produced various organic acids from the cholesteatoma content. Facultatives such as Staphylococcus aureus and Proteus mirabilis produced acetate in the content under aerobic and anaerobic conditions, whereas no organic acid was produced by Pseudomonas aeruginosa. Organic acids in the cholesteatoma content could be fermentative products made by the microorganisms, anaerobes and facultatives, which use the content as a substrate for acid production.

Acetates↗
PubMedDate not supplied

The growth of microorganisms in total parenteral nutrition admixtures.

Total nutrient admixtures (TNAs) containing glucose, amino acids, and lipid emulsion in one container and amino acid/dextrose solutions [conventional total parenteral nutrition (TPN) formulations] were studied in a controlled laboratory experiment for their ability to support the growth of microorganisms. Both TNA and conventional TPN formulations for peripheral and central venous administration with standard additives were inoculated with microorganisms to provide 10(1)-10(2) colony-forming units/ml (CFU/ml) of Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Candida albicans. The admixtures were stored at room temperature and samples for quantitative microbiology were taken at time 0, 6, 12, 24, 48, 72, and 96 hr. K. pneumoniae, E. coli, and P. aeruginosa were able to proliferate in central TNAs, but the growth of these organisms was retarded in conventional TPN solutions. In the peripheral formulations, K. pneumoniae and E. coli proliferated in both the TNA and conventional TPN systems, whereas P. aeruginosa grew well only in the peripheral TNA. S. epidermidis was not able to grow in any admixtures tested; however, C. albicans grew well in all admixtures, but growth was slower in the conventional central TPN. In conclusion, peripheral and central TNAs supported the growth of microorganisms significantly better than conventional TPN solutions.

Amino Acids↗
PubMed1997

Exposure to Organic Dusts, Endotoxins, and Microorganisms in the Municipal Waste Industry.

The waste-collection and -processing industry in Europe is developing rapidly due to environmental constraints in the direction of separate collection, processing, and recycling of waste. It is likely that this will lead to an increase in the number of workers involved in the handling and processing of municipal waste, and an increase in the number of workers exposed to organic dust. This paper reports the results of an occupational hygiene study of the waste-collection and -processing industry (a compost-screening facility, a resource-recovery facility, and two waste-transfer facilities) in The Netherlands. It focuses on organic dusts, endotoxins, and microorganisms (total and gram-negative bacteria and fungi). Levels of exposure to inhalable organic dusts were highest in the waste-processing facilities (compost screening and resource recovery), with average concentrations for organic dusts up to 14.3 mg/m(3) during manual separation of waste and 9.7 mg/m(3) during compost screening activities. Personal endotoxin exposure was highest in the resource-recovery facility, ranging from 32.0 ng/m(3) for the supervisor to 131.1 ng/m(3) during manual separation of waste. High concentrations of microorganisms were found in all facilities. The highest levels for both total fungi and bacteria (<> 10&sup6; cfu/m(3)) were recorded in the dumping pit at the resource-recovery plant and in the dumping pit at one of the waste-transfer plants. It is concluded that high levels of exposures to microorganisms, and to a lesser extent organic dusts and endotoxins, are likely to occur in many processes and activities in the waste-transfer and -processing industry, and that the possibility of health effects due to these exposures cannot be excluded.

Journal Article↗
PubMed2005

The Microbial Rosetta Stone Database: a compilation of global and emerging infectious microorganisms and bioterrorist threat agents.

BACKGROUND: Thousands of different microorganisms affect the health, safety, and economic stability of populations. Many different medical and governmental organizations have created lists of the pathogenic microorganisms relevant to their missions; however, the nomenclature for biological agents on these lists and pathogens described in the literature is inexact. This ambiguity can be a significant block to effective communication among the diverse communities that must deal with epidemics or bioterrorist attacks. RESULTS: We have developed a database known as the Microbial Rosetta Stone. The database relates microorganism names, taxonomic classifications, diseases, specific detection and treatment protocols, and relevant literature. The database structure facilitates linkage to public genomic databases. This paper focuses on the information in the database for pathogens that impact global public health, emerging infectious organisms, and bioterrorist threat agents. CONCLUSION: The Microbial Rosetta Stone is available at http://www.microbialrosettastone.com/. The database provides public access to up-to-date taxonomic classifications of organisms that cause human diseases, improves the consistency of nomenclature in disease reporting, and provides useful links between different public genomic and public health databases.

Animals↗
PubMedDate not supplied

Farmers' exposure to airborne microorganisms in composting swine confinement buildings.

Farmers' exposure to airborne microorganisms was studied in 12 composting swine confinement buildings and in 7 buildings with traditional slatted-floor pit systems. Airborne cultivable mesophilic, xerophilic, and thermotolerant fungi, mesophilic bacteria, and thermophilic actinobacteria were determined with a six-stage impactor. Furthermore, the total concentrations of microorganisms were determined with filter sampling and direct count using a microscope. In swine confinement buildings where the composting system was functioning properly, the concentrations of microorganisms were 10-1000 times higher than in traditional swine buildings. High concentrations of thermotolerant fungi and thermophilic actinobacteria (up to 10(5) CFU/m(3)), which have been considered to be the main causative agents of farmer's lung, were found in the composting swine confinement buildings that were studied. The conclusion was reached that farmers are exposed to high concentrations of fungal and actinobacterial spores also in swineries, at least in composting confinement buildings. Therefore, personal protection is strongly recommended in composting swineries, especially during the turning of the compost bed.

Air Pollution, Indoor↗
PubMed1990

Effect of pretreatment with antibiotics on the hydrolysis of salicyluric acid in rabbit intestinal microorganisms.

The effect of pretreatment with antibiotics on the hydrolysis of salicyluric acid in rabbit intestinal microorganisms was investigated. Latamoxef sodium (LMOX, 25 mg/kg/d, intravenously) and cephalexin (CEX, 16.7 mg/kg/d, orally) were administered for 1 or 3 d. The blood concentration of salicyluric acid and salicylic acid following oral, intracecal and rectal administration of salicyluric acid was determined. By the pretreatment with LMOX for 1 or 3 d, the blood concentration of salicylic acid following oral administration of salicyluric acid was slightly decreased. In rabbits pretreated with CEX for 3 d, the blood concentration of salicylic acid was detected at low concentration. By the pretreatment with LMOX and CEX, however, the decrease in the blood concentration of salicylic acid following rectal administration of salicyluric acid was not observed. Although the examination of population of intestinal microorganisms induced by the pretreatment with antibiotics was not performed, the metabolic activity of intestinal microorganisms may be changed.

Administration, Oral↗
PubMed2001

Antimicrobial characteristics of chitosans against food spoilage microorganisms in liquid media and mayonnaise.

Four different kinds of chitosans were prepared by treating crude chitin with various NaOH concentrations. The antimicrobial activities of the chitosans were tested against four species of food spoilage microorganisms (Lactobacillus plantarum, Lactobacillus fructivorans, Serratia liquefaciens, and Zygosaccharomyces bailii). The initial effect of the chitosans was biocidal, and counts of viable cells were significantly reduced. After an extended lag phase, some strains recovered and resumed growth. The activities of chitosan against these microorganisms increased with the concentration. Chitosan-50 was most effective against L. fructivorans, but inhibition of L. plantarum was greatest with chitosan-55. There was no significant difference among the chitosans in their antimicrobial activity against S. liquefaciens and Z. bailii. The addition of chitosan to mayonnaise significantly decreased the viable cell counts of L. fructivorans and Z. bailii during storage at 25 degrees C. These results suggest that chitosan can be used as a food preservative to inhibit the growth of spoilage microorganisms in mayonnaise.

Acetylation↗
PubMed2004

Susceptibilities against bovine lactoferrin with microorganisms isolated from mastitic milk.

Antibacterial effects of bovine lactoferrin were studied in vitro against microorganisms isolated from mastitic milk in Tokachi area, Hokkaido, Japan. Microorganisms isolated were Escherichia coli (11 isolates), Klebsiella pneumoniae (5 isolates), enterococci (8 isolates), Staphylococcus aureus (10 isolates), coagulase negative staphylococci (CNS, 13 isolates), streptococci (11 isolates), Prototheca zopfii (7 isolates) and yeast-like fungi (9 isolates). Lactoferrin has been known as a multifunctional protein and its antimicrobial effect is one of the most essential function of it. In order to compare their susceptibilities against lactoferrin, the minimal inhibitory concentration values were estimated by a microplate assay method using 96-well microplate, which involved measuring the optical density of the cultures. Prototheca zopfii was highly sensitive to bovine lactoferrin and complete inhibition of this microorganism was observed even at the low concentration of 7 mug/ml. On the other hand, E. coli and enterococci showed resistance against lactoferrin action and staphylococci showed strain-dependent resistance.

Animals↗
PubMed1995

The etiology and antimicrobial susceptibility patterns of microorganisms in acute community-acquired lung abscess.

OBJECTIVE: To determine the spectrum and antibiotic susceptibility patterns of microorganisms causing acute community-acquired lung abscess. DESIGN: A prospective survey. SETTING: Medical emergency department and wards of a tertiary teaching hospital. PATIENTS: Thirty-four adult patients with both clinical and radiologic features compatible with a diagnosis of acute community-acquired lung abscess who had received less than 48 h of antibiotic therapy. INTERVENTIONS: Microbiologic specimens obtained by percutaneous lung aspiration and with a protected specimen brush via fiberoptic bronchoscopy were submitted for aerobic and anaerobic culture. MAIN OUTCOME MEASURES: Identification of all microorganisms, including anaerobes, and determination of antibiotic susceptibility. RESULTS: A mean of 2.3 bacterial species per patient was isolated, anaerobes alone being isolated in 44% of cases, aerobes alone in 19%, and mixed aerobic and anaerobic isolates in 22%. Aerobic Gram-negative pathogens were uncommon. In seven patients, Mycobacterium tuberculosis was identified; in two it was associated with other bacteria. In four patients, no organisms were isolated. All the nonmycobacterial isolates were susceptible to amoxicillin-clavulanate and in addition the anaerobes were all susceptible to chloramphenicol and almost all to a combination of penicillin and metronidazole. Among the anaerobes, the level of resistance to penicillin, metronidazole, and clindamycin individually was 21%, 12%, and 5%, respectively. CONCLUSIONS: Community-acquired acute lung abscess is usually caused by multiple anaerobic and less frequently aerobic Gram-positive microorganisms, which should respond to empirical therapy with amoxicillin-clavulanate, chloramphenicol, or a combination of penicillin and metronidazole. Tuberculosis, which may be indistinguishable from an acute lung abscess, occurred in 21% of patients in our study. Most bacterial pathogens are sensitive to conventional antimicrobial therapy and further investigation with percutaneous lung aspiration or bronchoscopy is indicated only when there is lack of early response to therapy or there is the presence of atypical clinical features.

Acute Disease↗
PubMed2004

Bacterial surface characteristics applied to selection of probiotic microorganisms.

For the study of probiotic microorganisms, the in vitro selection tests need to be based on a solid scientific foundation. Surface characteristics, one of the in vitro properties are used to evaluate the potentially probiotic strains of lactobacilli. Bacterial surface properties have been associated with attachment to a variety of substrata. Bacterial adhesion to tissues is considered the first step, and such adhesion can also determine the colonization capability of a microorganism. Through adhesion ability and colonization of tissues, probiotic microorganisms can prevent pathogen access by steric interactions or specific blockage on cell receptors. One of the main characteristics studied is the hydrophobic nature of the bacterial cell surface. To test this property, Rosenberg and Doyle divided microbial cell hydrophobicity assays into two categories. The first includes contact angle measurements (CAMs), partitioning of cells into one or another liquid phase (TTP), and adsorption of individual hydrophobic molecular probes at the cell surface. The second category includes microbial adhesion to hydrocarbons (MATH), hydrophobic interaction chromatography (HIC), and adhesion to polystyrene and other hydrophobic solid surfaces. The tests included in the first category measure hydrophobic properties of the outer cell surface as a whole; those in the second measure hydrophobicity in terms of adhesion. Finally, those bacterium classified as hydrophobic can be considered as able to mediate adhesion. The objective of this chapter is to describe three different methods applied in our laboratory for the study of bacterial surface properties. They can be used to screen characteristics of lactobacillus strains for probiotic purposes. They are: Microbial adhesion to hydrocarbons (MATH); Salt aggregation test (SAT); Hemagglutination (HA) reaction.

Animals↗
PubMed2006

Microorganism screening for limonene bioconversion and correlation with RAPD markers.

The use of microorganisms for biotransformations of monoterpenes has stimulated the biotechnological market. Aiming at the highest efficiency in the process of strains screening, the application of molecular biology techniques have been proposed. Based on these aspects, the objective of this work was to select different strains able to convert limonene using fermentative process and random amplified polymorphic DNA (RAPD) markers. The results obtained in the fermentative screening, from 17 strains tested, pointed out that four microorganisms were able to convert limonene into oxygenated derivatives. The RAPD study showed a polymorphism of 96.02% and a similarity from 16.02 to 51.51%. Based on this it was possible to observe a high genetic diversity, even among strains of same species, concluding that the RAPD was not able to correlate the genetic characteristics of the microorganism with the results obtained from the biotransformation process.

Bacteria↗
PubMed2006

[Sampling and detection methods of bioaerosols for the risk assessment of microorganisms in work environments].

Bioaerosols including bacteria and fungi have been almost unrecognized as pollutants of work environments in Japan. The combination of filter sampling and DNA staining by ethidium bromide (EtBr) was examined for the detection and evaluation of total numbers of bioaerosols, including viable and dead microorganisms, for risk assessment in work environments. With direct counting of microorganisms by EtBr concentrations of total cells were obtained in a shorter time than plate culture, the traditional method for detection of microorganisms. Total cell concentrations (cells/m3) were about 100 times greater than colonized cell concentrations (CFU/m3) in all samples. In some microscopic fields, macro conidia produced from some kinds of fungi were observed, but they were not detected by plate culture. Airborne bacterial 16S rDNA amplified by PCR were determined for their base sequences by DNA sequence analysis and classified by sequence-based homologies. Base sequences from 2 samples each contained 6 common groups of phylum. The combination of filter sampling and direct counting by EtBr staining was shown to be a better method for detecting and evaluating total cell concentrations in the risk assessment of sick building syndrome and allergy.

Aerosols↗
PubMed2000

Rapid detection of microorganisms in blood cultures of newborn infants utilizing an automated blood culture system.

BACKGROUND: Neonatal sepsis is a low incidence, high-risk disease with many sepsis work-ups performed to detect a single case. Seventy-two hours of antibiotic therapy have been traditionally recommended pending negative culture results. Improved culture media and new technology integrated into blood culture systems could shorten incubation time required to detect positive culture results. This would then change the length of antibiotic therapy in the management of the newborn infant with suspected sepsis. In addition, previous data supporting the 72-hour recommendation were retrospectively acquired, utilized nonautomated systems, and reported in an era with a different population of microorganisms cultured in special care nurseries. OBJECTIVE: Evaluate the time of incubation to detect positive blood cultures from newborn infants with suspected sepsis using a computer-assisted, automated blood culture system, ESP (Trek Diagnostic Systems, Inc, Westlake, OH). DESIGN: Prospective, observational study. PATIENTS AND SETTING: All positive blood culture results that were obtained from term and preterm newborn infants born from November 1993 through June 1997 at a publicly funded hospital with over 6000 live births per year. METHODS: As positive blood culture results were identified, data were prospectively obtained from the patient's medical record. The computer algorithm in the automated blood culture system determined the time to positivity. Time to positivity was determined for blood cultures obtained before the initiation antimicrobial therapy and compared with those cultures obtained after beginning therapy. Time to positivity was also evaluated for clinically important Gram-positive and Gram-negative bacteria and yeast. RESULTS: Four hundred fifty-five positive blood culture results were obtained from 222 patients. Gram-positive organisms accounted for 80% (366/455) of the positive culture results, Gram-negative organisms accounted for 11% (48/455), and yeast for 9% (41/455). Virtually all cultures growing clinically significant Gram-positive and Gram-negative organisms were positive by 24 to 36 hours of incubation. Cultures growing Staphylococcus epidermidis were virtually all positive after 36 to 48 hours of incubation. Of cultures growing yeast, 88% (36/41) were positive by 48 hours of incubation. There was no difference in time to positivity in pretherapy or posttherapy obtained positive blood cultures. Prenatally administered antibiotics did not affect time to positivity in positive cultures drawn on the first day of life. In a selected group of microorganisms that are the frequent cause of bacteremia in term infants, 97% and 99% of cultures were positive by 24 to 36 hours of incubation when only pretherapy cultures are evaluated. CONCLUSIONS: The ESP blood culture system identified 77%, 89% and 94% of all microorganisms at 24, 36, and 48 hours of incubation in aerobic cultures obtained from both term and preterm infants. Introduction of antimicrobial therapy did not affect time to positivity. Reducing duration of antibiotic therapy to 24 to 36 hours should be considered in term, asymptomatic newborn infants undergoing evaluation for suspected sepsis for maternal indications. Confirmation of similar rapidity of detection using other blood culture systems should be undertaken.

Anti-Bacterial Agents↗
PubMed2002

Secondary metabolites from marine microorganisms.

After 40 years of intensive research, chemistry of marine natural products has become a mature field. Since 1995, there are signals of decreased interest in the search of new metabolites from traditional sources such as macroalgae and octocorals, and the number of annual reports on marine sponges stabilized. On the contrary, metabolites from microorganisms is a rapidly growing field, due, at least in part, to the suspicion that a number of metabolites obtained from algae and invertebrates may be produced by associated microorganisms. Studies are concerned with bacteria and fungi, isolated from seawater, sediments, algae, fish and mainly from marine invertebrates such as sponges, mollusks, tunicates, coelenterates and crustaceans. Although it is still to early to define tendencies, it may be stated that the metabolites from microorganisms are in most cases quite different from those produced by the invertebrate hosts. Nitrogenated metabolites predominate over acetate derivatives, and terpenes are uncommon. Among the latter, sesquiterpenes, diterpenes and carotenes have been isolated; among nitrogenated metabolites, amides, cyclic peptides and indole alkaloids predominate.

Animals↗
PubMed2002

[Prevalence of associated microorganisms in genital discharge, Argentina].

OBJECTIVE: There was a significant increase in the number of women demanding gynecological care in public hospital of the Great Buenos Aires, Argentina, between 1997 and 1998. It was necessary to update the prevalence of associated microorganisms in order to review the laboratory support and adjust prevention and control guidelines. METHODS: Samples from vaginal and endocervical discharge, from total cases: 84 adolescents (15 to 19 years) and 784 adults (20-60 years) attended in 1997-1998, were studied. Neisseria gonorrhoeae, Streptococcus agalactiae, Trichomonas vaginalis, Candida spp, and bacterial vaginosis, were diagnosed applying direct detection methods and specific culture isolation. Chlamydia trachomatis (antigen detection), Ureaplasma urealyticum and Mycoplasma hominis (culture) were also studied in part of the population. RESULTS: Patient care increased steadily from 1997 and there was an increase of 2.1 times from the first semester to the last one in 1998. Bacterial vaginosis was the most prevalent disease in the adult group, with 23.8%; followed by Candida spp 17.8%; S. agalactiae 5.6%; T.vaginalis 2.4%. In 50.3% of total adult cases neither bacterial vaginosis or presence of any sought microorganisms, was detected. In the adolescents group the most frequent detection was Candida spp with a 29.7%; bacterial vaginosis in 17.8%; followed by S. agalactiae 3.6%, T.vaginalis 2.4%. Also in this group on an important number of cases, 46.4%, none bacterial vaginosis or the presence of the sought microorganism were found. In some of the adult group, C. trachomatis (7/400) 1.76%, U. urealyticum (209/340) 61.4% and M. hominis (45/272) 16.5% were detected. CONCLUSIONS: Bacterial vaginosis and Candida spp prevalence is important in both groups. The absence of N. gonorrhoeae and lower prevalence of T. vaginalis and C. trachomatis is remarkable. A high prevalence of U. urealyticum and M. hominis were also detected, but the actual pathogenic role in adult women is still under discussion. The significant increase of attendance in the public system is due to social changes in the population and not due to changes in any particular pathology. Laboratory support has to be adjusted to the most cost-effective procedures to solve the most prevalent problems.

Adolescent↗