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PubMed2003

Cytokine profile in cerebrospinal fluid of children with echovirus type 4 meningitis.

Cytokines play a role in meningeal inflammation and leukocyte recruitment. Research has demonstrated that levels of different cytokines are elevated in aseptic and viral meningitis. Unfortunately, previous data were confounded by the inclusion of multiple viral agents as a study group. The aims of the study were to determine the cerebrospinal fluid concentrations of various cytokines in an outbreak of a single viral agent and to correlate between cytokine levels and leukocytes. Cerebrospinal fluid samples, collected during an outbreak of echovirus type 4 meningitis in infants and children in Israel, were tested for routine characteristics. In addition, cytokine levels were measured in 71 meningitis patients and compared with those of 11 nonmeningitis patients. Concentrations of interleukin-6 (2417 +/- 2713 vs 28 +/- 20 pg/mL; P < 0.01) and interferon gamma (36 +/- 38 vs 4.8 +/- 0.9 pg/mL; P < 0.01) were significantly higher in patients with meningitis than in the control group, whereas soluble intercellular adhesion molecule-1 (1.12 +/- 2.6 vs 0.06 +/- 0.1 ng/mL) levels did not differ significantly. In addition, only interleukin-6 levels correlated with leukocyte counts in viral meningitis patients. Interleukin-6 was the most sensitive and specific characteristic in predicting meningitis in this homogeneous group of patients. Furthermore, only interleukin-6 correlated with leukocyte counts in the cerebrospinal fluid.

Chi-Square Distribution↗
PubMed1984

Outbreak of JK diphtheroid infections associated with environmental contamination.

The group JK diphtheroid organism is a multiply resistant opportunistic pathogen which infects immunocompromised patients sporadically. We describe the first reported outbreak of JK diphtheroid infections, in which four cases of bacteremia and one Hickman catheter site infection occurred during 4 weeks on a hematology ward. On this ward, JK diphtheroid was recovered from 17 of 39 patients, 10 of 17 30-ft3 (0.840-m3) air samples, surfaces in 9 of 13 patient rooms, and hands of 4 of 22 personnel. Previously identified risk factors for JK diphtheroid sepsis (male gender, broad-spectrum antibiotic therapy, granulocytopenia, and prolonged hospital stay) were present in infected patients but did not distinguish them from patients who were only colonized. Emphasis on aseptic practices was associated with termination of the outbreak and negative hand cultures from personnel, despite continued patient colonization and environmental contamination.

Air Microbiology↗
PubMedDate not supplied

Effects of pH, temperature, concentration, and time on particle counts in lipid-containing total parenteral nutrition admixtures.

It has been standard practice in the United States to separate lipid emulsion from the other components of total parenteral nutrition (TPN) due to the reported instability of admixed intravenous lipid emulsions. Some clinicians, however, have combined all TPN components into one container and administered these admixtures to patients without apparent difficulties. Infusion of all nutrients from one container has many advantages. In this study standard and concentrated admixtures were aseptically prepared using generally accepted guidelines of the nutritional requirements for a 70-kg patient. Treatments of standard and concentrated admixtures consisted of: storing at 4 degrees C without adjusting the pH; increasing the pH to 6.6 and storing at 4 degrees C; increasing the pH to 6.6 and storing at room temperature. Samples were monitored for 3 weeks by means of Coulter Counter analysis, pH determinations, and visual observations. The pH of the admixtures did not change over 3 weeks. Mean counts of particles with sizes between 1.6 and 25.4 mu increased over time for each treatment group. Within treatments, concentrated admixtures had significantly greater particle counts than the corresponding standard admixtures. Within the standard and within the concentrated admixtures, the particle counts were significantly greater for group one than for group three. Particle counts in group two tended to lie between the values of group one and three. Visual signs of emulsion deterioration were greatest in those admixtures in which the pH was not adjusted and occurred earlier in concentrated admixtures.

Amino Acids↗
PubMed2002

[Surgical complications and their treatment options in total knee replacement].

INTRODUCTION: One of the most important achievements of modern orthopedics is the treatment of degenerative disorders of the knee joint with endoprostheses. The most often used type of knee prosthesis implanted in our times is the total condylar one. With increasing numbers of prosthesis operations the number of complications is also increasing. AIM: Knowledge of diagnostic and treatment principles of complications is important for all institutions applying knee prostheses. The aim of present study is to report the authors' experience with the most important surgical problems following knee arthroplasty. PATIENTS/METHODS: At the Department of Orthopedics of the University of Pécs between 1993 and 1999 344 primary total condylar prostheses were implanted. Based on their own cases, the authors show the most important surgical problems after total knee arthroplasty. RESULTS: In their patient sample they observed infections, patellofemoral complaints and supracondylar femoral fractures being the commonest complications. Besides these problems they faced with some rare ones, like instability of the artificial joint and temporary peroneal palsy. Probably because of the relatively short follow up period, the authors had to perform only one revision procedure due to aseptic mechanical problems. The incidence of the most common complications in the authors' patient material is described as well as the principles and results of the applied treatment methods. Own experiences are compared with data from the literature. CONCLUSIONS: Although knee arthroplasty complications can be variable and followed by serious consequences, even the most significant ones can be managed with methods which provide the option of healing and restoration of knee functions.

Arthroplasty, Replacement, Knee↗
PubMedDate not supplied

Aseptic meningitis in a large MMR vaccine campaign (590,609 people) in Curitiba, Paraná, Brazil, 1998.

The aseptic meningitis after Measles-Mumps-Rubella vaccine (MMR) is a well recognized complication, and different incidences have been observed in several studies. We retrospectively analyzed forty cases of aseptic meningitis, during a large public immunization campaign (1998) in Curitiba, Southern Brazil (590,609 people), admitted in our Service. The vaccine utilized was Leningrad-3-Zagreb mumps strain, Edmonston-Zagreb measles strain, and RA 27#3 rubella strain. In all county, a total number of 87 cases were reported, resulting in a incidence of 1.7 cases per 10,000 given doses. The mean age was 23.7 +/- 12.8 years. The female:male ratio was 1.35:1. Severe headache with meningismus (92.5%), fever (87.5%), nausea/vomiting (82.5%) were the most common clinical findings. Three cases (7.5%) developed mild mumps. All patients underwent cerebrospinal fluid (CSF) tap with the following findings: mononuclear pleocytosis from 100 to 500 cells/mm(3) in 17 cases (42.5%; 257.5 +/- 260.6 cells/mm3); increased protein 28 cases (67.5%; 92.1 +/- 76.9 mg/dL); glucose was normal in all cases (56.8 +/- 11.2 mg/dL) except in 4 (10%) cases, which presented less than 44 mg/dL. All serological tests (latex to bacterial meningitis, Cryptococcus, cysticercosis, VDRL) and bacteriological cultures were negative. Virus identification were also negative in 8 samples. None of the patients had neurological deficits or related symptoms after one year of onset. We believe the benefit of vaccination clearly outweighs the incidence of benign vaccine-associated meningitis.

Adolescent↗
PubMed1987

Oligoclonal IgG bands in cerebrospinal fluid. Principles for demonstration and interpretation based on findings in 1114 neurological patients.

Unconcentrated cerebrospinal fluid (CSF) and serum samples from 1114 consecutive patients were examined for presence of oligoclonal IgG bands (OB) by agarose isoelectric focusing (AIF) followed by protein transfer to nitrocellulose membrane, immunolabeling, and avidinbiotin-peroxidase staining (avidin-biotin AIF). Oligoclonal bands were demonstrated in CSF from all 58 patients with multiple sclerosis (MS), eight of 29 with aseptic nervous system infections, and 9% of 1014 with other neurological disorders (OND) considered as noninflammatory at primary clinical evaluation. Comparative examination of all specimens in another laboratory by conventional AIF after concentration of CSF revealed lower frequencies of OB in all diagnostic groups. In addition to the high sensitivity of avidinbiotin AIF, which enables detection of OB by separation of 5 microL of unconcentrated CSF even when the CSF IgG level is around the lower normal range, the procedure also has optimal specificity since IgG exclusively is detected. Avidin-biotin AIF may be the method preferred for routine examination of CSF for OB. Demonstration of OB in CSF is valuable especially in MS, where, in contrast to diagnostic aids such as evoked potentials and neuro-imaging, it establishes inflammatory type of nervous system involvements. Oligoclonal IgG bands in CSF from patients with OND reflect intrathecal immune response and should lead to investigations of infectious etiology.

Adult↗
PubMed2005

Inhibitory effects of microencapsulated allyl isothiocyanate (AIT) against Escherichia coli O157:H7 in refrigerated, nitrogen packed, finely chopped beef.

Allyl isothiocyanate (AIT) is an effective inhibitor of various pathogens, but its use in the food industry is limited by its volatility and pungency. The objective of this study was to overcome the volatility of AIT by microencapsulation and evaluate its antimicrobial effectiveness against Escherichia coli O157:H7 in chopped beef. Chopped beef was aseptically prepared and inoculated with a five-strain cocktail of E. coli O157:H7 to yield 4 or 8 log10 cfu/g. AIT was microencapsulated in gum acacia to yield 3.7-54.8 mg AIT/g at a ratio of 1:4 and freeze dried. Microcapsules at 5% or 10% (w/w) were then added to experimental samples that were packed under nitrogen, and stored at 4 degrees C for 18 days. Samples were analyzed for numbers of E. coli O157:H7 and the aerobic mesophilic bacteria (TAC) at 3-day intervals. AIT at 4980 ppm eliminated both low and high levels of inoculated E. coli O157:H7 after 15 and 18 days of storage, respectively. AIT at 2828 ppm reduced E. coli by 2.7 log10 cfu/g by 18 days of storage. AIT levels <1000 ppm were not more effective in reducing E. coli survival than the control treatment without AIT addition. AIT at 170-1480 ppm had negligible effects on the TAC, and while 4980 ppm kept TAC levels <or=3 log10 cfu/g during 18 days of storage, the TAC reached 7.25 log10 cfu/g in the control. It was found that AIT microencapsulated in gum acacia could be used in chopped refrigerated beef to reduce or eliminate large numbers of E. coli O157:H7.

Animals↗
PubMed2003

Acute meningitis due to Toscana virus infection among patients from both the Spanish Mediterranean region and the region of Madrid.

Toscana virus (TOSV) is a member of the genus Phlebovirus that is transmitted to humans by two different species of sand fly and causes acute aseptic meningitis (AAM) and meningoencephalitis in Central Italy. Fifteen cases of AAM due to TOSV have been found at the Spanish province of Granada, but no data regarding the presence of TOSV-related disease in other regions of Spain have been still reported. A collection of 88 serum and 53 cerebrospinal fluid (CSF) samples taken from 81 selected patients with AAM of unknown aetiology, residing at Madrid or at the southern Mediterranean coast of Spain, was retrospectively studied for presence of TOSV-specific antibodies from both IgG and IgM classes. Anti-TOSV IgG was also investigated in 457 serum samples from healthy individuals, aged 2-60 years, residing at the south of the Region of Madrid. Specific IgM in serum and/or intrathecally produced anti-TOSV IgG were detected in seven patients, three residents from the Mediterranean region and the remainder four from the Region of Madrid. The overall prevalence of anti-TOSV among the healthy population studied was 5%. These results confirm the role of TOSV as an agent causing AAM in the Spanish Mediterranean coast, extend these findings to the central region of the country and suggest that TOSV might be producing infection and neurological disease in every area of Spain harbouring significant populations of the viral vectors.

Adolescent↗
PubMed2001

An outbreak of Serratia marcescens associated with the anesthetic agent propofol.

BACKGROUND: In October 1999, 7 patients with postoperative infections caused by Serratia marcescens were identified at a community hospital in Ontario, Canada. We describe the investigation of this outbreak. METHODS: We undertook a case-control study to determine risk factors associated with infection. Case subjects consisted of patients who had undergone surgery and acquired bacteremia or wound infections that, when cultured, grew S marcescens. Control subjects were selected from the cohort of patients who underwent surgery at the same hospital during the outbreak period. Chart reviews were conducted for case and control subjects. Environmental samples were taken from medications and liquids in the operating rooms and from one health care professional who was involved in all the cases. S marcescens isolates were forwarded to a reference laboratory for pulsed field gel electrophoresis. RESULTS: We identified 7 case subjects and 29 control subjects. Five patients had bacteremia and 2 patients had wound infections. Two patients with bacteremia died. All patients with bacteremia or wound infections were exposed to a single anesthetist (anesthetist A) and were administered the anesthetic medication propofol. These patients were more than 40 times more likely to have had anesthetist A administer their anesthetic (OR 41.6, 95% CI 3.6-1120) and 22 times more likely to have received propofol (OR 22, 95% CI 2.1-550) than were control subjects. None of the environmental samples or cultures from anesthetist A were positive for S marcescens. Six of the 7 human isolates had an identical pulsed field gel electrophoresis pattern, and the seventh was untypable. CONCLUSIONS: This outbreak of postoperative infections was very strongly linked to the use of propofol by one anesthetist. Health care professionals must follow strict aseptic techniques when using propofol and should review these techniques regularly.

Aged↗
PubMed2004

Isolation and characterization of mycobacteria from striped bass Morone saxatilis from the Chesapeake Bay.

Mycobacteriosis in striped bass Morone saxatilis of Chesapeake Bay, USA, was first diagnosed in 1997 based on the presence of granulomatous inflammation and acid-fast bacteria in skin and spleen. To confirm histopathology, bacteriological detection and identification of mycobacteria were begun using splenic tissue from fish with and without skin ulcerations. On the basis of initial studies using a variety of selective and nonselective media, decontamination, homogenization and incubation conditions, a simple and quantitative recovery method using aseptic necropsy of splenic tissue was developed. Optimal recovery was obtained by spread-plating homogenates on Middlebrook 7H10 agar with incubation for 3 mo at 23 degrees C. Mycobacteria were recovered from 76% (n = 149/196) of fish examined. Mycobacterial densities exceeded 10(4) colony forming units x g tissue(-1) in 38% of samples (n = 63/168) that were examined using a quantitative approach. The most frequently recovered mycobacterium, present in 57% (n = 109/192) of characterized samples, was the recently named new species Mycobacterium shottsii. Polyinfections of M. shottsii and other mycobacteria were observed in 25% of samples (n = 47/192) with densities of M. shottsii usually 1 or more orders of magnitude higher than co-isolate(s). Other mycobacteria recovered included isolates that, based on phenotypic traits, resembled M. interjectum, M. marinum, M. scrofulaceum, M. szulgai and M. triplex. M. marinum, commonly associated with fish mycobacteriosis and human disease, was recovered infrequently (3%, n = 6/192). The presence of multiple mycobacterial types occurring at high densities suggests that a variety of mycobacteria could be causative agents of mycobacteriosis in striped bass from the Chesapeake Bay. Striped bass is the major recreational fish species in the Chesapeake Bay, and the significance of the current epizootic to human health and the potential adverse effects on fish stocks are not known.

Animals↗
PubMed1989

A simple electronic volume cell sorter for clonogenicity assays.

A single-parameter electronic volume flow cell sorter that can be easily and inexpensively constructed using existing technology is described. The instrument is designed for ease and flexibility of operation, including such features as a large open area for recovering sorted cells into a variety of dishes or vessels; a remote, electrically activated fluidics system; a mechanism for heating or cooling samples during sorting; a simple arrangement for monitoring and adjusting the sorting control parameters; and an interface to a standard IBM personal computer for data acquisition, analysis, and control of the sorting windows. Several researchers in our laboratory now routinely use this sorter for plating precise numbers of cells directly into culture dishes in an aseptic manner for clonogenicity assays. The instrument can sort cells at rates of up to approximately 2,000 per second with greater than 80% sorting efficiency and no cytotoxicity. An advantage of this system is that the sorting windows can be set to exclude acellular debris and include either the entire cell volume distribution or a subset thereof. Applications of the instrument are detailed, including 1) precise cell plating for low-dose survival studies, 2) separation of cells into age compartments, and 3) rapid inoculation of single cells into multiwell dishes for cloning studies. Advantages of this technology for cell survival studies are detailed, along with some limitations to its applicability.

Animals↗
PubMed2005

Detection of enterovirus RNA in cerebrospinal fluid (CSF) using NucliSens EasyQ Enterovirus assay.

Rapid detection of enterovirus (EV) infections is essential in the management of aseptic meningitis. Molecular approaches have opened the way to such rapid, but also specific and sensitive, diagnostic tests. The aim of this study was to compare the performance of the CE marked NucliSens EasyQ Enterovirus assay with an in-house two-step RT-PCR assay using cerebrospinal fluid (CSF) and throat swab samples. In addition, specificity was tested with clinical isolates positive for viruses with clinical importance in CSF samples. For nucleic acid extraction, the NucliSens miniMAG and NucliSens magnetic extraction reagents were used. Subsequently real-time nucleic acid sequence-based amplification (NASBA) RNA amplification was performed using NucliSens EasyQ basic kit reagents and NucliSens EasyQ Enterovirus reagents. An EV-specific internal homologous control (IC) RNA was used to monitor the entire NucliSens EasyQ procedure at the individual sample level. No IC but an external inhibition control was available for the RT-PCR method. For the NucliSens EasyQ procedure, amplification and real-time detection reactions were carried out in the NucliSens EasyQ analyzer. The real-time NASBA enterovirus detection was based on NASBA amplification and real-time molecular beacon technology. Data were analyzed using the manufacturer's software on the NucliSens EasyQ analyzer. For the in-house assay, RT-PCR amplicons were detected using agarose gel analysis. The analysis of clinical samples positive for HSV-1, HSV-2, adenovirus, CMV, VZV, mumps and rhinovirus were all negative by NucliSens EasyQ Enterovirus assay. Three rhinovirus samples were, however, strongly positive in RT-PCR. A total of 141 clinical samples were retrospectively tested, including 126 cerebrospinal fluid (CSF) samples and 15 throat swabs. The 91 CSF samples were negative by both methods, 31 CSF samples and 14 throat swab samples were positive by both methods. The four CSF samples were positive by RT-PCR only. One throat swab sample was negative in NucliSens EasyQ but positive in RT-PCR. The sensitivity and specificity of both methods seem to be more or less comparable. However, the in-house RT-PCR assay appears to amplify some rhinovirus strains and should therefore not be used for throat swab samples. NucliSens EasyQ Enterovirus assay gave more invalid results than the in-house RT-PCR, which is obvious taken into account the difference in quality control between the CE marked NucliSens EasyQ Enterovirus assay and the in-house enterovirus assay. The NucliSens EasyQ procedure can be completed within 5h versus 9.5h for the RT-PCR. NucliSens EasyQ Enterovirus assay showed to be a standardized, rapid, specific, sensitive and reliable procedure for the detection of enterovirus RNA.

Adolescent↗
PubMed1983

New medium for improved recovery of coliform bacteria from drinking water.

A new membrane filter medium was developed for the improved recovery of injured coliforms from drinking water. The new medium, termed m-T7, consists of 5.0 g of Difco Proteose Peptone no. 3, 20 g of lactose, 3.0 g of yeast extract, 0.4 ml of Tergitol 7 (25% solution), 5.0 g of polyoxyethylene ether W-1, 0.1 g of bromthymol blue, 0.1 g of bromcresol purple, and 15 g of agar per liter of distilled water. Additional selectivity may be obtained by aseptically adding 0.1 microgram of penicillin G per ml to the medium after autoclaving. In laboratory studies, m-T7 agar recovered 86 to 99% more laboratory-injured coliforms than did m-Endo agar. m-T7 agar also recovered an average of 43% more verified coliforms from 67 surface and drinking water samples than did the standard m-Endo membrane filter technique. From drinking water, m-T7 agar recovered nearly three times more coliforms than did m-Endo agar. Less than 0.5% of the colonies on m-T7 agar gave false-negative reactions, whereas greater than 70% of the typical yellow colonies from m-T7 agar produced gas in lauryl tryptose broth. Most of the verified coliforms isolated on m-T7 agar belonged to one of the four common coliform genera: Escherichia, 17.6%; Klebsiella, 21.7%; Citrobacter, 17.3%; Enterobacter, 32.2%. The results demonstrate that m-T7 agar is superior to m-Endo agar, especially for the isolation of injured coliforms from drinking water.

Citrobacter↗
PubMed2005

Stability of premixed syringes of diamorphine and hyperbaric bupivacaine.

BACKGROUND: It is common clinical practice to add diamorphine to heavy bupivacaine when performing spinal anaesthesia for either obstetric or general surgical procedures. If pre-filled syringes were available potential problems arising due to the wrong mixture being administered could be reduced, whilst also providing greater assurances of sterility and accuracy of dosage. It is therefore necessary to establish whether diamorphine 100 microg/mL is stable in solution with 0.5% hyperbaric bupivacaine, to allow production of pre-filled syringes for use in spinal anaesthesia. METHOD: Diamorphine hydrochloride was dissolved in water for injection, and added to hyperbaric bupivacaine then stored in 5-mL plastic syringes. Eleven syringes were stored at 40 degrees C/75% relative humidity, 25 degrees C/60% relative humidity and 7 degrees C for 90 days. Samples were taken at five time points for measurement of diamorphine and bupivacaine concentrations using high performance liquid chromatography. RESULTS: Diamorphine concentrations fell over the study period. No significant changes were observed the bupivacaine content of the samples. There was 10% degradation of diamorphine after 4 days at 40 degrees C, after 7 days at 25 degrees C, and after 26 days at 7 degrees C. CONCLUSION: Diamorphine is stable in hyperbaric bupivacaine at 7 degrees C for long enough to allow preparation of pre-filled syringes in advance (by hospital pharmacy aseptic units) for use in spinal anaesthesia.

Analgesics, Opioid↗
PubMed1994

Isolation and characterization of debris in membranes around total joint prostheses.

Particles of wear debris have been implicated in osteolysis around and aseptic loosening of total joint prostheses, but the number and size distribution of particles present in periprosthetic tissues are unknown. A method of particle assay was developed, consisting of nitric-acid digestion of tissue followed by collection of particles, electronic quantitation, and parallel morphological and chemical characterization. Nitric acid had minimum deleterious effects on control samples of titanium, cobalt-chromium alloy, and polyethylene particles, as determined by atomic absorption spectroscopy, scanning electron microscopy, and electronic measurements of the sizes of the particles. Acid digestion of twelve control samples of tissue, including tissue rich in hemosiderin, resulted in particle counts that were no higher than that in the digestion solution background. Other digestion preparations, including hydrochloric acid and sodium hypophosphate, were not as effective as nitric acid. With the low size limit of detection of approximately 0.58 micrometer, particle analysis of tissue adjacent to twenty retrieved total joint implants indicated a range of concentration of 0.85 to 141.85 x 10(9) particles per gram of tissue (dry weight). Although a few particles of more than 100 micrometers were detected, the mode of particle diameter from each sample ranged from the lower limit of detection (approximately 0.58 micrometer) to 0.79 micrometer. The findings of morphological studies and x-ray spectroscopy of isolated particles corresponded with those of light microscopy of the fibrous membranes. These data indicate that most of the particles in implant membranes are smaller than the resolution of the light microscope and that tissue digestion is necessary for quantitation and characterization.

Adolescent↗
PubMed2001

Bacterial populations on 30-night extended wear silicone hydrogel lenses.

PURPOSE: Ocular infection and inflammation during hydrogel lens extended wear is often associated with colonization of the lenses with bacteria. This study compares colonization of a high Dk silicone hydrogel contact lens (lotrafilcon A) worn on a 30-night extended wear basis to a low Dk HEMA-based lens (etafilcon A) worn on a 6-night extended wear schedule. METHODS: The group wearing the low Dk/t soft contact lens (n = 63) replaced their lenses weekly and the group wearing high Dk/t soft contact lenses replaced their lenses monthly (n = 64). Lens allocation was assigned randomly at enrollment. Worn lenses, from one eye only, were collected aseptically and placed in sterile vials. Microbial growth on various media was enumerated and the number of colony forming units (cfu) per lens was calculated in categories of normal ocular microbiota (such as coagulase-negative staphylococci and Propionibacterium spp.) and known ocular pathogens (such as Staphylococcus aureus and gram-negative bacteria). The proportion of samples colonized with these bacteria and the extent of colonization were compared between the two groups. The proportion of sterile lenses was calculated, and the types of bacteria on each lens group were compared. RESULTS: No differences between the low and high Dk/t Soft contact lens groups were observed in the proportion of lenses colonized by Propionibacterium spp. (48% vs 43%, P = 0.4) or coagulase-negative staphylococci (47% vs 54%, P = 0.2). Similarly, no differences were found for lenses colonized by S. aureus (0% vs 2%, P = 0.1) or gram-negative bacteria (3% vs 2%, P = 0.8). The types of bacteria isolated from the high and low Dk/t lenses were similar. There were no differences in the number of sterile samples (28% vs 27%, P = 0.8) from each group. CONCLUSIONS: These findings suggest that high Dk/t silicone hydrogel materials are colonized by similar numbers and types of microorganisms during extended wear compared to HEMA-based material. Most lenses were colonized by commensal bacteria during 30-night extended wear with high Dk/t lenses and during 6-night extended wear with low Dk/t lenses. The incidence of sterile samples was the same between the high and low Dk/t soft contact lens groups.

Adult↗
PubMed1991

Diagnostic value of cerebrospinal fluid immunoglobulin G (IgG) in pediatric neurological diseases.

A total of 71 cerebrospinal fluid (CSF) specimens with paired serum samples from 16 controls and 55 patients with various neurologic diseases ranging in age from 1 to 15 years old were studied using a rate nephelometer to measure their immunoglobulin G (IgG) and albumin levels in both their CSF and serum. The patients included 15 cases of encephalitis, 6 cases of purulent meningitis, 20 cases of aseptic meningitis, 2 cases of multiple sclerosis and 12 cases of other noninflammatory neurologic diseases. The values of the CSF IgG quotient, IgG index, and de novo central nervous system (CNS) IgG synthesis were then calculated for each subject. In the control group, the mean values were as follows: CSF IgG, 1.45 mg/dl; IgG quotient, 6.2%; IgG index, 0.55; and de novo IgG synthesis, -1.17 mg/day. Those with CNS inflammatory diseases had significantly higher CSF IgG levels and IgG quotients compared with controls (p less than 0.05). The IgG index was selectively elevated in cases of encephalitis (p less than 0.005). The values for de novo IgG synthesis showed significant increase in all types of CNS inflammatory diseases except for the group with aseptic meningitis. In the noninflammatory diseases, none of the CSF parameters revealed any significant differences from those of the control group. Six cases (40%) of encephalitis showed normal CSF protein value, but an abnormal IgG component, IgG index and de novo IgG synthesis. Quantitation of IgG and other derivatives in CSF gives a sensitive supplementary reference for the detection of CNS infection.

Adolescent↗
PubMedDate not supplied

Moving towards a (microbiological) environmental monitoring programme that can be used to release aseptically produced pharmaceuticals: a hypothesis, a practical programme, and some results.

We present, in detail, the (microbiological) environmental monitoring programme for cleanrooms that is in use at the RIVM. The parameters that are measured are: Total airborne particles of 0.5 micron and larger, airborne colony forming units (cfu's), cfu's on surfaces, cfu's on fingertips of gloves and settling cfu's. Most attention is paid to areas where critical handling is performed (class A areas). In these areas sampling is performed continuously during work. The areas surrounding class A areas are seen as a necessary environment to create a class A area and are called supporting areas. Changes in these supporting areas that will adversely effect the quality of the class A area, will be detected in the continuous sampling of the class A area. Sampling the supporting areas should only bring forward whether the measured parameters of these areas are consistent. The frequency of sampling, either weekly, monthly or three monthly, is based on the data obtained in previous sampling. In addition to the programme some data are presented. These data indicate that the values of the earlier mentioned parameters are not particularly dependent upon the lay-out or classification of areas, but rather on the use of the areas, and how the operators behave in them. The results support the concept of our sampling schedule, that relevant information about the production areas can be gathered with relatively little effort. Evaluating the programme, we conclude that the main missing element is a known relation between the results of environmental monitoring and contamination of products. We strongly advocate research that could result in establishing such a relation.

Drug Industry↗