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PubMed1978

The ultrastructure of mycobacterium marinum granuloma in man.

3 biopsies of 3-5 week-old nodular lesions in 2 patients with so-called swimming-pool (aquarium-) granuloma have been examined by electron microscopy. The cytohistological spectrum simultaneously comprises acute exudative as well as chronic proliferative phenomena. Epithelioid cells and collagen producing fibroblasts are already conspicious in 3 week-old granuloma. According to the cytological composition the Mycobacterium marinum granuloma represents a high-turnover granuloma with immunogenic origin. It is comparable to mycobacterial diseases in the presence of well developed cell mediated immunity (Lupus vulgaris, tuberculoid leprosy). Degrading mycobacteria have been rarely detected in phagocytes and are compared with viable bacilli in macrophages of experimentally infected mice. Curved and annular parallel membranes ("worm-like structures") in the cytoplasm of transformed macrophages and in fibroblasts presumably originate from the membranes of endoplasmic reticulum. Cord-like structures with transverse bands (periodicity 170-180 A) in the lumen of RER of some fibroblasts are interpreted as intracellularly aggregated collagen precursors.

Adolescent↗
PubMed1977

Meningoencephalitis due to Acanthamoeba SP. Pathogenesis and clinico-pathological study.

Amebic Meningoencephalitis (AM) and Primary Amebic Meningoencephalitis (PAM) are infectious diseases essentially confined to the Central Nervous System (CNS) and caused by free-living amebas of the genus Acanthamoeba (A.) and Naegleria (N.) respectively. AM due to A. sp. (Acanthamoeba castellanii and Acanthamoeba culbertsoni) have been reported in chronically ill debilitated individuals, some of them under immunosuppressive therapy, or in immunologically impaired patients without a history of recent swimming in contrast to cases due to N. sp. which usually occurs in healthy, young individuals with a recent history of swimming in man-made lakes or heated swimming pools. AM due to A.sp. is characterized by a subacute or chronic granulomatous meningoencephalitis involving mainly the midbrain, basal areas of the temporal and occipital lobes and posterior fossa structures. CNS lesions in AM are perhaps secondary and the portal of entry in humans is probably from the lower respiratory tract, genitourinary system or skin reaching the CNS by hematogenous spread. The predominant host reaction is usually composed of lymphocytes, plasma cells, monocytes and multinucleated foreign body giant cells. Necrosis is moderate and hemorrhage scant or absent. Cysts as well as trophozoites may be seen within the CNS lesions. PAM is due to Naegleria fowleri and is characterized by an hemorrhagic necrotizing meningoencephalities with an acute inflammatory response. Only trophozoites are found in lesions. The portal of entry is through the olfactory neuroepithelium. CNS tissues fixed in formalin may be used for further identification and taxonomical classification of the causative protoza using immunofluorescent antibody techniques (IFAT) and electron microscopic methods.

Amebiasis↗
PubMedDate not supplied

An outbreak of molluscum contagiosum in a kibbutz.

Molluscum contagiosum is a viral disease that presents in a primary care setting as single or multiple wart-like lesions. We have seen an outbreak of Molluscum contagiosum in a small rural community, affecting 34 individuals. The most infected were children two-to nine-years-old. The diagnosis was made on clinical grounds. Spread appeared to be as a result of direct contact and by fomites. There was no evidence, in our study, of spread via swimming pool. Cryosurgery was used to treat our patients with Molluscum contagiosum.

Adolescent↗
PubMedDate not supplied

Acanthamoeba, an opportunistic microorganism: a review.

Granulomatous amebic encephalitis due to Acanthamoeba spp. usually occurs in chronically ill and debilitated individuals. Some of these patients may have received immunosuppressive therapy. Another infection due to Acanthamoeba spp. has been corneal ulcerations which usually occur after minimal trauma to the corneal epithelium (1). In contrast, primary amebic meningoencephalitis due to Naegleria fowleri usually occurs in healthy, young individuals with a history of swimming in heated swimming pools, in manmade lakes or with recent contact with contaminated water and practising water-related sports. Subclinical infections due to free-living amebas are probably common in healthy individuals with the protozoa living as "normal flora" in the nose and throat. It is possible that in humans, antibodies and cell-mediated immunity protect the host in such ordinary circumstances against invasive infection. In debilitated and chronically ill individuals, depressed cellmediated immunity may allow these protozoa to proliferate, allowing a fulminant "opportunistic" infection to develop. In the case of acanthamoebic keratitis, it is important to keep in mind that the temperature and moist environment of the eye serve as a good medium for the growth and proliferation of the amebas and is not necessarily associated with immunosuppression but rather with trauma. This review confirms that opportunistic free-living amebic infections occur with increased frequency in patients treated with steroids, radiotherapy, chemotherapeutic drugs or with broad-spectrum antibiotics and suggest that the mechanism of such infection may be depressed cell-mediated immunity or some other alteration of the immune system, like acquired immunodeficiency syndrome (AIDS).

Adolescent↗
PubMed1996

Pulmonary oedema, pneumonia and mortality in submersion victims; a retrospective study in 125 patients.

OBJECTIVE: The identification of risk factors contributing to the development of pulmonary oedema, pneumonia and late mortality in submersion victims. DESIGN: A retrospective study of 125 submersion victims. SETTING: The medical intensive care unit in a university hospital. METHODS: Baseline examination on admission consisted of history, physical examination, arterial blood gas analysis and a chest radiograph. Patients were then classified into four groups: class I, baseline examination negative; class II, baseline examination positive, but mechanical ventilation not needed on admission; class III, mechanical ventilation required on admission; class IV, patients suffering from cardiopulmonary arrest. All patients who were not successfully resuscitated or who had expired within 24 h after admission were excluded for determination of the risk of pulmonary oedema and pneumonia. RESULTS: Class I patients did not develop pulmonary complications; neither pulmonary oedema nor pneumonia occurred in this group. In the remaining classes the incidence of pulmonary oedema was 72% and that of pneumonia, 14.7%. Stepwise logistic regression showed that pulmonary oedema was related to the type of water (seawater, ditch water, swimming pool) victims were submerged in and to the neurological state both at the time of rescue and on admission. The development of pneumonia was related to the use of mechanical ventilation (the risk was 52%). Pneumonia was not related to neurological state at the time of rescue or on admission, to body temperature on admission, to the prophylactic administration of antibiotics or to the use of corticosteroids. Mortality was high in class IV patients, but low in all other patients. Early mortality was 18.4% while late mortality was 5.6%. CONCLUSIONS: There is no need to hospitalise submersion victims when there are no signs or symptoms of aspiration upon arrival in the emergency room. All other patients should be admitted to an intensive care unit. The risk of pneumonia is high when mechanical ventilation is necessary. Mortality is high in patients with circulatory arrest on admission, but low in all other patients.

Adult↗
PubMed1990

Blockade of hoarding in rats by diazepam: an analysis of the anxiety and object value hypotheses of hoarding.

The "security hypothesis" suggests food hoarding by rats serves to preempt attack and therefore might be motivated by "anxiety". The "object value" hypothesis suggests rats hoard objects that they perceive as valuable as related to some state or need. These hypotheses were evaluated with the anxiolytic drug diazepam, which is purported to both decrease anxiety and increase motivation to eat, and which accordingly either may decrease or increase hoarding. Using a new hoarding paradigm, diazepam (Valium: 0.25-5 mg/kg), was found to produce a dose-related reduction in hoarding that was dependent upon food pellet size and that was reversed by flumazenil (Ro 15-1788), a benzodiazepine receptor antagonist. Diazepam also slowed eating speed, blocked "dodging", a movement used to initiate hoarding, and impaired spatial navigation in a learning-set swimming pool task. The results fail to support the object value hypothesis of hoarding. Since perception of food size, motivation, motor ability and spatial abilities all probably contribute to successful food hoarding, the results provide several explanations other than, or in addition to, anxiety reduction for the drug's effects on hoarding. Nevertheless, the study provides a number of new sensitive measures of the effects of anxiolytic drugs and new insights into their behavioral effects.

Animals↗
PubMed2000

Valsalva-induced syncope during apnea diving.

A young man had two dangerous episodes of transient loss of consciousness during apnea diving in a swimming pool. Medical and neurologic examination results were normal. Standard autonomic test results (including heart rate variability, baroreflex sensitivity, tilt-table test, and Valsalva ratio) were unremarkable, with the exception of an increased blood pressure decrease during early phase II of the Valsalva maneuver. Syncope with arrhythmic myoclonic jerks could be evoked by a strong straining maneuver. Simultaneous physiologic recordings showed extreme blood pressure and cerebral blood flow velocity decreases and electroencephalographic slowing during syncope. The electrocardiogram showed a continuous sinus rhythm with a progressive tachycardia. The authors' findings were not compatible with baroreflex failure or vasovagal mechanisms (Bezold-Jarisch reflex activation) as the underlying causes. The authors concluded that mechanical factors (strong reduction of blood reflux to the heart) in combination with a reduced threshold of the brain for developing ischemia-related arrhythmic myoclonic jerks were responsible for Valsalva-induced syncope in the patient.

Adult↗
PubMed2002

Radionuclide cisternography in intracranial hypotension syndrome.

A 44-year-old male patient complaining of severe headache right after twisting his body during aerobic exercises in a swimming pool underwent In-111 DTPA radionuclide cisternography. Leakage of cerebrospinal fluid (CSF) was proved on the right side of T2 and T3 vertebrae. Cisternography after bed and conservative treatments demonstrated the disappearance of abnormal tracer accumulations. Radionuclide cisternography is of great value in diagnosing cerebral-spinal fluid leak and in evaluating the therapeutic effect.

Adult↗
PubMed1980

Near-drowning: an unusual case.

This paper reports the case of a 2 1/2-year-old male who appeared to have drowned in the family swimming pool. Immediate continuous cardiopulmonary resuscitation eventually restored circulation and respiration. Subsequently, in the intensive care unit, he appeared to "cone" and suffer brain "death". Prompt and continuous use of measures to support cerebral resuscitation were successful and the child subsequently was completely normal. A reevaluation of current information seems indicated in regard to the prognosis of the near-drowned child.

Brain Death↗
PubMed2005

[Hyperhidrosis as risk factor for tinea pedis].

BACKGROUND: The purpose of this study was to evaluate a possible association between tinea pedis (interdigital mycosis) and hyperhidrosis by a case-control-study. PATIENTS AND METHODS: 30 otherwise healthy patients (age 22-56 years, 30% female) with mycologically proven tinea pedis and 51 control patients were included. RESULTS: 53.3% of the patients with tinea pedis and 33.3% of the control-patients had focal hyperhidrosis defined by gravimetry (definition as > or =30 mg sweat/min) (p-value=0.08). To control for possible confounding variables a multivariate analysis was performed including possible risk factors such as gender, regular visits in sauna and/or swimming pools. Multivariate analysis found a 3.5-fold increased risk for patients with tinea pedis to have hyperhidrosis. CONCLUSION: The study supports an association between tinea pedis or interdigital mycosis and focal plantar hyperhidrosis and therefore lends credence to the treatment of hyperhidrosis in patients with tinea pedis.

Adult↗
PubMed1998

[Prevention of malignant melanoma].

Dermatologists and physicians of other specialties, as well as other health professionals have made tremendous efforts to improve the public education (primary prevention) and early detection (secondary prevention) of cutaneous malignant melanoma (CMM) especially during the last decade. In Australia, the country with the highest incidence of CMM in the world, the first public and effective campaigns were already carried out in the sixties. Through the public campaigns, the knowledge increased about skin cancer, and the attitude and behavior toward sun exposure changed in the population. In the USA and Great Britain too, effective public campaigns were carried out in great numbers and extensive experience was acquired. In Germany, prevention campaigns were first run in regional areas. In 1989, the Commission of Early Detection and Prevention of Melanoma of the German Dermatological Society launched nation-wide campaigns. These activities were complemented by regional campaigns in the 1990s. The analysis of previous campaigns demonstrates that single activities are less effective and repeated campaigns are necessary to increase knowledge about skin and to change attitudes and behavior towards UV-exposure. In addition, the development of sun protective clothing and structural changes, e.g. creation of shady places around open-air swimming pools, should be aimed for. Physicians of other specialties and other health professionals should also be included in prevention campaigns.

Cross-Cultural Comparison↗
PubMed2001

[Injuries of the thoracic vertebrae in head-first dive into water].

116 patients with cervical spine injuries due to water sport accidents treated in eight Austrian institutions from 1991 to 1998 were reviewed retrospectively. There were 93% male, 72% were 15 to 29 years of age. 93% had injuries from diving into swimming pools or into open water. At discharge 58 patients had Frankel A lesions, 39 had incomplete cord lesions Frankel B to D, and 19 patients had no neurological injury. This data suggest that in Austria approximately one person per one million inhabitants per year sustains a spinal cord injury in a diving accident in shallow water.

Adolescent↗
PubMed2002

Method optimization for the determination of carbonyl compounds in disinfected water by DNPH derivatization and LC-ESI-MS-MS.

A method has been developed for quantitative determination of carbonyl disinfection by-products (DBP) from aqueous samples by derivatization with 2,4-dinitrophenylhydrazine combined with high-performance liquid chromatography (HPLC) and electrospray ionization (ESI) tandem mass spectrometry (MS-MS). The effect of excess of derivatization reagent and derivatization time, the effect of buffer and dry-gas temperature in the ESI process, and the effect of focus potential and collision energy in MS measurement are shown. Major fragment ions for compound identification on the basis of collision-induced dissociation (CID) mass spectra (MS) are given, as are common fragments for screening analyses by MS experiments such as the use of precursor ion scans. Detection limits in the microg x L(-1) range could be achieved by selected ion monitoring measurements without sample preconcentration. Solid-phase extraction improved the sensitivity by a factor of 25 to 250. The applicability of the method is illustrated by DBP analyses of samples from outdoor swimming pools after chlorination. Several carbonyl compounds, e.g. aldehydes, ketones, hydroxybenzaldehyde, and dicarbonyl compounds were identified.

Journal Article↗
PubMed1998

[Toxocara canis infection. Environmental parasitologic and epidemiologic studies].

UNLABELLED: Due to the large number of differential diagnostic possibilities, the etiology of endogenous uveitis is still hard to determine. One reason for uveitis may be the occurrence of parasites. However, too little attention is paid to this underlying disease. METHODS: To identify certain sources of infection, ovoscopic probes of 98 dog feces from the urban area of Halle were taken. The material was collected from children's playgrounds, parks and swimming pools. A retrospective analysis of patient case data from the records of the University Eye Hospital for the years 1986-1995 complemented the environmental and parasitological examination of patients with Toxocara canis and T. cati infections. RESULTS: From the ovoscopic examinations, 16% of the fecal samples contained T. canis eggs. Seventeen percent contained coccicidal sporocysts. Eggs of Trichuris vulpis and not clearly identifiable nematodal larvae were found in 1% of the samples. The reasons for the morphology was, in one instance, suspected Echinococcus eggs. The fact that 12 or 15 parasitologically positive dog excrement samples were taken from the immediate vicinity of children's playgrounds and another three directly from these grounds should be regarded as particularly critical. The investigated patient case data records revealed for the period studied nine uveitic patients with T. conis infection. The diagnosis was based on the larva precipitation test in all cases. After correct diagnosis and appropriate treatment, the prognosis was favorable. The specific treatment had to be repeated in two patients. CONCLUSIONS: The environmental parasitological study presented proves the relatively high prevalence of pathogenic causal agents in dog excrement samples from the area of urban recreation and leisure grounds, in particular, children's playgrounds. Parasite infestation is a mirror of the efficiency of hygienic and social measures. Public health education must be reinforced. Differential diagnosis of chronic endogenous eye diseases must pay more attention to infections by parasites.

Adult↗
PubMed2000

Bacillus subtilis spore film dosimeters in personal dosimetry for occupational solar ultraviolet exposure.

OBJECTIVE: Ultraviolet (UV) radiation is noted to be one of the most important risk factors for nonmelanoma and melanoma skin cancers. The recent development of a spore film test chamber containing spores of Bacillus subtilis resulted in a new method of UV measurement with a spectral sensitivity profile similar to erythema-weighted data calculated from spectroradiometric measurements. METHODS: The practical application of dosimeters was tested on 11 persons for 43 days, under different conditions of UV exposure in five different geographical regions. Four professional lifeguards at a public swimming pool carried dosimeters attached to their shoulders or to their caps, for 11 days. Three mountain guides attached dosimeters laterally to their heads on 27 different occasions of mountaineering activity in different mountain regions. Four ski instructors carried lateral head dosimeters during eight days of skiing in the Alps. RESULTS: The life guards received daily UV exposures ranging from 3.6 to 9.5 minimal erythema doses (MED) (mean 5.9, SD +/- 1.9). The mountain guides had personal daily UV exposures of from 4.4 to 17.1 MED (11.9 +/- 3.9) and ski instructors from 2.8 to 8.8 MED (6.1 +/- 1.8). CONCLUSIONS: Bacillus subtilis spore film dosimeters can be applied effectively for personal solar UV measurements of occupationally exposed persons. such as lifeguards. mountain guides and ski instructors. UV levels in these occupations exceed international limits of exposure.

Bacillus subtilis↗
PubMed2006

A family outbreak of cryptosporidiosis: Probable nosocomial infection and person-to-person transmission.

Cryptosporidium is an important cause of community gastroenteritis, usually associated with drinking contaminated water, visits to swimming pools or animal exposure. In immunocompetent patients, cryptosporidiosis is usually a self-limiting disease but it can be devastating illness in immunocompromised persons. This report presents a family outbreak of cryptosporidiosis and describes a probable nosocomial infection with Cryptosporidium in one patient and subsequent spread of the parasite among members of his family. The index patient, a 72-year-old man with hemiparesis after his third stroke, died after 28 days of persistent diarrhea. Control measures must be undertaken to prevent nosocomial transmission of cryptosporidial oocysts.

Aged↗
PubMed1990

Alcohol and drowning: an analysis of contributing factors and a discussion of criteria for case selection.

We test the hypothesis that there are host or environmental factors that significantly affect the likelihood of alcohol involvement in drownings. Our results are based on records of 234 drownings that meet predetermined eligibility criteria designed to exclude cases with postmortem blood alcohol concentrations (BACs) that do not reflect the BAC at the time of immersion. Cases are drawn from a total of 442 drownings occurring in Sacramento County, California, from 1974 to 1985. Overall, 41% of deaths were alcohol-associated; among these only one victim was under 15 years old. Among older persons, increasing age generally suggested a higher likelihood of alcohol involvement, and particularly of a BAC greater than 200 mg/dl. Other associated factors were male gender (OR = 2.5; 95% CI = 1.6, 3.8), activity (for land motor-vehicle occupants vs. all others, OR = 3.3; 95% CI = 2.6, 4.3), and time of year (January-June vs. July-December, OR = 2.1; 95% CI = 1.6, 2.8). A lower likelihood of alcohol involvement was seen for drownings in bathtubs (OR = .16; 95% CI = .04, .57) and swimming pools (OR = .47; 95% CI = .27, .82). Race was not a factor. Differing eligibility criteria have been used in studies of alcohol and drowning. After a critical review of the experimental literature, we propose that the following be adopted in future such studies: (i) death must occur within six hours of the onset of immersion, unless an antemortem sample is available and, unless evidence to the contrary exists, death can be assumed to have occurred within a few minutes of immersion; (ii) blood must be drawn for BAC determination within 24 hours of death.

Adolescent↗
PubMed1996

Occurrence and determination of organic pollutants in tap and surface waters of the Gdańsk district.

The results of the determination of different classes of organic pollutants (trihalomethanes, polycyclic aromatic hydrocarbons (PAHs), pesticides, volatile hydrocarbons and phenols) in ground water and drinking water sampled at different sites in the Gdańsk District are presented. Different methods were used to determine organic compounds in water: direct aqueous injection or sorption on solid sorbent (XAD-4) and extraction with pentane followed by a gas chromatography-electron capture detection (GC-ECD) for determination of volatile organohalogen compounds: purge and trap with a gas chromatography-flame ionization detection for determination of volatile hydrocarbons; sorption on solid sorbent XAD-4 or C18, elution with organic solvent and GC-ECD for determination of pesticides; sorption on solid sorbent C18, elution with organic solvent and a gas chromatography-mass spectrometry for determination of PAHs and sorption on solid sorbent C18, elution with organic solvent and high performance liquid chromatography-ultraviolet determination of phenols. The proposed methods have been used successfully for the determination of organic compounds in samples of tap, swimming pool, river and sea waters. The content of analysed organic compounds in the water delivered to the water supply system for Gdańsk from the surface water intake in Straszyn and from other selected intakes satisfies Polish, EC and WHO standards. The surface water bodies, i.e., rivers, sea and lakes in the Gdańsk District are not very polluted by anthropogenic compounds originating from municipal and industrial sewages and from agriculture.

Chlorofluorocarbons, Methane↗