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PubMed1993

Mycobacterium marinum cutaneous infections acquired from occupations and hobbies.

BACKGROUND: Non-tuberculous mycobacterial (NTB) infections are not commonly diagnosed in Thailand. The dissertation of reported cases among 10 published reports of 44 cases within 20 years revealed only six cases of cutaneous infections in which M. marinum was not included. METHODS: The proven cases of M. marinum infection were studied at the Institute of Dermatology, Bangkok from 1981 to 1990. The clinical data, histopathology, tuberculin test, chest x-ray, and treatments were recorded. RESULTS: M. marinum skin infection accounted for 18 cases (81.8% of NTB skin infection), 10 men and 8 women. A history of preceding trauma occurred in 11 cases (61.1%), most of which were negligible wounds or minor abrasions. Twelve cases (66.7%) were in contact with organisms in their occupations and hobbies associated with fish and water exposure. CONCLUSIONS: Eighteen cases of M. marinum cutaneous infection acquired from occupations and hobbies were reported. The term "M. marinum cutaneous infection" or "M. marinum granuloma" instead of swimming pool granuloma or fish tank granuloma was proposed. According to this study, cotrimoxazole was the most appropriate drug for the treatment of M. marinum cutaneous infection.

Adolescent↗
PubMed2004

Australian and New Zealand birth cohort studies: breadth, quality and contributions.

OBJECTIVE: To understand factors associated with successfully conducting longitudinal studies across early childhood by (i) describing the designs of Australian and New Zealand birth cohort studies; (ii) describing the breadth of variables studied; and (iii) identifying factors influencing study quality, productivity and contributions. METHODS: A systematic review was undertaken of 13 birth cohort studies. Data were collected from published papers and questionnaires administered to study investigators. RESULTS: These single cohort studies recruited children prior to their first birthday. Using an ecological model as an organizing framework, the studies were found to have contributed to knowledge about health and development in multiple domains and well beyond early childhood. Areas for increased focus included policy-relevant environmental factors such as child-care and rural/urban differences, and the influence of fathers, family factors, peers, social competence, and genetic factors. Investigators' responses indicated desires for an increased depth of data collection and stronger sampling designs. Data quality was enhanced by maintaining skilled staff and reduced by inadequate data for tracking study participants. Productivity ranged from 1 to 760 publications per study (median = 14.0). The most productive studies were those that had started before 1990, had representative samples, ongoing funding, and larger research teams. Policy impacts have included changed infant sleeping practices, reduced environmental lead emissions and regulated swimming pool safety standards. CONCLUSIONS: A suite of coordinated and nested studies could meet sampling needs and facilitate depth of inquiry. Stable, long-term funding is required to staff and maintain well-designed longitudinal studies that can address priority research areas and contribute to the development of health and social policy.

Australia↗
PubMed1993

Acanthamoeba keratitis. A masquerade of presentation in six cases.

Acanthamoeba keratitis is an uncommon but devastating complication of contact lens wear causing significant ocular morbidity. Six consecutive cases occurring in Western Australia in an 18-month period are reported. In all cases either poor contact lens hygiene or an association with swimming pools and contact lens use is a feature. There is invariably a delay in making the diagnosis, with the appearance frequently mistaken for herpes simplex keratitis. In all cases corneal biopsy was required to confirm the diagnosis. Of the six patients, four responded to medical therapy alone, one required a corneal graft and one required enucleation. We suggest that earlier rather than later corneal biopsy is important in unresponsive cases of culture-negative keratitis, especially in contact lens wearers. We would agree that the treatment of choice is intensive topical propamidine and neosporin. Prevention by strict adherence to contact lens care and hygiene is urged.

Acanthamoeba Keratitis↗
PubMed2005

Cardiorespiratory effects of warm water immersion in elderly patients with chronic heart failure.

BACKGROUND: Hydrotherapy might be included in the rehabilitation of patients with chronic heart failure (CHF), but little is known about the acute cardiorespiratory reaction in warm water. The aim of this study was to assess the acute cardiorespiratory effect of immersion in warm water, in a clinical setting, in elderly patients with CHF compared with healthy age and sex matched persons. METHODS: Twelve patients (three females) with CHF, NYHA II-III, age 64 +/- 6 years, and 12 healthy subjects were studied. Cardiorespiratory changes, on land and in a temperature-controlled swimming pool (33-34 degrees C) were assessed during rest and exercise, in a sitting position, using continuous gas analyses. RESULTS: There were no significant differences, land versus water, in carbon dioxide production, total ventilation, respiratory frequency, respiratory exchange ratio, heart rate or blood pressure in either of the groups. A significant difference was found in oxygen uptake, at rest, land versus water in patients with CHF in comparison with healthy subjects (-0.2 +/- 0.4 versus +0.3 +/- 0.6 ml kg(-1) min(-1), P < 0.01). Oxygen kinetics (tau) increased significantly (P = 0.01) in both groups during exercise in water. CONCLUSION: Hydrotherapy was well tolerated and the vast majority of the cardiorespiratory responses, during warm water immersion in a clinical setting, are similar in patients with CHF compared with healthy subjects. However, further larger studies, are needed to better understand the physiological reactions during hydrotherapy.

Blood Pressure↗
PubMed1994

Recurrent Pseudomonas folliculitis.

Pseudomonas aeruginosa has attracted the attention of the dermatologic literature through repeatedly reported outbreaks of folliculitis occurring in small epidemics related to contaminated whirlpools, hot tubs, and swimming pools. In contrast, sporadic cases without these recreational exposures may present a diagnostic challenge. Two sisters, age 8 and 4 years, had sporadic Pseudomonas folliculitis. It is important to recognize the organism as the cause of this recurrent, papulopustular, follicular eruption on the trunk and gluteal regions, also called nonrecreational Pseudomonas folliculitis, to avoid misdiagnosis and mismanagment. Inadvertent therapy with steroids may result in rapid spread of the lesions. Unless a meticulous investigation of contaminant sources in the environment leads to the detection of the vehicle of infection, the dermatitis tends to recur and become chronic.

Baths↗
PubMed1996

Etiology of dental erosion--extrinsic factors.

The extrinsic causes of dental erosion can be grouped under the headings of environmental, diet, medications and lifestyle. Environmental factors mainly involve exposure to acid fumes by workers in factories without proper safeguards. Swimming pools with low pH due to inadequate maintenance have also been implicated. Dietary factors have received the most attention and are likely to affect the broadest segment of the population. Most acidic foods and drinks have the potential to cause dental erosion in the human mouth. The total acid level (titratable acid) of dietary substances is considered more important than their pH, because it will determine the actual H+ available to interact with the tooth surface. Other constituents of foods and beverages will also have a modifying effect, including the calcium, phosphate and fluoride concentration, the acid type, and physical and chemical properties that influence the clearance rate from the mouth. It is not appropriate to assign relative degrees of risk to the different dietary substances except in general categories, because of the many human biological and behavioral factors that influence the clinical expression of dental erosion. The types of foods and beverages consumed, and the frequency and time of consumption are lifestyle factors that are considered most important regarding the clinical development of dental erosion. Low pH medications and oral hygiene products have also been suggested as potential causes of erosion. The combination of frequent consumption of acidic substances and overzealous oral hygiene practices may be another high risk lifestyle factor.

Acids↗
PubMed1997

Free-living, amphizoic and opportunistic amebas.

Amebas belonging to the genera Naegleria, Acanthamoeba and Balamuthia are free-living, amphizoic and opportunistic protozoa that are ubiquitous in nature. These amebas are found in soil, water and air samples from all over the world. Human infection due to these amebas involving brain, skin, lung and eyes has increased significantly during the last 10 years. The epidemiology, immunology, protozoology, pathology, and clinical features of the infections produced by these protozoa differ strikingly. Infection by the pathogenic Naegleria fowleri is acquired by exposure to polluted water in ponds, swimming pools and man-made lakes. Raised temperatures during the hot summer months or warm water from power plants facilitate the growth of N. fowleri. N. fowleri is a thermophilic ameba that grows well in tropical and subtropical climates. The CNS infection, called Primary Amebic Meningoencephalitis (PAM), produced by N. fowleri is characterized by an acute fulminant meningoencephalitis leading to death 3-7 days after exposure. Victims are healthy, young individuals with a history of recent water-related sport activities. The portal of entry is the olfactory neuroepithelium. The pathologic changes are an acute hemorrhagic necrotizing meningoencephalitis with modest purulent exudate, mainly at the base of the brain, brain-stem and cerebellum. Trophozoites can be seen within the CNS lesions located mainly around blood vessels. Thus far 179 cases have been reported; 81 in the USA alone. Balamuthia mandrillaris and several species of Acanthamoeba are pathogenic "opportunistic" free-living amebas which cause Granulomatous Amebic Encephalitis (GAE) in humans and animals. GAE is an infection, usually seen in debilitated, malnourished individuals, in patients undergoing immunosuppressive therapy for organ transplants and in Acquired Immunodeficiency Syndrome (AIDS). The granulomatous component is negligible, particularly in immunocompromised individuals. Pathologically these amebas produce a patchy, chronic or subacute granulomatous encephalitis with the presence of trophozoites and cysts. The portal of entry is probably through the respiratory tract or an ulceration of the skin reaching the CNS by hematogenous spread. As of October 1, 1996, 166 cases (103 due to Acanthamoeba and 63 due to Balamuthia) of GAE have been reported from around the world. Of these 103 cases due to Acanthamoeba (72 have been reported in the USA alone, > 50 in AIDS). It is well known that several species of Acanthamoeba can also produce, chronic sight threatening ulceration of the cornea called Acanthamoeba keratitis (AK), mostly in contact lens wearers or in individuals with minor corneal abrasions. Hundreds of cases of AK have been documented world wide.

Acanthamoeba Keratitis↗
PubMed1976

Differences in destruction of cysts of pathogenic and nonpathogenic Naegleria and Acanthamoeba by chlorine.

The destructive action of chlorine on the pathogenic Naegleria fowleri and Acanthamoeba culbertsoni, the nonpathogenic N. gruberi, and an avirulent Acanthamoeba isolate was investigated. N fowleri is somewhat more sensitive to chlorine than N. gruberi, whereas the two Acanthamoeba strains are very resistant. This study yields information needed for the destruction of amoebic cysts in drinking water and swimming pools. It also gives some explanation for the occurence of Acanthamoeba strains in these waters.

Cell Wall↗
PubMed1985

Enhanced chlorine resistance of tap water-adapted Legionella pneumophila as compared with agar medium-passaged strains.

Previous studies have shown that bacteria maintained in a low-nutrient "natural" environment such as swimming pool water are much more resistant to disinfection by various chemical agents than strains maintained on rich media. In the present study a comparison was made of the chlorine (Cl2) susceptibility of hot-water tank isolates of Legionella pneumophila maintained in tap water and strains passaged on either nonselective buffered charcoal-yeast extract or selective differential glycine-vancomycin-polymyxin agar medium. Our earlier work has shown that environmental and clinical isolates of L. pneumophila maintained on agar medium are much more resistant to Cl2 than coliforms are. Under the present experimental conditions (21 degrees C, pH 7.6 to 8.0, and 0.25 mg of free residual Cl2 per liter, we found the tap water-maintained L. pneumophila strains to be even more resistant than the agar-passaged isolates. Under these conditions, 99% kill of tap water-maintained strains of L. pneumophila was usually achieved within 60 to 90 min compared with 10 min for agar-passaged strains. Samples from plumbing fixtures in a hospital yielded legionellae which were "super"-chlorine resistant when assayed under natural conditions. After one agar passage their resistance dropped to levels of comparable strains which had not been previously exposed to additional chlorination. These studies more closely approximate natural conditions than our previous work and show that tap water-maintained L. pneumophila is even more resistant to Cl2 than its already resistant agar medium-passaged counterpart.

Agar↗
PubMed2001

Genetic diversity of Pseudomonas aeruginosa strains isolated from ventilated patients with nosocomial pneumonia, cancer patients with bacteremia, and environmental water.

Random amplified polymorphic DNA typing was used to study the genetic diversity of Pseudomonas aeruginosa strains from (i) ventilated patients with nosocomial pneumonia who were hospitalized in intensive care units, (ii) cases of bacteremia in cancer patients with severe neutropenia, and (iii) rivers and swimming pools. Genetic diversity was determined by three phylogenetic methods and by statistical analysis of population genetics. The population studied undergoes epidemic clonality with a high rate of genetic recombination. P. aeruginosa bacteremia and pneumonia are not caused by specific clones within this species.

Bacteremia↗
PubMed1993

Pseudomonas aeruginosa folliculitis acquired through use of a contaminated loofah sponge: an unrecognized potential public health problem.

Pseudomonas aeruginosa folliculitis is a well-known entity that occurs among users of closed-cycle recreational water sources such as whirlpools, swimming pools, and hot tubs. In the absence of this epidemiologic link, isolated cases are difficult to diagnose. We encountered a patient who developed P. aeruginosa folliculitis subsequent to the use of a loofah sponge grossly contaminated with the same P. aeruginosa strain (serotype 10; pyocin type 1/a 4,b) that was recovered from her skin lesions. Furthermore, we demonstrated that sterile unused loofah sponges can serve as the sole growth-promoting substrate for P. aeruginosa. To obviate the potential public health problem of contaminated loofah sponges, it is strongly recommended that manufacturers append, and consumers adhere to, instructions as to the care of loofah sponges, which includes allowing the sponge to dry after use.

Adult↗
PubMed1983

Clinical and epidemiological features of adenovirus keratoconjunctivitis in London.

Ninety-eight patients were studied. Ninety were consecutive patients who were isolation-positive for adenovirus, and 8, who were associated with a hospital outbreak of adenovirus serotype 8 infection, developed characteristic features of infection but were isolation-negative. The ratio of males to females was 2 to 1, and most patients were aged 20 to 39. Adenovirus serotypes 3, 7, and 8 were isolated from 86% of patients, and serotypes 2, 4, 5, 11, 15, and 15/29 from the remaining 14%. Adenovirus serotype 7 was more commonly isolated from patients under the age of 19 and was Not isolated during winter. Sources of infection could be identified in 36% of patients and included contact with upper respiratory tract of ocular infections, a hospital outbreak, and a recent visit to a swimming pool. Associated systemic disease was detected in 47% of patients, most of whom had upper respiratory tract infection. The most severe and prolonged conjunctivitis was caused by serotypes 5 and 8. Most patients developed epithelial punctate keratitis. Subepithelial punctate keratitis, which was once-considered to be a characteristic feature of adenovirus serotype 8, developed in cases of serotype 3, 4, 5, 7, and 8 infection.

Adenoviridae Infections↗
PubMed1980

An inexpensive method of determining body composition by underwater weighing.

A simple inexpensive densiometric method of determining body composition was compared to a more sophisticated one. Body density (Db), lean body mass (LBM), and relative fat content (%fat) were determined for 16 volunteers, 9 men and 7 women using a simple T-bar apparatus suspended in a swimming pool, and an electronic apparatus in conjunction with a metal tank. Residual volumes (RV) used in the determinations were estimated from age and height (RV-1), held constant at 1,300 ml for men and 1.000 ml for women (RV-2), and measured by the nitrogen washout method (RV-3). No significant difference was observed between the two methods of weighing, although significant differences did exist among the RV techniques. It was concluded that a simplified method of determining body composition is acceptable for screening purposes, but long term studies might require more sophisticated techniques with RV measured at the time of weighing.

Adipose Tissue↗
PubMed1997

Home drowning among preschool age Mexican children.

OBJECTIVES: To estimate the risk of drowning by different bodies of water in and near the home for children aged 1 to 4 years. SETTING: The Metropolitan Area of Guadalajara, Mexico. METHODS: A population case-control study. Cases (n=33) were children 1 to 4 years old who drowned at their home; controls (n=200) were a random sample of the general population. RESULTS: The risk of drowning for children whose parents reported having a water well at home was almost seven times that of children in homes without a water well (adjusted odds ratio (OR)=6.8, 95% confidence interval (CI)=2.2 to 20.5). Risk ratio estimates for other bodies of water were: swimming pools (OR=5.8, 95% CI=0.9 to 37.5), water barrel (OR=2.4, 95% CI=1.0 to 5.6), underground cistern (OR=2.1, 95% CI=0.8 to 5.2), and a basin front (courtyard pool to store water) of 35 or more litres (OR=1.8, 95% CI=0.8 to 4.4). CONCLUSION: Drowning at home is frequent in the Metropolitan Area of Guadalajara, but the causes are different from those reported in developed countries. Accordingly, the preventive strategies must also be different.

Accidents, Home↗
PubMed1992

Inactivation of coliphage MS-2 and poliovirus by copper, silver, and chlorine.

The efficacy of electrolytically generated copper and silver ions (400 and 40 micrograms/L, respectively) was evaluated separately and in combination with free chlorine (0.2 and 0.3 mg/L) for the inactivation of coliphage MS-2 and poliovirus type 1 in water at pH 7.3. The inactivation rate was calculated as log10 reduction/min: k = -(log10 Ct/C0)/t. The inactivation of both viruses was at least 100 times slower in water containing 400 and 40 micrograms/L copper and silver, respectively (k = 0.023 and 0.0006 for MS-2 and poliovirus, respectively), compared with water containing 0.3 mg/L free chlorine (k = 4.88 and 0.036). Significant increases in the inactivation rates of both viruses were observed in test systems containing 400 and 40 micrograms/L copper and silver, respectively, with 0.3 mg/L free chlorine when compared with the water systems containing either metals or free chlorine alone. Poliovirus was approximately 10 times more resistant to the disinfectants than coliphage MS-2. This observation suggests either a synergistic or an additive effect between the metals and chlorine for inactivation of enteric viruses. Use of copper and silver ions in water systems currently used in swimming pools and spas may provide an alternative to high levels of chlorination.

Chlorine↗
PubMed2002

Use of sunscreens in families living in Switzerland.

BACKGROUND: The hazards due to sun exposure are well known. Many recent studies have emphasized the protection against the harmful effects of the sun by the use of sunscreens and, moreover, by staying in the shade and wearing long-sleeved shirts, hats and sunglasses. Switzerland has one of the highest rates of skin cancer induction in Europe and the incidence of melanoma in Switzerland is constantly increasing with an incidence of 10-12/100,000 inhabitants/year. Interestingly, some studies have evoked the possibility that sunscreen use can increase the risk of melanoma by increasing overall sun exposure. OBJECTIVE AND METHODS: In this context, the aim of our study was to estimate the amount of sun exposure of children, and their parents, living in Switzerland and to give a description of how they protect themselves against sun irradiation. Questionnaires were provided to pediatricians in every state (canton) in Switzerland and were given to families coming for consultation. RESULTS: A total of 328 forms including 1,285 individuals were returned from most of the cantons in Switzerland. The majority of the Swiss families had 2 children under 16 years of age with middle-aged parents (30-45 years) and a central European skin type (light skin of type II-III, brown or blue eyes, and brown to blond hair). An important sun exposure was noted even though the population seems to be conscious of the associated dangers. Sunscreens were the first-line defense against sun exposure with clothing and shielding oneself from the sun not being highly used. Moreover, sunscreens tended to be misused with most people applying them at the beach or swimming pool (instead of 15 min before exposure) and few applications throughout the day. CONCLUSIONS: Prevention should imperatively be emphasized for lower overall sun exposure as sunscreens are primarily used at the beach and not in routine daily exposure. In addition, it is agreed that prevention campaigns would be better directed towards children because up to 80% of detrimental sun exposure occurs during childhood.

Adolescent↗
PubMed2004

Prevalence and risk factors for superficial fungal infections among Italian Navy Cadets.

BACKGROUND: Limited studies on the prevalence and risk factors for superficial mycoses are available. OBJECTIVE: The aim of this paper was to evaluate the prevalence and risk factors for superficial mycoses (dermatophytes and Candida spp.) in a sample of young Italian people resident at a military school. METHODS: A total of 1,024 young cadets from the Italian Navy Petty Officers School in Taranto, including 975 (95.21%) males and 49 (4.79%) females, mean age 22.5 +/- 3.0 years (range 18-30), were consecutively examined by the same observer. A complete dermatological examination was performed on all the subjects, and skin scrapings for microscopy and fungal culture were obtained from suspected lesions. All the subjects completed a questionnaire providing information on sports practice, swimming-pool attendance, marching, wearing shower sandals, frequent use of 'gummed' shoes, history of severe traumas to the nails, presence of hyperhidrosis and history of superficial mycoses. The affected subjects were also asked if they were aware of their condition. Data were analysed by the Statistical Analysis System, version 8.0. The Fisher exact test and odds ratios were calculated. RESULTS: A total of 33 subjects (3.2%) were found to suffer from a mycologically confirmed fungal infection (3% by dermatophytes and 0.2% by Candida albicans): tinea pedis/Candida intertrigo of the feet was suspected in 126 (12.1%) subjects and confirmed in 30 (2.9%), including 28 cases of tinea pedis and 2 cases of Candida intertrigo; tinea cruris/Candida intertrigo of the groin was suspected in 28 (2.7%) subjects, but confirmed in only 1 case (0.1%); onychomycosis was suspected in 64 (6.1%) subjects and confirmed in 2 cases (0.2%). The organism most frequently responsible in tinea pedis was Trichophyton mentagrophytes var. interdigitale (82.1%). The same species (50%) and T. mentagrophytes var. mentagrophytes (50%) were associated with tinea unguium, Epidermophyton floccosum was the only species detected in tinea cruris. Non-dermatophytic filamentous fungi (Penicillium spp., Fusarium spp., Aspergillus spp. and Paecilomyces spp.), not considered pathogenic, were isolated in 48 samples. None of the risk factors analysed were significantly associated with fungal infection. Only 2 subjects out of the 33 people affected were aware of their condition. They both had tinea pedis. CONCLUSION: The prevalence of mycoses in sailors living in an Italian military school was lower than rates detected in other military populations. This may be due to the cadets' lifestyle and environmental conditions. The most frequent infection was tinea pedis, mainly caused by T. interdigitale. None of the investigated risk factors were significantly associated with the disease, and most of the affected individuals were not aware of their condition.

Adolescent↗
PubMed2005

Right hemisphere activation of joke-related information: an event-related brain potential study.

Two studies tested the hypothesis that the right hemisphere engages in relatively coarse semantic coding that aids high-level language tasks such as joke comprehension. Scalprecorded event-related brain potentials (ERPs) were collected as healthy adults read probe words (CRAZY) preceded either by jokes or nonfunny controls ("Everyone had so much fun jumping into the swimming pool, we decided to put in a little water/platform"). Probes were related to the meaning of the jokes, but not the controls. In Experiment 1a, with central presentation, probes following jokes (related) elicited less negative ERPs 300-700 msec postonset (N400) than did probes following nonfunny controls (unrelated). This finding suggests related probes were primed by the jokes. In addition, unrelated probes elicited a larger anterior positivity 700-900 msec than did related, as irrelevant stimuli impacted control processes invoked by task demands. In Experiment 1b, probes (CRAZY) were preceded only by sentence-final words from jokes (water) or controls (platform). No ERP effects were observed in Experiment 1b, suggesting the N400 priming effect and the anterior positivity observed in Experiment 1a ref lect semantic activations at the discourse level. To assess hemispheric differences in semantic activations, in Experiment 2, ERPs were recorded as participants read probe words presented in their left and right visual fields (LVF and RVF, respectively). Probes elicited a smaller N400 component when preceded by jokes than controls. This N400 priming effect was larger with presentation to the LVF, suggesting joke-relevant information was more active in the right hemisphere. The anterior positivity was observed with RVF but not LVF presentation, suggesting an important role for the left hemisphere in controlled retrieval in language comprehension.

Acoustic Stimulation↗