Protein profile of Helicobacter pylori strains by isoelectrofocusing in patients affected by chronic gastritis

BACKGROUND: To understand if relapse, following antimicrobial treatment was due to re-infection or to recrudescence. METHODS: Fifty patients with dyspepsia were studied prospectively. They were followed up by endoscopy and biopsy of antral mucosa before and after treatment with anti-microbial therapy. Gel isoelectrofocusing was used to characterize protein profile of Hp. RESULTS: At baseline 40 patients were affected by chronic gastritis associated with Hp. At the end of treatment 75% patients given omeprazole, amoxicillin and clarithromycin were Hp infected: 43% showed the same protein profile and 57% different. CONCLUSIONS: Our data suggest that the relapse is due to recrudescence or to reinfection.     

Quality improvement for pressure ulcer care in the nursing home setting: the Northeast Pressure Ulcer Project

OBJECTIVES: The objectives of this study were to evaluate the impact of a collaborative model of quality improvement in nursing homes on processes of care for the prevention and treatment of pressure ulcers. STUDY DESIGN: The study design was experimental. SETTING: We studied 29 nursing homes in New Jersey, Pennsylvania, and Rhode Island. PARTICIPANTS: Participants consisted of pressure ulcer quality improvement teams in 29 nursing homes. INTERVENTION: Quality improvement teams attended a series of workshops to review clinical guidelines and quality improvement principles and to share best practices, and worked one-on-one with mentors to implement quality improvement techniques and to collect data independently. MEASUREMENTS: We calculated process measures based on the Agency for Healthcare Research and Quality (AHRQ) guidelines. Process measures addressed each facility's processes of care for the prevention and treatment of pressure ulcers at baseline and after 12 months of intervention. Prevention measures focused on recent admissions and high-risk residents; treatment measures focused on patients newly diagnosed with pressure ulcers and all patients with pressure ulcers. RESULTS: Overall, 6 of 8 prevention process measures improved significantly, with percent difference between baseline and follow up ranging from 11.6% to 24.5%. Three of 4 treatment process measures improved significantly, with 5.0%, 8.9%, and 25.9% difference between baseline and follow up. For each process measure, between 5 and 12 facilities demonstrated significant improvement between baseline and follow up, and only 2 or fewer declined for each process measure. CONCLUSION: Improvement in processes of care after the use of a structured collaborative quality improvement approach is possible in the nursing home setting.     

Clinical factors related to the frequency and intensity of glistenings in AcrySof intraocular lenses

PURPOSE: To assess the frequency of glistenings in eyes that had phacoemulsification and implantation of AcrySof intraocular lenses (IOLs) (Alcon) and to evaluate the clinical factors related to the glistenings. SETTING: Departamento de Oftalmología, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain. METHODS: A consecutive series of 129 eyes of 94 patients was prospectively evaluated. All patients had cataract surgery and implantation of an MA30BA AcrySof IOL by the same surgeon using the same technique. The operating surgeon examined patients for the presence of glistenings. The frequency and intensity of glistenings were assessed in relation to 14 clinical factors. The effect of glistenings on postoperative Snellen best corrected visual acuity (BCVA) was also evaluated. RESULTS: Glistenings, which occurred in 38 cases (29.5%), were slight in 15 eyes, moderate in 18, and intense in 5. The frequency of the glistenings was related to the time between surgery and evaluation (P =.0001), the IOL dioptric power (P =.01), postoperative inflammation (P =.01), and phacotrabeculectomy (P =.01). The intensity of the glistenings was related to the time after surgery (P =.01) and presence of postoperative inflammation (P =.004). No relation between glistenings and Snellen BCVA was found. CONCLUSIONS: The frequency and intensity of glistenings in AcrySof IOLs increased with time after surgery and were higher when postoperative inflammation was present. Glistenings developed more frequently in cases of phacotrabeculectomy but not after combined phacoemulsification and deep sclerectomy. Glistenings did not result in decreased Snellen BCVA.     

Lymphoid tumours of the ocular adnexa: a morphologic and genotypic study of 15 cases

PURPOSE: To examine all lymphoproliferative lesions of the ocular adnexa diagnosed in Iceland during 1983-2000 and to determine whether polymerase chain reaction (PCR) methods to determine clonality are helpful in characterizing these lesions. METHODS: All patients diagnosed with lymphoproliferative lesions in the ocular adnexa in the years 1983-2000 were included in the study. Polymerase chain reaction studies for clonality were performed on these lesions. RESULTS: Fifteen cases were identified. Seven were classified as inflammatory pseudotumour, one as lymphoid hyperplasia, four as atypical lymphoid hyperplasia and three as lymphoma. Of 12 cases examined by PCR, three were monoclonal for B-cells (one lymphoma, one inflammatory pseudotumour and one atypical lymphoid hyperplasia) while the remaining lesions (including two lymphomas) appeared polyclonal. CONCLUSION: The results of this study suggest that analysis of clonality by PCR methods may be of limited use in classifying lymphoproliferative lesions of the ocular adnexa as benign or malignant. These results underscore the importance of using several techniques when determining clonality.     

Yessotoxin,a novel phycotoxin,activates phosphodiesterase activity. Effect of yessotoxin on cAMP levels in human lymphocytes

Yessotoxin (YTX) is a novel phycotoxin with an unknown mechanism of action that has been reported as cardiotoxic, when injected, but non-toxic if ingested orally. In this paper, we studied the effect of YTX on adenosine 3',5'-cyclic monophosphate (cAMP) pathway, since this pathway can be a cellular target to this toxin as happens in other diarrhetic toxins. We determined cAMP levels by enzymeimmunoassay and by using the cAMP dye recombinant fluorescein- and rhodamine-labeled protein kinase A, which increases their fluorescence when cAMP levels are increased. In the presence of YTX, and after a transient small increase, cAMP levels were decreased. This effect was Ca(2+) dependent since in a Ca(2+)-free medium YTX increased cAMP levels, but this event was reverted after addition of external calcium. YTX also reverted the increase of cAMP induced by the adenylyl cyclase activator forskolin. These variations in fluorescence units were confirmed when cAMP levels were measured by enzymeimmunoassay, YTX decreases cAMP from 52.81+/-3.66 to 44.53+/-4.5 fmol. Phosphodiesterase (PDE) IV inhibitors, rolipram or etazolate, did not modify the effect of YTX, however, when PDE IV was first inhibited no effect of YTX was observed. On the other hand, the PDE III inhibitor milrinone counteracted the effect of YTX, and a similar effect was observed with the unspecific PDE I inhibitor chlorpromazine. These results point to an effect of YTX on PDE activity. In the presence of YTX, the fluorescent PDE substrate Mant-cAMP, increased its rate of hydrolysis, the same as the PDE from bovine brain increased the hydrolysis of cAMP substrate. In addition, YTX increased interleukin-2 production, which indirectly confirms a decrease in cAMP. Although results show a very complex pattern of responses, due to the interactions and crosstalks between many systems, results suggest that YTX is a PDE activator in the presence of external Ca(2+).     

Duodenal administration of solid lipid nanoparticles loaded with different percentages of tobramycin

Three types of solid lipid nanoparticles (SLN) containing three different percentages of tobramycin (1.25, 2.50, 5.00%) were prepared (Tobra-SLN), and the in vitro tobramycin diffusion through a hydrophilic/lipophilic membrane was determined. A variable quantity of each of the three SLN types was placed in the donor compartment to achieve the same amount of tobramycin in each case. Tobramycin diffusion varied with the percentage of drug incorporated in SLN: the higher the percentage of tobramycin incorporated, the greater the amount of the drug diffused. In vivo uptake and transport were determined after administering a fixed dose of tobramycin (5 mg/kg) in each of the three types of SLN intraduodenally to rats. At fixed times, blood was sampled from the jugular vein and lymph from the thoracic duct. Lymph and blood were examined by transmission electron microscopy (TEM) analysis to detect the presence, sizes, and shape of SLN. The pharmacokinetic parameters varied considerably with the type of Tobra-SLN: the area under the curve of plasma concentration versus time (AUC) of 1.25% Tobra-SLN was more than five times higher than that of 5.00% Tobra-SLN; the longest residence time was obtained with 1.25% Tobra-SLN; and the clearance of 5.00% Tobra-SLN was fivefold than that of 1.25% Tobra-SLN. This behavior may be related to the differences among the three types of SLN; namely, the number of SLN administered and the mean diameter, the total surface area, and the drug content in each nanoparticle. TEM analysis showed that Tobra-SLNs were targeted to the lymph. Tobra-SLN may act as a reservoir of the drug in the lymphatic system, thereby favoring its sustained release.     

Poliovirus detection in wastewater and stools following an immunization campaign in Havana, Cuba

BACKGROUND: Recent outbreaks of poliomyelitis caused by vaccine-derived virus have raised concerns that vaccine-derived poliovirus may continue to circulate after eradication. In these outbreaks, the virus appears to have replicated for > or =2 years before detection. Early detection is critical for an effective response to these outbreaks. Although acute flaccid paralysis (AFP) surveillance will remain the standard for poliovirus detection, wastewater sampling could be a useful supplement. In this study, we evaluated the sensitivity of wastewater sampling by concurrently collecting stools from children aged < 3 years attending two neighbourhood clinics in Havana, Cuba, and wastewater from the same neighbourhoods. METHODS: Sample collection was begun during the third week after the national immunization campaign, continued weekly through the seventh week, and was repeated during weeks 15 and 19. Virus detection and titration were performed using both cell culture and polymerase chain reaction techniques. RESULTS: Wastewater sampling was found to be at least as sensitive as stool sampling under these conditions. Poliovirus was isolated from children through week 7, suggesting that viral shedding reached undetectable levels between weeks 8 and 14. The last virus-positive wastewater sample was collected during week 15. CONCLUSIONS: Wastewater sampling under the conditions studied can be a sensitive supplement to AFP surveillance. Similar studies under different conditions are needed to determine the role of wastewater sampling in post-eradication surveillance.     

Risk groups for hepatitis A virus infection

We report the conduct and results of a systematic search for evidence of risk of infection with hepatitis A virus (HAV) among blood transfusion recipients, travellers, the military, healthcare workers, sewage workers, foodhandlers, day care assistants, institutionalised subjects, blood transfusion recipients, drug addicts, homosexuals, prisoners and other risk groups such a liver transplantees. We report our recommendations for the use of the HAV vaccine in these groups.     

Differences in the size of eggshells among three Pangstrongylus megistus colonies

The objective of the study was to evaluate the measurements of eggshells from three colonies of P. megistus, two from the lab and one from a sylvatic habitat. Fifty eggshells from each colony were measured with the use of a stereoscopic microscope and the Qwin image analysis system,. The statistical analysis was performed using unpaired t-test in INSTAT program. The length, width and diameter of the opercular opening of the eggshells from the sylvatic colony were larger than the two laboratorial colonies of P. megistus.     

Mercury and health in the dental practice

Mercury is a heavy metal widely used by man. It is considered very toxic causing conditions in the central nervous system, behavior disturbances, and renal and sexual disorders. For a century, mercury has been used in the dental practice for its capacity of joining metals (amalgamate), its low cost and its rapid fixing in dental pieces repair. Currently, there is much controversy about the safety of dental amalgams and it has been demonstrated it poses occupational risks to dental practitioners and their assistants. The objective of this study is review aspects related to metallic mercury toxicity for personnel involved in the dental practice and patients with dental amalgams. Routes of mercury exposure in dentistry, occupational risks and measures to prevent mercury poisoning are presented here. A literature review was conducted mostly on data from Biological Abstracts and the Science Citation Index for the period between 1990 and 2000.