Occurrence of Enterobacter sakazakii in food production environments and households

Enterobacter sakazakii occasionally causes illness in premature babies and neonates. Contamination of infant formulae during factory production or bottle preparation is implicated. Advice to health-care professionals focuses on bottle preparation, but the effectiveness of prevention depends on the degree of contamination and contamination sites, which are generally unknown. To keep contamination to a minimum in the finished product depends on knowledge of the occurrence of E sakazakii. We used a refined isolation and detection method to investigate the presence of this micro-organism in various food factories and households. Environmental samples from eight of nine food factories and from five of 16 households contained E sakazakii. The widespread nature of this micro-organism needs to be taken into account when designing preventive control measures.     

Evidence-based medicine in orthopaedics

Evidence-based medicine (EBM) is medicine based on the sum of personal clinical experience and clinical studies with the best possible design (preferably, but not necessarily, randomised controlled trials or RCTs), while focusing on the expectancies of patients and institutions.     

Automatic quantification of right ventricular function with gated blood pool SPECT

BACKGROUND: Quantification of right ventricular (RV) function is clinically relevant for the risk stratification and follow-up of patients with a wide spectrum of disease. This can be achieved with electrocardiography-gated blood pool single photon emission computed tomography (GBPS). We aimed to evaluate the accuracy of the completely automatic QBS GBPS processing software as compared with equilibrium planar radionuclide angiography (RNA) and with a GBPS manual segmentation method (GBPS(35%)) for the measurement of global RV ejection fraction (EF), taking the first-pass RNA (FP-RNA) as the gold standard. In parallel, we compared the RVEF, RV end-diastolic volume (EDV), and RV end-systolic volume (ESV) provided by QBS and GBPS(35%). METHODS AND RESULTS: The population included 85 patients with chronic post-embolic pulmonary hypertension. Twenty-one patients were excluded because of unsuccessful FP-RNA. Intraobserver and interobserver RVEF, RVEDV, and RVESV reproducibilities encountered with planar RNA, QBS, and GBPS(35%) were similar and compared favorably with those calculated with FP-RNA for RVEF. Mean RVEF was different between all methods. RVEF calculated with FP-RNA was better correlated to QBS (r = 0.68) and GBPS(35%) (r = 0.70) than to planar RNA (r = 0.59). RVEDV and RVESV with QBS were lower than with GBPS(35%), by 29% +/- 14% and 36% +/- 13%, respectively. RVEDV and RVESV with QBS were highly correlated to corresponding GBPS(35%) values: r = 0.88 and r = 0.91, respectively. CONCLUSION: As opposed to FP-RNA, GBPS is highly successful for the quantification of RV function. Both QBS and GBPS(35%) provide RVEF values similarly well correlated to FP-RNA and performed better than planar RNA. RVEF, RVEDV, and RVESV provided by QBS and GBPS(35%) are highly correlated. All of these RV functional measurements require further validation versus a better gold standard before their accuracy can be established.     

Lingual artery bifurcation aneurysms for training and evaluation of neurovascular devices

We present a canine lingual artery bifurcation aneurysm and assess its value for training in endovascular techniques and testing new embolic agents. The experimental aneurysm described herein mirrors human bifurcation aneurysms, and with this model, we sought to reproduce endovascular technical difficulties. However, the lesions created in this canine model did not show angiographic or histologic evidence of aneurysmal recurrence. We conclude that this model may be useful for training in endovascular techniques, but because of the lack of sufficient aneurysmal recurrence, it is not suitable for evaluating new embolic agents.     

Serial chest CT findings in interstitial lung disease associated with polymyositis-dermatomyositis

OBJECTIVE: A retrospective study was carried out in two institutions to determine serial changes in the pattern, distribution, and extent of interstitial lung disease (ILD) associated with polymyositis (PM)-dermatomyositis (DM) using HRCT. SUBJECTS AND METHODS: Twenty patients with PM-DM and clinical suspicion of ILD who underwent at least two serial HRCT examinations were retrospectively evaluated by two readers. Patients were classified according to the dominant CT pattern which was correlated with clinical evolution and underlying histology when available (n=6). RESULTS: Patients were classified into four groups according to the dominant pattern: ground-glass attenuation and reticulation (group 1, n=9); honeycombing (group 2, n=4); airspace consolidation (group 3, n=4), and normal or almost normal lung (group 4, n=3). Under medical treatment, serial HRCT showed that the extent of areas of ground-glass opacities (group 1) decreased in five patients, stabilized in two, and increased in two. Pathologic findings demonstrated usual interstitial pneumonia (UIP) in two cases and unspecified interstitial pneumonia in one. In group 2, extent of honeycombing increased in three cases and stabilized in one. In group 3, dramatic resolution of airspace consolidation occurred in three cases. Clinical deterioration with extensive consolidation at CT and diffuse alveolar damage (DAD) at histology occurred in one patient of each of the three previous groups. Lesions stayed invisible or progressed slightly in the fourth group. CONCLUSION: In ILD associated with PM-DM, clinical deterioration and DAD in the follow-up can be observed whatever the HRCT pattern. However, unfavorable evolution is constant when honeycombing is present at the initial CT.