Search

Abstract Aim--To assess the role of etamsylate [*] in reducing the risk of haemorrhagic brain damage and its consequences. Design--Follow up of babies recruited into a randomised controlled trial. Methods--A [...]

AbstractSalmonella entericais one of the most common causes of foodborne illness in the United States. Although salmonellosis is usually self-limiting, severe infections typically require antimicrobial treatment, and ceftriaxone, an extended-spectrum cephalosporin (ESC), is commonly used in both adults and children. Surveillance conducted by the National Antimicrobial Resistance Monitoring System (NARMS) has shown a recent increase in ESC resistance among SalmonellaHeidelberg isolated from food animals at slaughter, retail meat, and humans. ESC resistance among Salmonellain the United States is usually mediated by a plasmid-encoded blaCMYβ-lactamase. In 2009, we identified 47 ESC-resistant blaCMY-positive Heidelberg isolates from humans (n=18), food animals at slaughter (n=16), and retail meats (n=13) associated with a spike in the prevalence of this serovar. Almost 90% (26/29) of the animal and meat isolates were isolated from chicken carcasses or retail chicken meat. We screened NARMS isolates for the presence of blaCMY, determined whether the gene was plasmid-encoded, examined pulsed-field gel electrophoresis patterns to assess the genetic diversities of the isolates, and categorized the blaCMYplasmids by plasmid incompatibility groups and plasmid multi-locus sequence typing (pMLST). All 47 blaCMYgenes were found to be plasmid encoded. Incompatibility/replicon typing demonstrated that 41 were IncI1 plasmids, 40 of which only conferred blaCMY-associated resistance. Six were IncA/C plasmids that carried additional resistance genes. pMLST of the IncI1-blaCMYplasmids showed that 27 (65.8%) were sequence type (ST) 12, the most common ST among blaCMY-IncI1 plasmids from Heidelberg isolated from humans. Ten plasmids had a new ST profile, ST66, a type very similar to ST12. This work showed that the 2009 increase in ESC resistance among SalmonellaHeidelberg was caused mainly by the dissemination of blaCMYon IncI1 and IncA/C plasmids in a variety of genetic backgrounds, and is likely not the result of clonal expansion.

Salmonella isolates were recovered from a monthly sampling of chicken breasts, ground turkey, ground beef, and pork chops purchased from selected grocery stores in six participating FoodNet sites (Connecticut, Georgia, Maryland, Minnesota, Oregon, and Tennessee) in 2002 and an additional two sites in 2003 (California and New York). In 2002 and 2003, a total of 6,046 retail meats were examined, including 1,513 chicken breasts, 1,499 ground turkey samples, 1,522 ground beef samples, and 1,502 pork chops. Retail meat samples tested increased to 3,533 in 2003 as compared to 2,513 in 2002. Overall, six percent of 6,046 retail meat samples (n = 365) were contaminated with Salmonella, the bulk recovered from either ground turkey (52%) or chicken breast (39%). Salmonella isolates were serotyped and susceptibility tested using a panel of 16 antimicrobial agents. S. Heidelberg was the predominant serotype identified (23%), followed by S. Saintpaul (12%), S. Typhimurium (11%), and S. Kentucky (10%). Overall, resistance was most often observed to tetracycline (40%), streptomycin (37%), ampicillin (26%), and sulfamethoxazole (25%). Twelve percent of isolates were resistant to cefoxitin and ceftiofur, though only one isolate was resistant to ceftriaxone. All isolates were susceptible to amikacin and ciprofloxacin; however, 3% of isolates were resistant to nalidixic acid and were almost exclusive to ground turkey samples (n = 11/12). All Salmonella isolates were analyzed for genetic relatedness using pulsed-field gel electrophoresis (PFGE) patterns generated by digestion with Xba1 or Xba1 plus Bln1. PFGE fingerprinting profiles showed that Salmonella, in general, were genetically diverse with a total of 175 Xba1 PFGE profiles generated from the 365 isolates. PFGE profiles showed good correlation with serotypes and in some instances, antimicrobial resistance profiles. Results demonstrated a varied spectrum of antimicrobial resistance and PFGE patterns, including several multidrug resistant clonal groups among Salmonella isolates, and signify the importance of sustained surveillance of foodborne pathogens in retail meats.

Two-hundred eight Salmonellaisolates recovered from over 5,000 imported foods entering the United States in 2001 were tested for antimicrobial susceptibilities and further characterized for quinolone resistance mechanisms, integron carriage, and genetic relatedness. SalmonellaWeltevreden (20%), SalmonellaNewport (6%), SalmonellaLexington (5%), and SalmonellaThompson (4%) were the four most common serotypes recovered. Twenty-three (11%) isolates were resistant to at least one antimicrobial, and seven (3.4%) to three or more antimicrobials. Resistance was most often observed to tetracycline (9%), followed by sulfamethoxazole (5%), streptomycin (4%), nalidixic acid (3%), and trimethoprim/sulfamethoxazole (2%). One SalmonellaSchwarzengrund isolate recovered from squid imported from Taiwan exhibited resistance to eight antimicrobials, including ampicillin, chloramphenicol, gentamicin, kanamycin, nalidixic acid, sulfamethoxazole, tetracycline, and trimetho-prim/sulfamethoxazole. Six isolates (SalmonellaBareilly, SalmonellaDerby, SalmonellaOhio and three SalmonellaSchwarzengrund) contained class 1 integrons, which carried several resistance genes including dhfrI/dhfrXII, aadA, pse-1,and sat1,conferring resistance to trimethoprim/sulfamethoxazole, streptomycin, ampicillin, and streptothricin, respectively. Five of six nalidixic acid–resistant isolates possessed DNA point mutations at either Ser83 or Asp87 in DNA gyrase. One ciprofloxacin-resistant isolate possessed double mutations in DNA gyrase at positions Ser83 and Asp87 as well as a single mutation at Ser80 in parC.The top three serotypes identified, SalmonellaWeltevreden (n= 41), SalmonellaNewport (n= 13), and SalmonellaLexington (n= 11), were further characterized for genetic relatedness by pulsed-field gel electrophoresis. Fifty-five distinct pulsed-field gel electrophoresis patterns were observed among the 65 isolates, indicating extensive genetic diversity among these Salmonellaserotypes contaminating imported foods.

Salmonella Typhimurium remains one of the most common causes of salmonellosis in animals and humans in the United States. The emergence of multi-drug resistant Salmonella reduces the therapeutic options in cases of invasive infections, and has been shown to be associated with an increased burden of illness. In this study, 588 S. Typhimurium (including var. Copenhagen) isolates obtained from either animal diagnostic specimens (n = 199) or food animals after slaughter/processing (n = 389) were examined for antimicrobial susceptibility, presence of class-1 integrons, and characterized using pulsed-field gel electrophoresis and phage typing. Seventy-six percent (448/588) of isolates were resistant to at least one antimicrobial. Salmonella isolates displayed resistance most often to streptomycin (63%), tetracycline (61%), ampicillin (61%), and to a lesser extent, chloramphenicol (36%), ceftiofur (15%), gentamicin (9%), and nalidixic acid (4%), with more resistance observed among diagnostic isolates. Salmonella recovered from turkeys (n = 38) exhibited the highest rates of resistance, with 92% of isolates resistant to least one antimicrobial, and 58% resistant to ≥10 antimicrobials. Class 1 integrons were present in 51% of all isolates. Five integron associated resistance genes (aadA, aadB, pse-1, oxa-2 and dhfr) were identified. A total of 311 PFGE patterns were generated using XbaI, indicating a genetically diverse population. The largest PFGE cluster contained 146 isolates, including DT104 isolates obtained from all seven animal species. Results demonstrated a varied spectrum of antimicrobial resistance, including several multidrug resistant clonal groups, among S. Typhimurium and S. Typhimurium var. Copenhagen isolates recovered from both diagnostic and slaughter/processing samples.

The iridoid caudatoside A (2) was synthesized in seven steps from the naturally occurring iridoid 5-deoxypulchelloside I (1) using a straightforward series of protection and deprotection procedures to introduce the requisite C-6 cinnamoyl ester.

Six new iridoid glucosides, caudatosides A−F (2−7), and one known iridoid glucoside, 5-deoxypulchelloside I (1), were isolated from the fruits of Citharexylum caudatum. The structures of these compounds were elucidated by various one- and two-dimensional NMR techniques as well as high-resolution negative-ion ESIMS. Other plant parts were extracted on a small scale, and TLC of these extracts revealed the presence of the same iridoids.

Fifty isolates of Escherichia coli serogroup O111 recovered from humans and various animal species over a 24-year period (1976-1999) were examined for typical virulence-associated factors and susceptibilities to antimicrobials of human and veterinary significance. Nine H (flagellar) types were identified including nonmotile (n = 24), 32 (n = 12), negative (n = 5), and 56 (n = 3). Thirty-five (70%) isolates possessed at least one Shiga-toxin-producing E. coli (STEC)-associated virulence determinants (eae, stx1, stx2, hlyA) via PCR analysis. Of these 35 isolates, 20 possessed eae, stx1, and hlyA genes, whereas three isolates possessed eae, stx1, stx2, and hylA genes. Multiple antibiotic resistance was observed in 70% of the 50 E. coli O111 isolates. The majority of isolates displayed resistance to streptomycin, sulfamethoxazole, tetracycline, and kanamycin. Bacterial resistance to ampicillin, gentamicin, chloramphenicol, trimethoprim and apramycin was also observed. Integrons were identified in 23 (46%) of the E. coli isolates assayed, with a 1-kb amplicon being most frequently observed. DNA sequencing of these integrons revealed the presence of the aadA gene, encoding resistance to streptomycin. Two integrons of 1.5 and 2 kb contained the aadA2 and either dfrI or dfrXII genes, encoding resistance to streptomycin and trimethoprim, respectively. Integrons were also identified from isolates dating back to 1982. Isolates were further genetically characterized via ribotyping, which identified 15 distinct ribogroups, with 62% of isolates clustering into four major ribogroups. Certain riboprint patterns from different animal species, including humans, were observed in isolates spanning the 24-year collection period, suggesting the dissemination of specialized pathogenic O111 clones.

This paper evaluates questionnaire measures of anxiety, depression and posttraumatic stress disorder for use with pregnant and postpartum women. For each area of measurement the main issues or problems are delineated, two appropriate measures are described and the validity and reliability of the measures are discussed, as well as the problems and benefits of using the measures with pregnant or postpartum women. Finally, norms are provided for female and obstetric samples, where available. It is hoped that this paper will provide a valuable resource for future research into psychopathology in pregnant and postpartum women.

This paper evaluates questionnaire measures of stress and coping for use with pregnant and postpartum women. For each area of measurement the main issues or problems are delineated, appropriate measures are described and the validity and reliability of the measures are discussed, as well as the problems and benefits of using each measure with pregnant or postpartum women. Finally, norms are provided for female and obstetric samples, where available.The following constructs are examined: stress, demands of the infant, social support, coping and repressive coping style. A version of the Hassles and Uplifts Scale that was shortened for use with postpartum women is appended. It is hoped that this paper will provide a valuable resource for future research into stress and coping in pregnant and postpartum women.

Objective To determine whether prophylactic, low dose controlled‐release aspirin improves outcome for pregnant women and their babies in Barbados.

Introduction: Iron deficiency is commonly encountered in haemodialysis (HD) patients and may be overcome by i.v. therapy. We have examined the percentage hypochromic red cells (%HRC) for predicting response to i.v. iron in subjects with a low serum ferritin.
Methods: Prospective study of i.v. iron saccharate (trivalent iron 200 mg/week for 8 weeks) in anaemic (Hb <10 g/dl) HD patients with serum ferritin <100 μg/l despite oral iron therapy. Response to i.v. iron was assessed by comparing Hb at 0 and 8 weeks according to %HRC at baseline (0-3%, 4-9%, 10%). Results are mean±1 SD.
Results: For all subjects (n=82), Hb and ferritin increased between 0 and 8 weeks (8.9±1.0 to 10.1±1.4, P<0.0001; 55±24 to 288±126, P<0.0001). Patients were stratified into three groups according to %HRC at baseline (0-3%, 4-9%, 10%). Hb increased significantly in all three groups. The mean increase in Hb was greater (0-3%, 0.6±1.2; 4-9%, 1.2±1.0; 10%, 1.6±1.4; P=0.02) and the proportion of patients showing a 1 g/dl increase in Hb was greater (0-3%, 27%; 4-9%, 47%; 10%, 67%; P=0.02) in those with the largest %HRC pre-treatment.
Conclusion: Intravenous iron therapy is effective in improving Hb in anaemic HD patients with a low ferritin. However, the magnitude of this response and the proportion of patients responding is related to the percentage hypochromic red cells prior to treatment.

Iron deficiency is commonly encountered in haemodialysis (HD) patients and may be overcome by i.v. iron therapy. We have examined the percentage hypochromic red cells (%HRC) for predicting response to i.v. iron in subjects with a low serum ferritin.

The solubilization of 80% of the acetylcholinesterase activity of mouse brain was performed by repeated 2h incubations of homogenates at 37 degrees C in an aqueous medium. Analysis of the soluble extract by gel filtration on Sephadex G-200 showed that up to 80% of the enzyme activity was eluted in a peak which was estimated to consist of molecules of about 74000mol.wt. This peak was called the monomer form of the enzyme. After 3 days at 4 degrees C, the soluble extract was re-analysed and was eluted from the column in four peaks of about 74000, 155000, 360000 and 720000 mol.wt. Since the total activity of the enzyme in these peaks was the same as that in the predominantly monomer elution profile of fresh enzyme, we concluded that the monomer had aggregated, possibly into dimers, tetramers and octomers. Extracts of the enzyme were analysed by polyacrylamide-gel electrophoresis and the resulting multiple bands of enzyme activity on gels were shown to separate according to their molecular sizes, that is by molecular sieving. All these forms had similar susceptibilities to the inhibitors eserine, tetra-isopropyl pyrophosphoramide and compound BW 284c51 [1,5-bis-(4-allyldimethylammoniumphenyl)pentan-3-one dibromide]. Thus the forms of the enzyme in mouse brain which can be detected by gel filtration and polyacrylamide-gel electrophoresis may all be related to a single low-molecular-weight form which aggregates during storage. This supports similar suggestions made for the enzyme in other locations.

Single crystal boules of meta-nitroaniline of good optical quality have been grown. Metanitroaniline exhibits a strong linear electro-optic effect, has a low refractive index and low permittivity, making it attractive for use in high-speed electro-optic modulators and deflectors.

Background: RCT have shown that a slight delay in clamping the cord benefits preterm infants by reducing intraventricular hemorrhages and donor blood transfusion. One ethical problem with such study is obtaining informed consent from parents at a time when they are very vulnerable and stressed by expecting a preterm baby.Aim: To evaluate parents' perception of including their unborn infant < 33 weeks' gestation into a RCT on a slight delay in clamping the cord or four times milking the cord.Methods: Prospective, single centre study. Parents, whose infants had participated in the RCT, were offered to take part in a structured interview either performed at the hospital or at home. Recorded interviews were transcribed. The interview analysis was performed by a researcher, who was blinded to the infant's allocation, by using NVivo software. Analysis was then summarized by using systematic thematic analysis.Results: 37 (31.9%) of 116 eligible parents agreed to take part in the interviews (22 female, mean age 29.9 years (19-41), 15 male mean age 33.12 years (21-46)). The results identified five main themes for parents:(i) timing of recruitment;(ii) reasons for participating in the RCT;(iii) implications of taking part;(iv) professionalism of staff (including attitude, care and information giving); and(v) suggestions for improvement.Conclusions: On the basis of the sample there was no difference in parents' perceptions even when related to infants' CRIB scores between milking the cord (mean 2.52; SD 3.19; n=27) and delaying clamping the cord (mean 2.75; SD 4.15; n=28).

&lt;it>Objectives&lt;/it>: The objectives of this study were to determine the potential risk of dog treats in transmitting &lt;it>Salmonella&lt;/it> to humans in the USA, and to characterize genetic relatedness and antimicrobial resistance among the isolates. &lt;it>Methods&lt;/it>: A total of 158 dog treats derived from pig ears and other animal parts were randomly collected nationwide and assayed for the presence of &lt;it>Salmonella&lt;/it>. The &lt;it>Salmonella&lt;/it> isolates were characterized using serotyping, pulsed-field gel electrophoresis (PFGE) and antimicrobial susceptibility testing. &lt;it>Results&lt;/it>: Forty-one percent (65/158) of samples were positive for &lt;it>Salmonella&lt;/it>. Eighty-four &lt;it>Salmonella&lt;/it> isolates, comprising 24 serotypes, were recovered from the 65 positive samples. Fourteen samples were contaminated with more than one &lt;it>Salmonella&lt;/it> serotype. PFGE analysis of 78 &lt;it>Salmonella&lt;/it> isolates yielded 64 patterns. &lt;it>S&lt;/it>. Infantis with PFGE patterns indistinguishable from those of strains identified in Canadian outbreaks in 1999 were recovered in several dog treat products. The majority of &lt;it>Salmonella&lt;/it> isolates were susceptible to the antimicrobials tested; however, resistance was observed to tetracycline (26&percnt;), streptomycin (23&percnt;), sulfamethoxazole (19&percnt;), chloramphenicol (8&percnt;) and ampicillin (8&percnt;). Twenty-eight (36&percnt;) &lt;it>Salmonella&lt;/it> isolates were resistant to at least one antimicrobial and 10 (13&percnt;) isolates displayed resistance to four or more antimicrobials. Two isolates were identified as &lt;it>S&lt;/it>. Typhimurium DT104 with the characteristic penta-resistance phenotype (ampicillin, chloramphenicol, streptomycin, sulfamethoxazole and tetracycline). One &lt;it>S.&lt;/it> Brandenburg isolate was resistant to eight antimicrobials. Seven &lt;it>Salmonella&lt;/it> isolates also contained class I integrons encoding resistance genes to aminoglycosides, &bgr;-lactam and streptothricin antimicrobials. &lt;it>Conclusions&lt;/it>: The study indicates that animal-derived dog treats in the USA could be a potential source of animal and human infections with &lt;it>Salmonella&lt;/it>, including multidrug-resistant &lt;it>Salmonella&lt;/it> strains.