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A new ingredient from date palm coproducts (pits) was obtained and tested as a preservative in burgers. Different concentrations of date pit (0%, 1.5%, 3%, and 6%) were added to beef burgers, and its effect on the safety and quality was evaluated during 10 days of storage. The incorporation of date pit was able to improve the shelf life and the cooking properties of the burgers. The date pit stabilized the color, lipid oxidation, and microbial growth of the burgers during the storage time due to the antioxidant activity and the phytochemical content of the date pits. For the consumer panel, the color and the off-odors were improved, and the addition of 1.5% and 3% date pit in cooked burgers obtained similar scores. Based on the obtained results, the new ingredient from date pit may have potential preservative properties for enhancing stability during shelf life and could improve the composition of bioactive compounds (fiber and phenolic content) of beef burgers.

Background: Cryptococcosis is a generally systemic and potentially lethal fungal infection. Although HIV infection is a predisposing condition, especially if the CD 4+ lymphocyte count is less than 100cells/mm 3 , other forms of immunosuppression may be associated with this opportunistic fungal condition, such as prolonged steroid therapy or solid organ transplantation. Pulmonary presentation must be included in the differential diagnosis of pneumonia or pulmonary neoplasia in the immunosuppressed patient., Case Report: We report a case of pulmonary cryptococcosis in a non-diagnosed HIV patient. In a 44 year-old male suffering from dyspnea and chest pain the image of a pulmonary nodule was observed in a radiological finding. In the histopathological study, intracellular structures suggestive of fungal conidia, and morphologically compatible with Cryptococcus, were observed. HIV serology and cryptococcal antigen detection in serum were requested, given the possibility of cryptococcosis. Cryptococcus neoformans var. grubii was isolated from the culture of the pulmonary biopsy. The patient was finally diagnosed with pulmonary cryptococcosis and HIV-1 infection. With a proper antifungal treatment the patient evolved satisfactorily., Conclusions: The best strategy to avoid opportunistic infections such as cryptococcosis in HIV-infected patients consists of an early diagnosis and a highly active antiretroviral treatment. In our case, the diagnosis of a pulmonary infection by C. neoformans var. grubii allowed a late diagnosis of HIV-1 infection., (Copyright © 2019 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Two novel ingredients were incorporated into spreadable liver pâtés to study their effect on physicochemical and sensory characteristics and their possible use in the meat industry. Fresh date ( Phoenix dactylifera , cv. Confitera) co-products, as a paste (0, 2.5 and 7.5%), and annatto ( Bixa orellana ) extract (0 and 128 mg/kg), as a colourant, and their combinations were incorporated into liver pâtés to study their effect on the final quality. The six formulations were analysed for chemical composition, physicochemical characteristics (pH, a w , colour, emulsion stability, and texture), and sensory properties. Pâtés tolerated suitable incorporation of date paste, providing emulsifying activity and being able to counteract to some extent the emulsion destabilisation caused by the annatto. All formulations showed an acceptable sensory quality, particularly pâtés with annatto and 7.5% date paste, which was softer, juicier, and presented redness values similar to the control as well as better emulsion stability. The combined use of these novel ingredients could be used as natural ingredients., Competing Interests: The authors declare no conflict of interest.

Objective: Enterobius vermicularis, also known as pinworn, is the responsible agent for Human Enterobiasis. It is one of the most prevalent, but underrated, parasitic disease in children population. Diagnosis involves demonstration of either eggs or adult worms by Graham test. The aim of this study is to describe the clinical, demographic and microbiological features of patients with suspected diagnosis of Enterobiasis in southern Gran Canaria., Methods: Descriptive and prospective study of perianal samples evaluated by Graham test in the Microbiology Department of `Insular de Gran Canaria´ University Hospital between November 2014 and November 2015. Descriptive analysis to evaluate the correlation between clinical and demographic variables and the results of Graham test microbiological observation., Results: 1,128 samples were analyzed. E. vermicularis was found in 11.4% of the samples. Among the positives samples, 88.4% belonged to children under 14 years, and 53.5% were male. Abdominal pain (18.6%), anal itching (11.6%), eosinophilia (8.5%) and intestinal parasitosis suspicion (7.8%) were the reasons of parasitological investigation request in positive samples. Nevertheless, a high proportion of the requests was not founded in a suspicious diagnosis or was unrelated to Enterobiasis., Conclusions: Enterobiasis is a common disease in primary health care and is of great importance in Gran Canaria. Quality in sample collection as well as diagnosis suspicious information are necessary for a good microbiological analysis.

Introduction: Multidrug resistant organisms (MDRO) are an important cause of nosocomial infections, with complicated clinical-therapeutic management and elevated morbidity-mortality, and an increase in healthcare costs. In long term care facilities (LTCFs) colonization/infection by MDRO among residents is increasing, and they may act as reservoirs and vehicles for the dissemination and production of outbreaks by resistant strains in acute hospitals. This study aimed at determining the prevalence of carriers of some common MDRO, and identifying factors associated with carrier state., Material and Methods: A cross-sectional prevalence study was conducted on 235 residents in two LTCFs in the province of Las Palmas de Gran Canaria (Canary Islands, Spain) between October and November of 2012. The presence of MMR was investigated in nasal, pharyngeal and rectal swabs using selective media. Risk factors associated with carrier state were calculated using univariate and multivariate analysis., Results: More than one-third (36.2%) of residents were found to be carriers of ≥ 1 distinct MDROs. More than one-quarter (26.6%) were carriers of ESBL producing Enterobacteriaceae, and 10.2% were MRSA carriers. Factors found to be associated with colonization by any MDRO were: prior colonization or infection by MDRO, hospitalization in the past 3 months, recurrent infections of the urinary tract, and peripheral arterial disease., Conclusions: The prevalence of MDRO in the LTCFs settings studied is greater than that found in the literature, and in particular ESBL producing Enterobacteriaceae. Due to the high prevalence of infection/colonization by MDRO, it is possible that residents of LTCFs could act as important reservoirs of MDRO, and facilitate their spread into the acute care setting., (Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.)

Dates are an interesting source of bioactive compounds, and coproducts from the date industry are of potential use in the manufacturing of meat products. In the present research, spreadable pork liver pâtés were made using fresh date coproducts (2.5% and 7.5%) as a potential functional ingredient and an ethanolic annatto extract (128 mg/kg) as colorant. The effect of these 2 ingredients on the lipid oxidation and microbial quality of the pâtés was assessed during 21 d of storage. The pâtés containing 7.5% date paste were seen to have the highest content of phenolic compounds during storage. The combination of 2.5% date paste and annatto protected pâtés against lipid oxidation throughout the 21 d of storage, thiobarbituric acid-reactive substances values being 0.47 mg MDA/kg at the end of this period, while other combinations increased oxidation compared to the control pâté. The control and those made with 2.5% date paste alone showed the highest counts of mesophilic aerobic bacteria, while the addition of annatto and/or 7.5% date paste reduced this count. The results suggest that a combination of both ingredients is necessary to reduce oxidation and microbial growth, but whereas the concentration of 2.5% is more appropriate to reduce oxidation, the combination with 7.5% date paste reduces the microbial counts. Both ingredients could have an opportunity of valorization in the meat industry for improving the quality., (© 2014 Institute of Food Technologists®)

The date agro-industry needs to find appropriate techniques to give value to their co-products. This study analyzes twelve intermediate food products (IFPs) from date co-products, Medjool and Confitera cv. at several ripening stages, blanched and unblanched, for their content in bioactive compounds (phenols, tannins, flavonoids, carotenoids and anthocyanins) and the antioxidant activity (AA). IFPs from the more unripe stages had the highest AA and phytochemicals content, mainly phenols, up to 1.4 g GAE/100 g, with high proportions of tannins. Flavonoids were found in high amounts, up to 874 mg RE/100 g. Among the AA are significant the antiradical efficiency (4.62 mM TE/100 g) and chelating activity (252 μM EDTA/100 g). Blanching was beneficial for Confitera IFPs. A positive correlation was found between phenols, tannins and flavonoids and the AA; and their content could be used as indicator of the AA. Date IFPs have potential use as an antioxidant functional ingredient., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The nutritive, physicochemical and technological characteristics of several intermediate food products (IFPs) from Spanish Confitera fresh date co-products were investigated. Three IFPs were obtained, two from unblanched dates in different ripening stages (Khalal and Rutab), and a third one from blanched Khalal fruits. The IFPs were rich in dietary fibre (13-16%, dry matter), phenolics (0.56-4.26g GAE/100g dry matter) and sugars (55-82%, dry matter), with glucose and fructose as the predominant sugars. Malic acid was the major organic acid, and potassium was the main mineral. Blanching Khalal dates aided to prevent browning in the IFP, but also the thermal treatment modified the sugars profile. The results indicated that both maturity stages yield IFPs with potential in the food industry; and according to their sugar and phenolic content they could be suitable for the elaboration of new ingredients with different industrial applications. In addition, it would be recommendable blanching unripe fruits., (Copyright © 2014. Published by Elsevier Ltd.)

Date palm co-products are a source of bioactive compounds that could be used as a new ingredient for the meat industry. An intermediate food product (IFP) from date palm co-products (5%) was incorporated into a paprika added dry-cured sausage (PADS) model system and was analysed for physicochemical parameters, lipid oxidation and sensory attributes during ripening. Addition of 5% IFP yielded a product with physicochemical properties similar to the traditional one. Instrumental colour differences were found, but were not detected visually by panellists, who also evaluated positively the sensory properties of the PADS with IFP. Therefore, the IFP from date palm co-products could be used as a natural ingredient in the formulation of PADS., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become an important hospital-acquired pathogen, with transfer of the organism from a carrier or infected patient to uninfected patients by the hands or clothing of staff as the main mode of transmission., Methods: Investigation of a cluster of new cases of MRSA resistant to mupirocin and fusidic acid, using epidemiological and microbiological resources., Results: From September 2010 to February 2012, sixteen patients had at least one culture positive for MRSA resistant to mupirocin and fusidic acid. Some not apparently related cases and outbreaks appeared. By analysing cultures taken from patients and staff using pulsed-field gel electrophoresis, it was demonstrated that most likely this situation was started by an auxiliary nurse who was a carrier of the MRSA. Healthcare worker decontamination using oral antibiotic therapy was unsuccessful. Eventually, the situation was controlled by placing the carrier in a different job, with no further cases to date (September, 2012)., Conclusion: This report illustrates the risk of nosocomial transmission linked to care delivered by healthcare workers., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)

Date palm is an interesting source of bioactive compounds that could be used as ingredient in meat products; thus a campagne type pork liver pâté was elaborated using fresh date by-products (0, 5, 10 and 15%). Physicochemical properties, pigment and lipid oxidation, residual nitrite level, texture and sensory analysis during 4 days after the elaboration process were evaluated. Date paste mostly incorporated moisture, fibre and phenolic compounds. Physicochemical parameters, myoglobin content and heme iron stability were not severely affected. Addition of 10% of date was enough to avoid lipid oxidation through all storage times. Colour was the most affected parameter; however, in terms of overall acceptability, panellists preferred samples with added date., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The superficial antifungal activity of oregano essential oil (OEO) in Spanish fermented dry-cured sausages ("salchichón"), and its effects on lipolysis, proteolysis and sensory characteristics were evaluated. The surface application of OEO reduced mold contamination on the surface, without significantly affecting the drying process. To evaluate the intensity of lipolysis during the ripening process, the profile and content of free fatty acids were determined. The addition of OEO led to a higher amount of unsaturated fatty acids, but lipolysis was not greatly affected. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), which was used to qualitatively assess the proteolytic changes in the sarcoplasmic and myofibrillar proteins during the process, pointed to very similar patterns in all the sausages. OEO did not significantly affect the sensory properties, but increased hardness, resulting in a better texture. Therefore, a shorter ripening time may be necessary for sausages treated with OEO., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Objective: The aim of this work was to evaluate the prevalence of past infection due to Rickettsia typhi and Rickettsia conorii in the Canary Islands (Spain)., Methods: A representative sample of the population of the seven islands, formed of 662 people aged between 5 and 75 years (368 females, 294 males), was analyzed. Epidemiological data were obtained by direct survey. The detection of serum IgG antibodies against both microorganisms was based on an indirect immunofluorescence test, considered positive if the titers were ≥ 1/80., Results: Of the analyzed population 3.9% had IgG antibodies against R. typhi and 4.4% against R. conorii. Out of these positive samples, only three were positive for both species. The seroprevalence was similar in both sexes. Positive results were found in all age groups, but a higher rate was noticed in those aged 46 years and older (p<0.05). R. typhi was found to be more prevalent in rural areas of all islands, as well as in farmers., Conclusions: Our results confirm the presence of antibodies against the causative agents of murine typhus and Mediterranean spotted fever in the Canary Islands. Indirect data suggest that the detection of antibodies to R. conorii might be due to a cross-reaction between these species., (Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

A 1-year retrospective multicentre study was performed to identify factors influencing hospital length of stay (LOS) and mortality of patients (n = 3233) admitted to hospital because of community-acquired pneumonia (CAP). Pneumonia severity index (PSI) high-risk classes (IV and V), positive blood culture, admission to an intensive care unit (ICU), multi-lobar involvement and alcohol consumption were associated independently with prolonged LOS. Tobacco smoking was associated with a reduced LOS. The LOS varied markedly among centres. Only PSI high-risk class, admission to ICU and multi-lobar involvement were associated with early, late and global mortality. Positive blood cultures, antimicrobial therapy according to treatment guidelines and the establishment of an aetiological diagnosis were linked to reduced late and global mortality. These data suggest that early mortality associated with CAP is highly dependent on the clinical status of the patient at presentation. Conversely, late mortality seems to be associated more closely with clinical management factors; hence, an aetiological diagnosis and compliance with appropriate therapeutic guidelines have a significant influence on outcome.

Context: A prospective study has been conducted in order to known the prevalence and the type of intestinal parasitoses in a cohort of healthy Subsaharian immigrants that reached Gran Canaria along the year 2000., Methods: 348 fecal samples of 121 immigrants have been studied. In each patient a minimum of two samples and a maximum of three samples was studied. Each sample was evaluated through two techniques: visualization of a direct preparation dyed with Lugol and through the technique of concentration of Kato., Results: 23.1% of the patients presented pathogenic parasites in feces, being observed 2 parasites in 5 of the patients (17.8%). The geohelminths (Ancylostoma duodenale/Necator americanus, Ascaris lumbricoides, Trichuris trichiura and Strongyloides stercolaris) were the parasites more frequently found (87.9%). Specifically, the parasitosis found in the greatest number of participants was hookworm disease (44.8%). In this study the effectiveness of the evaluation of three feces samples is demonstrated in order to increase the percentage of diagnosed intestinal parasitoses. The visualization of a direct preparation dyed with Lugol permitted the diagnosis of 63.6% of the parasitoses, while the technique of Kato detected 56.6% of the helminth infections., Conclusions: The prevalence of geohelminths in the asymptomatic Subsaharian immigrant population is elevated. The complementary use of the microscopic study of a direct preparation dyed with Lugol and the technique of Kato increase the diagnostic performance.

The Aims of Our Study Were: (i) to know the seroprevalence of Coxiella burnetii infection in the Canary Islands, (ii) to evaluate its epidemiologic features and (iii) to compare the rates of seroprevalence using two different cut-offs (1:20 and 1:80) for the diagnosis of past infection., Methods: We analysed a representative sample of the canarian population. 662 sera were tested. For the detection of IgG and IgM antibodies against C. burnetii phase II antigens an immuofluorescence assay was used. The serologic screening for IgG detection begun with a 1:20 dilution. A titer of IgG > or = 1:80 along with a negative IgM were used as criteria for previous infection., Results: At an IgG antibody titer against C. burnetii of 1:80 as diagnostic for past infection, the observed global seroprevalence was 21.5%. If the cut-off used was 1:20, the observed prevalence increased up to 35.8% (p = 0.001). Significantly different seroprevalence rates were obtained at these different cut-offs when results were analysed for groups of age and socioeconomic status, but not for either the island of origin or for farmers., Conclusion: Our results strongly suggest that Coxiella burnetii infection is endemic in all the Canary Islands. Although it is more frequent in males above 30 years old, it do affect people of all ages, and thus it should be borne in mind in the face of any acute febrile syndrome.

Introduction: The aim of this study was to describe the clinical and epidemiologic features of Q fever in the southern area of the island of Gran Canaria (Spain)., Methods: We conducted a retrospective analysis of the clinical and epidemiological data of the cases of Q fever diagnosed by the Microbiology Laboratory of the Hospital Universitario Insular in Gran Canaria between 1998 and 2000. Antibodies against phase II Coxiella burnetii antigens were detected using an indirect immunofluorescence test. The diagnosis of acute Q fever was established by IgG titers > or = 1:320 and IgM titers > or = 1:80, or by seroconversion., Results: During the period of study 59 cases of acute Q fever were diagnosed, making an incidence of 5 cases/100,000 inhabitants/year. The seroprevalence (IgG > or = 1:80) in the patients for whom Q fever serology was requested during that period was 23.9%. Clinical and epidemiologic data were available for 40 patients. All were sporadic cases and 57% were hospitalized. The mean age of the patients was 40.6 6 13.3 years (range 20-74 years), 85% were males and 67.5% came from a rural background. The majority of cases (65%) clustered from April to July. The most frequent clinical presentation was an acute febrile process with elevated liver enzymes (87.5%). Pneumonia was infrequent (only three cases)., Conclusions: In our area Q fever is mainly manifested as an acute febrile illness with subclinical hepatic involvement. This fact and the small number of cases with pneumonia and chronic forms suggest the etiological involvement of C. burnetii strains different from those in other geographic areas.

Six quinolones were tested on 817 consecutive pneumococcal isolates for which ciprofloxacin MICs were high (> or =2 microg/ml); the isolates had been collected during two recent Spanish surveillance studies. For strains for which the ciprofloxacin MIC was >or =4 microg/ml, the MICs at which 90% of the isolates tested against gemifloxacin, moxifloxacin, gatifloxacin, sparfloxacin, levofloxacin, and ofloxacin were inhibited were 0.25, 1, 1, 1, 4 and 16 microg/ml, respectively, and the corresponding prevalences of resistance were 0, 1, 4.5, 9.5, 8.4 and 23%. The proportion of isolates for which the ciprofloxacin MIC is high has increased over time.

In this paper we describe a case in which acute renal colic was associated with elimination of multiple hyphal masses of Aspergillus flavus. Also, we reviewed the literature on similar cases and we found a similar pattern characterized by a marked male predominance, association with at least one underlying medical condition that predisposes to fungal infection, the presence of local symptoms resembling acute ureteral colic, and the absence of systemic manifestations. Moreover, our data suggest that Aspergillus balls must be suspected when a diabetic and intravenous drug user presents with acute renal colic and that non-obstructive renal aspergillosis may be initially treated with itraconazole., (Copyright 2001 The British Infection Society.)

Ten quinolone-resistant mutants of Citrobacter freundii, which were selected in vitro with fluoroquinolones from two clinical isolates, were studied. The parent isolates were susceptible to quinolones in spite of showing a single substitution in the GyrB (His-417 --> Leu). No change was observed in the outer membrane proteins or in the lipopolysaccharide in any of the ten mutants studied with respect to their parent isolates. The development of quinolone resistance in selected mutants was associated with the appearance of a substitution in the GyrA (Thr-83 --> Ile) in nine of the ten mutants plus enhanced active efflux in all of them.

Five quinolone-resistant strains were developed from a clinical Morganella morganii isolate (M1 strain) which was susceptible to nalidixic acid and fluoroquinolones. All five in vitro selected mutants showed diminished norfloxacin accumulation and two of them also decreased the expression of the AgO in the outer membrane lipopolysaccharide with respect to their parent strain and to the M. morganii NCTC-235 type strain. Likewise, the M1 strain did not express a 37-38 kDa protein and accumulated less norfloxacin than the M. morganii NCTC-235 strain. The decreased norfloxacin uptake in the five mutants compared with the M. morganii NCTC-235 strain was due to an enhanced proton-dependent active efflux plus a pre-existent decreased expression of a 37-38 kDa protein in the parent strain.

The use of 0.5% sodium dodecyl sulfate in polyacrylamide separation gels allowed the resolution in several bands of high-molecular-mass components in smooth lipopolysaccharide of bacterial outer membrane from Escherichia coli, Morganella morganii, Citrobacter freundii and Citrobacter diversus. With or without 0.1% SDS, however, such a result was not possible.

Eighteen quinolone-resistant isolates of Escherichia coli were selected by exposing ten clinical isolates to increasing concentrations of norfloxacin and lomefloxacin. The mutant isolates showed a multiple-antibiotic-resistance phenotype. All of them contained single mutations in gyrA consisting of the substitution of Ser-83-->Leu (n = 14), Val (n = 1) or Ala (n = 1) and the substitution of Asp-87-->Asn (n = 2). Only one concomitant mutation in parC (Ser-80-->Arg) was detected. Four parent isolates exhibited a single mutation in gyrA which required < or = 12 mg/L of norfloxacin to be inhibited. Fluoroquinolone resistance, in the 18 quinolone-resistant mutants, was a result of mutations affecting DNA gyrase plus decreased fluoroquinolone uptake. This latter mechanism of resistance was a combined effect of an absence of OmpF and an increase in active efflux in eight isolates, or an increased active efflux alone in the remaining ten selected mutants.

The effect of fluoroquinolones in Citrobacter freundii strains that results in a decreased expression of cephalosporin-hydrolysing beta-lactamases was studied. Resistance to broad-spectrum cephalosporins and penicillins in two C. freundii clinical isolates was associated with moderate production of chromosomal AmpC-type-beta-lactamase in addition to changes in the outer membrane proteins profile with respect to wild-type C. freundii strains. Ten quinolone-resistant mutants were derived from the two clinical isolates using increasing fluoroquinolone concentrations. The level of susceptibility to cephalosporins and meropenem of these 10 mutants was increased and was associated with a 3.6-32% diminution in the hydrolyzing activity of their periplasmic extracts containing beta-lactamases on cephaloridine as compared with those from their parent strains. Susceptibility to cephalosporins and meropenem, as well as the expression of chromosomal AmpC-type-beta-lactamase in C. freundii strains, was influenced by the exposure to quinolones.

Background: Keratitis by Acanthamoeba is a severe infectious complication which may be derived from the use and bad preservation of contact lens. This disease la increasingly more frequent and rapid diagnosis and treatment condition the posterior evolution of the disease., Patients and Methods: The cases of 2 contact lens waters who developed keratitis by Acanthamoeba are presented. The diagnostic methods and treatment are commented upon., Results: Keratitis by Acanthamoeba was diagnosed in 2 patients following analysis of corneal scrapings and of the saline solution used for lens maintenance. Trophozoites and cystes of this parasite were observed in all the samples processed. The evolution was good in the patient treated at 15 days after initiation of the symptoms. However, the evolution was very bad in the patient who delayed in initiating the amebicide treatment. Penetrating keratoplasty was performed in both patients., Conclusions: Specific treatment with derivates of propamidine implemented early may avoid severe ocular complications. As prophylaxis for contact lens users, it is recommended that the contact lens be maintained clean and correctly care for, and the use of home-made saline solutions which are easily contaminated by Acanthamoeba, should be avoided.

Background: The presence of surface antigen of hepatitis B (HBsAg) virus in serum from recently vaccinated adults has been scarcely investigated. In this work, after the detection by chance of seven HBsAg-positive patients on hemodialysis who reported recent hepatitis B vaccination, a prospective study was undertaken to verify the presence and duration of post-vacunal antigenemia., Patients and Methods: Nineteen non-selected patients on hemodialysis were followed for serologic markers of hepatitis B, after receiving a dose of the recombinant vaccine (Engerix B) according to their vaccination schedule. Enzyme-immunoassay techniques were used for the study of serologic markers, and the reactivity of HBsAg was confirmed by means of a neutralization assay with specific anti-HBs antibodies., Results: After the administration of one vaccine dose, 31.5% of patients were HBsAg positive at least once. Antigenemia was identified more frequently 2 to 4 days (83.3%) after immunization. In all cases antigenemia was transient and had cleared after 11 days of vaccination. The follow-up of serologic markers revealed the absence of infection with virus B. Only 16.6% of patients with transient antigenemia responded to vaccination (titer of anti-HBs > or = 10 mIU/ml), while the corresponding percentage in the group of HBsAg-negative patients was 69.2% (p < 0.05). All patients were HCV and HIV negative., Conclusions: A high frequency of post-vacunal antigenemia is reported in patients on hemodialysis, in absence of virus B infection as well as the possible relationship between the presence of transient antigenemia and the non-responder status.

Injection drug use (IDU) is one of the most significant risk factors for viral hepatitis (B, D and C) and human immunodeficiency virus (HIV) infection. However, there is little information about the risk of infection among non-injection drug users (non-IDUs). The present study was designed to perform several objectives: (a) to evaluate the prevalence of serological markers of hepatitis B, D, C virus and HIV in IDU and non-IDU patients; (b) to compare the prevalence of these markers between both groups; (c) to identify risk factors for HCV and HIV in this population; and (d) to correlate the presence of HCV and liver function. A total of 385 consecutive patients (122 IDUs and 263 non-IDUs), admitted to the Drug Dependency Treatment Unit at the Hospital Insular of Gran Canaria between 1993 to 1994, were included in the study. The serological markers of HBV, HDV, HCV and HIV were determined by ELISA and immunoblot methods. In all cases we also measured syphilis tests (RPR and FTAabs), serum aminotransferases and serum gammaglutamiltranspeptidase. Compared to the non-IDU, the IDU group presents a higher prevalence of antiHBc (55.0% vs. 20.7%, p < 0.0001), antiHCV (87.6% vs. 35.3%, p < 0.0001) and antiHIV (21.8% vs. 2.7%, p < 0.0001). There was no significant difference in RPR positivity (0.9% vs. 4.9%, p = 0.06). Delta infection was only detected in injection drug users, and the prevalence was low. Using logistic regression, the only risk factors associated with antiHCV positivity were injection drug addiction (OR: 9.2, 95% CI: 4.9-17.0) and antiHBc positivity (OR: 5.5, 95% CI: 3.0-9.9). Similarly, the associated risk factors for HIV were injection drug addiction (OR: 5.9, 95% CI: 2.3-15.0) and antiHBc positivity (OR: 3.8, 95% CI: 1.5-9.2). However, no correlation was found between antiHCV positive and antiHIV or between these markers and RPR positivity. Patients positive for antiHCV showed significant elevations in aspartate aminotransferase and alanine aminotransferase levels, when compared with patients negative for antiHCV: 65.0 vs. 39.2 U/l (p < 0.001) and 88.4 vs. 40.3 U/l (p < 0.001), respectively. We conclude that drug users have an elevated prevalence of HCV, HBV and HIV infection, even if drug use is only inhalated. On the other hand, the main risk factors associated with HCV and HIV are injection drug addiction and exposure to hepatitis B virus. Finally, in the study population, liver dysfunction is closely related to HCV infection.

Background: To assess the usefulness of an enzyme immuno-assay test for the diagnosis of two familial outbreaks of Fasciola hepatica parasitosis in the Zamora area, where watercress are a normal part of the diet., Patients and Methods: The microbiological diagnosis of two familial outbreaks of fascioliasis was analyzed, which included the search for eggs in feces by the Kato technique and two serologic tests, one screening test by indirect hemagglutination, and a confirmatory test by enzyme-immunoassay in 12 patients., Results: Five out of the six seropositive patients had eggs detected in their feces. To note that two of the patients with eosinophilia that excreted eggs--one asymptomatic and the other with abdominal pain--had a positive result in the EIA test only and with high titers., Conclusions: The EIA test is useful for the diagnosis and study of fascioliasis outbreaks to interpret the significance of low titers in the screening test in patients with eosinophilia.