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Abstract: Objectives: High-flow nasal oxygen (Optiflow™) is validated in paediatric intensive care but not in adults’ patients for severe hypoxemia. The aim of this study was to evaluate this oxygen system delivery in adults’ patients for postoperative hypoxemia after cardiac surgery. Study design: Prospective, open study for evaluation of medical practice. Patients and methods: Patients operated upon for cardiac surgery with immediate postoperative hypoxemia characterized by SpO2 <0.96 with 50% oxygen with a Venturi mask were treated with the high-flow nasal oxygen system (O group) when it was available or with the classical high-flow oxygen face mask (M group). Gas exchanges were measured at the end of the surgery, at the beginning of the treatment and 1 hour, 6 hours after the inclusion and at day 1 and 2 post-treatment. Parameters studied were: duration of hypoxemia, duration of ICU stay, postoperative pneumonia occurrence, requirement of re-intubation, non invasive ventilation and catecholamine. Tolerance was evaluated with measurement of pain (visual scale), satisfaction (visual scale), and dryness of mouth. Results: Forty patients were included, 19 in group O, 21 in group M. Patient''s characteristics did not differ between the two groups before treatment. There were no significant differences between groups for duration of hypoxemia (3.8±2.2 days in O group versus 4.3±2.3 days in M group), duration of hypoxemia, duration of ICU stay, postoperative pneumonia occurrence, requirement of re-intubation, non invasive ventilation and catecholamine. Pain was not significantly different between groups, satisfaction was better (P <0.001) and mouth drier (P <0.001) in group O than in group M. Conclusion: These results give good arguments for an improvement in gas exchange and better tolerance of high-flow nasal oxygen (Optiflow™) versus classical high-flow oxygen face mask in postoperative cardiac patients. These results must be confirmed by a randomised study with a larger population. [Copyright &y& Elsevier]

A specific PCR assay based on unique sequences of the rrs genes (16S rRNA) of Mycoplasma conjunctivae was developed for direct detection and identification of this pathogen from clinical material. DNA from eye swabs was amplified after a simple lysis step by either a single PCR with the M. conjunctivae specific primer pair McoR1 and McoF1, or by a nested PCR with the Mycoplasma genus specific primer pair MOLIGEN1-L and 16UNI-R in the first step and McoR1 and McoF1 in the second step. The specificity of the primer pair McoR1 and McoF1 was verified with purified DNA from the type strain, from 17 field isolates of M. conjunctivae and from several Mollicutes which are phylogenetically related to M. conjunctivae or which can be isolated from the same host animals. This method identified mycoplasma isolates from goat, sheep, ibex and chamois originating from different countries as M. conjunctivae. No cross amplifications with other mycoplasmas which are related to M. conjunctivae were observed. Eye swab samples containing known numbers of M. conjunctivae cells were analysed after direct lysis of the material. The detection level was estimated to be 20 cells per swab when the nested PCR procedure was used and 2 × 105 by the single PCR method. In an experimental infection model of sheep, the nested PCR method for detection of M. conjunctivae gave results which were comparable to mycoplasmal culture. These are the implications for diagnostic purposes: M. conjunctivae isolates can be identified by the one-step PCR method, whereas for detection and identification of M. conjunctivae in clinical material the two-step method should be used (higher sensitivity). [ABSTRACT FROM AUTHOR]

Potent immunogenicity of certain extracellular `chymotrypsin-like' enzymes of Micropolyspora faeni are demonstrated. One of them, Enzyme 1 seems particularly active in stimulating the formation of precipitins after intratracheal exposure in rabbits. Man or cattle exposed naturally to mouldy hay, either with or without clinical farmer's lung symptoms show a rather constant immunological reaction against Enzyme 1 and partly also against others of the same group. The detection of specific precipitins against these enzymes is not likely to improve the diagnostic value of the standard farmer's lung serology. Possible implications of these proteolytic enzymes in the pathogenesis of farmer's lung are discussed. [ABSTRACT FROM AUTHOR]

Rabbits were exposed intratracheally to enzyme 1, a highly immunogenic esterase isolated from Micropolyspora faeni. A single exposure to active enzyme 1 induced no histologically or immuno-histochemically detectable changes in the lungs of experimental animals, while signs of focal interstitial and perivascular inflammatory reactions were evident following a course of three exposures to the enzyme. Interstitial pneumonia with characteristic generalized vasculitis and perivasculitis was produced following seven or nine inoculations. An enzymatically inactive preparation of enzyme 1, even by repeated administration, proved ineffective in eliciting pneumonia. Intracellular antigen within macrophages/histiocytes was demonstrated in the lungs of all experimental animals, including those which had been exposed to inhibited enzyme. Repeated exposure to the enzymatically active preparation resulted in the deposition of immunoglobulin and complement in association with vascular endothelia and in the walls of small- and medium- sized blood vessels; both immunoglobulin and complement could also he demonstrated within macrophages/histiocytes. On the basis of these findings it is concluded that (1) Farmer's lung- like interstitial pneumonia may be produced in rabbits by exposure to a purified, enzymatically active derivative of M. facni, (2) an important pathogenic principle of the disease may consist in the rapid vascular deposition of immune complexes (type III reaction), and (3) damage by direct enzyme action may prove to contribute significantly in eliciting tissue damage by (an) ancillary mechanism(s) not yet understood. [ABSTRACT FROM AUTHOR]

Abstract: The present study aimed to improve the microbiological quality of the milk, from the cow’s udder to the selling point by container washing and disinfecting. The total counts (TC), Enterobacteriaceae counts (EBC) were used as quality indicators. The results showed a significant decrease of milk flora at the selling point, from 1.6×107 ±1.3×107 (control) to 4.8×105 ±0,8×107 (intervention) colony forming units per ml (cfu ml−1) for TC and 1.2×106 ±1.1×106 (control) to 0.9×104 ±1.1×104 (intervention) cfu ml−1 for EBC. The study suggests that in milk production area, besides udder infection and water quality, hygiene behaviour with respect to hand washing, container’s cleaning and disinfection are the key areas that remain of relevance to milk hygiene intervention. [Copyright &y& Elsevier]

As a part of a research-and-action partnership between public health and veterinary medicine, the relationships between the seroprevalences of brucellosis and Q-fever in humans and livestock were evaluated in three nomadic communities of Chad (Fulani cattle breeders, and Arab camel and cattle breeders). Nomad camps were visited between April 1999 and April 2000. A total of 860 human and 1637 animal sera were tested for antibodies against Brucella spp., and 368 human and 613 animal sera for Coxiella burnetii. The same indirect ELISA was used for livestock and human sera, and the test characteristics for its use on human sera were evaluated. Twenty-eight people were seropositive for brucellosis (seroprevalence 3.8%). Brucella seroprevalence was higher in cattle (7%) than other livestock, and brucellosis seropositivity was a significant factor for abortion in cattle (OR=2.8). No correlation was found between human brucellosis serostatus and camp proportions of seropositive animals.Q-fever-seropositive blood samples were taken from 11 Arab camel and 4 Arab cattle breeders (seroprevalence 1%). Being a camel breeder was associated with Q-fever seropositivity in humans (OR=9). Camels had the highest Q-fever seroprevalence (80%) among livestock species.Although there was high-risk human behaviour for the acquisition of brucellosis and Q-fever from livestock through raw-milk consumption (98%) and contact with placentas of livestock (62%), we concluded that seroprevalences in humans were relatively low (likely due to limited active foci in livestock). [Copyright &y& Elsevier]

The microbiological quality of raw cows’ milk, taken at different intervals from the udder to the selling point in Bamako was studied. Prior to taking the milk samples, each container and all the related material used were flushed with sterile water and bacteriological determination were made. A strong increase in the total count (TC) of bacteria was observed during transport from the farm to the market (107 colony forming unit per ml (CFU ml−1)). The main indicators considered were TC, Enterobacteriaceae and Staphylococcus aureus. The milk containers of the farmer and the milk vendor played a major role in the increase in the milk flora that occurred during transport from the farm to the selling points. [Copyright &y& Elsevier]