Mechanisms of resistance to beta-lactam antibiotics amongst Pseudomonas aeruginosa isolates collected in the UK in 1993.

Antimicrobial resistance among 1991 Pseudomonas aeruginosa isolates collected at 24 UK hospitals during late 1993 was surveyed. Three-hundred and seventy-two of the isolates were resistant, or had reduced susceptibility, to some or all of azlocillin, carbenicillin, ceftazidime, imipenem and meropenem, and the mechanisms underlying their behaviour were examined. Only 13 isolates produced secondary beta-lactamases: six possessed PSE-1 or PSE-4 enzymes and seven had novel OXA enzyme types.

Resistance to extended-spectrum cephalosporins, caused by PER-1 beta-lactamase, in Salmonella typhimurium from Istanbul, Turkey.

Two Salmonella typhimurium isolates were studied, one as a representative from a series of neonatal meningitis cases treated at an Istanbul teaching hospital, the other from a gastro-enteritis case seen at a different Istanbul hospital. Both isolates were resistant to extended-spectrum cephalosporins, as well as penicillins, aminoglycosides and chloramphenicol. Cephalosporin resistance depended on production of PER-1 beta-lactamase, which is an extended-spectrum class A enzyme that is only distantly related to TEM and SHV enzymes, and which was previously known only from Pseudomonas aeruginosa isolates.

An update on glass-ionomer cements.

It has been claimed that glass-ionomer cements possess properties that could make them the "ideal' restorative material. In the light of current disquiet about the safety of dental amalgam, are glass-ionomer cements likely to become the replacement materials of choice?

Migration and Helicobacter pylori seroprevalence: Bangladeshi migrants in the U.K.

Helicobacter pylori, an infectious agent of worldwide public health importance, has higher seroprevalence in developing countries than in developed countries. We investigated whether Bangladeshi women, born in Bangladesh, have a greater H. pylori seroprevalence than Bangladeshi women born in the U.

The effect of barium sulphate on small bowel motility in man.

Objective: To investigate the effect of barium sulphate on small bowel motor activity.

Methods: Nine healthy male volunteers underwent two separate, ambulatory 24 h manometry studies. Jejunal motor activity was recorded during fasting and after ingestion of 300 ml volumes of barium, water or a glucose solution (1380 kJ).

Prevention of Helicobacter pylori infection.

A gastroenterologist, treating a patient with H. pylori, must decide whether the unit of treatment is only the ill individual, or the family, perhaps including close contacts. If it is the family and close contacts, is it all family members and contacts, or are there some ages, relationships, or clinical characteristics that increase the risk of transmission to the patient after successful treatment of their infection? In preventing reinfection, the available data suggest: the natural infectious dose has not been determined infection may occur from oral or faecal shedding children are more infectious than adults socio-economic factors are important in any comparison of infection rates food and water seem unlikely vehicles in the developed world travel in the third world may increase risk of infection seropositivity in adults predominantly reflects exposure in childhood infection is frequently with more than one strain reinfections are not more frequent in families with other members infected reinfections are infrequent with strains different from the original strain reinfection might be more frequent in developing countries no need for all family members to be treated to reduce reinfection rates.

Abnormal amniotic fetal antigen 2 concentrations in trisomy 18 and trisomy 21.

Fetal antigen 2 (FA-2) is a human protein, first identified in amniotic fluid, and shown to be identical to the aminopropeptide of the alpha 1 chain of collagen type I. It exists in several different size and charge forms. In the present study, FA-2 was measured in amniotic fluid using two different assays: a rocket line immunoelectrophoretic assay which measured total FA-2, and a radioimmunoassay which was specific for the high molecular mass forms of FA-2.

The use of GDA-J/F3 monoclonal antibody for the detection of dead spermatozoa (necrosperm) during semen analysis.

The distinction between immotile necrosperm (dead spermatozoa) and those with immotility due to other causes is of the utmost clinical importance. The supravital dyes currently used for the identification of necrosperm are not highly reliable or accurate. In this study, GDA-J/F3 monoclonal antibody (MoAb) which reacts with the fibrous sheath (FS) was used as a specific probe for the detection of necrosperm using indirect immunofluorescence (IIF).

The NHS reform programme: implications for dental public health and the community dental services.

The structure and funding of the National Health Service in the United Kingdom has undergone major changes in recent years. A survey was conducted among senior personnel working within the dental public health and the community dental services to identify their roles and responsibilities, their views on the effects of the changes, and the future opportunities and challenges. A response rate of 76 per cent was obtained using a postal questionnaire.

Neurogenic influences on contralateral responses during experimental rat monoarthritis.

Many inflammatory conditions show topographically precise symmetrical responses. In this study we assessed vascular and cellular responses of apparently normal knees following induction of monoarthritis on the opposite side. A strictly localised monoarthritis was induced in the right knee of experimental animals using intra-articular latex spheres.

Decision-making in surgery: splenectomy.

Interest in splenectomy is topical because of the need to develop protocols for the prevention of overwhelming systemic infections postsplenectomy. Partial splenectomy is possible in only a few patients undergoing splenectomy for trauma. In haematological disorders, total splenectomy is mandatory.

Effects of Porphyromonas gingivalis culture products on the morphology of peripheral blood polymorphonuclear leucocytes from periodontitis patients and healthy subjects.

The effects of Porphyromonas gingivalis culture supernatant from strain W50, its avirulent variant (W50/BE1) and sterile BM culture medium on the morphological changes in polymorphonuclear leucocytes (PMN) from 10 patients with periodontitis (3 juvenile periodontitis, 7 rapidly progressive periodontitis) were compared with those from 10 healthy controls. Large non-polar cells ( > 160 microns2) were increased in patients to 182.8% (p = 0.

Intra-articular pressure changes in rheumatoid and normal peripheral joints.

Objective: To investigate the intraarticular pressure (IAP) dynamics of a spectrum of joints in rheumatoid and normal subjects in order to determine whether a reperfusion event is likely to occur at these sites.

Methods: IAP was measured in the metacarpophalangeal (MCP) (n = 8), wrist (n = 8), ankle (n = 4), and elbow joints (n = 4) of rheumatoid subjects, in addition to the MCP (n = 8), wrist (n = 6), and ankle joints (n = 1) of normal healthy controls, using the hand held portable 295-1 Intra-Compartmental Pressure Monitor System (Stryker, UK).

Results: Resting IAP was positive in all rheumatoid joints, and subatmospheric or weakly atmospheric in normal subjects (p < 0.

Haemodynamic and metabolic effects in diabetic ketoacidosis in rats of treatment with sodium bicarbonate or a mixture of sodium bicarbonate and sodium carbonate.

To examine factors determining the haemodynamic and metabolic responses to treatment of diabetic ketoacidosis with alkali, groups of anaesthetised and ventilated rats with either diabetic ketoacidosis (mean arterial pH 6.86-6.96, mean arterial blood pressure 63-67 mm Hg) or hypovolaemic shock due to blood withdrawal (mean pHa 7.

Descending control of pain.

Thanks largely to the study of the brainstem nuclei that mediate stimulation analgesia, the involvement of the monoamines in the descending control of pain is now well established. The periaqueductal grey, the raphe nuclei (NRM and DRN) and the locus coeruleus are all key brainstem sites for the control of nociceptive transmission in the spinal cord. Although the initial emphasis was on 5-HT as the transmitter mediating this control at spinal levels, it is clear from more recent work that NA has an equally important part to play.

OXA-14, another extended-spectrum variant of OXA-10 (PSE-2) beta-lactamase from Pseudomonas aeruginosa.

Pseudomonas aeruginosa 455, isolated in Ankara, Turkey, produced a pI 6.2 beta-lactamase determined by plasmid pMLH53 and resisted all beta-lactams except carbapenems. This beta-lactamase, named OXA-14, corresponded to OXA-10 (PSE-2) except that aspartate replaced glycine at position 157 and thus is intermediate between OXA-10 and OXA-11, which has aspartate at position 157 and a further substitution at position 143.

Immunocytochemical detection of ornithine decarboxylase (ODC) in paraffin-embedded tissues as a possible prognostic indicator for oral lesions.

Intracellular levels of ornithine decarboxylase (ODC) are raised following mitogenic stimulus and in neoplasia. Because lesions of the oral cavity are often difficult to assess histologically, we have determined the value of immunocytochemical detection of ODC as a prognostic indicator in 74 routinely fixed and paraffin-embedded oral biopsies using peroxidase-antiperoxidase and immunogold-silver staining. The latter proved more sensitive, yielding positive reactions in 32 of 43 oral carcinomas (11/14 well differentiated, 16/21 moderately differentiated and 3/5 poorly differentiated) and 7/11 potentially malignant lesions, compared with 19/45 carcinomas and 1/15 potentially malignant lesions, by peroxidase anti-peroxidase.

The qualitative assessment of complete dentures produced by commercial dental laboratories.

Comprehensive criteria and simple methods of assessment have been developed for the evaluation of complete dentures supplied by commercial dental laboratories. One hundred laboratories in England and Wales were selected by random sampling. A single identical complete denture case was sent from general practice addresses to each of the selected laboratories and each of the laboratory stages evaluated according to specific criteria.

Sensory denervation with capsaicin attenuates inflammation and nociception in arthritic rats.

The relatively few studies that have investigated the effects of the nervous system on chronic joint disease have reported conflicting results. We have reassessed the effects of capsaicin on experimental polyarthritis with particular reference to the relationship between changes in nociception and changes in process and outcome measures of disease activity. Capsaicin pretreatment significantly attenuated both joint swelling and disease outcome as determined by quantitative radiology and histology.