Utilidad de la detección del ganglio centinela en el tratamiento y la estadificación del carcinoma de cérvix uterino inicial

OBJECTIVE

The aim of this study was to evaluate the usefulness of intraoperative sentinel node (SN) detection in patients with initial cervix cancer.

PATIENTS AND METHODS

Lymphoscintigraphy and intraoperative SN detection was performed in 17 patients with initial cervix cancer who we going to have a radical laparoscopic hysterectomy and pelvic lymphadenectomy. Conization was performed in 4/17. The day before surgery, an injection of 111 MBq 99mtechnetium nanocolloid around the primary tumour and a subsequent lymphoscintigraphy were carried out. Blue dye was injected at the same location intraoperatively. A laparoscopic gamma probe was used to identify SNs.

RESULTS

SNs were successfully localized using a combination of radiocolloid and blue dye in 16/17 patients (detection rate 94 %). The detection rate only using blue dye technique decreases to 71 % (12/17) and it reaches an 82 % (14/17) if we avoid the blue dye injection. In 3 cases, there was no migration in lymphoscintigraphy and in one of the three SN could not be detected. Thirty-three SNs were identified (1.9 nodes/patient). The most frequent location was left external iliac nodal group (13 nodes: 39 %). SNs were identified in regions that are not included in usual lymphadenectomy: right parametrium (2 sentinel nodes, one of them in the retrouterine region), and interiliac (2 SNs). In all four patients with previous conization SNs were identified (detection rate 100 %).

CONCLUSIONS

The rate of SN detection combining lymphoscintigraphy with gamma probe and blue dye is 82 %. The use of blue dye allows increasing this rate to 94 % in those cases which migration was not seen or when the SN is placed near the injection site. The SN technique offers the possibility to find SNs in regions not included in usual lymphadenectomy.

Stress proteins of Clostridium perfringens type A immunoreact with antiserum from rabbits infected with gas gangrene

Various stressors were used to induce stress proteins in Clostridium perfringens. Cultures of C. perfringens FD-1041 were subjected to cold shock (28 degrees C for 1 h), acid shock (pH 4.5 for 30 min), or heat shock (50 degrees C for 30 min). Cells were lysed and protein samples were analyzed by immunoblotting with antiserum derived from rabbits suffering from gas gangrene. Eight cold shock proteins (approximate Mr 101, 82, 70, 37, 22, 12, 10 and 6 kDa) and also eight heat shock proteins (approximate Mr 101, 82, 70, 27, 22, 16, 12 and 10 kDa) were immunoreactive with the serum. No immunoreactive proteins were detected in samples subjected to acid shock proteins and purified DnaK protein was also non-immunoreactive with the serum. These immunogenic stress proteins may be important in regulating diseases caused by C. perfringens. Such proteins could be involved in cell survival mechanisms, serve as targets during infection, or play a role in recognition of the bacteria by the host.

Relationship between the effects of stress induced by human bile juice and acid treatment in Vibrio cholerae

The effects of low pH and human bile juice on Vibrio cholerae were investigated. A mild stress condition (exposure to acid shock at pH 5.5 or exposure to 3 mg of bile per ml for 20 min) slightly decreased (by < or = 1 log unit) V. cholerae cell viability. However, these treatments induced tolerance to subsequent exposures to more severe stress. In the O1 strain, four proteins were induced in response to acid shock (ca. 101, 94, 90, and 75 kDa), whereas only one protein (ca. 101 kDa) was induced in response to acid shock in the O139 strain. Eleven proteins were induced in response to bile shock in the O1 strain (ca. 106, 103, 101, 96, 88, 86, 84, 80, 66, 56, and 46 kDa), whereas only one protein was induced in response to bile shock in the O139 strain (ca. 88 kDa). V. cholerae O1 and O139 cells that had been preexposed to mild acid shock were twofold more resistant to pH 4.5 (with times required to inactivate 90% of the cell population [D-values] of 59 to 73 min) than were control cells (with D-values of 24 to 27 min). Likewise, cells that were preexposed to mild bile shock (3 mg/ml) were almost twofold more tolerant of severe bile shock (30 mg/ml; D-values, 68 to 87 min) than were control cells (with D-values of 37 to 43 min). These protective effects persisted for at least 1 h after the initial shock but were abolished when chloramphenicol was added to the culture during the shock. Cells preexposed to acid shock exhibited cross-protection against subsequent bile shock. However, cells preexposed to bile shock exhibited no changes in acid tolerance. Bile shock induced a modest reduction (0 to 20%) in enterotoxin production in V. cholerae, whereas acid shock had no effect on enterotoxin levels. Adaptation to acid and bile juice and protection against bile shock in response to preexposure to acid shock would be predicted to enhance the survival of V. cholerae in hosts and in foods. Thus, these adaptations may play an important role in the development of cholera disease.

[Bone metabolism alterations after kidney transplantation]

Early after renal transplantation (RT) a rapid decrease in bone mineral density at the lumbar spine, femoral neck, and femoral shaft has been documented. In addition, an appreciable proportion of patients still remain losing bone late after RT. As a consequence, RT patients are at a high risk of bone fractures as compared to general population. Most fractures involve appendicular skeleton, particularly the feet and ankles, and the diabetic patient is at increased risk of fractures. Thus, early institution of preventive measures and treatment of established osteoporosis are central. The major cause of post-transplantation bone loss is corticosteroid treatment, and this should be used at the lower dose compatible with graft survival. Preexisting hyperparathyroidism also affects the early cancellous bone loss at the spine, and post-transplantation bone loss reflects variable individual susceptibility, resembling the polygenic determination of bone mineral density in general. Clinical trials have demonstrated that bisphosphonates or vitamin D plus calcium supplementation, prevent post-transplantation bone loss during the first 6-12 months. However, their role in preventing bone fractures has not been proven. Finally, recommendations for management, prevention and treatment, are summarized.

Diagnosis and treatment of presumed STIs at Mexican pharmacies: survey results from a random sample of Mexico City pharmacy attendants

OBJECTIVES

People in developing countries often seek medical advice for common ailments from pharmacies. As one example, pharmacists routinely diagnose and treat symptomatic sexually transmitted infections (STIs). We aimed to assess the quality of advice provided in Mexico City pharmacies by presenting hypothetical STI related syndromes and recording pharmacy attendants' suggested diagnoses and treatments.

METHODS

We interviewed the first available attendant in each of a 5% random sample of Mexico City's pharmacies. We inquired about the training, age, and experience of the attendant and about the typical number of clients coming for treatment of suspected STIs. After considering three hypothetical case studies, attendants recommended diagnoses, treatments, and, sometimes, physician follow up.

RESULTS

Most Mexico City "pharmacists" are actually clerks, with trained pharmacists rarely available on the premises. The average pharmacy attendant was 32 years old, with a median of 5 years' experience at that pharmacy, but very limited (if any) training. 62% reported seeing 10 or more clients with genital or vaginal infections per month. Depending on the case study, attendants provided appropriate diagnoses in 0-12% of cases, recommended appropriate treatments in 12-16% of cases, and suggested physician follow up for 26-67% of cases.

CONCLUSIONS

In general, surveyed pharmacy personnel were unable to diagnose accurately or offer appropriate treatment advice when presented with classic, common STI symptoms. Given the volume of clients seeking advice from this source, training pharmacy attendants could significantly help to reduce the burden of disease associated with STIs in Mexico City.

Presumptive infection of a total hip prosthesis by Mycobacterium tuberculosis: a case report

Infection of a total hip prosthesis by Mycobacterium tuberculosis (MT) is an uncommon complication. We report a patient with septic loosening of a total hip prosthesis with a presumptive diagnosis of MT infection. His previous history was negative to any form of tuberculosis, and there was no evidence of a primary focus on the radiological study of the chest. He was diagnosed initially as presenting aseptic loosening and revision surgery was performed. Six months after surgery, septic loosening was diagnosed. The prosthesis was then removed. The histological study showed caseum granulomas and acid-fast bacilli, and routine cultures of the synovial fluid were negative. Since only a positive Löwenstein culture would have confirmed the diagnosis with certainty, a presumptive diagnosis of MR infection was made based on the findings in the histological study. Tuberculostatic treatment was administered for 9 months. At six years follow-up no signs of infection are present, neither by clinical or radiological criteria.

Absence of hepatitis C virus transmission in a prospective cohort of heterosexual serodiscordant couples

OBJECTIVE

To analyse hepatitis C virus (HCV) transmission in a cohort of heterosexual couples who are discordant both for HIV and for HCV.

METHODS

We followed an open cohort of 171 people, 152 women and 19 men, who were not initially infected by either HIV or HCV, and whose steady heterosexual partner presented antibodies to both viruses (index case). Other risk exposures were excluded. Every 6 months clinical, epidemiological, and risk behaviour information was collected, and antibodies to both viruses were determined.

RESULTS

During 529 person years of follow up more than 40 000 vaginal or anal penetrations were recorded. 74 partners (43.3%) had vaginal and/or anal intercourse without condoms with the index case; another 15.8%, who always used condoms, declared breaking or slipping episodes during intercourse; and another 22.2% had unprotected orogenital exposures. During the follow up, over 5800 unprotected vaginal and anal contacts with the index case were estimated, as well as more than 25 000 unprotected orogenital contacts. 31 women became pregnant (two were index cases), and seroconversion to HIV occurred for one woman (1.7 per 10 000 unprotected contacts; 95% CI, 0 to 9.5), but there was no seroconversion to HCV (95% CI, 0-6.3 per 10 000 unprotected contacts).

CONCLUSION

These results are consistent with a low or null transmissibility of HCV in heterosexual relations, even when the index case is HIV co-infected.

[Somatostatin receptor scintigraphy. When would a SPECT study be performed?]

Somatostatin receptor scintigraphy has become an essential tool in the treatment planning of patients with carcinoid tumor (CaT) and pancreatic neuroendocrine tumors (PNET). However, the contribution of SPECT images in the diagnosis and staging of these tumors has not been well established.

OBJECTIVE

1) To find out if SPECT improves the sensitivity of planar imaging and adds any value to tumor diagnosis, and 2) To determine under which circumstances SPECT images must be obtained.

MATERIAL AND METHODS

We have evaluated 49 patients, 26 females and 23 males, using both planar and SPECT 111In-DTPAOC images. The patients were classified into three groups according to their clinical indication: Group A: Indolent symptoms of CaT or PNET (n = 9); Group B: Known or functioning CaT or PNET tumors (n = 22); Group C: Post-surgical follow-up (n = 18). The total number of SPECT studies were 51 (37 abdomen, 13 thorax and 1 brain). In all cases SPECT was performed 24 hours after 111In-DTPAOC injection. Scintigraphic images were compared with surgical findings in 17 patients and with a synthesis of biochemical, clinical and CT findings in the other patients.

RESULTS

16 primary lesions were detected with planar images whereas SPECT detected 18. The two tumors detected only by SPECT were a bronchial CaT and an insulinoma located in the pancreatic tail. Planar and SPECT image sensitivities were 66.6% and 75% respectively. Twenty one patients developed metastatic disease. Sensitivities of planar and SPECT images for metastases were 76.1% and 90.4% respectively. Furthermore, SPECT helps planar images in the evaluation of six patients with uncertain images (lesions with low receptor density or with an uncertain scintigraphic localization). Therefore, in 15.6% of patients with primary or metastatic tumors, planar images were normal whereas SPECT was abnormal and SPECT provided an added value in 21.8% of the studies with abnormal planar images.

CONCLUSIONS

We recommend the use of SPECT images in: 1) Patients with specific functional clinical syndrome or with a known CaT or PNET and normal planar images. 2) When planar images are abnormal only in primary tumor. 3) In order to confirm the absence of other metastases in patients with known liver metastases. 4) In order to enhance the detection of lesions with low receptor density and uncertain planar images and 5) In order to determine exactly the anatomic location of some lesions

Textile dyeing wastewater treatment in a sequencing batch reactor system

This study was undertaken to examine the feasibility of treating biologically textile wastewater for organic carbon removal. The study was conducted over a lab scale SBR equipped with an in-house developed data acquisition and control software. From monitored operation of SBR and dissolved oxygen values, together with a simple compressed air ON/OFF control scheme, on-line Oxygen Uptake Rate (OUR) profiles during aerobic reaction periods were obtained. Due to the high variability of wastewater characteristics, periodical analyses of textile wastewater were conducted and thus characterized for pH, conductivity, total and volatile solids, COD, ammonia, and TKN. After an initial period of activated sludge adaptation to textile wastewater, the SBR was operated at step-feed strategy to reduce the effluent biodegradable matter presents in the wastewater by SBR water change ratio modification and feeding strategy.

[HIV prevalence among homosexual and bisexual men in Spain, 1992-2000]

BACKGROUND

Our purpose was to describe the time trend in HIV seroprevalence among homo/ bisexual men.

SUBJECTS AND METHOD

We analyzed 9,383 homo/ bisexual men who had a first voluntary test for HIV in 10 Spanish clinics from 1992 to 2000.

RESULTS

HIV prevalence decreased from 20.3% in 1992 to 8.4% in 2000. In the multivariate analysis this decline appeared independently associated with the testing year and the birth cohort.

CONCLUSIONS

New generations of voluntarily tested homo/bisexual men are less infected by HIV, but it is yet necessary to intensify the prevention programs.

Inhibition of growth, enterotoxin production, and spore formation of Clostridium perfringens by extracts of medicinal plants

The extracts of 14 plants used in the traditional medicine of Mexico were evaluated for their effects on the growth, spore formation, and enterotoxin production of Clostridium perfringens type A. The extracts of Psidium guajava L., Haemotoxylon brasiletto, and Euphobia prostata were the most effective inhibitors of growth, spore formation, and enterotoxin production. No enterotoxins were detected when extracts were added to the media at less than the MIC for growth.

[Diffusion-weighted magnetic resonance in deep cerebral venous thrombosis]

Changes in the apparent diffusion coefficient (ADC) are well established in acute ischemic stroke of arterial origin. However, ADC behaviour and its prognostic significance in cerebral venous thrombosis (CVT) are not fully understood. Diffusion-weighted imaging (DWI) findings in a 34-year old woman with deep cerebral venous thrombosis are described. Recent literature concerning DWI and cerebral venous thrombosis is also reviewed. A MRI performed within 7 hours from onset revealed hyperintensities in deep grey matter bilaterally (FLAIR/T2), without changes in ADC maps, suggesting vasogenic edema. After anticoagulation a new MRA disclosed complete recanalization of venous thrombosis. Despite her good clinical outcome the MRI showed hemorrhagic lesions suggesting venous infarct. Lesions detected in acute CVT with DWI may have normal ADC values. There is no good correlation between the acute ADC values and clinical and radiological evolution. The prognostic value of ADC in the acute phase of CVT remains unsettled.

Verotoxin-producing Escherichia coli (VTEC), enteropathogenic E. coli (EPEC) and necrotoxigenic E. coli (NTEC) isolated from healthy cattle in Spain

AIMS

To determine the prevalence and characteristics of verotoxigenic Escherichia coli (VTEC), enteropathogenic E. coli (EPEC) and necrotoxigenic E. coli (NTEC) in healthy cattle.

METHODS AND RESULTS

Faecal samples from 412 healthy cattle were screened for the presence of VTEC, EPEC and NTEC. Four isolates from each sample were studied. VTEC, EPEC and NTEC were isolated in 8.7%, 8.2% and 9.9% of the animals, respectively. VTEC and NTEC were isolated more frequently from calves and heifers than from adults. Seventy (4.2%), 69 (4.2%) and 74 (4.5%) of the 1648 E. coli isolates were VTEC, EPEC and NTEC, respectively. Seventeen (24.3%) of the VTEC strains were eae-positive. Thirty-six (51.4%) of VTEC strains belonged to E. coli serogroups associated with haemorrhagic colitis and haemolytic uraemic syndrome in humans. The serogroups most prevalent among the EPEC strains were O10, O26, O71, O145 and O156.

CONCLUSIONS

Healthy cattle are a reservoir of VTEC, EPEC and NTEC.

SIGNIFICANCE AND IMPACT OF THE STUDY

Although most of the VTEC strains were eae-negative, a high percentage of VTEC strains belonged to serogroups associated with severe disease in humans.

Factors influencing HIV progression in a seroconverter cohort in Madrid from 1985 to 1999

OBJECTIVE

To study HIV progression from seroconversion over a 15 year period and measure the population effectiveness of highly active antiretroviral therapy (HAART).

METHODS

A cohort study of people with well documented dates of seroconversion. Cumulative risk of AIDS and death were calculated by extended Kaplan-Meier allowing for late entry. Cox proportional hazards models were used to study variables associated with HIV progression. To assess the impact of HAART, calendar time was divided in three periods; before 1992, 1992-6, and 1997-9.

RESULTS

From January 1985 to May 2000, 226 seroconverters were identified. The median seroconversion interval was 11 months, median seroconversion date was March 1993. 202 (89%) were men, 76% of whom were homo/bisexual. A 66% reduction in progression to AIDS was observed in 1997-9 compared to 1992-96 (HR 0.34 95% CI: 0.16 to 0.70). People with primary education appeared to have faster progression to AIDS compared to those with university studies (HR 2.69 95%CI: 1.17 to 6.16). An 82% reduction in mortality from HIV seroconversion was observed in 1997-9 (HR 0.18 95% CI: 0.05 to 0.68) compared to 1992-6. Progression to death for people with primary education was twice as fast as for those with university education (p 0.0007). People without confirmation of an HIV negative test had faster progression (HR 4.47 95% CI: 1.18 to 16.92).

CONCLUSIONS

The reduction in progression to AIDS and death from seroconversion from 1992-6 to 1997-9 in Madrid is likely to be attributable to HAART. HIV progression was faster in subjects with primary education; better educational level may be associated with better adherence to medication.

The use of proximal femoral allografts in revision total hip arthroplasty

The implant of a proximal femoral structural allograft is one of the possibilities to restore circumferential defects of multiply revised total hip arthroplasties. A review of 7 patients who underwent proximal femoral reconstruction with an allograft-prosthesis composite to restore bone loss in revision hip replacements is presented. The average follow-up period was 50.2 months. Two patients developed an infection and in one case an instability of the prosthesis appeared. Incorporation in the remaining 5 cases was/achieved in an average period of 8.2 months. Neither fractures nor high rate of resorption appeared in our series. The majority of patients have improved in the functional assessment. Despite the rate of complications, structural femoral allografts can be used with success in this difficult challenge of reconstructing major segmental bone loss of the proximal femur in revision hip surgery.

Lipomatous melanocytic nevomatosis

Giant congenital melanocytic nevi (GCMN) are rare and occur in about one out of every 200,000-500,000 births. Their importance resides in the aesthetic alteration they produce and in the possibility of malignant transformation or in their association with nevi in the central nervous system as a distinctive syndrome: neurocutaneous melanoblastosis or nevomatosis, due to the fact that nervous system lesions are produced by infiltration of nevus cells. We present here a patient with a combination of GCMN with an outstanding lipomatosis located on the same area.

Long-term results of hemipelvic allograft: Report of four cases

Reconstruction after the excision of pelvic tumors involving the pelvic ring implies difficult problems. Restoration of the function is difficult and an allograft can be one of the possible solutions. Pelvic allograft is recommended by many authors to reconstruct the pelvic ring following extensive resections of bone tumors. Between 1988 and 1989, we performed hemipelvic resection and allograft reconstruction in 4 patients with pelvic sarcomas. The mean age was 42.3 years (range 38-48), consists of 3 male and 1 female. One case developed an infection and one case showed recurrence, both responding to surgical treatment. Outcome in those cases in which surgery was curative to the primary tumor was satisfactory at 10 years follow-up, with a mean total Enneking score of 25.3 (range 24-27) and a good functional result in Merlé D'Aubigne functional score. Despite the limited number of cases presented, our results added to the reported results in the literature led us to consider that allografts are valuable in pelvic reconstructions after en-bloc resections for bone tumors.

Oral candidiasis as a clinical marker related to viral load, CD4 lymphocyte count and CD4 lymphocyte percentage in HIV-infected patients

BACKGROUND

High viral load is currently considered to be one of the main indicators of the progression of HIV-induced immunodepression, but few studies have analysed its relationship to the presence of oral candidiasis (OC). The aim of this cross-sectional study is to analyse the relationship between viral load, total CD4 lymphocyte count, and percentage of CD4 lymphocytes to the occurrence of OC.

METHODS

The present cross-sectional study included 156 HIV-infected patients seen at a clinic for sexually transmitted diseases and HIV. We assessed the presence or absence of OC, and microbiological samples were obtained from the palatine mucosa and dorsal tongue for a smear stained with KOH (potassium hydroxide) and culture on Sabouraud's dextrose agar in all patients. Viral load was determined by quantification of viral RNA in peripheral blood with a minimum detectable level of 500 RNA copies/ml. CD4+ counts/CD4+ percentage were categorized as <200/<14%, 200-499/14-28%, and >500/>29%, and HIV viral loads were categorized as <500, 500-10,000, >10,000 copies/ml.

RESULTS

Thirty-eight percent (37.8%) of the patients had OC. Patients with CD4+ lymphocyte counts below 200 x 10(6)/l and CD4+ percentages below 14% showed a significantly higher frequency of OC (57.9% and 48.0%, respectively). Patients with a viral load over 10,000 copies/ml also had OC more frequently (44.8%). In the multiple logistic regression analysis, OC showed a statistically significant association with high viral load [>10,000 vs <500, odds ratio (OR)=11.4], low percentage of CD4+ lymphocytes (<14% vs >28%, OR=5), and injection drug use (IDU vs heterosexual transmission, OR=10.2). In HIV-infected patients, high viral load was associated with more frequent OC, regardless of CD4+ lymphocyte level.

CONCLUSIONS

These findings suggest that oral candidiasis could be a useful clinical marker of patients with high viral load. In view of these results, emphasis should be placed on the importance of systematic examination of the oral cavity in all medical follow-up examinations of HIV-infected patients.

Authentication of Galician (N.W. Spain) quality brand potatoes using metal analysis. Classical pattern recognition techniques versus a new vector quantization-based classification procedure

The objective of this work was to develop a classification system in order to confirm the authenticity of Galician potatoes with a Certified Brand of Origin and Quality (CBOQ) and to differentiate them from other potatoes that did not have this quality brand. Elemental analysis (K, Na, Rb, Li, Zn, Fe, Mn, Cu, Mg and Ca) of potatoes was performed by atomic spectroscopy in 307 samples belonging to two categories, CBOQ and Non-CBOQ potatoes. The 307 x 10 data set was evaluated employing multivariate chemometric techniques, such as cluster analysis and principal component analysis in order to perform a preliminary study of the data structure. Different classification systems for the two categories on the basis of the chemical data were obtained applying several commonly supervised pattern recognition procedures [such as linear discriminant analysis, K-nearest neighbours (KNN), soft independent modelling of class analogy and multilayer feed-forward neural networks]. In spite of the fact that some of these classification methods produced satisfactory results, the particular data distribution in the 10-dimensional space led to the proposal of a new vector quantization-based classification procedure (VQBCP). The results achieved with this new approach (percentages of recognition and prediction abilities > 97%) were better than those attained by KNN and can be compared advantageously with those provided by LDA (linear discriminant analysis), SIMCA (soft independent modelling of class analogy) and MLF-ANN (multilayer feed-forward neural networks). The new VQBCP demonstrated good performance by carrying out adequate classifications in a data set in which the classes are subgrouped. The metal profiles of potatoes provided sufficient information to enable classification criteria to be developed for classifying samples on the basis of their origin and brand.

Carpal tunnel syndrome: usefulness of sonography

The aim of this study was to evaluate sonographic signs described for carpal tunnel syndrome (CTS). Sixty-four wrists from 40 patients with CTS confirmed by electromyography, and 42 wrists from 24 healthy individuals, were examined using sonography. Cross-sectional area, flattening ratio in proximal, middle and distal segments of the carpal median nerve and bowing of the flexor retinaculum were measured. The accuracies of the sonographic diagnostic criteria for CTS were assessed using receiver-operating-characteristic (ROC) analytical techniques. A significant swelling of the median nerve was observed at the proximal (p < 0.001), middle (p < 0.0001) and distal (p< 0.0001) segments and a significant bowing of the flexor retinaculum in CTS patients with respect to healthy subjects. No significant differences were found in the mean value of flattening ratio between the groups. The sensitivity, specificity, positive predictive value, and the negative predictive value were 73.4, 57.1, 72.3 and 58.5%, respectively, in the proximal and middle segments; 75, 57.1, 72.7 and 60% in the distal segment for areas greater than 11 mm2: and 81.3, 64.3, 77.6 and 69.2% for the bowing of the flexor retinaculum greater than 2.5 mm. All sonographic criteria were found in 34 CTS patients (53.1%) and none in 3 patients. Sonography may be useful in the diagnosis of CTS. The most reliable sign was increased bowing of the flexor retinaculum and cross-sectional area of median nerve with specificity close to 60%.

Microbiological condition of ground meat retailed in Monterrey, Mexico

Eighty-eight samples of ground meat were randomly collected from retail stores in the metropolitan area of Monterrey, Mexico, and were analyzed for microbial contamination. Methods were those recommended by the Mexican regulation and/or the U.S. Food and Drug Administration. Over 75% of the samples contained > 10(5) total mesophilic microorganisms per g, and over 40% had >10(6) total coliforms per g. Fecal coliforms were present in most samples. Staphylococcus aureus was detected in 2.3% of the samples, Salmonella spp. in 11.4%, Listeria spp. in 62%, and L. monocytogenes in 16%. Escherichia coli was detected in 76% of samples, but none was serotype O157:H7. Shigella spp. was not found in any sample. Fusarium spp. and Mucor spp. were detected in 3.4% of the samples, and low levels of yeast in 93%. The microbiological quality of the ground meat analyzed was unsatisfactory, and the product could be an important cause of food poisoning.

[Behcet's disease: retrospective study]

BACKGROUND

Since the criteria for the diagnosis of Behçet's disease was established several isolated cases have been reported to the literature with clinical manifestations associated. We tried to analyze the clinical parameters associated to this disease in 24 patients in our hospital.

METHODS

A retrospective analysis was made of the patients diagnosed of Behçet's disease at Hospital General of Valencia since 1990 to 2000. The diagnosis of Behçet's disease was made by the criteria of the International Study Group for Behçet disease. Data regarding personal, clinical manifestations and clinical course were collected.

RESULTS

Of the 24 cases, fourteen (58%) were men and ten (42%) were women. The median of the diagnosed was 33 years. All of them had oral recidivant ulcers. The genital ulcers appeared in twenty (83%) cases. Thirteen cases (54%) had ocular manifestations, and the skin lesions appear in 10 cases (42%). We review other clinical manifestations associated to Behçet disease: articular clinical appear in 17 cases (70%), digestive manifestations in six cases (25%), neurological manifestations three cases (12%), vascular clinical two cases (8%).

CONCLUSIONS

Our results are similar to the Mediterranean expression of Behçet's disease. We must study the clinical manifestations associated to this disease that are not include in the criteria of diagnosis.