Validation of the Hygicult® E Dipslides Method in Surface Hygiene Control: A Nordic Collaborative Study

A collaborative study with Enterobacteriaceae was conducted to validate Hygicult® E dipslides by comparison with violet red bile glucose agar (VRBGA) contact plates and swabbing, using stainless steel surfaces artificially contaminated with microbes at various levels. Twelve laboratories participated in the validation procedure. The total number of collaborative samples was 108. The microbial level in each sample was assessed in triplicate by using the 3 above-mentioned methods. No Enterobacteriaceae were used at the low inoculation level. At the middle inoculation level, the percentages detached from the test surfaces were 16.6 with the Hygicult E method, 15.3 with the contact plate method, and 14.6 with swabbing; at the high innoculation level, the percentages were 14.5, 15.8, and 9.8, respectively. The percentage of acceptable results after the removal of outliers was 97.2. Repeatability relative standard deviations ranged from 33.4 to 44.9%; reproducibility relative standard deviations ranged from 45.2 to 77.1%. The Hygicult E dipslide, VRBGA contact plate, and swabbing methods gave similar results at all 3 microbial levels tested: <1.0 colony-forming units (CFU)/cm2 at the low level, 1.2–1.3 CFU/cm2 at the middle level (theoretical yield 8.0 CFU/cm2), and 1.2–2.0 CFU/cm2 at the high level (theoretical yield 12.5 CFU/cm2).

Validation of the Microbiological Methods Hygicult Dipslide, Contact Plate, and Swabbing in Surface Hygiene Control: A Nordic Collaborative Study

A collaborative study on total aerobic bacterial count was conducted to validate the Hygicult® TPC dipslide against contact plates and swabbing, using stainless-steel surfaces artificially contaminated with different microbes at various levels. Twelve laboratories took part in the validation procedure. The total number of collaborative samples was 108. The microbial level in each sample was assessed in triplicate using the 3 above-mentioned methods under 3 different incubation conditions (at 25 ± 1°C for 48 and 72 h and at 30 ± 1°C for 48 h). Surface sampling methods detached 25–30% at the lowest (theoretical yield, 1.4 cfu/cm2), 18–20% at the middle (theoretical yield, 10.7 cfu/cm2), and 16–21% at the highest (theoretical yield, 43.6 cfu/cm2) levels of microbes from the test surfaces. The percentage of acceptable results after removing outliers was 89%. Repeatability standard deviations ranged from 27.2 to 74.6% and reproducibility standard deviations ranged from 42.1 to 97.5%. There were no significant differences between results obtained at different incubation temperatures (25 and 30°C) or incubation times (48 and 72 h) for all 3 methods. The Hygicult TPC dipslide, contact plate, and swabbing methods gave similar results at all 3 microbial levels tested: 0.35–0.43 cfu/cm2 at the lowest level, 1.9–2.2 cfu/cm2 at the middle level, and 7.1–9.1 cfu/cm2 at the highest level.

Abstract P6-20-06: Withdrawn

This abstract was withdrawn by the authors.

Citation Format: Dann S, Chionis J, Eisele K, Zhang Q, Liu C, Yuan J, Miller N, Murray B, Xu M, Solowiej J, Wei P, Weinrich S, Sutton S, Behenna D, Ninkovic S, Hoffman R, Freeman-Cook K, Jessen B, Huser N, Zhang C, Visswanathan R, Boras B, VanArsdale T, White MA. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-20-06.

Increase in thyroid follicular cell tumors in nelfinavir-treated rats observed in a 2-year carcinogenicity study is consistent with a rat-specific mechanism of thyroid neoplasia

The carcinogenic potential of nelfinavir mesylate (nelfinavir) was evaluated in a 2-year oral (gavage) study on Sprague-Dawley rats at dose levels of 0 (control), 0 (vehicle control), 100, 300 and 1000 mg/kg per day. At the end of the treatment, increased incidences of thyroid follicular cell hyperplasia and neoplasms were observed at 300 (males) and 1000 mg/kg per day (both sexes). There were no other treatment-related effects and no tumors at other sites. Results from previous studies indicated a number of effects in the liver and thyroid, as well as metabolic profiles that suggested nelfinavir might cause thyroid hyperplasia/neoplasia secondary to hormone imbalance by altering thyroid hormone disposition. To investigate this hypothesis, the effects of nelfinavir on gene expression in rat hepatocytes and liver slices (in vitro), thyroxine plasma clearance, and thyroid gland function were evaluated. Compared to controls, gene expression analyses demonstrated an increased expression of glucuronyltransferase (UDPGT) and CYP450 3A1 in nelfinavir-treated rat hepatocytes and liver slices. In rats treated with nelfinavir (1000 mg/kg per day) for 4 weeks, liver weights and centrilobular hepatocellular hypertrophy were increased and minimal to mild diffuse thyroid follicular cell hypertrophy and follicular cell hyperplasia were evident in the thyroid gland. Thyroid-stimulating hormone (TSH) levels were significantly increased (three-fold), while tri-iodothyronine (T3)/tetraiodothyronine (T4) and reverse T3(rT3) levels were unchanged, indicating that a compensated state to maintain homeostasis of T3/T4 had been achieved. Plasma 125I-thyroxine clearance was increased and the plasma thyroxine AUC0 48 was decreased (24%) compared to control. In conclusion, these data indicate that thyroid neoplasms observed in the nelfinavir-treated rats were secondary to thyroid hormone imbalance. Increased thyroxine clearance contributes to the effects of nelfinavir on thyroid gland function and is probably a result of UDPGT induction that leads to elevated TSH levels in the rat and eventual thyroid neoplasia. These results are consistent with a well-recognized rat-specific mechanism for thyroid neoplasms.

Graded defects in cytotoxicity determine severity of hemophagocytic lymphohistiocytosis in humans and mice

Primary hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease of hyperinflammation resulting from immune dysregulation due to inherited defects in the cytolytic machinery of natural killer and T cells. In humans, mutations in seven genes encoding proteins involved in cytolytic effector functions have so far been identified that predispose to HLH. However, although most affected patients develop HLH eventually, disease onset and severity are highly variable. Due to the genetic heterogeneity and variable time and nature of disease triggers, the immunological basis of these variations in HLH progression is incompletely understood. Several murine models of primary HLH have been established allowing to study HLH pathogenesis under more defined conditions. Here we directly compare the clinical HLH phenotype in six HLH-prone mouse strains with defects in the granule-dependent cytotoxic pathway. A severity gradient of HLH manifestations could be identified that is defined by the genetically determined residual lytic activity of cytotoxic T lymphocytes (CTL) and their ability to control lymphocytic choriomeningitis virus, which was used as a trigger for disease induction. Importantly, analysis of cohorts of HLH patients with severe bi-allelic mutations in the corresponding genes yielded a similar severity gradient in human HLH as reflected by the age at disease onset. Our findings define HLH as a threshold disease determined by subtle differences in the residual lytic activity of CTL.

Case reports: hyperbaric oxygen therapy for the treatment of cerebral air embolism

Cerebral air embolism is one of the most deleterious disorders that may affect divers, but it is also a possible complication of surgeries and medical procedures. We report our experience with iatrogenic cerebral air embolism and hyperbaric oxygen treatment.

Qualitative and quantitative risk assessment for human salmonellosis due to multi-resistant Salmonella Typhimurium DT104 from consumption of Danish dry-cured pork sausages

Salmonella Typhimurium DT104 (DT104) is unwanted in products for human consumption due to its antibiotic resistance and ability to cause disease. We intended to set up an improved monitoring and management program to aid in deciding when to use pork contaminated with DT104 for production of sausages without jeopardizing consumer safety. We started by carrying out two assessments of the risk for human health associated with consumption of sausages produced by: (1) Danish pork from average slaughter days; (2) imported pork (IMP) with average prevalence of DT104. The assessments showed that, if Salmonella is present, it is usually in lower numbers (< or =50 per 400 cm(2) surface). Additionally, during processing, the numbers will be reduced by at least 2 log-units. In Danish (DK) pork, DT104 constitutes 0.2-1.0% of the Salmonella isolates reported, while in imported pork (IMP), 18%. We estimated that out of one million, 25 g servings of DK dry-cured sausages, up to two DT104 bacteria could be found in each of 245 servings. Out of one million servings of 25 g IMP dry-cured sausages, up to two DT104 bacteria would occur in each of 19,260 servings.

Assessment of the human risk associated with use of pork with possible presence of Salmonella typhimurium DT104 for dry-cured sausages

We examined whether pork with suspected content of Salmonella Typhimurium DT104 (DT104) could be used for production of dry-cured sausages without jeopardizing consumer safety. The results of the risk assessment showed, that if Salmonella is present in raw pork, it is usually in low numbers. Additionally, during processing, an eventual presence of Salmonella will be reduced with at least two log units. The simulations showed that only 1-2 DT104 would be present in dry-cured sausages made by Danish pork, and this extremely seldom. Likewise, up to 4 DT104 would be present in dry-cured sausages made by foreign pork. It is not clear whether these low numbers of DT104 are capable of producing disease at all. However, if higher numbers are present, disease might occur. Therefore, we set up a monitoring and managing program, including a list with demands to processing in order to achieve minimum two-log reduction of any DT104 bacteria. The suggested scheme implies a far better and more systematic monitoring than the current system, ensuring the consumer a higher degree of food safety.

[Treatment of carbon monoxide poisoning. Background and guidelines for oxygen therapy]

Treatment of carbon monoxide (CO) poisoning is still controversial. Standard treatment is pure oxygen either by means of a nasal catheter or oral-facial mask (normobaric oxygen treatment). Since 1960, hyperbaric oxygen (HBO) therapy has been applied in various centres, i.e. treatment in hyperbaric chambers with 100% O2 at 2-2.8 bars absolute pressure. Physically dissolved oxygen at this pressure is sufficient to maintain normal life functions at rest. HBO causes fast reoxygenation of tissues and accelerates the elimination of CO. In this paper, two cases treated with hyperbaric oxygen are reported. Aetiology, pathogenesis and possible sequelae of CO poisoning are reviewed. It is recommended, that all CO-victims, who have been or are unconscious at admission to the emergency ward, should be treated with HBO. In spite of there being comprehensive clinical literature concerning treatment of CO poisoning, there is still a great need for clinically controlled studies.

Motion sickness susceptibility in student navigators

Identification of individuals highly susceptible to motion sickness could be of significant benefit in managing flying personnel in training. Several studies in the past four decades with this end have been primarily aimed at pilot trainees. The following study is a prospective evaluation of airsickness in Air Force navigation students. Motion Sickness Questionnaires and Minnesota Multiphasic Personality Inventories were given to the students at the beginning of navigator training. Airsickness was assessed by means of questionnaires and evaluation by a flight surgeon. Motion sickness among navigation trainees was found to be quite common. However, prediction of susceptible individuals by methods used was not reliable. Further investigation of airsickness susceptibility in navigation students by means of physiologic techniques is suggested.

A control, double-blind comparison of mepivacaine injection versus saline injection for myofascial pain

In a double-blind study 28 patients with acute, localised muscle pain received four local injections of mepivacaine 0.5%, and 25 patients with the same type of pain received local injections of an equivalent volume of physiological saline. The group receiving saline tended to have more relief of pain, especially after the first injection. The results thus show that pain relief is not due merely to the local anaesthetic. The study therefore raises questions about the mechanism by which local injections into muscle relieves pain, since there is the possibility that a similar effect might also be achieved by merely inserting a needle into the trigger point. Physiological saline is considered to be a more appropriate fluid for injection therapy than local anaesthetics since it is less likely to produce side-effects.

Radioimmunoassay, enzyme immunoassay, spectrophotometry, and gas-liquid chromatography compared for determination of phenobarbital and diphenylhydantoin

Sera from epileptic patients were assayed for phenobarbital and diphenylhydantoin by four different analytical procedures. Quantitative results obtained by radioimmunoassay (I) and enzyme immunoassay (II) were compared to each other and to the results obtained on aliquots of the same sample by gas-liquid chromatography (III) and ultraviolet spectrophotometry (IV). For phenobarbital the correlation coefficients were I vs. II, 0.909; I vs. III, 0.947; II vs. III, 0.917; I vs. IV, 0.950; II vs. IV, 0.953. For diphenylhydantoin the correlation coefficients were I vs. II, 0.953; I vs. III, 0.951; II vs. III, 0.957; I vs. IV, 0.862; II vs. IV, 0.898. The immunoassays can be substituted for liquid chromatography or ultraviolet spectrophotometry without changing the resulting clinical interpretations.

Radioimmunoassay, enzyme immunoassay, spectrophotometry, and gas-liquid chromatography compared for determination of phenobarbital and diphenylhydantoin

Sera from epileptic patients were assayed for phenobarbital and diphenylhydantoin by four different analytical procedures. Quantitative results obtained by radioimmunoassay (I) and enzyme immunoassay (II) were compared to each other and to the results obtained on aliquots of the same sample by gas-liquid chromatography (III) and ultraviolet spectrophotometry (IV). For phenobarbital the correlation coefficients were I vs. II, 0.909; I vs. III, 0.947; II vs. III, 0.917; I vs. IV, 0.950; II vs. IV, 0.953. For diphenylhydantoin the correlation coefficients were I vs. II, 0.953; I vs. III, 0.951; II vs. III, 0.957; I vs. IV, 0.862; II vs. IV, 0.898. The immunoassays can be substituted for liquid chromatography or ultraviolet spectrophotometry without changing the resulting clinical interpretations.

Radioimmunoassay, enzyme immunoassay, spectrophotometry, and gas-liquid chromatography compared for determination of phenobarbital and diphenylhydantoin

Sera from epileptic patients were assayed for phenobarbital and diphenylhydantoin by four different analytical procedures. Quantitative results obtained by radioimmunoassay (I) and enzyme immunoassay (II) were compared to each other and to the results obtained on aliquots of the same sample by gas-liquid chromatography (III) and ultraviolet spectrophotometry (IV). For phenobarbital the correlation coefficients were I vs. II, 0.909; I vs. III, 0.947; II vs. III, 0.917; I vs. IV, 0.950; II vs. IV, 0.953. For diphenylhydantoin the correlation coefficients were I vs. II, 0.953; I vs. III, 0.951; II vs. III, 0.957; I vs. IV, 0.862; II vs. IV, 0.898. The immunoassays can be substituted for liquid chromatography or ultraviolet spectrophotometry without changing the resulting clinical interpretations.