Postinfectious irritable bowel syndrome may occur after non-gastrointestinal and intestinal infection

Postinfectious functional gastrointestinal disorders (FGIDs) may not be specific to gastroenteritis. This pilot study aimed to ascertain the 3- and 6-month incidence of functional gut disorders in people with non-gastrointestinal (GI) infection, gastroenteritis and healthy controls. This was a prospective study of three cohorts recruited from hospital (non-GI infections) and the community (others). FGIDs were diagnosed using self-completed Rome II modular questionnaires administered at baseline, 3 and 6 months. Thirty-six subjects with non-GI infection, 219 healthy subjects and 108 with bacterial gastroenteritis participated. No difference in incidence of FGID was detected between the GI and non-GI infection cohorts. Any FGID was more frequent in people who had a non-GI infection than in controls at both 3 [odds ratio: 4.34 (95% CI: 3.60-16.45)] and 6 months [4.76 (4.42-27.92)]. Irritable bowel syndrome (IBS) alone was more frequent in people with non-GI infections than in controls at 3 months (6.12 [1.30-29.12]) but did not quite reach statistical significance at 6 months (4.58 [0.79-26.46]). Our findings were unexpected. Postinfectious FGIDs may be related to non-GI and GI infection, although not all potential biases were controlled in study design. Further studies need to explore these preliminary findings and, if confirmed, the underlying mechanisms.

A cross sectional study of water quality from dental unit water lines in dental practices in the West of Scotland

OBJECTIVE

To determine the microbiological quality of water from dental units in a general practice setting and current practice for disinfection of units.

DESIGN

A cross-sectional study of the water quality from 40 dental units in 39 general practices and a questionnaire of the disinfection protocols used in those practices.

SETTING

NHS practices in primarydental care.

SUBJECTS

Thirty-nine general practices from the West of Scotland.

METHODS

Water samples were collected on two separate occasions from dental units and analysed for microbiological quality by the total viable count (TVC) method. Water specimens were collected from the triple syringe, high speed outlet, cup filler and surgery tap. Each participating practitioner was asked to complete a questionnaire. Results Microbial contamination was highest from the high speed outlet followed by the triple syringe and cup filler. On average, the TVC counts from the high speed water lines at 37 degrees C and for the high speed lines, triple syringe and cup filler at 22 degrees C were significantly higher than that from the control tap water specimens. The study included units from 11 different manufacturers with ages ranging from under one year to over eight years. The age of the dental unit analysed did not appear to influence the level of microbial contamination. Five of the practices surveyed used disinfectants to clean the dental units but these had no significant effect on the microbiological quality of the water. The majority of dental units (25 out of 40) were never flushed with water between patients. A number of different non-sterile irrigants were used for surgical procedures.

CONCLUSION

The microbiological quality of water from dental units in general dental practice is poor compared with that from drinking water sources. Suitable sterile irrigants should be used for surgical procedures in dental practice. Further work is required for pragmatic decontamination regimens of dental unit water lines in a general dental practice setting

Urea metabolism in sheep given conventional feeds or nourished by intragastric infusion

A comparison has been made of the kinetics of urea metabolism in sheep given conventional feeds or maintained wholly by intragastric infusions of volatile fatty acids, buffer, mineral and casein solutions. Daily nitrogen supply was 13.2 g/day in 'fed' sheep and 6.0 g/day in 'infusion' sheep. On each feeding system measurements were made at the basal (maintenance) level of intake and when the basal level was supplemented with infusions of urea into the abomasum (125 mmol/day) or into the rumen (300 mmol/day). Additional measurements were made when ammonium carbonate (100 mmol/day) was infused into the rumen, when cassava (150 g/day) was added to the diet of 'fed' sheep or when the input of casein to 'infusion' sheep was reduced by half. Urea kinetics were measured by means of a single intravenous injection of [14C]urea. Urea irreversible loss rate, urea pool size, urinary urea excretion, plasma urea concentrations and rumen ammonia concentrations were all significantly higher in sheep given conventional feeds than in those nourished by infusion but urea degradation in the gastrointestinal tract did not differ between the two methods of feeding. Regression analysis indicated only minor differences between the two feeding systems in the relationships between the various indices of urea metabolism. It is concluded that most of these findings can be attributed to differences in the quantity and nature of the nitrogen supplied in the basal diets and that the sheep nourished by infusion would be a suitable model for the study of factors involved in the control of urea recycling.