A severe case of Ramsay Hunt Syndrome treated with acupuncture and related techniques.

Ramsay-Hunt syndrome presents with a vesicular eruption in the ear canal or oral cavity associated with ipsilateral peripheral facial paralysis. The cause is reactivation of the herpes zoster virus in the geniculate ganglion. It is the second most frequent cause of non-traumatic peripheral facial paralysis. Acupuncture is a medical procedure endorsed by the WHO with a wide range of indications. It consists of the application of very fine needles in certain points of the body to relieve pain and relieve certain diseases. We present a case of a young woman with unilateral facial paralysis as part of Ramsay Hunt syndrome. She received conventional treatment with acyclovir, analgesics, corticosteroids and eye protection measures 48 h after the onset of symptoms. At three weeks, due to the lack of improvement of the facial paralysis, manual acupuncture was started along with electroacupuncture, plum blossom hammer for facial stimulation and Chinese herbal medicine. An almost complete improvement was obtained at 14 weeks since the onset of the condition. Acupuncture and related techniques may be an effective intervention for this type of condition, and are associated with very few adverse effects.

Chemotaxis of halophilic bacterium Halomonas anticariensis FP35 towards the environmental pollutants phenol and naphthalene.

Chemotaxis can play an important role in bioremediation and substrate bioavailability. The bioremediation of hydrocarbons in saline environments can be carried out by technologies using halophilic bacteria. The aim of this study is to analyse chemotactic responses of the halophilic bacterium Halomonas anticariensis FP35T to environmental pollutants, as well as its catabolic potential for biotechnological use in bioremediation processes under saline conditions. Chemotaxis was detected and quantified using a modified Adler capillary assay. PCR amplification with degenerate primers for genes encoding ring-cleaving enzymes was used to characterize the catabolic versatility of FP35T. The results indicate that phenol (100-1,000 ppm) and naphthalene (100-500 ppm) are chemoattractants for H. anticariensis FP35T in a dose-dependent manner. These hydrocarbons were observed to act as chemoattractants for FP35T grown in a wide range of sea salt solutions (5-12.5% (w/v). However, the 7.5% (w/v) saline concentration was found to have the strongest chemotactic response. We also detected genes encoding ring-cleaving enzymes in the ß-ketoadipate pathway for aromatic catabolism. These results suggest that H. anticariensis FP35T has the potential to catabolize aromatic compounds and to be used in bioremediation processes under saline conditions.

Saprobe fungi decreased the sensitivity to the toxic effect of dry olive mill residue on arbuscular mycorrhizal plants.

We studied the influence of olive mill dry residue (DOR) treated with saprobe fungi on growth of tomato and alfalfa colonized by Glomus deserticola. The application of 25g kg(-1) of dry DOR to soil decreased the shoot and root dry weight of tomato and alfalfa. Plants were more sensitive to the toxicity of DOR when colonized with the arbuscular mycorrhizal (AM) fungi. The sensitivity of both plants to the toxicity of DOR differed according to whether they were colonized by G. deserticola or by indigenous AM fungi. The phytotoxicity of DOR towards tomato and alfalfa was decreased by incubation the residue before planting with saprobe fungi for 20wk. The beneficial effects of AM fungi on plant growth added with DOR incubated with saprobe fungi depend of the type of the plant and AM fungi. The contribution of AM fungi to the beneficial effect of DOR incubated with saprobe fungi varied according to the type of the plant and AM fungi. G. deserticola increased the shoot and root dry weight of plants when they were grown in the presence of DOR incubated with saprobe fungi for 20wk. The beneficial effect of saprobe fungi on the dry weight and the level of AM mycorrhization of plants seem to be related to the decrease caused by these fungi in the phenol concentration in DOR. However, the toxicity of DOR due to substances other than phenols can not be ignored. The use of certain saprobe and AM fungi allows the possibility of using DOR as an organic fertilizer.

Bioconversion of olive-mill dry residue by Fusarium lateritium and subsequent impact on its phytotoxicity.

The present study investigated the ability of the non-pathogenic fungus Fusarium lateritium to either degrade or modify aromatic substances in olive-mill dry residue (DOR) and to reduce its phytotoxicity. The 80% reduction of ethylacetate extractable phenols in DOR colonized by the fungus for 20 weeks appeared to be due to polymerization reactions of phenol molecules as suggested by mass-balance ultrafiltration and size-exclusion chromatography experiments. Several lignin-modifying oxidases, including laccase, Mn-peroxidase and Mn-inhibited peroxidase were detected in F. lateritium solid-state cultures. Tests performed with tomato seedlings in soils containing 6% (w/w) sterilized non-inoculated DOR showed that the waste was highly phytotoxic. By contract, F. lateritium growth on DOR for 20 weeks led to a complete removal of the waste toxicity and to a higher shoot dry weight of tomato plants than that obtained in the absence of DOR.

Group-C beta-hemolytic streptococcal bacteremia.

Group-C beta-hemolytic streptococci (GCBHS) is an uncommon cause of bacteremia. In a 5-year period, GCBHS accounted for 0.28% of positive blood cultures and 0.35% of bacteremias documented at our hospital. The incidence of GCBHS bacteremia was 0.05 episodes per 1000 admissions. We were able to analyze clinical data of 10 of the 13 patients with GCBHS bacteremias. All but one were adults with significant underlying diseases, and seven episodes were community acquired. The skin was the portal of entry in only one case. Clinical syndromes included primary bacteremia (four cases), pneumonia (two cases), endocarditis (two cases), and meningitis, intraabdominal infection, and metastatic suppurative pericarditis (one episode each). Of 13 isolates, 12 were identified to species level: six, Streptococcus equisimilis; three S. equi; two S. dysgalactiae; and one S. zooepidemicus. Resistance to penicillin was detected in one isolate and none of our isolates displayed penicillin tolerance, Four patients died (40%) despite appropriate antimicrobial therapy.

Short-term dynamics of culturable bacteria in a soil amended with biotransformed dry olive residue.

Dry olive residue (DOR) transformation by wood decomposing basidiomycetes (e.g. Coriolopsis floccosa) is a possible strategy for eliminating the liabilities related to the use of olive oil industry waste as an organic soil amendment. The effects of organic fertilization with DOR on the culturable soil microbiota are largely unknown. Therefore, the objectives of this study were to measure the short-term effects of DOR and C. floccosa-transformed DOR on the culturable bacterial soil community, while at the same time documenting the bacterial diversity of an agronomic soil in the southeastern Iberian Peninsula. The control soil was compared with the same soil treated with DOR and with C. floccosa-transformed DOR for 0, 30 and 60 days. Impact was measured from total viable cells and CFU counts, as well as the isolation and characterization of 900 strains by fatty acid methyl ester profiles and 16S rRNA partial sequencing. The bacterial diversity was distributed between Actinobacteria, Alphaproteobacteria, Gammaproteobacteria, Betaproteobacteria, Bacilli, Sphingobacteria and Cytophagia. Analysis of the treatments and controls demonstrated that soil amendment with untransformed DOR produced important changes in bacterial density and diversity. However, when C. floccosa-transformed DOR was applied, bacterial proliferation was observed but bacterial diversity was less affected, and the distribution of microorganisms was more similar to the unamended soil.

Improvement of growth of Eucalyptus globulus and soil biological parameters by amendment with sewage sludge and inoculation with arbuscular mycorrhizal and saprobe fungi.

Sewage sludge is widely used as an organic soil amendment to improve soil fertility. We investigated the effects of sewage sludge (SS) application on certain biological parameters of Eucalyptus globulus Labill. The plant was either uninoculated or inoculated with saprobe fungi (Coriolopsis rigida and Trichoderma harzianum) or arbuscular mycorrhizal (AM) fungi (Glomus deserticola and Gigaspora rosea). Sewage sludge was applied to the surface of experimental plots at rates of 0, 2, 4, 6 and 8 g 100 g(-1) of soil. Inoculation with both AM and saprobe fungi in the presence of SS was essential for the promotion of plant growth. The AM, saprobe fungi and SS significantly increased dry shoot weight. The AM fungi induced a significant increase in Fluorescein diacetate (FDA) activity but did not increase beta-glucosidase activity. Addition of SS to AM-inoculated soil did not affect either FDA or alpha-glucosidase activities in plants from soil that was either uninoculated or inoculated with the saprobe fungi. SS increased beta-glucosidase activity when it was applied at 4 g 100 g(-1). SS negatively affected AM colonization as well as the mycelium SDH activity for both mycorrhizal fungi. SS increased Eucalyptus shoot biomass and enhanced its nutrient status. Inoculation of the soil with G. deserticola stimulated significant E. globulus growth and increases in shoot tissue content of N, P, K, Ca, Mg and Fe. Dual inoculation with G. deserticola and either of the saprobe fungi had positive effects on K, Ca, Mg and Fe contents. The application of 8 g 100 g(-1) of SS had no positive effects on plant nutrition. The experimental setup provided a suitable tool for evaluating SS in combination with saprobe and AM fungi as a biological fertiliser for its beneficial effects on E. globulus plant growth.

Contribution of the saprobic fungi Trametes versicolor and Trichoderma harzianum and the arbuscular mycorrhizal fungi Glomus deserticola and G. claroideum to arsenic tolerance of Eucalyptus globulus.

The presence of high concentrations of arsenic (As) decreased the shoot and root dry weight, chlorophyll and P and Mg content of Eucalyptus globulus colonized with the arbuscular mycorrhizal (AM) fungi Glomus deserticola or G. claroideum, but these parameters were higher than in non-AM plants. As increased the percentage of AM length colonization and succinate dehydrogenase (SDH) activity in the root of E. globulus. Trichoderma harzianum, but not Trametes versicolor, increased the shoot and root dry weight, chlorophyll content, the percentage of AM root length colonization and SDH activity of E. globulus in presence of all As concentrations applied to soil when was inoculated together with G. claroideum. AM fungi increased shoot As and P concentration of E. globulus to higher level than the non-AM inoculated controls. The contribution of the AM and saprobe fungi to the translocation of As from root to shoot of E. globulus is discussed.

Interactions of Trametes versicolor, Coriolopsis rigida and the arbuscular mycorrhizal fungus Glomus deserticola on the copper tolerance of Eucalyptus globulus.

The presence of high levels of Cu in soil decreases the shoot and root dry weights of Eucalyptus globulus. However, higher plant tolerance of Cu has been observed in the presence of the arbuscular mycorrhizal (AM) fungus Glomus deserticola. The hyphal length of G. deserticola was sensitive to low Cu concentrations, and the percentage of AM root colonisation and the metabolic activity of the AM fungus were also decreased by Cu. Therefore, a direct effect of Cu on the development of the AM fungus inside and outside the root cannot be ruled out. E. globulus colonised by G. deserticola had higher metal concentrations in the roots and shoots than do non-mycorrhizal plants; however, the absence of a higher root to shoot metal ratio in the mycorrhizal plants (1.70+/-0.11) indicated that G. deserticola did not play a filtering/sequestering role against Cu. The saprobe fungi Coriolopsis rigida and Trametes versicolor were able to remove Cu ions from the asparagine-glucose growth media. However, plants inoculated with C. rigida and T. versicolor did not accumulate more Cu than non-inoculated controls, and the growth of the plant was not increased in the presence of these fungi. However, C. rigida increased the shoot dry weight, AM root length colonisation, and metabolic mycelial activity of plants colonised with G. deserticola in the presence of Cu; only this saprobe-AM fungus combination increased the tolerance of E. globulus to Cu. Inoculation with G. deserticola and C. rigida increased the E. globulus Cu uptake to levels reached by hyperaccumulative plants.

Assessment of olive-mill wastewater as a growth medium for lipase production by Candida cylindracea in bench-top reactor.

Olive-mill wastewater (OMW) was investigated for its suitability to serve as a medium for lipase production by Candida cylindracea NRRL Y-17506. The OMW that best supported enzyme production was characterized by low COD and low total sugars content. In shake flask batch cultures, OMW supplementation with 2.4 g l(-1) NH(4)Cl and 3 g l(-1) olive oil led to an enzyme activity of about 10 U ml(-1). The addition of glucose or malt extract and supplements containing organic N (e.g., peptone, yeast extract) either depressed or did not affect the enzyme production. Further experiments were then performed in a 3-l stirred tank reactor to assess the impact of medium pH and stirring speed on the yeast enzyme activity. The lipase activity was low (1.8 U ml(-1)) when the pH was held constant at 6.5, significantly increased (18.7 U ml(-1)) with uncontrolled pH and was maximum (20.4 U ml(-1)) when the pH was let free to vary below 6.5. A stirring regime, that varied depending on the dissolved oxygen concentration in the medium, both prevented the occurrence of anoxic conditions during the exponential growth phase and enabled good lipase production (i.e., 21.6 U ml(-1)) and mean volumetric productivity (i.e., 123.5 Ul(-1)h(-1)).

[Treatment of "intractable" hiccup with baclofen]. / Tratamiento del hipo "intratable" con baclofén.

The clinical features of seven patients with persistent hiccup are reported. Hiccup did not respond to the usual therapies and resolved with baclofen. The administration guidelines and secondary effects are discussed. The authors suggest baclofen should be considered the drug of choice for treating persistent hiccup.

Contribution of hydrolytic enzymes produced by saprophytic fungi to the decrease in plant toxicity caused by water-soluble substances in olive mill dry residue.

We studied the influence of saprophytic fungi on the toxic effect that the water-soluble substances in dry residues from olive (ADOR) have on the growth of plants. All saprophytic fungi were able to decrease the phytotoxicity of ADOR, although the toxicity of this residue did not decrease in the same way. Penicillium chrysogenum was able to reduce the toxicity of ADOR when this residue was applied at the highest dose of 15%. Fusarium lateritum, F. graminearum and Mucor racemosus were able to reduce the toxicity of ADOR when this residue was applied at the intermediate doses. However, F. oxysporum decreased the phytotoxicity of ADOR only when the residue was applied at the lowest dose of 2.5%. All saprophytic fungi tested produce endoglucanase, endopolymetylgalacturonase and endoxiloglucanase when grown in the presence of ADOR. A close relationship was found between the decrease in the phytotoxicity of ADOR and the amount of hydrolytic enzymes produced by the saprophytic fungi. These results shows that hydrolytic enzymes can be important in the degradation of phytotoxic substances present in olive mill dry residue.

[An analysis of 100 consecutive tuberculosis cases in HIV-infected patients in a hospital in Cantabria]. / Análisis de 100 tuberculosis consecutivas en pacientes infectados por VIH en un hospital de Cantabria.

UNLABELLED: In our setting, patients infected by human immunodeficiency virus (HIV) show a high rate of tuberculosis infections which manifestations depend on the level of immunodeficiency reached. METHOD: Clinical, radiological and evolutive characteristics are discussed of 100 diagnosed tuberculosis in seropositive patients during a time span of 52 months, relating them to the number of CD4 detected. RESULTS: Tuberculosis pulmonary forms (65%) were more frequent than extra-pulmonary ones (35%) even in the advanced phases of the disease due to HIV, even tough the latter tend to cluster in patients with less than 200 CD1/mm. An unspecific febrile syndrome, normal results on simple radiological exploration and the difficulty to obtain diagnostic samples are facts which often delay the diagnosis. CONCLUSION: Even tough the extra-pulmonary forms are more frequent in the last stages of the disease due to HIV, in our setting there is still a high incidence of pulmonary forms in all stages.

Erythromycin and the treatment of Coxiella burnetii pneumonia.

Erythromycin is commonly used for the empirical treatment of community-acquired pneumonia, but there is some concern about its usefulness when Q fever is suspected because of in-vitro studies showing a lack of efficacy against Coxiella burnetii. This study was undertaken to assess the clinical value of the antibiotic in this setting. Nineteen patients with Q fever pneumonia treated with a variety of antibiotics considered ineffective against C. burnetii, were reviewed. Eleven patients who received erythromycin had a rapid clinical improvement and each became afebrile by the fourth day of treatment. However, only two of eight patients who received other antibiotics improved (both of them had been treated with beta-lactams). Both groups were comparable regarding to age and previous duration and severity of disease. Those patients who did not respond to other antibiotics improved promptly after erythromycin was started. This study suggests that erythromycin is an adequate treatment for Q fever pneumonia.

Improvement by soil yeasts of arbuscular mycorrhizal symbiosis of soybean (Glycine max) colonized by Glomus mosseae.

The effects of the soil yeasts Rhodotorula mucilaginosa, Cryptococcus laurentii and Saccharomyces kunashirensis on the arbuscular mycorrhizal (AM) fungus Glomus mosseae (BEG 12) was studied in vitro and in greenhouse trials. The presence of yeasts or their soluble and volatile exudates stimulated the percentage spore germination and hyphal growth of G. mosseae. Percentage root length colonized by G. mosseae and plant dry matter of soybean (Glycine maxL. Merill) were increased only when the soil yeasts were inoculated prior to the AM fungus. Higher beneficial effects on AM colonization and plant dry matter were found when the soil yeasts were inoculated as an aqueous solution rather than as a thin agar slice. Although soluble and volatile exudates of yeasts benefited the AM symbiosis, their modes of action were different.

Lung abscess due to Streptococcus mitis: case report and review.

Streptococcus mitis is a bacterium traditionally regarded as a normal commensal of the oropharynx, skin, and intestinal and genital tracts. To our knowledge, we describe the first case of bilateral lung abscesses caused by S. mitis in an immunocompetent host. The abscesses were successfully treated with clindamycin and gentamicin. Our case illustrates that S. mitis should be considered a cause of pulmonary abscesses.

Renal failure due to sulphadiazine in AIDS patients with cerebral toxoplasmosis.

Cerebral toxoplasmosis is optimally treated with the combination of high doses of sulphadiazine and pyrimethamine. We described two patients with AIDS treated for cerebral toxoplasmosis who developed renal failure due to sulphadiazine-induced crystalluria. Symptoms and renal failure were rapidly reversed with urine alkalinization and hydration. A careful monitoring and adequate hydration of patients with AIDS treated with high doses of sulphadiazine appears mandatory to avoid this complication.

[Domiciliary intravenous antibiotic therapy]. / Antibioterapia intravenosa domiciliaria.

BACKGROUND: To assess the efficiency and safety of intravenous antibiotic therapy (IAT) when performed through the traditional simple infusion system by gravity in the home setting. PATIENTS AND METHODS: The clinical records of patients undergoing intravenous antibiotic therapy through the traditional gravitational infusion system in the home care unit over a five year period were reviewed retrospectively. RESULTS: 120 patients were treated (44 F/76 M), with a mean age of 48 years (44-52). 67% of the total had chronic diseases. Infections were most commonly found in bones and joints (38%), followed by the skin and soft tissues. A wide variety of antibiotics was used, 61% as monotherapy. 76% of them were given intermittently. 161 intravenous catheters were used, 53% of which were central catheters with peripheral insertion, 27% inserted centrally and 20% peripheral catheters. The overall incidence of phlebitis was 18% without associated bacteremia. 91% of our patients evolved well, 6% had to become in-patients, none of them due to problems with the infusion system or by their own petition. The intravenous treatment lasted a mean of 17 days at home and 25 days at both home and hospital, which represents a decrease of 2,040 hospital stays. CONCLUSIONS: The traditional gravitational system of infusion is an effective and safe method for intravenous antibiotic administration at home. For these therapies to be successful, suitable patients must be selected and continuous attention is required. This treatment at home satisfies the patient and permits hospital stays to be reduced, thus improving the use of hospital resources.