Looking Beyond the Cell in Cellulitis.

BACKGROUND: Patients with erythematous skin are likely to receive a diagnosis of cellulitis; however, the accuracy of this diagnosis is approximately only 33%. The diagnosis of cellulitis should be made only after a thorough evaluation of all possible differential diagnoses. Cellulitis may be a primary process (superficial spreading infective process involving only the epidermis and dermis) versus a secondary (reactive) process incited by a subcutaneous process, such as an abscess, tenosynovitis, necrotizing fasciitis, and osteomyelitis. CASE PRESENTATION: A 50-year-old man was admitted to a general hospital with the diagnosis of cellulitis. He was initially treated with systemic antibiotics without improvement. Following consultation with a wound management physician, the patient received a diagnosis of a pretibial abscess and was treated with surgical evacuation and postoperative systemic antibiotic therapy guided by tissue cultures. A postoperative wound was successfully treated with inelastic compression therapy. CONCLUSIONS: This case demonstrates the potential for misdiagnosis when evaluating erythematous skin. Furthermore, concluding that the erythema is due to a primary cellulitis may result in monotherapy with systemic antimicrobial agents. In such cases, making a correct diagnosis through a skillful and complete physical examination of the patient, coupled with appropriate investigations, will lead to the best possible outcome. A comprehensive treatment approach may include systemic antimicrobials, as well as surgical options and compression therapy.

Integrating remote sensing methods during controlled exposure experiments to quantify group responses of dolphins to navy sonar.

Human noise can be harmful to sound-centric marine mammals. Significant research has focused on characterizing behavioral responses of protected cetacean species to navy mid-frequency active sonar (MFAS). Controlled exposure experiments (CEE) using animal-borne tags have proved valuable, but smaller dolphins are not amenable to tagging and groups of interacting individuals are more relevant behavioral units for these social species. To fill key data gaps on group responses of social delphinids that are exposed to navy MFAS in large numbers, we describe novel approaches for the coordinated collection and integrated analysis of multiple remotely-sensed datasets during CEEs. This involves real-time coordination of a sonar source, shore-based group tracking, aerial photogrammetry to measure fine-scale movements and passive acoustics to quantify vocal activity. Using an example CEE involving long-beaked common dolphins (Delphinus delphis bairdii), we demonstrate how resultant quantitative metrics can be used to estimate behavioral changes and noise exposure-response relationships.

Anxiety and mood disorders and cannabis use.

BACKGROUND: Cannabis use has been linked to anxiety and mood disorders (AMD) in clinical cases, but little research on this relationship has been reported at the epidemiological level. OBJECTIVES: We examined the relationship between self-reported frequency of cannabis use and risk for AMD in the general Ontario adult population. METHODS: Data were based on the CAMH Monitor survey of Ontario adults from 2001 to 2006 (n = 14,531). AMD was assessed with the 12-item version of the General Health Questionnaire (GHQ12). Frequency of cannabis use within the past year was grouped into five categories: No use (abstainer), less than once a month but at least once a year, less than once a week but at least once a month, less than daily but at least once a week, almost every day to more than once a day. Logistic regression analysis of AMD and cannabis use was implemented while controlling for demographics and alcohol problems. RESULTS: AMD was most common among heavy cannabis users (used almost every day or more) (18.1%) and lowest for abstainers (8.7%). Compared to abstainers, the risk of AMD was significantly greater for infrequent cannabis users (OR = 1.43) and heavy cannabis users (OR = 2.04) but not for those in between. CONCLUSION: These data provide epidemiological evidence for a link between both light and heavy cannabis use and AMD. SCIENTIFIC SIGNIFICANCE: Recognizing the comorbidity of heavy cannabis use and AMD should facilitate improved treatment efforts. Our results also suggest the possibility that, for some individuals, AMD may occur at relatively low levels of cannabis use.

Development of a positive youth development program: promoting the mental health of stressful adolescents using principles of Problem Solving Therapy.

This paper outlines the proposal for the development, implementation, and evaluation of a positive youth development program that attempts to promote the mental health of stressful Chinese adolescents using principles of Problem Solving Therapy (PST). There are two general aims of PST: to help clients identify life difficulties and resolve them, as well as to teach them skills on how to deal with future problems. The proposed project will utilize the principles of PST as the guiding framework to run two mental health promotion courses for adolescents who are experiencing disturbing stressful responses and students who want to improve their stress management style. Both objective and subjective outcome evaluation strategies will be carried out to assess the effectiveness of the intervention to promote the psychological well-being in adolescents who are experiencing stress. A related sample proposal is described that can give social workers some insight on how to prepare a proposal for developing the Tier 2 Program of the Project PATHS (Positive Adolescent Training through Holistic Social Programs).

Trends in adolescent suicide in Hong Kong for the period 1980 to 2003.

This paper utilizes existing statistics on adolescent suicide to examine adolescent suicide trends and patterns in Hong Kong for the period 1980 to 2003. Several trends and patterns could be revealed from the analyses. First, there was a gradual rising trend where adolescent suicide rates in the 1990s and the early 2000s were higher than those in the 1980s. Second, suicide rates for adolescents aged 10-24 years were lower than those of other adult age groups. Third, although adolescent suicide rates in Hong Kong were lower than those reported in some English-speaking countries and Mainland China, the figures were higher than those reported in Taiwan. Fourth, suicide rates among teenagers in early adolescence were lower than those among adolescents in late adolescence. Fifth, although male adolescent suicide rates were in general higher than female adolescent suicide rates (10-24 age group), gender differences in suicide rates appeared to be moderated by age. Sixth, there was a gradual rising trend in adolescent proportional mortality rates for suicide since the 1990s. Seventh, proportional mortality rates for suicide among teenagers in early adolescence were lower than those among adolescents in late adolescence. Finally, although jumping from a height was a common method of adolescent suicide, there was a rising trend of using other methods, such as taking drugs, hanging and charcoal burning. The observed adolescent suicide phenomena are discussed in this study with reference to the socio-cultural context of Hong Kong.

A continuous biological process to decolorize bleach plant effluents.

Although almost every U.S. pulp mill has a biological wastewater treatment system, these systems based on bacteria, are largely ineffective in the removal of color. For this reason, we have attempted to utilize Phanerochaete chrysosporium, a fungus known to degrade lignin, as the primary organism in a novel waste treatment scheme named the MyCoR Process. Color from bleached Kraft mills originates principally from the first extraction stage of the bleach plant. It is this waste stream which is sent to the MyCoR Process reactor, a rotating biological contactor, for decolorization. We have found that under optimal conditions up to 2,000 color units/L/day can be removed from the waste stream. There is also a concomitant removal of COD and BOD. In addition, chlorolignins originating from the bleaching process were found to be dechlorinated; this is of interest to those concerned with the impact of bleach plant effluents on the environment. The process uses conventional wastewater treatment equipment. However, the use of a pure culture of fungus in a secondary metabolic state has not been attempted previously in a waste treatment scheme. Minor equipment modification and close operator attention may therefore be required. A preliminary economic analysis shows that the MyCoR Process, in its present state, would cost about US$30/metric ton of bleached Kraft pulp produced. This cost will decrease as improved or new strains of fungi are developed for the process.

Influence of lignin and its degradation products on enzymatic hydrolysis of xylan.

The influence of lignin, lignin model compounds, and black liquor from the kraft pulping process on the hydrolysis of xylan by xylanase was investigated. Addition of vanillic acid, acetovanillone, and protocatechuic acid increased the rate of hydrolysis of xylan by as much as 18-50% at low concentrations, but reached maxima at about 0.05% concentration. Addition of vanillin caused a 15% improvement in xylan hydrolysis, while addition of guaiacol more than doubled the hydrolysis rate. Increasing concentrations of either lignin or black liquor also increased the hydrolysis rate of xylan. Circular dichroism spectroscopy indicated a change in the structure of xylanase in the presence of black liquor.

Degradation of 4,5-dichloroguaiacol by soil microorganisms.

No microorganisms could be isolated from chemostats or from a soil column fed with 4,5-dichloroguaiacol as the only carbon source. If guaiacol was added to chemostats with 4,5-dichloroguaiacol, either soil microbial consortia or guaiacol-degrading bacteria could dechlorinate the 4,5-dichloroguaiacol provided it was <0.2MM. A microbial consortium from farm soil removed 4,5-dichloroguaiacol under aerobic or anoxic conditions, with or without chlorolignin. Dichlorocatechol was the only 4,5-dichloroguaiacol-derived metabolite detected. In aerobic incubations, 4,5-dichlorocatechol was further degraded whereas under anoxic conditions it accumulated.