Antimicrobial resistance of Helicobacter pylori in Germany, 2015 to 2018.

OBJECTIVES: National and international guidelines recommend empiric first-line treatments of individuals infected with Helicobacter pylori without prior antimicrobial susceptibility testing. For this reason, knowledge of primary resistance to first-line antibiotics such as clarithromycin is essential. We assessed the primary resistance of H. pylori in Germany to key antibiotics by molecular genetic methods and evaluated risk factors for the development of resistance. METHODS: Gastric tissue samples of 1851 yet treatment-naïve H. pylori-positive patients were examined with real-time PCR or PCR and Sanger sequencing for mutations conferring resistance to clarithromycin, levofloxacin and tetracycline. Clinical and epidemiological data were documented and univariable and multivariable logistic regression analyses were conducted. RESULTS: Overall primary resistances were 11.3% (210/1851) to clarithromycin, and 13.4% (201/1497) to levofloxacin; resistance to tetracycline (2.5%, 38/1497) was as low as combined resistance to clarithromycin/levofloxacin (2.6%, 39/1497). Female sex and prior antimicrobial therapies owing to unrelated bacterial infections were risk factors for clarithromycin resistance (adjusted OR (aOR) 2.3, 95% CI 1.6-3.4; and 2.6, 95% CI 1.5-4.5, respectively); older age was associated with levofloxacin resistance (aOR for those ≥65 years compared with those 18-35 years: 6.6, 95% CI 3.1-14.2). CONCLUSIONS: Clarithromycin might still be recommended in first-line eradication therapies in yet untreated patients, but as nearly every tenth patient may carry clarithromycin-resistant H. pylori it may be advisable to rule out resistance ahead of treatment by carrying out susceptibility testing or prescribing an alternative therapy.

Effects of Er:YAG and Nd:YAP laser irradiation on the surface roughness and free surface energy of enamel and dentin: an in vitro study.

Sixty-seven extracted molars were selected (134 samples). Dentin and enamel samples were prepared by buccal and lingual surface sectioning to expose a planar enamel or dentin surface. For the roughness study, 80 samples were randomly assigned to eight groups. Enamel and dentin surfaces were etched with a 37% phosphoric acid solution, irradiated with an Er:YAG laser or irradiated with a Nd:YAP laser. Samples were then observed in SEM using BSE. For the free-surface energy study, 54 samples received the same treatment as above. Two contact angle measurements were made on each surface using a goniometer. Data were analyzed by a non-parametric statistical test. Morphological changes on enamel and dentin were greater with acid-etch and Er:YAG laser than with Nd:YAP laser. Free surface energy was significantly greater with acid-etch or Er:YAG laser than with Nd:YAP laser (p < 0.001).

Microleakage of class V composite restorations following Er:YAG and Nd:YAP laser irradiation compared to acid-etch: an In vitro study.

This study compared microleakage at enamel/composite and dentine/composite interfaces following Er:YAG laser, Nd:YAP laser, or acid-etch preparation. Class V cavities produced on the lingual and buccal surfaces of 20 extracted carie- and restoration-free human teeth were randomly assigned to four groups of 10 cavities. Teeth were treated with 37% phosphoric acid and primer (group 1), irradiated with an Er:YAG laser (group 2) or an Nd:YAP laser (group 3), or served as controls (group 4). The specimens were restored with Scotchbond Multipurpose/Z100 (3M), stored in physiological solution at 37 degrees C for 7 days, thermocycled 500 times between 5 degrees C and 55 degrees C, placed in a 0.5% solution of basic fuchsin for 48 h, embedded in resin, and sectioned. Microleakage was assessed according to the depth of dye penetration along the restorative composite. The results showed that irradiation with Er:YAG and Nd:YAP lasers did not produce a good seal. Mean microleakage was greater than with acid-etch and statistically comparable to that of control cavities (Kruskal-Wallis test).

[Pulmonary edema and tocolysis with beta-agonists]. / OEdème pulmonaire et tocolyse par bêta-mimétiques.

It is not unusual for respiratory specialists to be called to deal with respiratory problems in pregnancy. However, some conditions, such as tocolysis-induced pulmonary edema, although common, are largely unknown to our specialty. We report on the cases of three pregnant women, who developed pulmonary edema in the context of tocolysis with the intra-venous infusion of B-agonists. In all three patients, tocolysis was required because contraction developed well before term. Triple pregnancy was present in one patient. In another patient, mechanical ventilation was required. The outcome was good with full recovery in all three cases.

Amplifications of DNA primase 1 (PRIM1) in human osteosarcoma.

We studied the involvement of PRIM1 in osteosarcoma by differential display, Northern and Southern hybridization, as well as fluorescence in situ hybridization (FISH) on interphase nuclei. In total, 22 pediatric oncology specimens were tested. PRIM1 was found to be amplified in 41% of the samples. PRIM1 is coamplified with the core 12q13 amplicon genes CDK4, SAS, and OS9, and was physically mapped very close to them. PRIM1 is therefore a new candidate for the role of a major target gene of 12q13 amplifications in human cancers. Genes Chromosomes Cancer 26:62-69, 1999.

Scanning electron microscopic analysis of diseased and healthy dental hard tissues after Er:YAG laser irradiation: in vitro study.

The aim of this study was to treat carious lesions, sound dentin, and enamel either with conventional methods or with an Er:YAG laser and to compare the results. Thirty freshly extracted carious human teeth were divided into two groups. In the first group, lesions were treated with burs in a dental handpiece; in the second group, we used the Er:YAG laser with parameters recommended by the manufacturer (Kavo). After treatment, the teeth were prepared for scanning electron microscopic observation. On laser-treated teeth, scaly, flaky, rough surfaces were seen: surfaces were clean with several morphological reliefs that may enhance bonding resin restoration. The Er:YAG laser beam can ablate carious dentin with an energy level of 250 mJ at 2 Hz. Sound dentin can be cut at 300 mJ and 2 Hz; for enamel, 350 mJ and 3 Hz are required. The Er:YAG laser seems to be effective in the treatment of carious lesions and in cavity preparation in vitro.

In-vivo activity and tolerance of conventional formulation versus fat emulsion formulation of amphotericin B in experimental disseminated candidiasis in neutropenic rabbits.

Amphotericin B can cause significant toxicity but this can be reduced by direct dilution into a fat emulsion (Intralipid). To investigate the potential use of amphotericin B diluted in Intralipid, a study was made of its activity in the treatment of subacute disseminated candidiasis in persistently granulocytopenic rabbits, compared with the same dose of amphotericin B diluted in dextrose. Amphotericin-B-fat emulsion was at least as effective as amphotericin-B-dextrose. Amphotericin-B-fat emulsion was significantly more effective than amphotericin-B-dextrose therapy in reducing candida colony counts in both kidney and liver tissues (P < 0.05). Furthermore, amphotericin-B-fat emulsion was found less toxic on the renal function than conventional amphotericin B (P < 0.05). From these experimental results, we conclude that amphotericin-B-fat emulsion (Intralipid) was at least as effective and less toxic than conventional amphotericin B.

[The occurrence of Babesia divergens in the Freiburg i. Br. district and piroplasmosis prevention trials in cattle]. / Zum Vorkommen von Babesia divergens im Bezirk Freiburg i. Br. und Versuche zur Piroplasmoseprophylaxe beim Rind.

The occurrence of Babesia divergens in the Freiburg i. Br. district is reported. By interviewing farmers and by serological investigations, three valleys where located in which bovine piroplasmosis occurs since many years. Main objective of this study was to strategically control the vector ticks, Ixodes ricinus with the synthetic pyrethroid flumethrin, in order to prevent clinical piroplasmosis after turnout to pastures in spring, without interfering with protective immunity against Babesia divergens. A total of 200 cattle were used for trials in the period 1990-92. Three pour-on treatments of fortnightly intervals provided best results. Only 4.3% of 163 treated cattle contracted piroplasmosis, in contrast to 19% of 37 untreated cattle. All cattle were sero-negative at the time of turnout. At the end of pasture periods 1990 and 1991 82.4 and 79.6% respectively of treated cattle were sero-positive.

Analytical determination of the distribution of flumethrin on the body surface of cattle following topical pour-on application.

By means of chemical analysis, the distribution behaviour of flumethrin was determined in the hair coat of cattle following topical pour-on application. Flumethrin was applied at 1 mg active ingredient (a.i.) kg-1 body weight along the backline of cattle. It was demonstrated that this compound could be recovered from all hair samples taken on Day 1 following application from dorsal, lateral, ventral and distal body regions in concentrations ranging from 670 to 1 micrograms a.i. g-1 hair, depending on the distance from the site of application. On Days 3, 5 and 10 after treatment, the corresponding concentrations were 125.0-1.5, 23.0-1.0, and 44.0-0.9 micrograms a.i. g-1 hair, respectively. When correlating these values to the body surface of cattle, it is evident that on all sample days and body regions, a concentration of more than 0.01 microgram a.i. cm-2 body surface was present. This amount of active substance is sufficient for effective acaricidal action, as shown by laboratory and field data.

Scanning electron microscopic study of odontoblasts and circumpulpal dentin in a human tooth.

Two combined scanning electron microscopic methods including modified fixative procedures were used for studying the morphologic aspects of the odontoblasts and the corresponding dentinal wall at different endodontic levels. The odontoblasts were tightly packed in the pulp horn, where they assumed pear-shaped profiles and, from crown to apex, successively looked spindle shaped, club shaped, and globular. Their number decreased in the pulp radicular portion, where the interglobular spaces were enlarged. The filling fibrillar material varied from crown to apex. A globular circumpulpal dentin was observed at all levels of the root canal. The tubule openings varied in number and size.

The use of flumethrin 1% pour-on for the control of Amblyomma spp. in various southern African countries.

Efficacy trials with flumethrin 1% pour-on were conducted in 9 different areas in 3 southern and central African countries against Amblyomma hebraeum and A. variegatum on cattle. A dose volume of 10 ml/100 kg body mass applied at bi-weekly intervals provided excellent control of both tick species on their predilection sites, irrespective of locally and seasonally high tick pressure. The trial results demonstrate clearly that this new concept of tick control can be effectively applied in commercial and traditional cattle husbandry situations.