The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples: an NTM-NET collaborative study.

A significant knowledge gap exists concerning the geographical distribution of nontuberculous mycobacteria (NTM) isolation worldwide. To provide a snapshot of NTM species distribution, global partners in the NTM-Network European Trials Group (NET) framework (www.ntm-net.org), a branch of the Tuberculosis Network European Trials Group (TB-NET), provided identification results of the total number of patients in 2008 in whom NTM were isolated from pulmonary samples. From these data, we visualised the relative distribution of the different NTM found per continent and per country. We received species identification data for 20 182 patients, from 62 laboratories in 30 countries across six continents. 91 different NTM species were isolated. Mycobacterium avium complex (MAC) bacteria predominated in most countries, followed by M. gordonae and M. xenopi. Important differences in geographical distribution of MAC species as well as M. xenopi, M. kansasii and rapid-growing mycobacteria were observed. This snapshot demonstrates that the species distribution among NTM isolates from pulmonary specimens in the year 2008 differed by continent and differed by country within these continents. These differences in species distribution may partly determine the frequency and manifestations of pulmonary NTM disease in each geographical location.

Morphological sequence of Plastipore extrusion in experimental otitis media.

OBJECTIVES: Plastipore prostheses are still used by many surgeons, although the functional results are controversial. The aim of this study was the morphological analysis of Plastipore material performance in the middle ear of rats, with special attention to extrusion. METHODS: Twenty-four Wistar rats were given implants made of commercially available Plastipore and assigned to 3 groups: group A, with implantation in a healthy middle ear; group B, with implantation and cauterization of the nasopharyngeal orifice of the eustachian tube (hypoventilation); and group C, with implantation, cauterization of the eustachian tube, and bacterial inoculation with Pseudomonas aeruginosa. RESULTS: The pathological study showed in nearly all cases the disintegration of the biomaterial. Adhesion between the biomaterial and bone could be seen in 1 rat from group C (hypoventilation and infection). In group C, the Plastipore was in contact with the tympanic membrane in 1 case and was extruding in 2 animals. Different phases of extrusion were defined. No extrusion was observed in the other groups. CONCLUSIONS: The sequential stages of Plastipore extrusion are demonstrated. Infection seems to be the most important factor in Plastipore extrusion in our model.

Tissular changes induced by Pseudomonas aeruginosa in an otitis media rat model with tubal obstruction.

CONCLUSIONS: This is a suitable model for the study of different features of middle ear inflammation. This model allows manipulations inside the middle ear while preserving relevant structures such as the tympanic membrane, and provides a useful model for the study of interactions between bacterial infection and eustachian tube dysfunction. OBJECTIVES: Analysis of early and late histological features in an experimental model of Pseudomonas aeruginosa middle ear inoculation in the rat designed for the study of middle ear procedures. MATERIALS AND METHODS: Thirty Wistar rats were inoculated with Pseudomonas aeruginosa in the tympanic bulla followed by the cauterization of the eustachian tube. Culturing of middle ear effusion was carried out at 7 days follow-up and at sacrifice. Processing of the temporal bones for light microscopy was performed at 7, 14, 30 and 60 days. RESULTS: Early cultures were positive in most cases, thus proving that middle ear inflammation was due to the presence of inoculated Pseudomona aeruginosa. Mucoperiosteal inflammatory changes similar to those observed in human middle ear infection were seen. Acute inflammatory cell infiltration was seen at 7 and 14 days, gradually decreasing to chronic inflammatory changes with fibroplasia at 60 days. Bone resorption was observed at 7 and 14 days, changing to a bony deposition at 30 and 60 days.

Labyrinthitis secondary to experimental otitis media.

PURPOSE: Analysis of labyrinthitis in a model of otitis media. MATERIALS AND METHODS: Morphologic study in 20 Wistar rats in which otitis media was induced by transbullar inoculation of Pseudomonas aeruginosa with obstruction of the eustachian tube. RESULTS: Seventy percent of rats showed vestibular signs. Histologic changes ranged from nonaffected labyrinths to suppurative labyrinthitis. CONCLUSIONS: Dissemination of infection probably occurs through round window membrane. A thinner round window membrane typical of rodents would be the reason for a more severe clinical and morphologic picture in rats when compared to human beings.

Papel de enfermeria en un servicio de farmacodependencia / Nurse's role in a pharmacodependence service

El objetivo general del trabajo es proporcionar cuidado integral del paciente, logrando su rehabilitación en un ambiente terapéutico adecuado. Este objetivo, así como los específicos se alcanzan a través de actividades administrativas, asistenciales, docente y psico terapéuticas. Son resumidos los factores mas importantes en el proceso de comunicación entre enfermera y paciente, y una lista de preguntas que permitiran una valoración continua de la conducta del profesional y del paciente. Para comprender las ideas básicas de los procesos de grupo a fin de conocer sus pautas de conducta el personal de enfermería lo utiliza como instrumento de aplicación de técnicas terapéuticas en grupo de ventilación y apoyo. Se hace una reseña histórica de la teroria de grupos, se especifica el contenido y el proceso de interacción de los mismos, así como los fenómenos de su interacción