Exploring the destiny and distribution of thiocyanate in the water-soil-plant system and the potential impacts on human health.

Endocrine disruptors like thiocyanate are some of the principal causes of chronic disorders worldwide. Prenatal and postnatal exposure to thiocyanate can interfere with normal neurological development in both fetuses and newborns. Currently, little information regarding thiocyanate levels and potential sources of exposure is available. In this study, we evaluated thiocyanate uptake and accumulation in chard and spinach grown under greenhouse conditions. Both chard and spinach are commonly used to produce baby foods. Three thiocyanate concentrations were compared: Control, T1 (30 ng mL-1), and T2 (70 ng mL-1). Thiocyanate accumulation depended on the concentration and exposure time. Chard was found to accumulate more thiocyanate than spinach, with leaf accumulation > stem accumulation (p < 0.0194) and maximum concentrations of 76 ng g-1 (control), 112 ng g-1, (T1), and 134 ng g-1 (T2). The estimated daily intake (EDI) of thiocyanate for chard and spinach (fresh) exceeded the subchronic reference dose of 200 ng-1 kg-1 day-1 and the chronic reference dose of 600 ng-1 kg-1 day-1. In addition, the EDI of thiocyanate for spinach in baby food exceeded twice the chronic reference dose in the vulnerable newborn-1 year age group. However, all EDIs were lower than the lowest observed adverse effect level (LOAEL) of 1.9 × 105 ng kg-1 day-1. Further studies are needed that increase our knowledge of thiocyanate levels and potential environmental sources to reduce opportunities for exposure, especially in vulnerable groups.

Accumulation and distribution of perchlorate in spinach and chard growing under greenhouse: Implications for food safety in baby foods commodities.

Very little information is available with regards to the bioavailability of perchlorate in spinach or chard used in the production of baby foods commodities. In the present study, the uptake and accumulation of perchlorate were compared under two different treatments (T1: 1 and T2: 10 mg L-1 ClO4-). Our results indicate that spinach has a higher capacity to accumulate perchlorate than chard (p < 0.0185). Concentrations of perchlorate in leaves, stems and roots (leaves > stem > roots) all gradually increased (p < 0.0001) as vegetable growing and treatment (T2 > T1). No significant differences were found between the control and T1. The daily intake for perchlorate (control) is below the proposed international standard, however, it was exceeded in T1 and T2. The results suggested that perchlorate is actively accumulate in high concentrations in vegetables used in the production of baby food commodities and the exposure of perchlorate via the food consumption (baby foods) was evaluated as not safe.

Field study on the uptake, accumulation and risk assessment of perchlorate in a soil-chard/spinach system: Impact of agronomic practices and fertilization.

The application of excessive fertilizer represents a primary source of entry for perchlorate into crop systems and thus has raised widespread concern regarding food safety. Several studies have reported the occurrence of perchlorate in vegetables. However, limited information is available on the fate of perchlorate in the soil-plant system. In this study, we performed field experiments to evaluate the effects of the application rate of Chilean nitrate fertilizer and the type of fertilization (manual or fertigation) on the uptake of perchlorate by plants grown in open fields. Interestingly, in the control, chard and spinach accumulated 21.3 and 25.9 µg kg-1, respectively. For both agronomic practices, the content of perchlorate in chard and spinach increased as the fertilizer application rate increased, with fertigation promoting more significant accumulations. Spinach accumulated almost two times more perchlorate than chard for all treatments; however, the concentrations generally remained below regulatory values. The intake of spinach and chard presented a low risk to human health for all age groups. These findings enhance our understanding of the environmental impact of the use of fertilizers in agriculture and food safety.

Consenso chileno para la atención integral de niños y adultos con fibrosis quística / Chilean consensus for the integral care of children and adults with cystic fibrosis

Cystic Fibrosis (CF) is the most frequent hereditary disease in whites, with a reserved prognosis. Since 2003, Chile began a comprehensive National Cystic Fibrosis Program, directed by the Respiratory Health Unit of the Ministry of Health. To date, the main results of the Program record a significantly longer survival (average 27 years) and a significant reduction in the age of diagnosis of patients admitted from 2006 onwards. Access to Chilean Explicit Health Guarantees, the implementation of neonatal screening in some regions of the country, the organization and setting up of CF-trained teams of various specialties, has contributed to improving results. Although the main manifestations are of the respiratory and digestive system, the multisystemic nature of CF makes it necessary to know the different aspects involved in its management, in order to optimize the results of the treatment and the resources invested, both in the public and private sectors. This document is a review and an update on the main aspects of the diagnosis, monitoring and treatment of the respiratory and non-respiratory manifestations of CF.

La Fibrosis Quística (FQ) es la enfermedad hereditaria de pronóstico reservado más frecuente en raza blanca. Desde el año 2003, Chile inicia un Programa Nacional de Fibrosis Quística, de carácter integral, dirigido por la Unidad de Salud Respiratoria del Ministerio de Salud. Hasta la fecha, los principales resultados del Programa registran una significativa mayor sobrevida (promedio 27 años) y una significativa reducción en la edad de diagnóstico de los pacientes ingresados desde 2006 en adelante. El acceso a la canasta GES (Garantías Explícitas en Salud), la implementación del tamizaje neonatal en algunas regiones del país, la organización y la constitución de equipos entrenados en FQ de diversas especialidades, ha contribuido a mejorar los resultados. Si bien las principales manifestaciones son del aparato respiratorio y digestivo, el carácter multisistémico de la FQ obliga a conocer los distintos aspectos involucrados en su manejo, a fin de optimizar los resultados del tratamiento y los recursos invertidos, tanto en el sector público como privado. Este documento es una revisión y actualización sobre los principales aspectos del diagnóstico, seguimiento y tratamiento de las manifestaciones respiratorias y no respiratorias de la FQ.

Avaliação da dosagem de própolis pulverizada nas folhas de amoreira (morus sp.) sobre o desenvolvimento biológico e produtivo do bicho-da-seda (bombyx mori L. ) / Evaluación de la dosis de propóleos esparcidas en las hojas de morera (morus sp.) en el desarrollo biológico y productivo del gusano de seda (bombyx mori L.) / Evaluation of the doses of propolis pulverization in mulberry leaves (morus sp.) on the biological and productive development of silkworm (bombyx mori L.)

Este experimento foi realizado no Laboratório de Sericicultura, no Campus Sede da Universidade Paranaense (UNIPAR) de Umuarama, no período de 17/09/2009 a 17/10/2009, com o objetivo de verificar o efeito da própolis em diferentes dosagens na alimentação durante o desenvolvimento biológico do bicho-da-seda (Bombxy mori L). O método empregado na parte experimental foi a pulverização do extrato alcoólico de própolis, diluído em 500 mL de água destilada nas folhas de amoreira, nas seguintes dosagens, água-controle, 5mL, 10mL, 15mL e 20mL compondo os tratamentos T1, T2, T3, T4, T5, respectivamente. As folhas de amoreira foram fornecidas cinco vezes ao dia, durante o manejo alimentar. Verificou-se pelos resultados obtidos, que as diferentes dosagens de própolis utilizadas interferem no ganho de peso das lagartas, no peso dos casulos verdes e crisálidas quando comparado ao tratamento controle, influenciando também no número de casulos formados e, para os teores de seda bruto e líquido não apresentaram resultados significativos, quando comparados com o tratamento controle. Portanto, verificou-se que a própolis, nas dosagens utilizadas, não trouxe efeitos depressivos à biologia e produção do bicho-da-seda.

This experiment was conducted at the Sericulture Laboratory, in the Campus Sede of the Universidade Paranaense (UNIPAR) in Umuarama, from 17/09/2009 to 17/10/2009, in order to verify the effects of propolis in different dosages during the development of silkworm (Bombyx mori L). The method used during the experiment was the dillution of an alcohoolic solution of propolis, in 500 mL of destilled water with its further pulverization on mullberry leaves, with the following doses: water control; 5 mL; 10 mL; 15 mL; 20 mL, composing the following treatments: T1, T2, T3, T4, T5, respectively. The mullberry leaves were sprinkled five times a day, during the feed management. It was verified by the results that the different doses of propolis used interfere with gain-weight of the larvae, weight of cocoons and chrysalis, when compared to control. The treatment also influenced the number of cocoons formed. The contento fraw and liquid silk were not significant when compared with the control. Therefore, it was concluded that the propolis, used in those dosages, brought no depressive effects to the development and the production of silkworm.

Este experimento se realizó en el Laboratorio de Sericicultura del Campus Sede de la Universidad Paranaense (UNIPAR) de Umuarama, en el período de 17/09/2009 a 17/10/2009, con el objetivo de verificar el efecto de propóleos en diferentes dosis en la alimentación durante el desarrollo biológico del gusano de seda (Bombyx mori L.). El método usado en la parte experimental fue la pulverización del extracto alcohólico de propóleos, diluido en 500 ml de agua destilada en las hojas de morera, en las siguientes dosis: agua control, 5 ml, 10 ml, 15 ml y 20 ml componiendo los tratamientos T1, T2, T3, T4, T5, respectivamente. Las hojas de morera fueron suministradas cinco veces al día, durante el manejo alimentar. Por los resultados obtenidos se verificó que las dosis diferentes de propóleos utilizadas interfieren en el gano de peso de los gusanos, en el peso de los capullos verdes y crisálidas cuando comparado al tratamiento control, influenciando también en el número de capullos formados y, para contenidos de seda bruta y líquida no presentan resultados significativos, mientras comparado con el tratamiento control. Sin embargo, se puede verificar que propóleos, en dosis utilizadas, no trajo efectos depresivos a la biología y producción del gusano.

Tolerance and short-term effect of a cluster schedule with pollen-extracts quantified in mass-units.

We performed a prospective, multicenter study to assess the tolerance and possible short-term effects of allergen vaccines administered according to a cluster schedule in the months immediately preceding the onset of the pollen season. The study was carried out in eight centers and included 191 patients (children and adults) with allergic respiratory disease due to sensitization to olive tree and/or grass pollen. Of these, 34 patients acted as controls and the remaining patients received immunotherapy administered in the initiation phase according to a cluster schedule of eight doses injected on four visits. After 3 months of treatment, significant differences were found between the two groups in medication consumption (antihistamines in drops and oral formulations: p = 0.045 and p = 0.001, respectively; short-acting beta2-agonist treatments: p = 0.004) and respiratory symptoms (wheezing and coughing: p = 0.035 and 0.014, respectively). The cytokine profile (interleukin [IL]-4, 5, 10 and 2, interferon [IFN-gamma], and tumor necrosis factor [TNF-alpha]) was determined before the start of treatment and at the end of follow-up (4-5 months). Levels of IL-4, 5 and 10 (Th2 profile) decreased while those of IL-2, IFN-gamma, and TNF-alpha (Th1 profile) decreased. These differences were more marked in the active group than in the control group but were not statistically significant. No severe adverse effects were recorded. This study shows that the schedule tested had an acceptable tolerance profile and produced significant changes in symptom and medication scores after a few months of treatment. A double-blind, placebo-controlled study is needed to confirm these results.

Tolerance and short-term effect of a cluster schedule with pollen-extracts quantified in mass-units

We performed a prospective, multicenter study to assess the tolerance and possible short-term effects of allergen vaccines administered according to a cluster schedule in the months immediately preceding the onset of the pollen season. The study was carried out in eight centers and included 191 patients (children and adults) with allergic respiratory disease due to sensitization to olive tree and/or grass pollen. Of these, 34 patients acted as controls and the remaining patients received immunotherapy administered in the initiation phase according to a cluster schedule of eight doses injected on four visits. After 3 months of treatment, significant differences were found between the two groups in medication consumption (antihistamines in drops and oral formulations: p = 0.045 and p = 0.001, respectively; short-acting β2-agonist treatments: p = 0.004) and respiratory symptoms (wheezing and coughing: p = 0.035 and 0.014, respectively). The cytokine profile (interleukin [IL]-4, 5, 10 and 2, interferon [IFN-γ], and tumor necrosis factor [TNF-α]) was determined before the start of treatment and at the end of follow-up (4-5 months). Levels of IL-4, 5 and 10 (Th2 profile) decreased while those of IL-2, IFN-γ, and TNF-α (Th1 profile) decreased. These differences were more marked in the active group than in the control group but were not statistically significant. No severe adverse effects were recorded. This study shows that the schedule tested had an acceptable tolerance profile and produced significant changes in symptom and medication scores after a few months of treatment. A double-blind, placebo-controlled study is needed to confirm these results (AU)

Se ha llevado a cabo un estudio prospectivo y multicéntrico con el objetivo de valorar la tolerancia y posible efecto a corto plazo de las vacunas alergénicas administradas bajo pauta cluster en los meses inmediatamente anteriores al inicio de la estación polínica. El estudio se realizó en 8 centros, incluyéndose un total de 191 pacientes (niños y adultos) con enfermedad alérgica respiratoria por sensibilización a polen de olivo y/o gramíneas. De ellos, 34 actuaron como controles y a los pacientes restantes se les administró inmunoterapia bajo una pauta cluster, en la fase de iniciación, de 8 dosis administradas en 4 visitas. Tras 3 meses de tratamiento, se registraron diferencias significativas entre ambos grupos en el consumo de medicación (antihistamínicos en colirio y orales -p = 0,045 y p = 0,001 respectivamente- y ß2 de corta duración -p = 0,004-) así como en síntomas pulmonares (sibilancias y tos -p = 0,035 y 0,014 respectivamente-). Por otro lado, se determinó el perfil de citocinas (IL-4, 5, 10 y 2, IFN-gamma y TNF-a) de forma previa al inicio del tratamiento y al finalizar el seguimiento (4-5 meses). Se observaron descensos en los niveles de IL-4, 5 y 10 (perfil TH2) y aumento en los valores de IL-2, IFN-gamma y TNF-a (perfil TH1), más marcados en el grupo activo que en el control, sin alcanzar significación estadística. No se registraron efectos adversos severos. Por tanto, podemos observar que la pauta ensayada mostró un adecuado perfil de tolerancia, y tras pocos meses de tratamiento se registraron cambios significativos en la puntuación de síntomas y medicación, siendo necesaria la realización de un estudio con un diseño doble ciego frente a placebo para confirmar los resultados obtenidos (AU)

Unilateral rhinorrhea and nasal obstruction in an adult.

BACKGROUND: choanal atresia is an uncommon malformation, consisting of congenital blockage of one of both choanae. Symptomatology varies according to the type of atresia and the age of the patient. The bilateral, or complete, form presents in newborns as respiratory distress while unilateral, or incomplete, forms present in older children or adults. CASE REPORT: a 16-year-old girl presented with a lifelong history of right-sided nasal blockage and unilateral watery rhinorrhea. The rhinorrhea increased when the patient bent her head forward. Treatment with antihistamines and topical nasal corticosteroid sprays produced little improvement. The patient's previous medical history was unremarkable except for the expulsion of a coagulated mass through the right nostril a few days after birth, and event that provoked her symptoms. Physical examination was normal except for excoriation of the right external nasal margin. Anterior rhinoscopy revealed watery rhinorrhea, erythematous mucosa in the right nasal cavity and deviated nasal septum. No nasal masses or polyps were found. Physical examination confirmed the absence of ventilation in the right nasal airway and nasal endoscopy indicated right choanal obstruction. DIAGNOSTIC TEST: skin prick tests with aeroallergens were positive for grass pollen and negative for all other allergens tested (mites, moulds, latex, and epithelia). Total IgE was normal (9 IU/ml). No eosinophilia was detected in the nasal secretion specimen. The results of laboratory tests including complete blood count and differential, erythrocyte sedimentation rate, and biochemical parameters were normal. The glucose level in nasal secretion was 4.6 mg/dl. X-rays of the paranasal sinuses and cavum showed no anomalies. Axial fine-cut computed tomography scans (3 3 mm) revealed choanal obstruction with bony and membranous components. CONCLUSIONS: a diagnosis of congenital choanal atresia should be considered in cases of unilateral blockage and rhinorrhea. Nasal endoscopy and computed tomography scans are essential to establish diagnosis.

Unilateral rhinorrhea and nasal obstruction in an adult

Background: choanal atresia is an uncommon malformation, consisting of congenital blockage of one of both choanae. Symptomatology varies according to the type of atresia and the age of the patient. The bilateral, or complete, form presents in newborns as respiratory distress while unilateral, or incomplete, forms present in older children or adults. Case report: a 16-year-old girl presented with a lifelong history of right-sided nasal blockage and unilateral watery rhinorrhea. The rhinorrhea increased when the patient bent her head forward. Treatment with antihistamines and topical nasal corticosteroid sprays produced little improvement. The patient's previous medical history was unremarkable except for the expulsion of a coagulated mass through the right nostril a few days after birth, and event that provoked her symptoms. Physical examination was normal except for excoriation of the right external nasal margin. Anterior rhinoscopy revealed watery rhinorrhea, erythematous mucosa in the right nasal cavity and deviated nasal septum. No nasal masses or polyps were found. Physical examination confirmed the absense of ventilation in the right nasal airway and nasal endoscopy indicated right choanal obstruction. Diagnostic test: skin prick tests with aeroallergens were positive for grass pollen and negative for all other allergens tested (mites, moulds, latex, and epithelia). Total IgE was normal (9 IU/ml). No eosinophilia was detected in the nasal secretion specimen. The results of laboratory tests including complete blood count and differential, erythrocyte sedimentation rate, and biochemical parameters were normal. The glucose level in nasal secretion was 4.6 mg/dl. X-rays of the paranasal sinuses and cavum showed no anomalies. Axial fine-cut computed tomography scans (3 ¥ 3 mm) revealed choanal obstruction with bony and membranous components. Conclusions: a diagnosis of congenital choanal atresia should be considered in cases of unilateral blockage and rhinorrhea. Nasal endoscopy and computed tomography scans are essential to establish diagnosis (AU)

Introducción: la atresia de coanas es una malformación infrecuente que consiste en una obstrucción congénita de una o ambas coanas. La sintomatología varía según el tipo de atresia y la edad del paciente. La forma bilateral completa se manifiesta en el recién nacido con un distrés respiratorio, mientras que las formas unilaterales o incompletas pueden diagnosticarse en niños más mayores o adultos.Caso clínico: mujer de 16 años de edad, enviada para estudio por presentar una historia de larga evolución de obstrucción nasal derecha y rinorrea acuosa unilateral. La rinorrea aumentaba al inclinar la cabeza hacia delante. Poca mejoría a pesar de tratamiento con antihistamínicos y corticoides tópicos. No refería antecedentes personales de interés salvo la expulsión de un coágulo a través de la fosa nasal derecha pocos días después del nacimiento a raíz del cual comenzaron los síntomas. La exploración clínica era normal salvo excoriación del vestíbulo nasal derecho.La rinoscopia anterior mostraba rinorrea acuosa, mucosa nasal eritematosa en la fosa nasal derecha y desviación del tabique nasal. No se observaron masas ni pólipos. El examen clínico permitió confirmar la usencia de ventilación en la fosa nasal derecha y la exploración mediante endoscopia nasal reveló la obstrucción de la coana derecha.Pruebas diagnósticas: los tests cutáneos con neumoalergenos inhalantes fueron positivos para pólenes de gramíneas y negativos para el resto de los alergenos testados (ácaros, hongos, epitelios y látex). IgE total normal (9 UI/ml). Eosinofilia nasal negativa. Hemograma, VSG y parámetros bioquímicos normales. Cifras de glucosa en la secreción nasal 4,6 mg/dl (normal). Rx de senos paranasales y cavum sin hallazgos. TAC de senos paranasales de cortes finos (3 3) demuestra la obstrucción de la coana derecha que presenta un componente óseo y membranoso.Conclusiones: el diagnóstico de la atresia congénita de coanas unilateral debe ser considerado en los casos de obstrucción nasal y rinorrea unilaterales. La endoscopia nasal y la TAC de senos paranasales son fundamentales para el diagnóstico (AU)

Behavioral treatment of hypertensive heart disease in African Americans: rationale and design of a randomized controlled trial.

African Americans experience higher morbidity and mortality than Whites do as a result of hypertension and associated cardiovascular disease. Chronic psychosocial stress has been considered an important contributing factor to these high rates. The authors describe the rationale and design for a planned randomized controlled trial comparing Transcendental Meditation, a stress-reduction technique, with lifestyle education in the treatment of hypertension and hypertensive heart disease in urban African Americans. They pretested 170 men and women aged 20 to 70 years over a 3-session baseline period, with posttests at 6 months. Outcomes included clinic and ambulatory blood pressure, quality of life, left ventricular mass measured by M-mode echocardiography, left ventricular diastolic function measured by Doppler, and carotid atherosclerosis measured by beta-mode ultrasound. This trial was designed to evaluate the hypothesis that a selected stress reduction technique is effective in reducing hypertension and hypertensive heart disease in African Americans.

Fatty acids specifically related to the anisotropic properties of plasma membrane from rat urothelium.

Four different luminal surfaces of rat urothelium differing in their fatty acid composition were prepared by dietary induction. In order to induce lipid changes, each of four groups of rat received a basal diet rich in one of the unsaturated n-3, n-6 or n-9 fatty acid families and a commercial (control) diet. The effects of the dietary regime on the fatty acid composition of luminal urothelial membranes and their relation to the mobility of fluorescent probes were studied. In comparison with the control diet membrane, all three fatty acid-rich diets induced a decrease of the percentage amount of saturated fatty acid while that of the unsaturated fatty acids was increased. Accordingly, all three diets increased the unsaturation index in comparison with the control diet. The anisotropy across each membrane fraction was assessed using the n-(9-anthroyloxy) fatty acid fluorescent probes 3-AS, 7-AS and 12-AS, which locate at different depths in the membrane. Two different anisotropy profiles were observed. One profile showed the highest anisotropy at the C7 depth, whereas the other exhibited a continuous decrease of the anisotropy from the surface to the center of the bilayer. The molecular properties (isomerization) of 18:2n-9 fatty acid may account, at least in part, for the observed V-shaped profile (the ascending trend) of the membrane anisotropy values as a function of the respective 18:2n-9 fatty acid contents. Nevertheless, the minimum value of the profile did not correspond to the minimum 18:2n-9 fatty acid content, but rather to the higher amount of docosahexaenoic (22:6n-3) fatty acid. Thus, a modulating role of the 22:6n-3 fatty acid on the rigidifying effect of 18:2n-9 fatty acid is suggested, possibly mediated by relationships between fatty acid composition, saturated and unsaturated chain lengths, and freedom of motion of the phospholipid acyl chains.

Stress, stress reduction and hypercholesterolemia in African Americans: a review.

Psychological stress may directly contribute to the disproportionately high rates of coronary heart disease morbidity and mortality and its etiologic risk factors in African Americans. Specifically, acute and chronic stress have been shown to raise serum lipids and are associated with clinical coronary events. The mechanisms by which stress contributes to alterations in lipid levels are not fully known, but various pathways (ie, hormonal, dietary, etc) have been implicated. Traditional methods for reducing blood serum lipids include diet, drugs or both. These methods have been criticized because of issues of compliance, side effects, and cost. Because of these limitations, nondrug behavioral methods are recommended by the National Cholesterol Education Program as the first line of prevention and treatment for hypercholesterolemia and other risk factors. Research shows that CHD morbidity and mortality and major risk factors may be modifiable by behavioral intervention. Specifically, the Transcendental Meditation technique, an effective antidote to stress, reduces levels of major CHD risk factors including hypercholesterolemia, as well as blood pressure and smoking. Using an effective stress reduction approach for prevention and treatment of CHD and its risk factors in African Americans may prove to be a valuable asset for this underserved population.

Estenosis laringotraqueal / Laryngotracheal stenosis

Se realiza una evaluación retrospectiva de los pacientes con estenosis laringotraqueal vistos por el autor en el departamento de otorrinolaringología, en los últimos 12 años. La muestra consta de 64 pacientes en los cuales se analiza la distribución por sexo, edad y causas de la estenosis laringotraqueal en la que destaca la intubación endotraqueal prolongada en un 62 por ciento de los casos, seguida por el traumatismo laringotraqueal en un 18 por ciento. Se analizan algunos aspectos del manejo de estos pacientes, agrupados en dos categorías: manejo quirúrgico y observación. Se evalúa el éxito de la terapia en base al porcentaje de pacientes que logran decanularse posterior al tratamiento y al tiempo en que dicha decanulación puede realizarse. Finalmente se realiza una revisión de la literatura acerca del tema, haciendo hincapié en la prevención de la estenosis laringotraqueal, atacando directamente las causas que mayormente inciden en su producción, como es la intubación endotraqueal prolongada

Report on an outbreak of postinjection abscesses due to Mycobacterium abscessus, including management with surgery and clarithromycin therapy and comparison of strains by random amplified polymorphic DNA polymerase chain reaction.

An outbreak of postinjection abscesses occurred in Barranquilla, Colombia, and was associated with local injections of lidocaine given in a single physician's office. Over a 5-month period, 350 (18%) of approximately 2,000 injected patients developed localized cutaneous abscesses or cellulitis; of 210 abscess specimens that were cultured, 205 were positive for rapidly growing mycobacteria, subsequently identified as Mycobacterium abscessus. The source of the outbreak was not identified. M. abscessus could not be characterized by pulsed-field gel electrophoresis, but all isolates were identical in terms of drug and heavy metal resistance patterns and random amplified polymorphic DNA PCR profiles. We believe this is the first report of the use of this latter technique for investigation of an outbreak due to M. abscessus. Therapy with a combination of surgical excision and 3-6 months' administration of clarithromycin was successful for 95% of 148 patients treated in this manner; in contrast, therapy was successful for less than one-third of patients treated with surgery alone or clarithromycin alone. This is the largest of the nine known outbreaks of postinjection abscesses that have occurred due to rapidly growing mycobacteria and is the first in which an effective method of therapy was demonstrated.