Novel plasmid conferring kanamycin and tetracycline resistance in the turkey-derived Campylobacter jejuni strain 11601MD.

In Campylobacter spp., resistance to the antimicrobials kanamycin and tetracycline is frequently associated with plasmid-borne genes. However, relatively few plasmids of Campylobacter jejuni have been fully characterized to date. A novel plasmid (p11601MD; 44,095nt) harboring tet(O) was identified in C. jejuni strain 11601MD, which was isolated from the jejunum of a turkey produced conventionally in North Carolina. Analysis of the p11601MD sequence revealed the presence of a high-GC content cassette with four genes that included tet(O) and a putative aminoglycoside transferase gene (aphA-3) highly similar to kanamycin resistance determinants. Several genes putatively involved in conjugative transfer were also identified on the plasmid. These findings will contribute to a better understanding of the distribution of potentially self-mobilizing plasmids harboring antibiotic resistance determinants in Campylobacter spp. from turkeys and other sources.

Chromosomal tet(O)-harboring regions in Campylobacter coli isolates from turkeys and swine.

In turkey-derived Campylobacter coli isolates of a unique lineage (cluster II), the tetracycline resistance determinant tet(O) was chromosomal and was part of a gene cassette (transposon) interrupting a Campylobacter jejuni-associated putative citrate transporter gene. In contrast, the swine-derived C. coli strain 6461 harbored a chromosomal tet(O) in a different genomic location.

Diagnóstico diferencial del estreñimiento crónico. A propósito de un caso / Differential diagnosis of chronic constipation. A case report

El estreñimiento crónico supone un motivo frecuente de consulta en Atención Primaria y de automedicación, pues hasta un 20% de los pacientes mayores de 65 años emplean laxantes de forma regular. Debido a las múltiples causas que lo pueden producir; principalmente trastornos funcionales y, en menor medida, otras causas como la ingesta de fármacos, enfermedades digestivas o extradigestivas y ante la relevancia de las mismas, debemos realizar una buena anamnesis, exploración y seguimiento de éste, intentando llegar al diagnóstico etiológico valorando los signos de alarma y solicitando pruebas complementarias ante la sospecha de origen orgánico. El pronóstico en algunas ocasiones podría depender de la precocidad con la que se diagnostique; véase en nuestra paciente, cuya evolución fue favorable debido al diagnóstico y tratamiento precoz del pseudomixoma peritoneal

Chronic constipation is a frequent reason for a visit to Primary Care and self-medication, since up to 20% of the patients over 65 years commonly use laxatives. Due to the multiple causes that can cause it, mainly functional disorders, and to a lesser degree, other causes such as drugs, digestive or extradigestive diseases and due to their relevance, we should make a good anamnesis, examination and follow-up. We should then try to reach the etiological diagnosis, assessing the alarm signs and requesting complementary tests when there is suspicion of an organic origin. Prognosis in some occasions could depend on the earliness of the diagnosis. Consider our patient, whose course was favorable due to the early diagnosis and treatment of the pseudomyxoma peritonei

Consultation-Liaison psychiatric service delivery: results from a European study.

The reported findings of the European Consultation-Liaison Workgroup (ECLW) Collaborative Study describe consultation-liaison service delivery by 56 services from 11 European countries aggregated on a C-L service level. During the period of 1 year (1991), the participants applied a standardized, reliability tested method of patient data collection, and data were collected describing pertinent characteristics of the hospital, the C-L service, and the participating consultants. The consultation rate of 1% (median; 1.4% mean) underscores the discrepancy between epidemiology and the services delivered. The core function of C-L services in general hospitals is a quick, comprehensive emergency psychiatric function. Reasons to see patients were the following. deliberate self-harm (17%), substance abuse (7.2%), current psychiatric symptoms (38.6%), and unexplained physical complaints (18.6%) (all means). A significant number of patients are old and seriously ill. Mood disorders and organic mental disorders are most predominant (17.7%). Somatoform and dissociative disorders together constitute 7.5%. C-L services in European countries are mainly emergency psychiatric services and perform an important bridge function between primary, general health, and mental health care.

Nitric oxide inhibits isoproterenol-stimulated adipocyte lipolysis through oxidative inactivation of the beta-agonist.

Nitric oxide has been implicated in the inhibition of catecholamine-stimulated lipolysis in adipose tissue by as yet unknown mechanisms. In the present study, it is shown that the nitric oxide donor, 2,2-diethyl-1-nitroso-oxyhydrazine, antagonized isoproterenol (isoprenaline)-induced lipolysis in rat adipocytes, freshly isolated from white adipose tissue, by decreasing the potency of the beta-agonist without affecting its efficacy. These data suggest that nitric oxide did not act downstream of the beta-adrenoceptor but reduced the effective concentration of isoproterenol. In support of the latter hypothesis, we found that pre-treatment of isoproterenol with nitric oxide abolished the lipolytic activity of the catecholamine. Spectroscopic data and HPLC analysis confirmed that the nitric oxide-mediated inactivation of isoproterenol was in fact because of the modification of the catecholamine through a sequence of oxidation reactions, which apparently involved the generation of an aminochrome. Similarly, aminochrome was found to be the primary product of isoproterenol oxidation by 3-morpholinosydnonimine and peroxynitrite. Finally, it was shown that nitric oxide released from cytokine-stimulated adipocytes attenuated the lipolytic effect of isoproterenol by inactivating the catecholamine. In contrast with very recent findings, which suggest that nitric oxide impairs the beta-adrenergic action of isoproterenol through intracellular mechanisms and not through a chemical reaction between NO and the catecholamine, we showed that nitric oxide was able to attenuate the pharmacological activity of isoproterenol in vitro as well as in a nitric oxide-generating cellular system through oxidation of the beta-agonist. These findings should be taken into account in both the design and interpretation of studies used to investigate the role of nitric oxide as a modulator of isoproterenol-stimulated signal transduction pathways.

European consultation-liaison services and their user populations: the European Consultation-Liaison Workgroup Collaborative Study.

The authors identified variations in the characteristics of patients referred to 56 consultation-liaison (C-L) services in 11 European countries. The authors found differences in the types of patients referred to the services, and there were significant differences between countries. The first difference lays in whether services saw patients for deliberate self-harm and for substance abuse. German psychosomatic C-L services saw virtually no such patients, although in other C-L services these patients constituted one-quarter to one-third of the patients referred. The second difference lays in the remaining group of referred patients. This group is best characterized by two dimensions. One describes the severity of psychopathology -- ranging from organic mental conditions to somatization. The other describes the clarity of the physical diagnosis -- ranging from patients referred by surgical wards to those referred by general medicine and neurology wards.

European Consultation-Liaison Psychiatric Services: the ECLW Collaborative Study.

OBJECTIVE: To describe the patterns of organization of consultation-liaison (C-L) services in 11 European countries in relation to hospital characteristics and national approaches to C-L psychiatry. METHOD: Cross-sectional survey. RESULTS: Services can best be described in terms of their size and seniority of their staff and whether or not they are multidisciplinary. Single-discipline services are based upon the standard medical consultant model, whereas those with multidisciplinary teams work in a way that is comparable with community mental health teams. German psychosomatic C-L services belonged to either model. National differences were found. CONCLUSION: This first international study provides empirical evidence for the wide variation in the organization of C-L services. In view of the increasing numbers of patients with psychiatric disorder who are being treated in general hospitals and the changing patterns of medical care there are important implications for clarification and improvement of the role of C-L services.

[Bacteremia and multiple and recurrent skin ulcers due to Brucella melitensis. A new modality of self-induced infection]. / Bacteriemia y múltiples y repetidos abscesos cutáneos por Brucella melitensis. Una nueva modalidad de infección autoinducida.

Self-induced infections are a special form of factitious disease. They are characterized by the autoinoculation of contaminated substances or bacterial cultures which may lead to cutaneous infections, bacteremias, or arthritis by various germs. The conditions produced are difficult to diagnose and may lead to multiple operations, and sometimes mutilations or death of the patient. Herewith, a patient who, over a period of 10 months, presented 4 episodes of bacteremia and cutaneous abscess in which Brucella melitensis was isolated is described. In addition, during the second admission, the patient had factitious fever. Despite the evidence of self induced infection, the patient denied autoinoculation however, following confrontation with the facts and supportive psychotherapy the patient has not presented any further episodes after 6 months of follow up. Although the microorganisms involved in this type of disorders are various, this is the first case described in the literature of self-induced infections by Brucella melitensis.

[Psychosis and cannabis consumption: study of the psychopathologic differences and risk factors]. / Psicosis y consumo de cannabis: estudio de las diferencias psicopatológicas y los factores de riesgo.

The consumption of Cannabis has been related with different psychiatric disorders. However the role of this drug in the etiology of disorders has not yet precisely been established. It has been discussed that the existence of an Induced Psychosis is brought about by the consumption of Cannabis. The objective of our study is to determine if there exists specific characteristics in the psychotic disorders manifested after the Cannabis consumption in comparison with a group of Psychotics non consumers. We also defined the risk factors that influence the appearance of the psychopathologic troubles.

[Update on the morbidity of psychiatric disorders in patients with AIDS: results of a clinical follow-up]. / Actualización de la morbilidad de trastornos psiquiátricos en pacientes con SIDA: resultados de un seguimiento clínico.

A follow-up study after one or two years of treatment was carried out on 107 AIDS patients who were seen by the Consultation-Liaison Psychiatry Unit of the Ramon y Cajal Hospital. The sample was reduced to 52 patients (49%) mainly due to the lack of check-ups in 43% and to the death of 8% of the cases. 36% of patients suffered from Delirium or Dementia and these had the greater mortality rate. Grade IV patients and those with a diagnosis of Adjustment Disorders came to the check-ups most frequently.

[Abdominal pain in childhood due to a Cryptosporidium parasitosis]. / Dolor abdominal en la infancia debido a parasitosis por cryptosporidium.

Three cases of cryptosporidiosis in children are described. Abdominal pain without concomitant acute diarrhoea, was the main clinical symptom. No other intestinal pathological agent was isolated. All children were males, aged between 25-27 months, living in urban area and with a high socioeconomic level. They went to day nurseries and only one was contacted with home animal. This last child had a previous giardiasis treated with metronidazole. Nutritional status was normal. Neither humoral nor cellular immunodeficiency was detected. Cryptosporidium muris isolation was performed with Ziehl-Neelsen modified technique. All recovered with negativity of abdominal pain and bacteriologic controls, using solely dietetic measures.