First Report of Crown and Root Rot Caused by Rhizoctonia solani AG-4 on Banana Passionflower (Passiflora mollissima) in Italy.

The genus Passiflora (Passifloraceae family) contains more than 500 species and several hybrids. In Italy, some of these species and hybrids are grown as ornamental evergreen vines or shrubs. During August and September 2010, a crown and root rot was observed in a stock of approximately 6,000 potted 2-year-old plants of Passiflora mollissima (Kunth) Bailey, commonly known as the banana passionflower, in a nursery located in eastern Sicily (southern Italy). Disease incidence was approximately 20%. Disease symptoms consisted of water-soaked lesions at the crown and a root rot. Successively, older crown lesions turned light brown to brown and expanded to girdle the stem. As crown and root rot progressed, basal leaves turned yellow and gradually became necrotic and infected plants wilted and died. A fungus with mycelial and morphological characteristics of Rhizoctonia solani Kühn was consistently isolated from crown lesions and brown decaying roots when plated on potato dextrose agar (PDA) amended with streptomycin sulfate at 100 µg/ml. Fungal colonies were initially white, turned brown with age, and produced irregularly shaped, brown sclerotia. Mycelium was branched at right angles with a septum near the branch with a slight constriction at the branch base. Hyphal cells removed from 10 representative cultures grown at 25°C on 2% water agar were determined to be multinucleate when stained with 1% safranin O and 3% KOH solution (1) and examined at ×400. Anastomosis groups were determined by pairing isolates on 2% water agar in petri plates (4). Pairings were made with tester strains of AG-1, AG-2, AG-3, AG-4, AG-5, AG-6, and AG-11. Anastomosis was observed only with tester isolates of AG-4 (3). Pathogenicity tests were performed on container-grown, healthy, 3-month-old cuttings. Twenty plants of P. mollissima were inoculated near the base of the stem with five 1-cm2 PDA plugs from 5-day-old mycelial plugs obtained from two representative cultures. The same number of plants served as uninoculated controls. Plants were maintained at 25°C and 95% relative humidity with a 12-h fluorescent light/dark regimen. Wilt symptoms due to crown and root rot, identical to ones observed in the nursery, appeared 7 to 8 days after inoculation with either of the two isolates and all plants died within 20 days. No disease was observed on control plants. R. solani AG-4 was reisolated from symptomatic tissues and identified as previously described, confirming its pathogenicity. Damping-off or crown and root rot due to R. solani were previously detected on P. edulis in Brazil, Africa, India, Oceania, and Australia (2). To our knowledge, this is the first report of R. solani causing crown and root rot on P. mollissima. References: (1) R. J. Bandoni. Mycologia 71:873, 1979. (2) J. L. Bezerra and M. L. Oliveira. Fitopathol. Brasil. 9:273, 1984. (3) D. E. Carling. Page 37 in: Grouping in Rhizoctonia solani by Hyphal Anastomosis Reactions. Kluwer Academic Publishers, the Netherlands, 1996. (4) C. C. Tu and J. W. Kimbrough. Mycologia 65:941, 1973.

Nocturnal enuresis and daytime wetting: a multicentric trial with oxybutynin and desmopressin.

OBJECTIVE: Different etiopathological mechanisms of enuresis are today under study, and different therapies and drugs have been proposed. The Italian Multicentric Trial was undertaken in twelve pediatric and urological centers in order to assess the efficacy of two of the most popular drugs, desmopressin (DDAVP) and oxybutynin. METHODS: 114 enuretic patients were enrolled in the study. After a 2-week observation period, 66 patients with primary monosymptomatic enuresis were treated with DDAVP, 30 micrograms/day intranasally, for 6 weeks, 48 patients with enuresis and voiding dysfunction were randomly assigned to a protocol with oxybutynin alone or oxybutynin plus DDAVP. The efficacy of the two drugs was measured in terms of reduction of wet nights per week during the 6-week treatment period and a 2-week follow-up period. Children with 0-3 dry nights/week were considered as nonresponders. RESULTS: Patients with monosymptomatic enuresis treated with DDAVP reported a significantly lower number of wet night during treatment than during the baseline period, with 79% showing a 'good' (6-7 dry nights/week) or 'intermediate' response (4-5 dry nights/week). Of the patients with diurnal voiding disturbances and enuresis, those treated with oxybutynin alone had a 54% success rate. The patients treated with both oxybutynin and DDAVP showed a better response, with a 71% rate of success. CONCLUSIONS: The efficacy of the two drugs is confirmed in patients carefully selected on the clinical basis of voiding disturbances. In patients with enuresis and voiding dysfunction, the reduced urinary output and the lower bladder filling rate due to DDAVP can reduce uninhibited bladder contractions, thus enhancing the oxybutynin action.

Academic-community linkages: community-based training for family physicians.

BACKGROUND: Community-based curricular experiences have been proposed to fulfill the graduate training needs of future family physicians. Are such experiences feasible? How can such experiences be started? What outcomes can be expected? METHODS: We describe 15 years' experience with community-based training in family practice graduate medical education at UMDNJ-Robert Wood Johnson Medical School. We also describe the process of creating academic-community linkages using stakeholder management and the resultant programs that evolved to fulfill specific training requirements. RESULTS: Five of the curricular programs designed are described, four of which were successful. Community-based training enhanced recruitment of students of minority background into the residency, and a high proportion of residency graduates have established practices in communities with underserved populations. CONCLUSIONS: Community-based training of family physicians is a feasible and effective means of addressing unmet health needs of communities served by graduate medical education programs and their related health care institutions.

An era of mutual respect.

Nurses are skilled, dedicated and compassionate professionals. They are irreplaceable members of the American health-care team. Collaboration among health care professionals has enhanced the quality of care our patients receive.

[Concentration of aztreonam in plasma, urine, and seminal fluid of patients with chronic prostatitis]. / Concentrazioni di aztreonam nel plasma, nell'urina e nel liquido seminale di soggetti affetti da prostatite cronica.

The authors consider the concentration of antibacterial drugs in the seminal fluid as a reliable experimental model for the study of pharmacokinetics in chronic prostatitis (c.p.). The study was conducted on 32 subjects, 20 of whom were affected by c.p. and 12 were normal controls. All subjects were treated with aztreonam at a dosage of 1 g.i.m. The assay was performed 1 hour after the injection, on seminal fluid, urine and serum samples. No difference was observed between normal subjects and patients with c.p. with regard to serum and urinary levels of the drug. There was a trend towards a higher concentration of the drug in the seminal fluid of patients with c.p. when compared to normal subjects, with mean values of 1.8 and 0.9 mcg/ml respectively. This difference was not statistically significant. Furthermore, the drug concentration of the drug in semen was below the sensitivity limits of the assay in 43% of normal subjects and in 10% of patients with c.p. In the latter group of patients the mean values of aztreonam concentration exceeded the minimal inhibitory concentrations for most aetiological agents causing c.p. In conclusion, it is suggested that aztreonam is likely to be effective in acute prostatitis, caused by Gram negative strains and may be indicated in selected cases for the treatment of c.p.

Applying for and renewing institutional CME accreditation status.

The MSNJ-Committee on Medical Education provides accreditation for most of the institutions in New Jersey that sponsor continuing medical education activities. The process of applying for accreditation is described, including the decision and appeal procedures.

Influence of physical activity on gastric emptying of liquids in normal human subjects.

Liquid gastric emptying has been evaluated in 17 normal human subjects during basal conditions, after mild physical stress at 50% of the maximum predictable heart rate, and after maximal physical stress at 70% maximum heart rate. Each subject exercised on a treadmill for 30 min, its speed and inclination varied in order to obtain the desired heart rate. Immediately after the exercise, 400 ml of mineral water were drunk by each subject. Gastric emptying was evaluated by real-time ultrasonography (11 subjects) and scintigraphy (six subjects) through previously described methods. The results show similar data with both techniques. Gastric emptying of the water, considered either as reduction in gastric measurements at ultrasonography or decay in radioactivity in the region of interest corresponding to the stomach at scintigraphy, follows a linear relationship under basal conditions and during physical stress. Compared with basal conditions, gastric emptying of water after maximal stress was prolonged; after mild stress, gastric emptying of the water was accelerated. These findings may support the common belief that mild physical activity favors the digestive process.

Functional health status of relocated nursing home residents.

This article presents the functional health status results of 49 nursing home residents who were involuntarily relocated from one institution to another. The purpose of the study was to determine whether there would be pre- to postmove changes in health status. Nursing personnel on both the day and evening shifts completed separate assessments of the residents' functional health status using the Long-Term Health Care Minimum Data Set instrument. These assessments were completed 2 to 3 months before and 3 to 4 months after the move. The interrater reliability was high; overall day-evening agreement was 82 percent. After the move, only receptive communication was rated higher; dressing, transferring, using the toilet, continence, and mobility were rated lower. Six functional activities showed no significant changes. Relocation does not appear to have a uniformly negative impact on functional status.

Immune status towards Epstein-Barr virus in a group of Sicilian children.

The prevalence of antibodies to Epstein-Barr virus-determined antigens was studied in 17 children with acute infectious mononucleosis (IM) and in 263 children hospitalized for diseases unrelated to EBV infection. Antibodies against Epstein-Barr viral capsid antigens (VCA) were observed in 173 patients of the control group (66%), but 58 of them (33,5%) had not yet developed antibodies against Epstein-Barr virus-associated nuclear antigen (EBNA). IgM-specific antibodies were not found in any of the children of the control group but were present in all of the 17 patients with IM. The rates of positivity for IgA anti-VCA and IgG anti-early antigen (EA) were similar in all age groups. Anti-viral capsid antigen IgG seropositivity increased to 83% by the age of six years, the mean geometric titre being highest between the ages of 2 and 4 years. Our results suggest that in Sicilian children the primary infection occurs prevalently early in life, in parallel with the occurrence of IM.

Pharmacokinetic study on adenomatous prostate tissue concentrations of cefoperazone. Clinical efficacy and patient tolerance of intramuscular cefoperazone treatment of chronic bacterial prostatitis.

Cephalosporins do not reach active therapeutical concentrations in the prostatic tissue in patients suffering from chronic bacterial prostatitis. Cefoperazone is an exception. Its efficacy in the treatment of chronic bacterial prostatitis in 20 patients was studied and the concentrations, obtained after intramuscular administration, evaluated in patients who underwent transurethral operation due to prostatic hypertrophy (in 14 patients). The cefoperazone concentrations in the prostate have been evaluated 60, 90 and in some cases 120 min after the administration of the drug and compared to those obtained in serum. The clinical cure has been obtained in 16 patients. The average drug concentration in the prostate after 60 min was 22.8 +/- 13.6 versus 39.8 +/- 20.0 micrograms/ml in serum; 90 min after administration the average concentration in the prostate was 23.2 +/- 14.1 versus 35.7 +/- 18.1 micrograms/ml in serum. The correlation was significant both at 60 min (r = 64, p less than 0.05) and at 90 min (r = 64, p less than 0.05).