Infective endocarditis caused by Brucella melitensis: a case report highlighting the importance of history taking and laboratory analysis.

We present a case of Brucella endocarditis in a 13 year old patient with known aortic stenosis. She was admitted to the National Heart Institute/Institut Jantung Negara, Malaysia with complains of fever, pain and swelling of left knee. Transthoracic echocardiography and transesophageal echocardiography showed no evidence of vegetations on the aortic valve. Differential diagnosis was made based on clinical manifestations, positive serology tests and isolation of Brucella melitensis from blood culture. The patient has a history of consumption of unpasteurised goat's milk prior to clinical symptoms. Although rare, the case emphasize that Brucella could be a potential complication of infective endocarditis (IE) involving patient who consumed unpasteurised goat's milk. The diagnosis of bacterial endocarditis based on clinical findings and supported by laboratory results has led to the appropriate treatment of this patient. To the best of our knowledge, this is the first case reported for Brucella endocarditis in Malaysia.

Determination and confirmation of isopropyl p-toluenesulfonate in cosmetics by HPLC-diode array detector method and GC-MS.

OBJECTIVE: Isopropyl p-toluenesulfonate (IPTS) is a potentially genotoxic by-product formed during the esterification of palm oil-based palmitic and palm kernel oil-based myristic acid with isopropanol to produce isopropyl palmitate or isopropyl myristate. There are no methods described for the analysis of IPTS in cosmetic products. In this work, we have established a simple, precise and accurate method to determine the presence and level of IPTS in various finished cosmetic products which contain palm-based esters in their formulations. METHODS: An Agilent 1200 series high-performance liquid chromatography (HPLC) unit using a diode-array detector (DAD) has been employed and optimized to detect IPTS in cosmetic products. For the separation, a reverse-phase Hypersil Gold C8 column (5 µm, 4.6 mm i.d. 250 mm) 5 mM tetrabutylammonium phosphate buffer 50 : 50, (v/v) solution in acetonitrile as mobile phase, in isocratic mode and a flow rate of 0.8 mL min-1 were used. A second method using a gas chromatography/mass selective detector GC-MSD was also developed to confirm the IPTS identity in the cosmetic products. RESULTS: Recoveries of IPTS from cosmetic matrices such as a lotion, cleansing milk and a cream ranged from 94.0% to 101.1% with <5% relative standard deviation (%RSD) showing good accuracy and repeatability of the method. The six-point calibration curves (determined over the range 0.5-50 µg mL-1 ) have a correlation coefficient of 0.9999 (based on HPLC peak area) and 0.9998 (based on HPLC peak height). The intra- and interday precisions (measured by the %RSD) of the method were <2% and <5%, respectively, indicating that the developed method is reliable, precise and reproducible. The detection and quantification limit of the method were found to be 0.5 µg mL-1 and 1.6 µg mL-1 , respectively. Analyses of 83 commercial cosmetics showed no presence of IPTS. CONCLUSIONS: The validation data indicated that this method was suitable for the quantitative analysis of IPTS in commercial cosmetics. This method is applicable for analyses of trace levels of IPTS in cosmetics and has the advantage of using only simple sample preparation steps.

Proposed mechanism of antibacterial action of chemically modified apatite for reduced bone infection.

Surface-bound silver ions were demonstrated to be responsible for the antibacterial action of silver, silicon-containing hydroxyapatite (Ag,Si-HA). X-ray photoelectron spectroscopy, transmission electron microscopy, and induced coupled plasma spectroscopy results suggested that silver ions in the crystal structure diffused toward the crystal surface of Ag,Si-HA, and interacted with adherent Staphylococcus aureus bacteria, thus damaging the cell wall and inducing leakage of potassium ions. All these steps constitute the mechanism of antibacterial action for Ag,Si-HA. Consequently, Ag,Si-HA gave rise to a 7-log reduction of the adherent bacteria as compared to HA and Si-HA at 168 h. Silicon in Ag,Si-HA helped to mitigate the reduced effect of bone differentiation in Ag-HA as shown in the alkaline phosphatase, type I collagen and osteocalcin results, promoting enhanced biological response, without compromising the antibacterial property. On the whole, Ag,Si-HA containing an optimized content of 0.5 wt % silver and 0.7 wt % silicon provides antibacterial properties and enhanced biological response.

Identification and in vitro antimicrobial susceptibility of Brucella species isolated from human brucellosis.

Brucellosis is a world-wide zoonotic disease with a major impact on the public health. Due to the high risk of laboratory acquired infection, limited laboratory investigations were performed on this organism, including detailed identification and susceptibility study. Brucella melitensis is the commonest aetiological agent for human brucellosis in this region. The in vitro susceptibility pattern against selected antimicrobial agents was assessed using E-test. All isolates were noted to be sensitive to all the antimicrobial agents tested except for rifampicin where elevated MIC > 1 µg/mL was noted in 30 out of 41 isolates tested.

Analysis of isopropyl para-toluenesulphonate in palm-based esters by gas chromatography with flame ionization detection and confirmed with mass spectrometry.

A simple and rapid gas chromatography (GC) method with flame ionization detector was developed for detection of isopropyl para-toluenesulphonate (IPTS) in palm-based isopropyl palmitate (IPP) and isopropyl myristate (IPM). The method involved spiking the IPP/IPM samples with IPTS and directly injecting the spiked samples into GC without undergoing clean-up steps. The calibration curves for IPTS showed good linearity with coefficient correlation of 0.9999 for six-point calibration from 0.5 to 50 µg mL(-1) and 0.9996 for six-point calibration from 0.5 to 200 µg mL(-1) . IPTS recoveries from IPP were 98.6-103.5% with relative standard deviation (RSD) of 0.40-2.80%, whereas recoveries from IPM were 97.0-107.2% with RSD of 0.42-4.21%. The identity of IPTS recovered from the isopropyl esters was confirmed by a GC-mass spectrometer detector. The method was successfully applied to the analyses of IPTS in commercial samples. It was found that there were IPTS in the range of 34.8-1303.0 µg g(-1) in the palm-based esters for some of the samples analysed.

Synthesis and mechanism study of mesoporous SnO2/SiO2 composites.

Mesoporous SnO2/SiO2 composite particles (Si/Sn < or = 0.25) sustainable to calcination up to 600 degrees C have been fabricated using a stepwise sol-gel technique on nonionic surfactant template (tetradecylamine, TDA). The newly designed preparation method involved the pre-formation of SnO2 sol solution from SnCl4. Subsequently, SnO2 nanocrystals were covered by the silicate species (from the hydrolysis of tetraethylorthosilicate, TEOS) in a pH controlled colloidal solution. Upon mixing with the surfactant solution, mesophase composite was obtained. After the removal of templates at various temperatures (400 to 600 degrees C), worm-like mesoporous SnO2/SiO2 with large specific surface area and pore volume as high as 362 m2/g and 0.33 cc/g were obtained, respectively. High thermal stability is mainly due to the effective inhibition of SnO2 crystal growth (mean crystallite size <30 A) by the amorphous SiO2 species at the grain boundaries. Formation of mesoporous silicate skeleton such as M41S family material was prevented. The obtained materials maintain the relatively narrow pore size distribution typically in the range of 30 to 70 A. Relations between material properties and key synthesis parameters (i.e. TDA/Si/Sn molar ratio and calcination temperature) were investigated by TGA, wide/small-angle X-ray scattering, (HR)TEM, BET, and FTIR techniques. Mechanisms on the mesostructure formation and crystal growth inhibition were also proposed with detailed discussion.

In vitro bioactivity and osteoblast response of porous NiTi synthesized by SHS using nanocrystalline Ni-Ti reaction agent.

Porous NiTi with an average porosity of 55 vol % and a general pore size of 100-600 microm was synthesized by self-propagating high temperature synthesis (SHS) with the addition of mechanically alloyed nanocrystalline Ni-Ti as the reaction agent. The SHS of porous NiTi using elemental powders was also performed for comparison. To enhance the bioactivity of the metal surface, porous NiTi synthesized by nanocrystalline Ni-Ti was subjected to chemical treatment to form a layer of TiO(2) coating. The porous NiTi with TiO(2) coating was subsequently immersed in a simulated body fluid (SBF) to investigate its apatite forming ability. The effects of the addition of nanocrystalline Ni-Ti as reaction agent and the application of apatite coating on osteoblastic behavior were studied in primary cultures of human osteoblast cells. Results showed that the main phases in porous NiTi synthesized by elemental powders were NiTi, Ti(2)Ni, and unreacted free Ni. By using nanocrystalline Ni-Ti as reaction agent, the secondary intermetallic phase of Ti(2)Ni was significantly reduced and the free Ni was eliminated. TiO(2) coating with anatase phase was formed on the surface of porous NiTi after the chemical treatment. A layer consisting of nanocrystalline carbonate-containing apatite was formed on the surface of TiO(2) coating after soaking in SBF. The preliminary cell culture studies showed that the porous NiTi synthesized with the addition of nanocrystalline Ni-Ti attracted marked attachment and proliferation of the osteoblast cells. This gives the evidence of the potential biomedical applications of the porous NiTi.

Biomimetic deposition of apatite coating on surface-modified NiTi alloy.

TiO(2) coatings were prepared on NiTi alloy by heat treatment in air at 300, 400, 600 and 800 degrees C. The heat-treated NiTi alloy was subsequently immersed in a simulated body fluid for the biomimetic deposition of the apatite layer onto the surface of TiO(2) coating. The apatite coatings as well as the surface oxide layer on NiTi alloy were characterized using scanning electron microscopy equipped with energy dispersive spectroscopy, X-ray diffraction, X-ray photoelectron spectroscopy and Raman spectroscopy. Results showed the samples heat-treated at 600 degrees C produced a layer of anatase and rutile TiO(2) on the surface of NiTi. No TiO(2) was detected on the surface of NiTi after heat treatment at 300 and 400 degrees C by X-ray diffraction, while rutile was formed on the surface of the 800 degrees C heat-treated sample. It was found that the 600 degrees C heat-treated NiTi induced a layer consisted of microcrystalline carbonate containing hydroxyapatite on its surface most effectively, while 300 and 400 degrees C heat-treated NiTi did not form apatite. This was due to the presence of anatase and/or rutile in the 600 and 800 degrees C heat-treated NiTi which could provide atomic arrangements in their crystal structures suitable for the epitaxy of apatite crystals, and anatase had better apatite-forming ability than rutile. XPS and Raman results revealed that this apatite layer was a carbonated and non-stoichiometric apatite with Ca/P ratio of 1.53, which was similar to the human bone. The formation of apatite on 600 degrees C heat-treated NiTi following immersion in SBF for 3 days indicated that the surface modified NiTi possessed excellent bioactivity.