Does the Level and Complexity of Femur Fracture Determine Intramedullary Peak Pressures During Reamed Femoral Nailing? A Prospective Study.

OBJECTIVES: To investigate femoral intramedullary (IM) pressures during reamed antegrade nailing and to determine whether fracture level and/or complexity affect peak pressures. DESIGN: Prospective, nonrandomized observational cohort. SETTING: Single level I trauma center. PATIENT SELECTION CRITERIA: Patients presenting with femur fractures (OTA/AO 31A3; 32A; 32B; 32C; 33A2; 33A3), requiring antegrade IM nail fixation, were included in this study. Excluded were minors and patients presenting with hemodynamic instability, a reduced level of consciousness and intoxication. Femurs were divided into thirds based on preoperative radiological measurements and allocated to 3 groups based on fracture location: Proximal (A), middle (B), and distal (C) third femur fractures. Fracture complexity was also documented. OUTCOME MEASURES AND COMPARISONS: Peak IM pressures of proximal, middle, and distal third femoral fractures were compared during antegrade femoral IM nail fixation. RESULTS: Twenty-two fractures in 21 patients were enrolled and treated over a 4-month period with a distribution of fracture locations of group A = 12, group B = 6, and group C = 4. Measured mean resting distal IM pressures were significantly higher ( P < 0.05) in proximal fractures (group A: 52.5 mm Hg) than in middle and distal third fractures (group B: 36.6 mm Hg and group C: 27.5 mm Hg). Greatest peak pressures were generated during the first ream in groups A and B, occurring distal to the fracture in all cases. Group A averaged 363.8 mm Hg (300-420), group B 174.2 mm Hg (160-200), and group C 98.8 mm Hg (90-100). There was a significant difference comparing group A with B and C combined ( P < 0.01) and group A with B ( P < 0.05) and C ( P < 0.05]) individually. Group A consisted of 6 comminuted and 6 simple fracture configurations. Mean peak pressures in these subgroups differed significantly: 329 mm Hg (300-370) versus 398 mm Hg (370-430), respectively ( P < 0.05). Complex fractures in study groups B and C did not have significantly different peak pressures compared with simple fractures ( P > 0.05). CONCLUSIONS: Both the fracture location and comminution affect peak IM pressures during reamed antegrade femoral nailing. Proximal, simple fracture configurations resulted in significantly higher pressures when compared with more distal and comminuted fracture configurations. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Elimination of dog-mediated human rabies: the burden of human rabies in Africa.

Hope exists for the elimination of dog-mediated human rabies in Africa. Momentum is gathering towards this goal, with an increasing number of successful demonstration projects showing that elimination is feasible. The Pan African Rabies Control Network is bringing Africa together against rabies, supported by the World Health Organization, the World Organisation for Animal Health and the Food and Agriculture Organization of the United Nations, which have a combined resolution to eliminate human deaths from dog-transmitted rabies by 2030. Furthermore, the inspiring examples of both rinderpest and smallpox eradication hold all the elements necessary to have confidence that this momentum can lead to success. Smallpox and rinderpest, whose last battles were fought on the African continent, highlight the simple fact that once the primary tools are available (such as vaccines), by far the greatest challenges lie within the realm of implementation. Science can effectively argue the subtleties of virology, immunology, vaccinology, etc. but it often fails to describe the science of implementation. In the face of other major diseases and socio-economic difficulties, rabies is not perceived as a threat by many African countries, despite the fact that the burden of the disease has been shown to be extensive. The challenge of mobilising mass interventions requires leadership and fortitude within resource-poor, infrastructurally challenged, politically uninterested and often bureaucratically restricted environments. Continent-wide elimination remains a daunting prospect for investors, who often lack insight into environmental disease dynamics, which is essential for enabling the implementation of strategic, community-based interventions. Implementation in Africa needs to be seen through African eyes. It needs local community support, and it needs effective transport and procurement systems and systems of self-development with a view to sustainability. The Aidto- Africa model needs to be replaced by a model that empowers communities to act, demonstrates that success is possible and stimulates the expansion of control efforts.

Il existe un espoir de réussir à éliminer la rage humaine transmise par les chiens en Afrique. Nous assistons actuellement à la montée en puissance d'une dynamique vers cet objectif, avec la réalisation d'un nombre croissant de projets de démonstration qui en confirment la faisabilité. Le continent africain a décidé de rassembler ses efforts contre la rage en lançant le Réseau panafricain de contrôle de la rage, soutenu par l'Organisation mondiale de la santé, l'Organisation mondiale de la santé animale et l'Organisation des Nations Unies pour l'alimentation et l'agriculture, c'est-à-dire les trois organisations signataires de la résolution visant à ramener à zéro le nombre de décès humains dans le monde dus à la rage transmise par les chiens à l'horizon 2030. En outre, les exemples édifiants d'éradication réussie de la peste bovine et de la variole offrent tous les éléments nécessaires pour envisager avec confiance le succès de cette entreprise. Les dernières batailles contre la variole et la peste bovine, qui ont été livrées sur le continent africain, mettent en lumière une vérité simple, à savoir qu'une fois garantie l'existence des outils essentiels (par exemple les vaccins), il reste à relever le défi de leur mise en oeuvre, de loin le plus important. Si la science apporte nombre d'éclairages argumentés sur les subtilités en matière de virologie, d'immunologie, de vaccinologie, etc., elle ne parvient pas toujours à expliquer la science de la mise en oeuvre. Face à d'autres maladies majeures et aux difficultés d'ordre socio-économique que traversent les pays, ceux-ci ne perçoivent pas toujours la rage comme une menace malgré le fardeau considérable qu'elle représente pour eux. Les difficultés liées à la mobilisation d'interventions à très grande échelle exigent de la détermination et des capacités de leadership dans un environnement insuffisamment doté en ressources et en infrastructures, peu motivé au plan politique et souvent limité par des contraintes bureaucratiques. L'élimination à l'échelle du continent reste une perspective intimidante pour les investisseurs, qui ne sont pas toujours conscients de la dynamique environnementale de la maladie, facteur pourtant essentiel pour mettre en oeuvre des interventions stratégiques basées sur les communautés locales. La mise en oeuvre en Afrique doit être envisagée dans une optique africaine. Elle nécessite le soutien des populations locales, des systèmes de transport et d'approvisionnement efficaces et des dispositifs de développement autonomes afin d'en assurer la durabilité. Le modèle d'aide à l'Afrique doit être remplacé par un modèle qui repose sur l'autonomisation et la capacité d'action des populations locales et qui puisse à la fois démontrer les perspectives de réussite et promouvoir l'intensification des efforts dédiés à la lutte.

Hay esperanza por lo que respecta a acabar con la rabia humana transmitida por perros en África. La dinámica para lograrlo va ganando impulso, con un creciente número de fructíferos proyectos experimentales que demuestran que es un objetivo factible. La Red Panafricana para el Control de la Rabia está federando a todo el continente en torno a la lucha antirrábica, con apoyo de la Organización Mundial de la Salud (OMS), la Organización Mundial de Sanidad Animal (OIE) y la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO), que tienen suscrita una resolución común en la que afirman la voluntad de poner fin antes de 2030 a la muerte de personas por la rabia transmitida por perros. Además, los estimulantes ejemplos de la erradicación de la peste bovina y la viruela ofrecen todas las razones para confiar en que esta dinámica se vea coronada por el éxito. Las guerras contra esas dos enfermedades, cuyas últimas batallas se libraron en el continente africano, ponen de relieve un hecho simple: una vez están disponibles las herramientas básicas (como las vacunas), los mayores obstáculos, con diferencia, surgen en el terreno de la aplicación práctica. La ciencia puede adentrarse eficazmente en las sutilezas de la virología, la inmunología, la vacunología y demás, pero a menudo es incapaz de describir la ciencia de la aplicación. En comparación con otras importantes enfermedades y dificultades socioeconómicas, muchos países africanos no consideran que la rabia suponga una amenaza, pese a la probada magnitud de la carga que impone. El objetivo de poner en solfa intervenciones masivas exige liderazgo y fortaleza en contextos marcados no solo por la escasez de recursos, sino también por infraestructuras deficientes, desinterés político y, a menudo, cortapisas burocráticas. La eliminación de la rabia en todo el continente sigue pareciendo una empresa abrumadora a los inversores, que no suelen tener una idea clara de la dinámica ambiental de la enfermedad, algo esencial para posibilitar la aplicación de intervenciones estratégicas y enraizadas en el ámbito comunitario. En África este empeño hay que abordarlo desde una óptica africana. Ello pasa por el apoyo de las comunidades locales, por sistemas eficaces de compra y transporte y por sistemas de desarrollo autónomo que hagan posible la sostenibilidad a largo plazo. El modelo de la prestación de ayuda a África debe ser sustituido por un modelo que faculte a las comunidades para pasar a la acción, demuestre que el éxito es posible y estimule la extensión de las actividades de lucha antirrábica.

Management of acute complex traumatic wound with a dermal regeneration template: Case report.

BACKGROUND: Acute complex traumatic wounds of the lower limbs are usually managed by a combination of multiple debridements, dressing changes, and specialized surgical procedures which may include tissue transfers for the reconstruction of the soft tissue injury. The recovery is lengthy, and the outcome dependent on the initial injury, the surgical procedures undertaken and rehabilitation programs with a multidisciplinary team. METHOD: A nine-year-old male patient presented to Kimberly Hospital with an extensive soft tissue injury of the leg associated with a tibia fracture caused by a high velocity pedestrian vehicle accident. RESULTS: A combination of proper wound care, "homemade" negative pressure wound therapy dressings, reduction of fracture and use of a dermal regeneration template over the fracture site, followed by skin grafting was used to manage the wound. CONCLUSION: The final functional and cosmetic results obtained with the case suggest that the dermal regeneration template may provide a potential alternative for coverage of complex wounds, which might include an open fracture, without the need for complex tissue transfer interventions.

An information system to manage the rollout of the antiretroviral treatment programme in the Free State.

The Acquired Immune Deficiency Syndrome epidemic, caused by the Human Immunodeficiency Virus, is a global crisis which threatens development gains, economies, and societies. Within sub-Saharan Africa, where the epidemic began the earliest and the HIV prevalence is the highest, African countries have death rates not seen before. In South Africa the epidemic has a devastating impact which creates profound suffering on individuals and their families, and the impact on the socio-economic level is of great concern. The eradication of HIV/AIDS represents one of humanity's greatest challenges, which requires co-operation and comprehensive collaboration between many different role players. In this endeavour clinical information plays a major role. To combat the effect of the disease, the Free State Department of Health started with the provisioning of antiretroviral therapy in the public health sector. The objective of this paper was to address the challenges they faced in order to develop and implement an information system to manage the rollout of antiretroviral treatment effectively. They started with a paper-based system to collect vital information. It was followed by a palm computer project that was initiated to electronically capture the data collected by the paper-based system. This system was then replaced by a comprehensive Hospital and Clinic Information System which was acquired and customised for the antiretroviral data collection process. Research partners developed a standalone antiretroviral data warehouse for collecting information associated with the monitoring and evaluation of the Free State antiretroviral and HIV/ AIDS treatment programme. The data warehouse successfully produced several management information reports to the antiretroviral management team. A need was identified to design a comprehensive antiretroviral data warehouse that will integrate data from several operational sources which are all associated with HIV/AIDS.

Suicide Cases Investigated at the State Mortuary in Bloemfontein; 2003-2007

Background: Up to 8 000 South Africans commit suicide annually. This study aimed to investigate the profile of suicide cases in Bloemfontein and the southern Free State province. Methods: A cross-sectional descriptive study was performed. Suicides in the Bloemfontein and southern Free State areas (Xhariep and Motheo districts) investigated at the state mortuary in Bloemfontein in 2003 to 2007 were included. Data were collected retrospectively by using a specially designed data-capturing form. Results: A total of 469 suicide cases were included in the study. The estimated suicide rate for this part of the Free State province was 10.9/100 000 of the population per year. The majority (82.1) of the victims were men. In total; 338 (72.1) of the victims were black; 122 (26.0) were white; five (1.1) were coloured and three (0.6) were Indian. The most common methods were hanging (262; 55.9); shooting (99; 21.1) and overdosing on pills (43; 9.2). Most cases (57.8) occurred in victims 21 to 40 years of age. Five (1.1) victims were children younger than 11 years of age; while 12 (2.6) were older than 65 years. More than half (267 cases; 56.9) of the suicide victims were unemployed. The majority (43.1) of suicides occurred in January to April of each year; with the highest incidence (67 cases; 14.3) in January. Conclusion: The rate of suicide and the profile of victims with regard to the variables investigated corresponded to findings reported from other studies. The information obtained could make a meaningful contribution to suicide-prevention programmes

Avian influenza in ostriches: epidemiological investigation in the Western Cape Province of South Africa.

An H5N2 avian influenza virus was isolated from ostriches in the Eastern Cape Province of South Africa in July 2004. During a subsequent national survey to determine the possible presence of the disease in other areas of South Africa, specific antibodies against H5 avian influenza were detected by the haemagglutination inhibition test in ostrich sera collected in the Western Cape Province. However, the sampling strategy used in the initial survey was developed to accommodate practical constraints but did not truly reflect the prevalence of the sero-reactor entities. A follow-up survey was therefore conducted from March to May 2005 to obtain more representative samples. None of the 15 126 serum samples collected from ostriches aged 0-4 months was positive, while 2.4% of the 14 664 serum samples collected from slaughter ostriches aged 5-14 months and 3.66% of the 8 791 samples collected from breeder ostriches aged over 14 months were positive. Fourteen farms were inspected in particular to identify relevant risk factors and risk mitigation procedures that could minimise the spread of the disease. It was concluded that biosecurity measures should be improved on ostrich farms, in particular to minimise possible contact between ostriches and wild birds.

Microbial, chemical and physical aspects of citrus waste composting.

Citrus waste supplemented with calcium hydroxide and with a C/N ratio of 24:1, pH of 6.3 and moisture content of 60% was composted by piling under shelter. With regular turning over of the pile and replenishment of moisture, the thermic phase lasted for 65-70 days and composting was completed after 3 months. Compost thus prepared had an air-filled porosity of 14%, water-holding capacity of 590 ml l(-1), bulk density of 1.05 g cm(-3) and conductivity of 480 mS m(-1). Phosphorus content (in mg l(-1)) was 15, potassium 1,170, calcium 362, magnesium 121, sodium 32, chloride 143, boron 0.31, and water-soluble nitrogen and organic matter 126 and 4788, respectively. Total carbon amounted to 8.85% and total nitrogen to 1.26% of the dry weight, giving a C/N ratio of 7. Mature compost showed some, but acceptable, levels of phytotoxicity. Raw citrus waste was predominantly colonised by mesophilic yeasts. Thermophilous microorganisms present during the thermic phase mainly comprised the bacterial species Bacillus licheniformis, B. macerans and B. stearothermophilus and, to a lesser extent, fungi such as Absidia corymbifera, Aspergillus fumigatus, Emericella nidulans, Penicillium diversum, Paecilomyces variotii, Rhizomucor pusillus, Talaromyces thermophilus and Thermomyces lanuginosus. Bacteria prevalent in the final product included B. licheniformis, B. macerans, Proteus vulgaris, Pseudomonas aeruginosa, P. fluorescens, P. luteola and Serratia marcescens, whereas fungi isolated most frequently comprised Aspergillus puniceus, A. ustus, E. nidulans. Paecilomyces lilacinus, T lanuginosus, yeasts and a basidiomycetous species, probably Coprinus lagopus.

Field Sprays of Bacillus subtilis and Fungicides for Control of Preharvest Fruit Diseases of Avocado in South Africa.

In 3 consecutive years, preharvest applications of Bacillus subtilis field sprays integrated with copper oxychloride or benomyl consistently reduced severity of avocado black spot (BS), caused by Pseudocercospora purpurea at Omega, Republic of South Africa. Control was equal to that obtained with copper oxychloride or benomyl-copper oxychloride in the first and third years of spraying at Omega. In the second year, only the integrated treatment controlled BS, while copper oxychloride proved ineffective. The antagonist was applied on its own or integrated with copper oxychloride sprays at two other geographically distinct locations, Westfalia Estate and Waterval. The integrated and biological treatments at these localities were less effective than copper oxychloride sprays in controlling BS disease. Integrated control was more effective than B. subtilis sprays at Westfalia. On continuation of the biological spray program at Waterval for an additional three seasons, control was as effective as copper oxychloride in the last 2 years of spraying. Sooty blotch (SB), caused by an Akaropeltopsis sp., was reduced by the integrated treatment at Omega during the second season and at Westfalia during the first season. Although the two fungicide treatments reduced SB at Omega in the first season, copper oxychloride increased it above that of the control in the third season. Only the copper oxychloride treatment reduced SB at Waterval in the third season, while the B. subtilis treatment increased disease above that of the control in the fourth season.

Rind Stippling on Valencia Oranges by Copper Fungicides Used for Control of Citrus Black Spot in South Africa.

Four copper sprays and copper mixtures with dithiocarbamates aggravated stippling of the fruit rind of Valencia oranges if sprayed in succession at registered rates during the recommended protection period from October to January for control of citrus black spot in South Africa. Copper stippling was more severe on treatments in which copper oxychloride was sprayed in succession, individually, or in combination with mancozeb or maneb/ZnO. On the other hand, less copper stippling was observed on treatments in which three mancozeb applications were altered with a single copper oxychloride as tank mixtures with or without mancozeb, which was sprayed during midsummer (December and January). Cupric hydroxide resulted in more general copper stippling lesions than any other copper oxychloride spray program. Four successive applications of the wettable powder copper oxychloride formulation resulted in more copper stippling when compared with the suspension concentrate formulation. Stippling was calculated to be more severe with late applications of copper fungicides during December and January. In another experiment, all contact fungicides tested were effective in controlling citrus black spot.

Production of monoclonal antibodies against Xanthomonas campestris pv. mangiferaeindicae and their use to investigate differences in virulence.

Four Xanthomonas campestris pv. mangiferaeindicae isolates from mango black spot lesions were grouped according to differences in virulence and used to raise monoclonal antibodies (mAbs). Two immunization approaches were followed. In the first, four groups of mice were immunized, each with a different isolate and the spleens from each group homogenized together for cell fusion. The second approach entailed immunization of a single group of mice with bacteria pooled from all four isolates. The resultant mAbs were characterized with regard to the antigen binding specificity and antibody class. A relationship between mAb binding specificity and virulence of the bacteria was shown by Western blot analysis.

Epidemiological reference ranges for low-density lipoprotein cholesterol and apolipoprotein B for identification of increased risk of ischaemic heart disease.

Although there is widespread acceptance that total cholesterol (TC) value reference ranges should be based on epidemiological rather than statistical considerations, the epidemiological action limits for low-density lipoprotein cholesterol (LDL-C) are still incomplete and only statistical reference ranges for apolipoprotein B (Apo-B) levels are available. The combined use of epidemiological reference ranges for TC and incomplete or statistical reference ranges for LDL-C and Apo-B is illogical, since these parameters may fall into discordant risk categories that will hamper and complicate the management of hypercholesterolaemia. Based on a study of lipograms obtained from +/- 3,000 inhabitants of two industrialised Transvaal towns, the age-related epidemiological reference ranges for LDL-C and Apo-B were established. A comparison with published observational studies of other populations, in which comparable lipid, lipoprotein and apolipoprotein methodologies were used, reflected the severity of these lipid-related abnormalities in white South Africans, especially after the age of 30 years. In addition, the serum TC values found in this survey were not significantly different from those obtained 10 years ago.

The role of the ambulance service as part of the health profession.

The provincial ambulance services have developed into highly trained professional emergency medical services over the last few years. This rapid development seems to have caught the medical profession by surprise, so much so that in recent months some medical practitioners were of the opinion that ambulance personnel were being trained to do more than they should. Unfortunately many doctors still seem to view the ambulance service as mainly a patient transport service and not as the emergency medical service it has become. It would be in the interest of the patient if a sound working relationship between pre-hospital, hospital and private medical practitioners could be established and that each group becomes familiar with the capabilities of the other. It is equally important that ambulance personnel be welcomed into the health profession of which they are now an integral part.

Influence of a habitual high egg intake on serum lipid levels in a rural coloured population.

The effect of a habitual high cholesterol intake on serum cholesterol and other lipid levels against the background of a moderate fat intake was investigated in 30 rural coloured volunteers (16 men, 14 women) working on an egg farm. Protein contributed approximately 11%, fat 31%, carbohydrate 58% (sucrose 21%) of energy intake. Daily cholesterol intake averaged 575 mg. In men, although not in women, cholesterol intake correlated negatively with serum cholesterol and low-density lipoprotein cholesterol levels, indicating that a high consumption of eggs in the study population did not prejudice lipid homeostasis. The population exhibited a high profile of coronary heart disease risk factors.

Oxygen requirements of the isolated rat heart during hypothermic cardioplegia. Effect of oxygenation on metabolic and functional recovery after five hours of arrest.

Previous studies from this laboratory demonstrated that the use of an oxygenated cardioplegic solution in the hypothermic arrested rat heart resulted in improved preservation of high-energy phosphate stores (adenosine triphosphate and creatine phosphate), mechanical recovery during reperfusion, and preservation of myocardial ultrastructure. In the current study the effect of cardioplegic solutions oxygenated with 30%, 60%, and 95% oxygen was evaluated in the isolated rat heart with reference to the maintenance of adenosine triphosphate, creatine phosphate, oxygen consumption, functional recovery, and mitochondrial oxidative phosphorylation in vitro. Results indicate that the hearts receiving cardioplegic solutions supplemented with 95% oxygen and 5% carbon dioxide maintained adenosine triphosphate and creatine phosphate at control values for at least 5 hours. The oxygen consumption during elective cardiac arrest, mechanical performance during reperfusion, and in vitro mitochondrial oxygen uptake and phosphorylation rate were highest in the hearts receiving cardioplegic solutions supplemented with 95% oxygen when compared to solutions with 30% and 60% oxygen. Addition of glucose and insulin to the cardioplegic solution (95% oxygen) increased the adenosine triphosphate levels but failed to improve function after reperfusion. Although myocardial adenosine triphosphate and creatine phosphate were well preserved by the oxygenated cardioplegic solution, there was a discrepancy between the adenosine triphosphate levels at the end of the arrest period, which represents the potential for mechanical function, and the actual function of the hearts after 5 hours.

Effects of graded sucrose additions on taste preference, acceptability, glycemic index, and insulin response to butter beans.

Dried beans, because of their high-fiber content and low-glycemic index, are especially suitable for diabetic diets. Most South African bean recipes contain sucrose, and since a restriction of artificial sweeteners seems desirable, replacing sucrose would be impractical. Hence, we examined the effects of 10, 20, and 30% sucrose additions to cooked dried butter beans on taste preference and acceptability in 29 diabetic patients and 11 control subjects. The effect of sucrose additions on glycemic index and insulin response to butter beans was determined in control subjects. Both diabetic and control subjects preferred beans with sucrose additions (p less than 0.005). Additions of sucrose up to 20% of total carbohydrate had no adverse effects on glycemic index or insulin response of butter beans (p less than 0.05), which indicates that addition of moderate amounts of sucrose to a low glycemic index food may improve palatability without impairing the favorable effect on blood glucose and insulin response.

Mitochondrial Ca2+ fluxes and levels during ischaemia and reperfusion: possible mechanisms.

It has been shown that myocardial ischaemia depresses the uptake and enhances the release of Ca2+ by mitochondria. Reperfusion of the ischaemic areas may result in a further deterioration of the above processes. Despite these marked changes in Ca2+ fluxes, reperfusion has been shown always to be associated with a marked increase in mitochondrial Ca2+ content. To explain the latter observation, it has been proposed that reperfusion promotes respiration-supported mitochondrial Ca2+ uptake in preference to ADP phosphorylation. To evaluate this hypothesis, the effect of exogenous ADP on mitochondrial respiration-linked Ca2+ uptake was investigated in control, ischaemic and ischaemic-reperfused hearts. The results show that ADP significantly depresses mitochondrial Ca2+ uptake in all three preparations, indicating that Ca2+ is not taken up preferentially to ADP phosphorylation in reperfused tissue. It is suggested that reperfusion-induced increased mitochondrial Ca2+ levels are probably not due to increased respiration-linked Ca2+ uptake, but rather to augmented conversion of ionized Ca2+ to calcium phosphate which does not participate in ionic fluxes.

Antagonism of Lactic Acid Bacteria against Phytopathogenic Bacteria.

A variety of lactic acid bacteria, isolated from plant surfaces and plant-associated products, were found to be antagonistic to test strains of the phytopathogens Xanthomonas campestris, Erwinia carotovora, and Pseudomonas syringae. Effective "in vitro" inhibition was found both on agar plates and in broth cultures. In pot trials, treatment of bean plants with a Lactobacillus plantarum strain before inoculation with P. syringae caused a significant reduction of the disease incidence.