Molecular typing and prevalence of extended-spectrum ß-lactamase genes in diarrhoeagenic Escherichia coli strains isolated from foods and humans in Mashhad, Iran.

AIMS: Present study was aimed to determine ESBL-encoding genes distribution in Diarrhoeagenic Escherichia coli (DEC) isolated from animal-source food products and human clinical samples in Mashhad, Iran. The strains were also further studied to analyse genotypic diversity and find genetic relationships between them. METHODS AND RESULTS: The number of 85 DEC strains including 52 and 33 strains isolated from 300 food and 520 human stool samples, respectively. Randomly amplified polymorphic DNA (RAPD), and repetitive extragenic palindromic-PCR (rep-PCR) typing methods were used to track their genetic relationships. The ESBL-encoding genes prevalence was approximately 70% in both groups of isolates. The blaTEM , blaCTX-M and blaSHV were prevalent in 67·1, 20 and 10·6% of isolates, respectively. The ESBL-positives showed significantly higher resistance rates to gentamicin, co-trimoxazole, tetracycline, aztreonam and chloramphenicol (P < 0·05). Fingerprinting patterns-based dendrograms divided DEC strains into separate clusters irrespective of their sources and pathotypes. In typing field, rep-PCR provided more discriminatory power (Simpson's index of diversity (SID) = 0·925) than RAPD (SID = 0·812). CONCLUSION: Molecular similarity between certain animal-sourced food products and clinical sample strains supported food-borne transmission routes for genotypic elements such as ESBL-encoding genes. SIGNIFICANCE AND IMPACT OF THE STUDY: Findings emphasize the importance of resistance issues, the need to improve treatment guidelines and routine surveillance of hygienic measures during food processing.

Application of Liposomes in Some Dairy Products.

The application of liposomes as potential carriers to deliver food components is considerably an innovative technology. While the application of liposome technology has been very limited to date, researches indicating the potential of liposomes for improving the flavor of ripened cheese using accelerated methods, the targeted delivery of functional food ingredients, the synergistic delivery of ascorbic acid and tocopherols for promoting antioxidant activity in foods, and the stabilization of minerals (such as iron) in milk have been performed. In the food industry, liposomes and nanoliposomes have been employed to encapsulate flavoring and nutritive agents, and also, they have been suitable candidates to deliver antimicrobials. In this paper, application of lipase, proteinase, nisin, and flavor-containing liposomes in products during the processing (such as cheese maturity) as well as the application of liposomes-encapsulated micronutrients (such as iron) in milk are reviewed.

Reliability of the spine adverse events severity system (SAVES) for individuals with traumatic spinal cord injury.

STUDY DESIGN: Test-retest analysis. OBJECTIVES: To determine the intra- and inter-rater reliability of the Spine Adverse Events Severity System for Spinal Cord Injury (SAVES-SCI) in patients with traumatic SCI. SETTING: Quaternary care spine program in Vancouver, Canada. METHODS: Ten hypothetical patient cases were developed. The cases were completed by 10 raters (seven physicians, one nurse, one physiotherapist and one researcher) who were asked to identify and grade the severity of adverse events using SAVES-SCI twice with 1-week interval. Intra- and inter-rater reliability were calculated using kappa statistics and intraclass correlation coefficients (ICC). RESULTS: Intra-rater reliability for both identifying and grading AEs were high with all AEs (kappa greater than 0.6) except for bone implant, diathermy burn, massive blood loss, myocardial infarction, neurological deterioration, pressure ulcer, return to operating room and tracheostomy requirement. The inter-rater reliability measured with ICC were all above 0.6 for identifying and grading intraoperative, pre and postoperative AEs and consequences of SCI. CONCLUSIONS: The SAVES-SCI demonstrated acceptable intra-and inter-rater reliability for a majority of the AEs. Further clarification and definition of some of the AEs as well as provision of sample training cases for clinicians would assist in reducing measurement errors. The SAVES-SCI is a useful tool to assess and capture AEs in patients with acute traumatic SCI.

Effect of brown rice flour fortification on the quality of wheat-based dough and flat bread.

The objective of present study was to investigate the impact of Brown Rice flour (BR) incorporation, at three different levels of 5, 10 and 15 % to the Wheat Flour (WF) preparations on rheological properties of wheat-based dough and quality of wheat-based flat bread. The BR flour incorporation mainly affected the chemical properties of flours, the rheological characteristics of dough and, quality and shelf life of bread. The protein-related properties of flours principally experienced reduction; however, the ash content had an increase, along with BR flour incorporation. The rheological properties of dough were affected considerably by BR flour substitution, wherein the sample containing 5 % BR flour was closest to BR flour-free dough (control). Regarding the yielded bread, BR flour addition affirmatively affected sensorial properties and firmness quality evaluation, wherein the bread made from dough with composite flour fortified with 5 % BR flour was scored the best. The findings from instrumental firmness quality assessment were confirmed as the bread containing 5 % BR flour remained softer and demanded lowest force to be compressed over the storage period. Overall, results showed that adding BR flour up to 5 % can be used in baking of flat bread since it meets the required criteria.

Prediction of Cognitive Status and 5-Year Survival Rate for Elderly with Cardiovascular Diseases: A Canadian Study of Health and Aging Secondary Data Analysis.

BACKGROUND: Given the important association between cardiovascular disease and cognitive decline, and their significant implications on frailty status, the contribution of neurocognitive frailty measure helping with the assessment of patient outcomes is dearly needed. OBJECTIVES: The present study examines the prognostic value of the Neurocognitive Frailty Index (NFI) in the elderly with cardiovascular disease. DESIGN: Secondary analysis of the Canadian Study of Health and Aging (CSHA) dataset was used for prediction of 5-year cognitive changes. SETTING: Community and institutional sample. PARTICIPANTS: Canadians aged 65 and over [Mean age: 80.4 years (SD=6.9; Range of 66-100)]. MEASUREMENT: Neurocognitive Frailty Index (NFI) and Modified Mini-Mental State (3MS) scores for cognitive functioning of all subjects at follow-up and mortality rate were measured. RESULTS: The NFI mean score was 9.63 (SD = 6.04) and ranged from 0 to 33. This study demonstrated that the NFI was significantly associated with cognitive changes for subjects with heart disease and this correlation was a stronger predictor than age. CONCLUSION: The clinical relevance of this study is that our result supports the prognostic utility of the NFI tool in treatment planning for those with modifiable cardiovascular disease risk factors in the development of dementia.

Comparison of the prognostic importance of diagnosed diabetes, co-morbidity and frailty in older people.

AIMS: To compare the relative prognostic importance in older people of diagnosed diabetes, the number and severity of co-morbidities and frailty. METHODS: Two thousand three hundred and five people aged > or = 70 years comprised the clinical examination cohort of the Canadian Study of Health and Aging. Frailty was defined as a score of > or = 5 on a 7-point Clinical Frailty Scale. The cohort was followed for 5 years. RESULTS: Diabetes was more likely to be associated with medium-term mortality (adjusted hazard ratio (HR) 1.42; 95% confidence interval (CI) 1.20-1.69) than co-morbidity (HR 1.03; 95% CI 1.01-1.05). Frailty most strongly predicted death (HR 2.72; 95% CI 2.34-3.16). Frail older adults were 2.62 times (95% CI 1.36-5.06) more likely to have a complication of diabetes, independent of age, sex and number of years living with diabetes. People with diabetes were younger than those without (81.3 vs. 83.3 years) but a similar proportion were frail (42.2 vs.43.4%). The median life expectancy for frail older adults with diabetes was 23 months (95% CI 18-28 months). CONCLUSIONS: In this cohort, the risk of mortality in older people was defined more precisely by a clinical measure of frailty than by diabetes or burden of co-morbidity. Those with diagnosed diabetes were younger than those without but had the same frailty status; diabetes can therefore be considered to increase 'biological age' by 2 years in those aged over 70 years. The limited life expectancy of frail older people with diabetes highlights the importance of recognizing frailty and supports the individualization of care in older people with diabetes.

Incidence of aflatoxins in Iran pistachio nuts.

Aflatoxins (AF) are highly toxic and carcinogenic secondary fungal metabolites and have been detected in various food commodities including pistachio nuts. Pistachio nuts were produced in Iran during March 2002-February 2003 analyzed for aflatoxin B1 (AFB1), aflatoxin B2 (AFB2), aflatoxin G1 (AFG1) and aflatoxin G2 (AFG2) using immunoaffinity column and quantitated by HPLC and/or TLC-scanner. In this regard, 3356 pistachio nut samples were collected. After dividing samples to sub-samples, 10,068 AF analyses were done. Among 10,068 samples analyzed, AFB1 was detected in 3699 samples (36.7% of the total) with the mean and median of 5.9 (+/-41.7) ng/g and 0.1 ng/g, respectively. Total AF (AFT) was detected in 2852 samples (28.3% of the total) with the mean and median of 7.3 (+/-53.2)ng/g and 0.4 ng/g, respectively. AFB1 level in 1191 samples (11.8%) was above the maximum tolerated level (MTL) of AFB1 in pistachio nut in Iran (5 ng/g). Regarding AFT, the mean contamination level (7.3 ng/g) was lower than MTL of AFT in pistachio nut in Iran as well as lower than the proposed draft maximum level of Codex Committee on Food Additives and Contaminants for AFT (15 ng/g), and only 7.5% of samples had levels above the MTL.

Transitions in cognitive status in relation to frailty in older adults: a comparison of three frailty measures.

OBJECTIVES: Cognitive decline is related to frailty. Frailty can be operationalized in different ways, which have an unknown impact on the estimation of risk. Here, we compared 3 frailty measures in relation to cognitive changes and mortality in the Canadian Study of Health and Aging (CSHA). DESIGN: Prospective population-based study, with 5 year follow up. PARTICIPANTS/SETTING: 2,305 subjects aged 70+ years. METHODS: For each participant, cognitive status was measured by the errors in the Modified Mini-Mental State Examination (3MS) score. Three frailty measures were used: a Frailty Index based on the Comprehensive Geriatric Assessment (FI-CGA) evaluated from 47 potential deficits, a Clinical Frailty Score and the Fried frailty phenotype. Multivariate Poisson regression and multivariate logistic regression were used to examine the association between baseline cognitive errors and frailty and death, respectively, while controlling for possible confounders (age, sex, education, and baseline cognitive status). RESULTS: Changes in cognitive status were strongly associated with baseline cognition and frailty, however defined. In multivariate models adjusted for age, sex and education, each frailty measure was associated with cognitive decline and with mortality. The frailest people (from the highest FI-CGA tertile) rarely showed cognitive improvement or stabilization (1.5%, 95% CI=0.002%-2.8%) compared with non-frail people (from the lowest tertile of the FI-CGA), of whom 27.8% (95% CI=24.5%-31.1%) did not deteriorate. CONCLUSIONS: Frail elderly people have an increased risk of cognitive decline. All frailty measures allowed quantification of individual vulnerability and predict both cognitive changes and mortality.

Kinetics of styrene biodegradation in synthetic wastewaters using an industrial activated sludge.

Kinetics of styrene biodegradation in synthetic wastewaters, containing either styrene or styrene together with ethanol, by an industrial activated sludge obtained from the wastewater treatment unit of a petrochemical complex was studied. The kinetic data could be fitted using the Haldane kinetic model. This model was previously used to predict kinetic data for biodegradation of styrene by pure or mixed microbial cultures isolated from biofilters, but the values of the model parameters reported in these studies was substantially different from that obtained for the industrial activated sludge. The presence of ethanol did not affect the kinetics of styrene biodegradation by the industrial activated sludge; however, it increased the rates of styrene biodegradation due to the resulting higher microbial growth rates. Styrene concentration was found to affect the specific growth rate in a manner similar to its effect on the styrene degradation rate. No lag phase was observed in styrene biodegradation by industrial activated sludge for styrene concentrations up to 100mg/L. Lag phase was observed for municipal activated sludge even at 50mg/L styrene concentration but the rate of styrene biodegradation after the lag phase was similar to that achieved by the industrial activated sludge.

Long-term operation of submerged membrane bioreactor (MBR) for the treatment of synthetic wastewater containing styrene as volatile organic compound (VOC): Effect of hydraulic retention time (HRT).

In this study, the membrane bioreactor (MBR) was utilized to remove styrene from a synthetic wastewater having a chemical oxygen demand (COD) and styrene concentration of 1500 mg/L and 50 mg/L, respectively. At two hydraulic retention times (HRTs) of 24 h and 18 h, the MBR was operated for a period in excess of 100 days. The HRT effects were studied and it was found out that the removal efficiency of COD and styrene for both HRTs was consistently higher than 99%. Unlike conventional activated sludge processes (CASPs), no styrene was detected in the exhaust air, which meant that biodegradation was the major styrene removal mechanism at both HRTs. The transmembrane pressure (TMP) profile during the operation of the MBR showed a fairly low and constant TMP up to day 70, after which, the TMP showed a dramatic rise, as a result of the occurrence of severe membrane fouling. It was thought that an increase in styrene loading rate, when HRT was reduced to 18 h, resulted in the release of extracellular polymeric substance (EPS) from the bacterial cells, which in turn was responsible for the rise in soluble microbial product (SMP) and sludge deflocculation. The severe fouling observed during operation of MBR at HRT of 18 h was attributed to the rise in SMP concentrations and decrease in mean floc size and increase in the proportion of small particles in the activated sludge.

Comparison of two frailty measures in the Conselice Study of Brain Ageing.

OBJECTIVES: Uncertainty about the definition of frailty is reflected by the development of many ways to identify frail people. We aimed to compare the validity of two frailty measures in participants of the Conselice Study of Brain Aging. DESIGN: Prospective population-based study with 4 year follow up. PARTICIPANTS/SETTING: 1,016 subjects aged 65 and over in a rural Italian population. METHODS: For each participant, a Frailty Index (FI) and a Conselice Study of Brain Aging Score (CSBAS) were determined. The FI was created from 43 deficits according to a standardized methodology; 7 variables derived from a previously validated Easy Prognostic Score comprised the CSBAS. RESULTS: The FI had characteristic properties described in other population samples, with a gamma distribution, a 99% limit of about 0.64 and higher values in women than men. CSBAS and FI were strongly correlated with each other (r = 0.72) and both correlated with age (r = 0.32, r = 0.27, respectively). Each was independently predictive of death in a multivariate model, with greater specificity and sensitivity than age alone. CONCLUSIONS: Frailty can be measured by different tools and facilitates a more direct quantification of individual vulnerability than chronological age alone. Though the Frailty Index and the Conselice Study of Brain Aging Score are underpinned by different rationales, clinical utility will continue to motivate their development.

[Correlation between osteoporosis and discarthrosis. Comparative frequency of spinal osteophytosis and thickness of intervertebral disk in 50 patients with osteoporosis confirmed by bone biopsy and in 50 controls. Study of lordosis in 50 osteoporotic patients]. / Etude corrélative de l'ostéoporose et de la discarthrose. Fréquence comparée de l'ostéophytose rachidienne et de l'épaisseur du disque intervertébral chez 50 sujets porteurs d'une ostéoporose vérifiée par la biopsie osseuse et chez 50 témoins. Etude de la lordose des 50 ostéoporotiques.

Comparative radiological study of the spine in 50 osteoporotic subjects selected on double criteria, radiological and histological, and 50 control subjects of the same age and same sex, confirmed the lesser frequency and the mildness of the osteophyte formation, and the disk degeneration in osteoporotic subjects. The vertebral radiological index, which measures both the number and importance of the vertebral body surface concavity and vertebral collapse, and has no significant correlation with age. A study of the degree of lordosis and of the index of bending of the trunk was carried out in 50 osteoporotic patients. Only one third of them had lumbar hyperlordosis. Owing to its inconstancy, lumbar hyperlordosis cannot be considered as responsible for the mildness of the osteophyte formation in osteoporotic patients. It seems reasonable to admit that the mildness of the osteophyte formation and of the osteoporosis are linked together and are probably the result of a reduced capacity of bone formation.

One-year efficacy of expanded polytetrafluoroethylene vascular graft in eighty-three hemodialysis patients.

INTRODUCTION: Our aim was to evaluate the patency and efficacy of expanded Polytetrafluoroethylene (ePTFE) vascular graft in hemodialysis patients. MATERIALS AND METHODS: In a prospective study from January 1999 to January 2001 at Sina hospital 41 patients underwent implantation of 6-mm vascular grafts and 42 underwent implantation of 8-mm grafts in order to make vascular assess for hemodialysis. They were followed up to 12 months, observing the complications. RESULTS: Mean patients' age was 52.2 years. Thirty-seven of them were females and 46 were males. Over a 12 months period of follow-up, 12 cases of graft infection (14.5%), 21 cases of thrombosis (25.3%), 7 cases with both complications (8.4%), and 1 case of pseudoaneurism (1.2%) were observed. One-year patency rate was 34.9%. Diabetes was the only factor associated with lower patency rate (27% versus 57%, p<0.05). CONCLUSION: ePTFE vascular graft seems to be an appropriate substitute for arteriovenous fistula as a vascular assess in hemodialysis patients. Educating patients and good care can decrease the rate of infection, thrombosis, and other complications, resulting in a better patency and lower morbidity rate.

[Estimate of the prevalence of rheumatoid arthritis based on a rheumatology study in the district of Angers]. / Estimation de la prévalence de la polyarthrite rhumatoïde à partir d'une étude en milieu rhumatologique dans l'arrondissement d'Angers.

The prevalence of rheumatoid arthritis is generally estimated to be 1 per cent, despite the marked differences between the various results published according to the survey techniques and the epidemiological criteria employed. The present survey consisted of patients from the target population (the 248,009 inhabitants of Angers over the age of 15 years), who had been examined by one of the hospital or private rheumatologists working in Angers between 1960 and 1984 and who were considered to be suffering from inflammatory rheumatism. The cases of rheumatoid arthritis included in this survey were still alive and were living in Angers between January 1 and June 30 1984 and corresponded to at least two of the New York criteria. The prevalence determined according to this technique was 0.17 per cent for two criteria and 0.11 per cent for three criteria. After discussing the bias and the particular conditions of the study, it appears that these particularly low levels are essentially related to: a recruitment bias due to the limitation of the survey to patients seen by rheumatologists, to the choice of New York criteria and more especially of 3 criteria which increases the specificity of the survey at the expense of the sensitivity, to the long observation (mean of 10.4 years) which contributed to a reduction in the number of false positives. The validity of this study is supported by the comparison with the study by O'Sullivan et al. also based 2 New York criteria with a follow-up of 3 to 5 years, which concluded on a prevalence of 0.24 per cent compared with 0.17 per cent in Angers.(ABSTRACT TRUNCATED AT 250 WORDS)

[Palindromic rheumatism. Immunologic survey and study of development in 43 cases]. / Le rhumatisme palindromique. Enquête immunologique et étude de l'évolution dans 43 cas.

43 patients (18 females, 25 males) presenting palindromic rheumatism were given follow-up examinations after a mean lapse of 14.75 years. 16 subjects still presented palindromic rheumatism and of these six showed complete remission. 27 patients had developed chronic inflammatory rheumatism after seven years (mean value) of palindromic rheumatism, but resolution of PR was seen in four cases. Male predominance was more marked in the palindromic subgroup (PAL) but was also seen in the subgroup of subjects who had developed PR (PAL-PR). Laboratory tests demonstrated a constant homogeneous increase in immunoglobulins (notable IgAs) and in the T4/T8 ratio in the PAL and PAL-PR subgroups. Rheumatoid serodiagnostic tests were positive significantly more frequently in the PAL-PR subgroup, which also comprised a high proportion of cases of erosive arthritis. Overall the frequency of HLA-DR 4 antigen did not increase in the subjects studied. Subjects in the PAL subgroup (cf. PAL-PR subgroup) were characterized by a twofold increase in frequency of DR 5 antigen, with a relative risk of 3.5 to 4.5, a significant increase in B35 and B5 and a clear decrease in B12.