Ostomy bag management: comparative study of a new one-piece closed bag.

The aim of this study was to compare the performance of a new one-piece closed ostomy bag, SenSura, to an already established bag with a focus on minimizing problems related to use of stoma bags for individuals with a colostomy. There were 68 Danish participants with a colostomy who tested each bag for 1 week in a randomized, open, comparative, crossover study. The SenSura bag was perceived more secure than the reference bag (p=0.0006). Crucial performance and safety parameters were rated significantly better for SenSura than for the reference bag. The high preference for SenSura (85%) reflected these results (p<0.0001). Individuals with a colostomy can expect a higher sense of security with the SenSura bag than with the reference bag. This may relate to good adhesion, tack, flexibility and effective filter performance. Future studies should examine the long-term effects of SenSura on peristomal skin conditions. To our knowledge, this is the first published comparative study of one-piece closed ostomy bags.

Membrane stabilizers inhibit potassium efflux from Staphylococcus aureus strain No. U2275.

The effect of different categories of membrane stabilizers on K+ loss and growth has been characterized in a culture of Staphylococcus aureus. Chlorpromazine, thiopental and tetracaine at low concentrations produced a marked inhibition of K+ loss and an equivalent increase in the K+ contents of S. aureus. Whereas the inhibitory effect of chlorpromazine on K+ loss was observed at lower than bacteriostatic concentrations of the drug, thiopental had no effect on growth in the concentration range where K+ loss was maximally inhibited. It is concluded that the bacteriostatic action of chlorpromazine is probably not related to its membrane stabilizing effect only.

Identification of coagulase-negative staphylococci and typing of Staphylococcus epidermidis by a 4 h micromethod.

A new 4 h micromethod (Minibact-S) for identification of coagulase-negative staphylococci (CNS) important in human medicine, Staphylococcus epidermidis, Staphylococcus hominis, Staphylococcus haemolyticus and Staphylococcus saprophyticus, has been investigated. The reproducibility for species identification was 100% and the reproducibility for the single reactions was 95%. When compared to a modified Kloos & Schleifer conventional identification method, discrepant identification was obtained with the Minibact-S in only 8 of 382 clinical and reference strains. The system has been used for typing and biotyping of 201 S. epidermidis strains, and gave a subdivision in 69 different types; 4 related types accounted for 91 (45%) of the isolates, whereas 44 types were represented by only 1 isolate. The discriminatory index was 0.82. In a comparison with other typing methods performed on 81 isolates from 15 patients Minibact-S gave about the same number of types as antibiograms, but in 20% of the patients extra types were obtained with Minibact-S alone compared to antibiogram alone and vice versa. The Minibact-S is of some value in the routine clinical microbiology laboratory as a first screening method for identification of coagulase-negative staphylococci and typing of S. epidermidis in combination with the antibiogram.

Hypochondria: a tentative approach.

The author begins his investigation of hypochondria by defining the condition and distinguishing between hypochondriacal symptoms and hypochondriacal crises, the latter being stated to arise when the defensive function of the former fails. After an enumeration of the main psychogenetic elements observed in the psychoanalytic psychotherapy of a sample population of eight patients, he concentrates on the psychodynamic and psychostructural aspects and demonstrates by means of clinical examples how conflicts of separation and dependence give rise to oral-sadistic, anal-sadistic and progressive-perverse defensive structures. Although regressive and progressive psychodynamic processes established between these structures may temporarily stabilise the psychic system to some extent, splits cause them to loom large in a hypochondriacal world full of disintegrative anxiety that is accompanied by an aggressive excitation pervaded with threatening confusion and sexual perversion, where the patient flees into quasi autistic withdrawal and tormenting self-observation. Catastrophic states resulting from earlier traumas are here fused with more mature psychic elements owing to earlier traumas. The author shows how instability in these structures, together with the failure of important ego and superego functions, may lead to a malignant regression and the consequent pathogenic reintrojection of projections. When the psyche is threatened by a dynamic of this kind, hypochondriacal symptoms may ensue as a last-ditch attempt by the patient to defend against psychic decompensation.

Microtests for rapid identification of Enterobacteriaceae. Four-hour tests by use of substrate-impregnated paper discs.

A number of microtests for the diagnosis of Enterobacteriaceae in 4 hours were developed. Composition of substrates and preparation of reaction wells are described. There were used substrate-impregnated paper discs affixed to microwell plates. Test results of 253 stock cultures of Enterobacteriaceae were correlated with results obtained by conventional tube methods. Twenty out of 23 microtests showed total correlations of more than 95%, and the remaining 3 tests 85-94%. The microtests are concluded to be economic and reliable alternatives to conventional tube methods and seem suitable for routine identification of Enterobacteriaceae.

Type-I reactions to commercial fish in non-exposed individuals.

The frequency of type-I reactions (contact urticaria) to plaice, whiting, common dab, witch, codfish, Norwegian haddock, herring and halibut has been examined in 26 individuals; 23 of these carried through all the investigations. 65% of the volunteers had a positive scratch patch test to one or more species of fish. All 20 min closed patch tests were negative. 5 of the volunteers were atopics. They showed about twice as many positive scratch patch tests when compared to the non-atopics. The investigation shows that the "fish allergen" is destroyed by cooking but not by freezing. The possibility of common and specific fish allergens is discussed.

Contact urticaria to commercial fish in atopic persons.

The frequency of contact urticaria provoked by certain fish prepared in the Danish fish industry was examined in 14 persons with atopia. In 71.4% of the test persons we found positive confirmation in a 20-minute scratch patch test to one or more fish species. All occluded patch tests were negative, while 33.9% of the scratch patch tests were positive. It was impossible to make a correlation between positive scratch patch tests and atopic allergen/total IgE. The investigation emphasizes that atopics have a higher frequency of contact urticaria to fish than have non-atopics.

Evaluation of Minibact, a new system for rapid identification of Enterobacteriaceae. Comparison of Minibact, Micro-ID and API 20E with a conventional method as reference.

Minibact, a new system for four-hour identification of Enterobacteriaceae, combined with a computer identification system, was compared with Micro-ID and API 20E in testing 110 strains of Enterobacteriaceae. Minibact gave identification rates of 96.4% at species level and 96.4% at genus level; the corresponding values for Micro-ID were 87.3% and 91.8%, and for API 20E 91.8% and 94.5%. In conclusion, Minibact combined with a computer identification program gave high identification rates fully comparable to those of Micro-ID and API 20E, and the system might be an alternative to conventional identification systems in clinical microbiological departments.

Influence of carbon-dioxide tension and medium buffer concentration on medium pH and MIC values of erythromycin for Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 25923 in a micro-aerobic atmosphere.

The effect of an elevated carbon-dioxide tension on medium pH and MIC determination with erythromycin for Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922) was investigated in a micro-aerobic atmosphere, using an agar dilution method. During 30 h of incubation in an atmosphere containing approximately 6% CO2, 5% O2 and 89% N2, pH of uninoculated, as well as of seeded, blood agar plates decreased from 7.4 to 6.8. MIC values of erythromycin were two dilution steps higher after micro-aerobic incubation than after aerobic incubation. A decrease in agar pH during micro-aerobic incubation was eliminated by increasing the phosphate buffer concentration in the medium. However, MIC values of erythromycin remained high.

Binding of human endothelium to Ulex europaeus I-coated Dynabeads: application to the isolation of microvascular endothelium.

A major problem encountered when isolating human microvascular endothelium is the presence of contaminating cells such as fibroblasts that rapidly over-grow the endothelial cells. We describe here a simple, rapid technique for purifying endothelial cells derived from the microvasculature of neonatal foreskin and osteoarthritic and rheumatoid arthritic synovium. This technique is based on the selective binding of the lectin Ulex europaeus I (UEA I) to the endothelial cell surface via fucose residues. Initially UEA I was covalently bound to tosyl-activated super-paramagnetic polystyrene beads (Dynabeads) by incubation for 24 h at room temperature. Cells were isolated by extracting microvascular segments from enzyme-treated (trypsin and Pronase) cubes of tissue. The mixed population of cells obtained were purified by incubating them at 4 degrees C for 10 min with the UEA I-coated Dynabeads. Endothelium bound to the beads whilst contaminating cells were removed by five washes with HBSS using a magnetic particle concentrator. The endothelial cells thus obtained grew to confluence as a cobblestone-like monolayer and expressed von Willebrand factor antigen. The cells were released from the Dynabeads by the competitive binding of fucose (10 min at 4 degrees C). This new method is simple and reproducible and allows pure human microvascular endothelial cells to be cultured within 2 h of obtaining a specimen.