The clinical picture of generalized forms of salmonellosis]

Clinical presentation of generalized salmonellosis is reviewed. Typhus-like form occurred in 28, septic form in 15 cases (0.5 and 0.3% of all the patients observed, respectively). Salmonellosis sepsis is hard to detect in view of multiple visceral lesions, long-term fever and severe intoxication.     

Cytogenetical problems in prenatal diagnosis

The effects of Microfibrillar Collagen Hemostat (MCH) and Gelfoam after surgical implantation into incision sites of the liver, kidney, and brain were studied in beagle dogs, rabbits, and beagle dogs, respectively. The results of these experimental animal studies suggest that MCH is comparable to Gelfoam with respect to biocompatibility, rate of bioassimilation, and a lack for adverse systemic effects. The brain, liver, and kidney tissues responded comparably to MCH and Gelfoam with a mild to moderate infiltration of macrophages and mononuclear cells. Most of the hemostatic compound had disappeared from the incision sites by Day 28 and completely disappeared by Day 84. The tissue degree response was interpreted as a factor in the process of bioassimilation of the two hemostatic materials. Both hemostatic compounds contributed to adhesion formation in the experimental models. The incidence of adhesions was somewhat lower for MCH than for Gelfoam, but both produced more adhesions than were found at the control sites. The adhesions were only to the adjacent structures and always localized to the surgical site. When MCH or Gelfoam is used under conditions similar to those in the present experimental study, where tissue approximation is impaired, and where growth of granulation tissue is stimulated by the physical presence of the hemostatic compound, there is the possibility for increased incidence of adhesion formation. However, when an intraperitoneal absorbable hemostatic compound is desired, the present studies in experimental animals suggest that MCH will be safe by exhibiting minimal tissue reaction.     

Isolation of multiple Salmonella serovars from a dairy two years after a clinical salmonellosis outbreak

Samples were obtained for bacteriologic culturing of salmonellae from cows and calves on, and the environment of, a large California dairy that used free-stall housing and a flush system for manure handling. Two years previously, the dairy had an outbreak of clinical salmonellosis in the lactating herd; however, since that time, it had not had problems with clinical salmonellosis. On the basis of mean annual milk production per cow, this dairy was consistently ranked in the top 25% of dairies in the area enrolled in the Dairy Herd Improvement Association. Results of bacteriologic culture of 76% (108/142) of environmental samples and 48% (639/1,339) of fecal samples were positive for salmonellae. Eighty-two percent of the isolates were serovar C1, subclassified as Salmonella montevideo, and 17% were serovar E. Results of bacteriologic culture of 85% of samples of recycled flush water being pumped into the free-stall alleys were positive, as were results of bacteriologic culture of 78% of samples of herd bulk milk filters, 97% of fecal samples collected from calves being fed nonsalable milk, and 25% of fecal samples collected from cows at the time of breeding. These findings suggest that freedom from clinical salmonellosis and comparatively high measures of herd performance do not indicate the absence of salmonellae from a premises, and that hardy infectious agents transmitted by ingestion of feces can become established in the environment of modern free-stall dairies that use recycled water in their manure flush systems.     

Digital images in the diagnosis of wound healing problems

The use of digital wound images could allow remote consultation among patients, physicians, or other care-givers located at quite distant sites by means of the Internet. To evaluate the efficacy and validity of digital images for the evaluation of wounds, the ability and reliability of surgeons to diagnose and make treatment suggestions using digital images of several types of wounds were compared. Twenty-four wound images on 35-mm slides were selected for use in this study. Each slide image was digitized at 24-bit color with a resolution of 640 pixels horizontal by 425 pixels vertical and stored as a JPEG file. These images were then presented as a slide show on a video monitor, with resolution set at 640 x 480. Six physicians examined the images, first in digital format and later in the original slide form. Each observer assessed each wound and possible treatment options by filling out a questionnaire using a series of yes/no questions. For all observers, there was an 87 percent agreement between digital and slide images (p = 0.004). The agreement between the digital and slide images was measured for each individual observer using a kappa coefficient. The agreement level corresponded to the experience of the observer, with the kappa values ranging from greater than 0.8 (almost perfect agreement) for the attending plastic surgeon to just greater than 0.5 (moderate agreement) for the intern. With this study, the feasibility of distance wound consultation using digital images of a quality consistent with consumer-grade digital photography was demonstrated.