Microbiologic assay for detection of antimicrobial agents in urine

Antimicrobial therapy can be a confounding factor in the diagnosis of urinary tract infection and is not always reported to laboratories by physicians. We developed a microbiologic assay for screening urine specimens for antimicrobial agents. Bacillus stearothermophilus was used as the indicator bacteria. A total of 1,921 urine specimens from three hospitals in Taiwan were screened using this assay. Of the samples assayed, 1,293 were positive for antimicrobial agents. Agreement between information provided by physicians and laboratory findings was 68.5% (419/612). In the presence of antimicrobial agents in the urine samples, the isolation of yeasts and Pseudomonas aeruginosa increased dramatically, from 4.5 to 19.5% and 4.2 to 13.2%, respectively. Additionally, Escherichia coli was more resistant to gentamicin (75.3% vs 48.7%, p < 0.0001), norfloxacin (85.2% vs 64.6%, p = 0.0006) and co-trimoxazole (58.5% vs 35.5%, p = 0.0018). In view of the high rate of occurrence of antimicrobial agents in urine specimens and the lack of information provided by most physicians to laboratories, a screening method to detect the presence (or absence) of antimicrobials in urine specimens may be a useful tool particularly in areas such as Taiwan where antimicrobial agents are commonly abused.     

Reflex sympathetic function in cortisol-induced hypertension in humans

Nine healthy male subjects underwent measurement of reflex sympathetic function, pressor responsiveness and baroreflex sensitivity to phenylephrine (PE) and glyceryltrinitrate (GTN) before (C1) and following six days of treatment (E6) with cortisol (F), 200 mg/day. Seven subjects had washout studies (W) performed at least two weeks following the end of treatment. The BP responses to head tilt, isometric exercise and mental arithmetic were unaltered by F, however, there was a significant diminution of the diastolic BP response to cold pressor stimulus (delta DBP: 19 +/- 3 vs 25 +/- 5 vs 27 +/- 5 mmHg; E6 vs C1 vs W, p < 0.05 C1 vs E6 and W). Baroreflex sensitivity to PE was increased (28 +/- 3 vs 19 +/- 2 ms/mmHg, E6 vs C1, p = 0.03). These data demonstrate that increased BP during F treatment is not attributable to increased SNS activity, and suggest that SNS activity may be decreased by F.     

Improved osseointeraction of calcium phosphate-coated external fixation pins. Studies in calves

The analysis of health state of drivers sent for an extra health examination for the estimation of driving capability for the driving of motor vehicle in alcoholic state was presented. The study included 380 drivers who were found driving drunk by traffic police (studied group) and 180 drivers of control group sent for an extra health examination for some other reason. The disorders in psychomotor sphere were noticed in the drivers of studied group and it was determined that they had caused significantly larger number of traffic accidents in last five-year period compared to the drivers of control group. The alcohol consumption in driving population represents significant medical, social, economic and traffic problem. The control of driver's alcoholism, the sending of alcoholic drivers to an extra health examination for the repeated estimation of driving capability and including in therapeutic and health-educational program can present significant measure of the primary prevention of road traffic traumatism which is on the constant increase.     

Symptom profiles of depression among general medical service users compared with specialty mental health service users

BACKGROUND: Since depressive disorders are now eminently treatable and early detection and treatment could bring substantial benefits, it is critical to address alternative presentations of depression in the general medical setting. Concern regarding under-diagnosis of depression in general medical settings has given rise to the question of whether the clinical disorder of depression differs qualitatively or only quantitatively across care settings. METHODS: Symptom profiles of depression were compared across care sectors to investigate how the presentation of depression among general medical service users might differ qualitatively from specialty mental health service users. Data on depression symptoms within 6 months of interview gathered in three community surveys that were part of the NIMH Epidemiologic Catchment Area Program were analysed using methods developed to assess item bias. The subjects were 4931 and 363 persons who reported a visit to the general medical sector or to specialty mental health respectively, within 6 months of interview. RESULTS: Compared with specialty mental health service users, general medical service users were less likely to present dysphoria (adjusted Odds Ratio, aOR = 0.57; 95% Confidence Interval, CI = 0.38-0.84) and feeling worthless, sinful, or guilty (aOR = 0.63; 95% CI = 0.40-0.98), but were more likely to present fatigue (aOR = 1.71; 95% CI = 1.09-2.69), even after holding constant other characteristics that might influence reporting of symptoms as well as level of depression. CONCLUSIONS: These results suggest that there are qualitative differences in depression presenting in general medical care compared with specialty mental health care and call for a re-conceptualization of depression in the general medical setting.