Concern exists that frequent use of topically-applied fusidic acid (FA) and chlorhexidine (CHX) for canine pyoderma is driving clinically relevant resistance, despite rare description of FA and CHX genetic resistance determinants in canine-derived staphylococci. This study aimed to determine minimum inhibitory concentrations (MICs) and investigate presence of putative resistance determinants for FA and CHX in canine-derived methicillin-resistant (MR) and -susceptible (MS) staphylococci. Plasmid-mediated resistance genes (fusB, fusC, fusD, qacA/B, smr; PCR) and MICs (agar dilution) of FA and CHX were investigated in 578 staphylococci (50 MR S. aureus [SA], 50 MSSA, 259 MR S. pseudintermedius [SP], 219 MSSP) from Finland, U.S.A., North (NUK) and South-East U.K. (SEUK) and Germany. In all isolates with FA MIC ≥64 mg/L (n = 27) fusA and fusE were amplified and sequenced. FA resistance determinants (fusA mutations n = 24, fusB n = 2, fusC n = 36) were found in isolates from all countries bar U.S.A. and correlated with higher MICs (≥1 mg/L), although 4 SP isolates had MICs of 0.06 mg/L despite carrying fusC. CHX MICs did not correlate with qacA/B (n = 2) and smr (n = 5), which were found in SEUK SA, and SP from NUK and U.S.A. Increased FA MICs were frequently associated with fusA mutations and fusC, and this is the first account of fusB in SP. Despite novel description of qacA/B in SP, gene presence did not correlate with CHX MIC. Selection pressure from clinical use might increase prevalence of these genetic determinants, but clinical significance remains uncertain in relation to high skin concentrations achieved by topical therapy.

Mycobacteriosis caused by non-tuberculous mycobacteria (NTM) is a rising concern in human medicine both in immunocompromised and immunocompetent patients. In cats, mycobacteriosis caused by NTM is considered mostly to be a focal or dermal infection, with disseminated disease mostly caused by Mycobacterium avium. We describe three cases of disseminated mycobacteriosis in cats, caused by Mycobacterium malmoense, Mycobacterium branderi/shimoidei and M. avium, with no identified underlying immunosuppression. In all cases, extracellular mycobacteria were seen in the pulmonary epithelium, intestinal lumen and glomerular tufts, which could affect the shedding of the organism. The present study highlights the importance of mycobacteriosis as a differential even in immunocompetent animals. Considering the close relationship of owners and pets and the potential presence of free mycobacteria in secretions, cats should be considered as a possible environmental reservoir for mycobacteria.

A mathematical model for fibrous structures using a direction dependent scaling law is presented. The orientation of fibrous nets (e.g. paper) is analysed with a method based on the curvelet transform. The curvelet-based orientation analysis has been tested successfully on real data from paper samples: the major directions of fibrefibre orientation can apparently be recovered. Similar results are achieved in tests on data simulated by the new model, allowing a comparison with ground truth.

Background and aims: Most gene expression studies examining the effect of obesity and weight loss have been performed using adipose tissue. However, the liver also plays a central role in maintaining energy balance. We wanted to study the effects of a hypocaloric diet on overall hepatic gene expression and metabolic risk factors.Methods and results: The study subjects were middle-aged, obese women. The diet intervention subjects (n = 12) were on a hypocaloric, tow-fat diet for 8 weeks with a daily energy intake of 5.0 MJ (1200 kcal), white the control subjects (n = 19) maintained their weight. Liver biopsies were taken at the end of the diet period during a gallbladder operation. Hepatic gene expression was analyzed using microarrays by comparing the gene expression profiles from four subjects per group. A global decrease in gene expression was observed with 142 down-regulated genes and only one up-regulated gene in the diet intervention group. The diet resulted in a mean weight toss of 5% of body weight. Triglyceride and fasting insulin concentrations decreased significantly after the diet.Conclusions: The global decrease in hepatic gene expression was unexpected but the results are interesting, since they included several genes not previously linked to weight reduction. However, since the comparison was made only after the weight reduction, other factors in addition to weight toss may also have been involved in the differences in gene expression between the groups. The decrease in triglyceride and fasting plasma insulin concentrations is in accordance with results from previous weight-toss studies. (C) 2008 Elsevier B.V. All rights reserved.

BACKGROUND:Tight glycemic control reduces mortality in surgical intensive care patients and in long-term medical intensive care patients. A large study on intensive insulin therapy was prematurely discontinued due to safety issues. As the safety of intensive insulin therapy has been questioned, we screened all patients during a 17-month period to reveal the incidence of hypoglycemia and its effects on the outcome of the patients.METHODS:All patients treated between February 2005 and June 2006 in two intensive care units (ICUs) of a tertiary care teaching hospital were included in the study. A nurse-driven intensive insulin therapy with a target blood glucose level of 4-6 mmol/l had been introduced earlier. The patients were divided into two groups according to the presence of severe hypoglycemia (<or=2.2 mmol/l).RESULTS:One thousand two hundred and twenty-four patients (1124 treatment periods) were included. During the study period, 61,203 blood glucose measurements were performed, 2.6% of which were below and 52.6% above the target range. Severe hypoglycemia (glucose <or=2.2 mmol/l) occurred in 25 patients (36 measurements). The incidence was 0.06% of the measurements and 2.3% of the patients. The median age, sex, Acute Physiology And Chronic Health Evaluation II, Simplified Acute Physiology Score II, diagnosis category, ICU or hospital length of stay did not differ between the groups. The hospital mortalities were 25% and 15% in patients with or without severe hypoglycemia, respectively (P=0.16).CONCLUSION:Severe hypoglycemia during intensive insulin therapy is rare in clinical practice compared with previous clinical trials.

Tight glycemic control reduces mortality in surgical intensive care patients and in long-term medical intensive care patients. The incidence of severe hypoglycaemia (glucose ≤2.2 mmol/l) in the intensive treatment group has been 3.1–5.1%. Recently, a large study on intensive insulin therapy was prematurely discontinued due to safety issues. The incidence of hypoglycaemia was 9.8% in intensive treatment group and the mortality among patients experiencing hypoglycaemia was 18.6%. As the safety of intensive insulin therapy has been questioned, we screened all patients during a 17-month period to see the incidence of hypoglycaemia and its effects on the prognosis of the patients.

Computer management systems and treatment protocols (CMS/P) have been recommended for their potential to improve patient safety and outcome. Computer management systems require substantial investments in the ICUs. In return, a high-quality, standardised ICU treatment with software-implemented protocols as well as decreased hand-written documentation has been aimed at. The objective of this study was to systematically review the literature on CMS/P to evaluate their impact on outcome benefit.

The aim of X-ray tomography is to reconstruct an unknown physical body from a collection of projection images. When the projection images are only available from a limited angle of view, the reconstruction problem is a severely ill-posed inverse problem. Statistical inversion allows stable solution of the limited-angle tomography problem by complementing the measurement data by a priori information. In this work, the unknown attenuation distribution inside the body is represented as a wavelet expansion, and a Besov space prior distribution together with positivity constraint is used. The wavelet expansion is thresholded before reconstruction to reduce the dimension of the computational problem. Feasibility of the method is demonstrated by numerical examples using in vitro data from mammography and dental radiology.

The telithromycin susceptibility of 210 erythromycin-resistant pneumococci was tested with the agar diffusion method. Twenty-six erm(B)-positive isolates showed heterogeneous resistance to telithromycin, which was manifested by the presence of colonies inside the inhibition zone. When these cells were cultured and tested, they showed stable, homogeneous, and high-level resistance to telithromycin.

The aim of our study was to evaluate antimicrobial use in dogs and cats in Finland. Information on veterinary prescriptions was gathered from University Pharmacies (n = 17) over a one-month period, April 2001. A total of 2719 prescriptions for veterinary use were delivered, of which the majority were for dogs (70%, n = 1898) and cats (14%, n = 384). The most prescribed therapy group was per-oral antimicrobial agents (53%, n = 1449), of which 16% (n = 237) were medicines approved for humans. The most commonly used substances for dogs and cats were betalactams, 66% and 78%, respectively. The proportion of fluoroquinolones was 3–5%. The average duration of the treatment periods was 10 days with the exception of treatment of cats with macrolide lincosamides, where the mean period was 20 days. Indication was mentioned only in 37% of the prescriptions.

ABSTRACT The prevalence and mechanisms of macrolide resistance among 1,007 clinical pneumococcal isolates collected in Finland were investigated. Of these, 217 (21.5%) were resistant to erythromycin and 11% to clindamycin. Among the erythromycin-resistant isolates, mef (E) was present in 95 isolates (44%), mef (A) was present in 12 isolates (6%), and erm (B) was present in 90 isolates (41%). A double mechanism, mef (E) and erm (B), was detected in five isolates (2%). Ribosomal mutation was detected in 14 (6%) macrolide-resistant isolates in which no other determinant was found. Based on the telithromycin MICs, two groups of isolates were formed: 83.3% of the isolates belonged to a major group for which the telithromycin MIC range was ≤0.008 to 0.063 μg/ml, and 16.7% belonged to a minor group for which the telithromycin MIC range was 0.125 to 8 μg/ml. All except three isolates in the minor population carried a macrolide resistance gene.