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Objective: It is posited that the effect of depression on BMD is dependent on the severity of depression. Conflicting evidence exists regarding this possible association. This study investigated the association between depression and low bone mineral density (BMD). Methods: The hypothesis was investigated in a random sample of volunteers (n=40) and in premenopausal female psychiatric patients (n=5) diagnosed with recurrent severe major depression. The outcome measures were BMD (DEXA); depression (Beck Depression Inventory and Psychological General Well-being Scale) and 24-hour saliva cortisol levels (ELISA). In a comparison of women (4 of the 40 i.e. ""control"" subjects) with negligible symptoms of depression and the five patients with severe recurrent major depression- BMD; depression; saliva cortisol and bone turnover markers were measured and compared. Pro-inflammatory status (IL-1 and TNF-alpha) was investigated in the psychiatric patients only. Results: In the random - non clinical - sample of women (n=40); 26 exhibited normal BMD and 14 exhibited low BMD. Depressive symptoms and cortisol levels were not significantly different between these two groups. Women with severe recurrent major depression(n=5) exhibited lower median BMD T-scores; higher overall bone turnover and higher 24-hour cortisol levels compared to ""control"" subjects (n=4). The psychiatric patients also exhibited elevated IL-1 levels. Conclusion: The effect of depression on BMD may be dependent on the depression severity. IL-1 and cortisol are possible mediators in depression-induced BMD loss

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Measurements of electrical resistivity (ρ(T)), magnetoresistivity (MR), magnetic susceptibility (χ(T)) and heat capacity (C(P)(T)) are presented for the (Ce(1-x)La(x))PtIn alloy system of which the CePtIn parent is a known dense Kondo compound that does not order magnetically down to 50 mK. χ(T) for alloys 0≤x≤0.8 exhibits Curie-Weiss behaviour. ρ(T) results indicate a transition from a dense Kondo behaviour for 0≤x≤0.2 to a single-ion Kondo region (0.3≤x≤0.8). The Kondo energy scale as given by T(K) values calculated from MR studies and by the temperature T(max)(ρ(mag)) where the magnetic contribution to ρ(T) exhibits a maximum value, is compared with theoretical models. It is shown that the experimental results not only depend on a volume effect as given by the compressible Kondo lattice model of Lavagna but in addition confirm the more complex behaviour recently presented by Burdin and Fulde for a Kondo alloy system in which the magnetic (Ce) and non-magnetic (La) atoms are distributed randomly. Non-Fermi-liquid behaviour is predicted by Burdin and Fulde at certain critical concentrations of the alloy system and experimental evidence for this is presented through χ(T), ρ(T) and C(P)(T) measurements.

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At this time, many antibiotics have decreased activity against Streptococcus pneumoniae, a major agent of infectious disease. In this study, we evaluated antibiotic susceptibility and serogroups of strains isolated from bacteraemia, meningitis and acute otitis media in adults and children over the 1997-2003 period in Brittany, France. In 2003, 62% of the isolates were not susceptible to penicillin and 11% were fully resistant. The prevalence of erythromycin resistance was 63%. Resistance rates were higher among isolates recovered from children than adults. Serogroups 19 and 14 were the most frequently isolated, especially the 19 one among children. The emergence of this serogroup might be a consequence of the use of heptavalent conjugate vaccine introduced in 2001 in France. Future surveillance after vaccination will be needed to detect emerging serogroups and resistance among S. pneumoniae.

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The encapsulation-dehydration protocol was optimized for an in vitro cultured hybrid Actinidia arguta x A. deliciosa. Shoot tips from 14-d reactivated mononodal microcuttings were embedded, transferred to liquid culture medium whose sucrose concentration was daily increased (0.3, 0.5, 0.75 M) and then kept at 0.75 M for 2 or 4 d. Dehydration on silica gel was monitored to 20+/-1.5% residual water content (dry weight basis), allowing direct quenching in liquid nitrogen and rewarming at room temperature. Differential scanning calorimetry analysis underlined the importance of reversible glass transition in shoots for survival. Regrowth ranged from 85% to 95%. Growing shoot tips showed no phenotypic abnormalities. Rooting was also achieved. This method was routinely applied to diploid A. chinensis and A. eriantha, and to several diploid hybrids, yielding over 70% regrowth. A slight decrease in sucrose molarity (0.65 M) allowed tetraploid A. chinensis and A. chrysantha x A. arguta to survive dehydration, but not quenching in LN. For A. deliciosa cv Hayward and cv Tomuri, normal regrowth after cryopreservation was achieved only after modification of the pre- and post-culture media, highlighting the importance of monitoring plant growth regulator balance, principally at the post-thaw recovery step.

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Mohs' surgery of periocular basal cell carcinoma (BCC) ensures a high cure rate with maximal preservation of normal tissue. The formalin-fixed paraffin-embedded tissue technique allows Mohs' surgery to be performed using routine pathology facilities and permits the efficient use of operating room personnel and theatre time. The inevitable delay between excision and closure may potentially result in a poor functional and cosmetic outcome, particularly around the eye. We prospectively studied all patients with periocular BCC treated with this technique at our unit between 1985 and 1996. One hundred and twenty-three periocular BCCs in 120 patients were treated. Microscopic clearance was achieved in all cases. Closure was performed on average 5 days after the initial excisional stage. Closing procedures included direct closure, flaps and grafts. Significant complications affecting outcome were noted in only two patients. Eighty-eight per cent of patients assessed had a functional and cosmetic result regarded as excellent, good or adequate. Mohs' surgery of periocular BCC using formalin-fixed paraffin-embedded tissue and delayed closure results in a satisfactory functional and cosmetic outcome and offers a viable alternative to the frozen section fresh tissue technique.

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A 15-year-old boy with classic clinical and histopathological features of Darier's disease developed viral warts that were confirmed by DNA hybridization studies. Histologically, there were features of acantholytic dyskeratosis in otherwise typical common warts.

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A premature infant with fatal zygomycotic necrotizing cellulitis is reported. Zygomycosis occurs as either an indolent or an acute fulminating form. Cutaneous zygomycosis is a fulminant form of the disease and affects mainly immunocompromised patients. Premature infants with perinatal complications are immunocompromised and therefore at risk for zygomycotic disease, including cutaneous zygomycosis. The different presentations of cutaneous zygomycosis are discussed. Early diagnosis and treatment are essential to ensure patient survival. The clinical differential diagnosis of zygomycotic necrotising cellulitis is mentioned as well as methods for the rapid confirmation of the diagnosis.

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Vibrio hollisae is a pathogenic Vibrio species known to cause gastroenteritis in humans after the consumption of shellfish. All cases of infection reported previously were restricted to the Atlantic and Pacific coasts of the United States. A case of gastroenteritis and bacteremia in a previously healthy 76-year-old man who ate cockles from the Quiberon Bay in Brittany, France, is described. This is the first report of Vibrio hollisae infection in Europe.

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Distance- or distance contact education provides registered nurses with an ideal opportunity for professional growth. This method also fulfils a need to study without the problem of being absent from family, occupational and social responsibilities. It seemed that students are enthusiastic about their studies despite personal, financial and other difficulties. At the end of the course students claimed that their self-confidence improved and that they were better equipped to give high quality nursing care. Using the Spearman Correlation Coefficient there was substantial correlation between the metric results and the final course symbol for this group of students [alpha .05 (p.002)]. No correlation existed between the selection average of 1-9 and the different subjects as for example General Nursing and Ethos. If the decision is taken to present courses according to the distance contact education method, careful planning is essential. Some of the recommendations to assure the success include: * sound structuring of infrastructure and subject material * improvement of selecting procedures; and * the orientation of lectures to cope with the role of facilitator. The professional growth of students during their period of study proves to be worth the effort to present such a course.

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Vancomycin-resistant enterococci have been isolated with increasing frequency since 1988. Thus far, most of these resistant enterococci have belonged to the Enterococcus faecium species, and epidemiological studies have shown a wide diversity among interhospital and intrahospital isolates. This report presents an epidemiologic investigation of 25 vancomycin-resistant Enterococcus strains--24 Enterococcus faecium and one Enterococcus gallinarum--isolated from the stools or blood of adult patients receiving intravenous vancomycin prophylaxis during neutropenia and hospitalized in a single hematologic unit. Macrorestriction patterns of total DNA and of ribosomal DNA regions were used to analyze the strains. Strains produced different total DNA restriction fragment length polymorphism patterns after SmaI digestion. Ribotyping was less discriminative than pulsed-field gel electrophoresis. The results confirmed the genetic unrelatedness of the strains. Prolonged vancomycin administration, commonly used in hematologic units, could be involved in the selection of endogenous resistant enterococcal strains.

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Fluoroquinolones are efficacious antibiotics for the treatment of Salmonella infections in humans. One of these quinolones, enrofloxacin, a precursor of ciprofloxacin, is used to treat respiratory infections in calves and poultry. There is a risk of developing resistant strains of Salmonella in animals, which may then contaminate humans. To evaluate current susceptibilities of Salmonella strains to quinolones, we collected 95 strains belonging to various serotypes in a district of intensive breeding (the Ille-et-Vilaine Département): 54 human strains, 24 bovine strains, and 17 poultry strains. The technique of dilutions in agar medium was used to determine Minimal Inhibitory Concentrations (MICs) for the following antibiotics: nalidixic acid, norfloxacin, pefloxacin, ofloxacin, ciprofloxacin, levofloxacin and clinafloxacin. Our results showed that human Salmonella strains remained very susceptible to quinolones. Only 3 animal strains had nalidixic-acid MICs > 128 mg/l. For these 3 strains, pefloxacin and ciprofloxacin MICs were respectively 1 or 2 mg/l and 0.25 mg/l. For all the other human and animal strains the nalidixic-acid MICs were < 4 mg/l, and their MICs 90 were: 0.12 mg/l for ofloxacin and norfloxacin, 0.06 mg/l for pefloxacin, 0.03 mg/l for ciprofloxacin, 0.016 mg/l for levofloxacin, and 0.004 mg/l for clinafloxacin.

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A prospective study was undertaken in patients with perforated peptic ulcer to ascertain which organisms were encountered and to assess what role the duration of peritoneal soiling plays in the flora encountered and whether the degree of peritoneal soiling, as judged by the surgeon, correlates with bacterial contamination. After assessing the degree of soiling, pus swabs were taken and aerobic and anaerobic cultures and antibiotic sensitivity tests were performed. The most common organisms encountered were Gram-positive cocci (47%) followed by Gram-negative organisms (33%). There was no statistically significant increased bacterial growth time elapsed up to 48 hours. Severe peritoneal soiling, as judged by the surgeon, did not imply greater contamination.

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The distribution of leprosy in Zambia is analysed on a district basis. High density areas are identified and it is suggested that genetic (tribal) factors may be relevant. It is shown that the treatment of leprosy patients has moved away from largely church-related institutions to Government Rural Health Centres. In spite of the urban drift, leprosy remains essentially a rural problem in Zambia. Differences in provincial prevalence rates for leprosy in Zambia have been recorded in previous Annual Reports of the Ministry of Health. However, an analysis of prevalence rates at a District level appears not to have been undertaken previously. It was felt this would prove of interest and be of value both for future planning of leprosy services and research.

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Tonga eye syndromes, aetiological concepts, and eye drops are presented. The attitude of a group of Secondary School Students to common traditional eye drops are presented together with ocular findings in a group of users and alleged non-users. No statistically significant difference was found between the groups. Not all traditional eye drops are dangerous, and a positive education approach is suggested to improve ocular health.

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