Fatal Pseudomonas aeruginosa pneumonia in a previously healthy woman was most likely associated with a contaminated hot tub

Community-acquired pneumonia due to Pseudomonas aeruginosa in previously healthy individuals is a rare disease that is associated with high fatality. On 14 February 2010 a previously healthy 49-year-old woman presented to an emergency room with signs and symptoms of pneumonia, 2 days after returning from a spa holiday in a wellness hotel. Blood cultures and respiratory specimens grew P. aeruginosa. Despite adequate antimicrobial therapy, the patient died of septic multiorgan failure on day nine of hospitalization. On February 26, nine water samples were taken from the hotel facilities used by the patient: In the hot tub sample 37,000 colony-forming units of P. aeruginosa/100 ml were detected. Two of five individual colonies from the primary plate used for this hot tub water sample were found to be genetically closely related to the patients’ isolates. Results from PFGE, AFLP and MLST analysis allowed the two lung isolates gained at autopsy and the whirlpool bathtub isolates to be allocated into one cluster. The patient most likely acquired P. aeruginosa from the contaminated water in the hotel’s hot tub. The detection of P. aeruginosa in high numbers in a hot tub indicates massive biofilm formation in the bath circulation and severe deficiencies in hygienic maintenance. The increasing popularity of hot tubs in hotels and private homes demands increased awareness about potential health risks associated with deficient hygienic maintenance

High-Resolution Melting Analysis as a Powerful Tool to Discriminate and Genotype Pseudomonas savastanoi Pathovars and Strains

Pseudomonas savastanoi is a serious pathogen of Olive, Oleander, Ash, and several other Oleaceae. Its epiphytic or endophytic presence in asymptomatic plants is crucial for the spread of Olive and Oleander knot disease, as already ascertained for P. savastanoi pv. savastanoi (Psv) on Olive and for pv. nerii (Psn) on Oleander, while no information is available for pv. fraxini (Psf) on Ash. Nothing is known yet about the distribution on the different host plants and the real host range of these pathovars in nature, although cross-infections were observed following artificial inoculations. A multiplex Real-Time PCR assay was recently developed to simultaneously and quantitatively discriminate in vitro and in planta these P. savastanoi pathovars, for routine culture confirmation and for epidemiological and diagnostical studies. Here an innovative High-Resolution Melting Analysis (HRMA)-based assay was set up to unequivocally discriminate Psv, Psn and Psf, according to several single nucleotide polymorphisms found in their Type Three Secretion System clusters. The genetic distances among 56 P. savastanoi strains belonging to these pathovars were also evaluated, confirming and refining data previously obtained by fAFLP. To our knowledge, this is the first time that HRMA is applied to a bacterial plant pathogen, and one of the few multiplex HRMA-based assays developed so far. This protocol provides a rapid, sensitive, specific tool to differentiate and detect Psv, Psn and Psf strains, also in vivo and against other related bacteria, with lower costs than conventional multiplex Real-Time PCR. Its application is particularly suitable for sanitary certification programs for P. savastanoi, aimed at avoiding the spreading of this phytopathogen through asymptomatic plants

Embedding of Alumina Reinforcing Elements in the Composite Extrusion Process

Abstract. Extruded aluminum profiles are essential for lightweight constructions in contemporary transport and automotive applications. The reinforcement of such aluminum-based profiles with high-strength materials offers a high potential for weight reduction and an improvement of functional and mechanical properties. In comparison to conventional composite extrusion using fiber or particle reinforced billets, the alternatively developed process for the embedding of endless reinforcing elements provides enormous advantages regarding extrusion forces, load-adapted reinforcement, and tool abrasion. In this extrusion process with conventional billets, modified tools with portholes are used to position reinforcing elements from outside the pressing tool and to embed them into the material flow during the pressing operation. This composite extrusion process is part of the research work started in 2003 and carried out within the scope of the Collaborative Research Center SFB/TR10. To increase the potential of composite extrusion with endless reinforcing elements, the manufacture of composite extrusion profiles with high-strength non-metallic alumina wires is planned. Due to the wires' specific properties, e.g. high stiffness, their deflection behavior must be analyzed to guarantee a stable feeding-in process. In this paper the specific behavior of alumina reinforcing elements regarding the feeding-in process is analyzed by experimental investigations. The main influencing factors are determined and a process window is deduced

Einflussfaktoren auf die langfristige Prognose für Zähne mit Wurzelspitzenresektion

Introduction: The aim of the study was to investigate possible predictive factors influencing the long-term success of root tip resection.Methods: The retrospective study included 216 patients ((MALE) 111, (FEMALE) 106, median age 43.3 years). A total of 261 root tip resections were performed on these patients between 1989 and 2012. In addition to determining the success rates 5 and 10 years postoperatively, the factors gender, age, tooth type, use of bone replacement material and preoperative periodontal tooth status were examined with regard to their significance for the long-term prognosis of root tip resected teeth. Results: The evaluation showed an average success rate of 63.6% for all included teeth over the entire observation period (tooth at least one year postoperatively still in situ). The 5-year success rate was 78.2%, the 10-year success rate 63.1%. A dependence of the success rates on the tooth type could not be evaluated. However, the examination showed a clear dependence of the success on the age of the patients. Root tip resections in patients in the age group 60 years and older had significantly worse success rates compared to the age groups 20 to 39 years and 40 to 59 years. The prognosis was also significantly better for patients in the age group 20 to 39 years than for patients in the age group 40 to 59 years. Periodontally compromised teeth showed only a tendency for a poorer prognosis than periodontally healthy teeth. With regard to sex and intraoperative filling of the resection defect with bone replacement material, no differences in the success rates were found.Conclusions: A root tip resection is a good option, largely independent of the type of tooth, to preserve a tooth in the medium to long term after unsuccessful endodontic treatment. However, a revision of the endodontic treatment or even an extraction with subsequent implantation should always be considered as an alternative, especially with increasing age.Hintergrund: Ziel der Studie war die Untersuchung möglicher prädiktiver Einflussfaktoren auf den Langzeiterfolg der Wurzelspitzenresektion.Methode: In die retrospektive Studie konnten 216 Patienten ((MALE) 111, (FEMALE) 106, medianes Alter 43,3 Jahre) eingeschlossen werden. Bei diesen waren im Zeitraum 1989 bis 2012 insgesamt 261 Wurzelspitzenresektionen durchgeführt worden. Neben der Ermittlung der Erfolgsraten 5 und 10 Jahre postoperativ wurden die Faktoren Geschlecht, Alter, Zahngattung, Einsatz von Knochenersatzmaterial sowie der präoperative parodontale Zahnstatus hinsichtlich der Bedeutung für die Langzeitprognose wurzelspitzenresezierter Zähne untersucht. Ergebnisse: Die Auswertung ergab bezogen auf alle eingeschlossenen Zähne, betrachtet über den gesamten Beobachtungszeitraum, eine mittlere Erfolgsquote (Zahn mindestens 1 Jahr postoperativ noch in situ) von 63,6%. Die 5-Jahres Erfolgsrate lag bei 78,2%, die 10-Jahres Erfolgsrate bei 63,1%. Eine Abhängigkeit der Erfolgsraten von der Zahngattung (Ober-/Unterkiefer-Frontzähne, Ober-/Unterkiefer-Prämolaren, Ober-/Unterkiefer-Molaren) konnte nicht evaluiert werden. Die Untersuchung zeigte jedoch eine eindeutige Abhängigkeit des Erfolgs vom Alter der Patienten. Dabei hatten Wurzelspitzenresektionen bei Patienten in der Altersgruppe 60 Jahre und älter im Vergleich zu den Altersgruppen 20 bis 39 Jahre und 40 bis 59 Jahre signifikant schlechtere Erfolgsraten. Auch war die Prognose bei Patienten der Altersgruppe 20 bis 39 Jahre signifikant besser als bei Patienten in der Altersgruppe 40 bis 59 Jahre. Parodontal geschädigte Zähne zeigten lediglich eine Tendenz für eine schlechtere Prognose im Vergleich zu parodontal gesunden Zähne. Bezüglich des Geschlechts sowie einer intraoperativen Auffüllung des Resektionsdefektes mittels Knochenersatzmaterial wurden keine Unterschiede in Bezug auf die zu erwartenden Erfolgsraten sichtbar.Schlussfolgerung: Eine Wurzelspitzenresektion stellt eine gute, von der Zahngattung weitestgehend unabhängige Option dar, um einen Zahn nach einer nicht erfolgreichen endodontischen Behandlung mittel- bis langfristig zu erhalten. Eine Revision der endodontischen Behandlung oder eine Extraktion ggf. mit anschließender Implantation sollten jedoch immer, insbesondere im höheren Alter, als Alternative in Betracht gezogen werden

Extrusion Benchmark 2009 - Experimental analysis of deflection in extrusion dies

In this paper experimental investigations aimed at measuring the die deformations during aluminum extrusion process is presented and discussed. A two-holes die generating two U-shape profiles with different supporting legs was produced and tested under strictly monitored conditions. The influence of die deformation on the speed, temperature distribution and distortion of the two profiles is reported and analyzed. AA6082 alloy was used as deforming material while H-13 hot-work tool steel was selected as die material. The experiments were repeated at least three times in the same conditions in order to achieve a statistical distribution of the acquired data: such data are then used as a reference for the 2009 edition of the extrusion benchmark