Objectives-To remind clinicians of the dangers of delayed diagnosis and the importance of early treatment of spinal epidural abscess. Methods-A review of the literature on spinal epidural abscess and a comparison of the published literature with local experience. Results-Imaging with MRI or CT enables early diagnosis of spinal epidural abcess and optimal therapy is surgical evacuation combined with 6-12 weeks (median 8 weeks) of antimicrobial chemotherapy. Clinical features are fever, pain, and focal neurological signs and may be associated with preceding and pre-existing bone or joint disease. The commonest aetiological organism is S aureus. Conclusion-Early diagnosis and appropriate early antimicrobial chemotherapy with surgery is associated with an excellent prognosis. (J Neurol Neurosurg Psychiatry 1998;65:209-212)
Dietary intake of nitrate generates salivary nitrite, which is acidified in the stomach, leading to a number of reactive intermediates of nitrogen, among which are the potentially carcinogenic N-nitrosamines. Acidified nitrite, however, also has antimicrobial activity which coincides with the formation of nitric oxide. The present study examines the antimicrobial effect in vitro of acidified nitrite on Salmonella enteritidis, Salmonella typhimurium, Yersinia enterocolitica, Shigella sonnei, and Escherichia coli O157. First-order regression plots showed a linear inverse relationship of log-transformed proton and nitrite concentrations with MICs and MBCs after 30 min, 2 h, and 24 h of exposure (P < 0.001 for all antibacterial activities). Susceptibility to the acidified nitrate solutions ranked as follows: Y. enterocolitica > S. enteritidis > S. typhimurium = Shigella sonnei > E. coli O157 (P < 0.05). Addition of SCN-, but not that of CI-, increased the antibacterial activity (paired t testing, P < 0.001). Generation of salivary nitrite from dietary nitrate may provide significant protection against gut pathogens in humans.
Background-There is evidence that endogenous nitrate synthesis is notably increased in patients with infective gastroenteritis. Aims-To determine whether this is due to nitric oxide (NO) production via the L-arginine/NO pathway. (Gut 1999;45:355-361)
Methods-Seven
Background-In subjects on a low nitrate diet, plasma nitrate concentration and urinary nitrate excretion are thought to reflect endogenous nitric oxide (NO) production, and have been reported to increase during infective and inflammatory bowel disease. Aits-To compare the extent of NO production in patients with infective versus non-infective forms of bowel dysfunction.
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