Chronic Suppurative Otitis Media in Cleft Palate: Microorganism Etiology and Susceptibilities

Objective: To investigate the microbial etiology of suppurative chronic otitis media (SCOM) in patients with complete cleft lip and palate and isolated cleft palate and to determine the sensitivity of isolated microorganisms to antibiotics by drug diffusion from impregnated discs in agar and the minimum inhibitory concentration of each drug to these microorganisms by drug dilution in agar. Design/Patients: Effusion samples of SCOM obtained from 40 patients with cleft lip and palate registered at the Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, at Bauru, Brazil, were bacteriologically analyzed by cultures. The isolated bacteria were submitted to an in vitro susceptibility test to clinically used drugs. Results: Positive cultures were obtained in 100% of studied cases. Among the 57 strains observed, the most frequent were Pseudomonas aeruginosa (35%), Staphylococcus aureus (15.5%), Enterococcus faecalis (14%), and Proteus mirabilis (12%). The frequency of Gram-negative bacilli (enterobacteriaceae and nonfermentative bacilli) was 67%. Pseudomonas aeruginosa presented the highest sensitivity to ciprofloxacin, and enterobacteriaceae exhibited the highest sensitivity to gentamicin. The strains of S. aureus and E. faecalis presented the highest sensitivity to imipenem and sulfamethoxazole/trimethoprim, respectively. Conclusion: Patients with cleft lip and palate presenting with SCOM exhibited 100% positive cultures, with the highest frequency of Pseudomonas and enterobacteriaceae. With regard to the action of antibiotics, imipenem was effective against the four species of isolated microorganisms, followed by ciprofloxacin, which was effective against 75% of isolated species.

Discontinuous Galerkin approximation of two-phase flows in heterogeneous porous media with discontinuous capillary pressures

We design and investigate a sequential discontinuous Galerkin method to approximate two-phase immiscible incompressible flows in heterogeneous porous media with discontinuous capillary pressures. The nonlinear interface conditions are enforced weakly through an adequate design of the penalties on interelement jumps of the pressure and the saturation. An accurate reconstruction of the total velocity is considered in the Raviart-Thomas(-Nedelec) finite element spaces, together with diffusivity-dependent weighted averages to cope with degeneracies in the saturation equation and with media heterogeneities. The proposed method is assessed on one-dimensional test cases exhibiting rough solutions, degeneracies, and capillary barriers. Stable and accurate solutions are obtained without limiters. (C) 2010 Elsevier B.V. All rights reserved.

Removal of phenol in high salinity media by a hybrid process (activated sludge plus photocatalysis)

The degradation of phenol by a hybrid process (activated sludge + photocatalysis) in a high salinity medium (50 g L-1 of chloride) has been investigated. The sludge used from a municipal wastewater facility was adapted to the high salt concentrations prior to use. The photocatalytic conditions were optimized by means of a factorial experimental design. TiO2 P25 from Degussa was used as the photocatalyst. The initial phenol concentration was approximately 200 mg L-1 and complete removal of phenol and a mineralization degree above 98% were achieved within 25 h of treatment (24 h of biological treatment and I h of photocatalysis). From HPLC analyses, five hydroxylated intermediates formed during oxidation have been identified. The main ones were catechol and hydroquinone, followed by 1,2,4-benzenetriol, 2-hydroxy- 1,4-benzoquinone, and pyrogallol, in this order. No formation of organochlorine compounds was observed. Therefore, the proposed hybrid process showed itself to be suited to treat phenol in the presence of high contents of salt. (c) 2007 Elsevier B.V. All rights reserved.