Influence of temperature on the number of Legionella pneumophila in hot water systems

The occurrence of legionella in the hot water systems of two buildings (A and B) was investigated in relation to the water temperature. The peripheral parts of both hot water systems were found to be colonized by these organisms. A temperature of 60 degrees C in the hot water mains returning from the building eliminated legionellas from the mains as well as from the peripheral taps and showers. Legionellas could be isolated from taps, showers and the mains when the temperature in the return mains was kept at 54 degrees C. The hot water systems could not be completely decontaminated by raising the hot water temperature in the return mains to 70 degrees C combined with flushing all the taps and showers. It is suggested that failure to decontaminate the systems is due to dead ends in the pipeline network, which are not reached by the hot water and that these dead ends are the source for recolonization of the systems.     

The role of cardiac magnetic resonance imaging in differentiating the underlying causes of left ventricular hypertrophy

The onset of sudden cardiac death and large inter- and intra-familial clinical variability of hypertrophic cardiomyopathy pose an important clinical challenge. Cardiac magnetic resonance imaging is a high-resolution imaging modality that has become increasingly available in the past decade and has the unique possibility to demonstrate the presence of fibrosis or scar using late gadolinium enhancement imaging. As a result, the diagnostic and prognostic potential of cardiac magnetic resonance imaging has been extensively explored in acute and chronic ischaemic cardiomyopathy, as well as in several nonischaemic cardiomyopathies. This review aims to provide a critical overview of recently published studies on hypertrophic cardiomyopathy and discusses the role of cardiac magnetic resonance imaging in differentiating underlying causes of hypertrophic cardiomyopathy, such as familial hypertrophic cardiomyopathy, cardiac involvement in systemic disease and left ventricular hypertrophy due to endurance sports. Also, it demonstrates the use of cardiac magnetic resonance in risk stratification for the onset of sudden cardiac death, and early identification of asymptomatic family members of hypertrophic cardiomyopathy patients who are at risk for the development of hypertrophic cardiomyopathy. (Neth Heart J 2010;18:135-43.)