Excisional surgery versus ablative surgery for ovarian endometriomata: a Cochrane Review

BACKGROUND: The objective of this review was to determine which is the most effective technique for treating an ovarian endometrioma; excision or ablation. METHODS: A systematic review employing the principles of the Cochrane Menstrual Disorders and Subfertility Group was undertaken. No randomized studies of the management of endometriomata by laparotomy were found. Two randomized studies of the laparoscopic management of ovarian endometriomata of >3 cm in size were included. RESULTS: Laparoscopic excision of the cyst wall of the endometrioma was associated with a reduced rate of recurrence of the endometrioma [odds ratio (OR) 0.41, confidence interval (CI) 0.18-0.93], reduced requirement for further surgery (OR 0.21, CI 0.05-0.79), reduced recurrence rate of the symptoms of dysmenorrhoea (OR 0.15, CI 0.06-0.38), dyspareunia (OR 0.08, CI 0.01-0.51) and non-menstrual pelvic pain (OR 0.10, CI 0.02-0.56). It was also associated with a subsequently increased rate of spontaneous pregnancy in women who had documented prior subfertility (OR 5.21, CI 2.04-13.29). CONCLUSIONS: There is some evidence that excisional surgery for endometriomata provides for a more favourable outcome than drainage and ablation, with regard to the recurrence of the endometrioma, recurrence of symptoms and subsequent spontaneous pregnancy in women who were previously subfertile. Consequently this should be the favoured surgical approach. However, we found no data to indicate the best surgical approach in women planning to undergo assisted reproductive techniques.     

Effect of meteorological variables on the incidence of respiratory tract infections

OBJECTIVE: The possible effect of the various meteorological variables on the incidence of upper and lower respiratory tract infections (RTIs) has intrigued the scientific community for decades. METHODS: We performed a retrospective analysis regarding the association between meteorological variables and clinical data for upper and lower RTIs in the area of Attica, Greece. RESULTS: There was a statistically significant (P<0.001) negative correlation between weekly average temperature with the proportion of weekly house call visits resulting in a diagnosis of upper or lower RTIs 4 days later (R=-0.56 and -0.71 for upper and lower RTIs, respectively) as well as 7 days later (R=-0.57 and -0.71 for upper and lower RTIs, respectively) and during the same day (R=-0.55 and -0.68 for upper and lower RTIs, respectively). In addition, there was a negative correlation between weekly wind chill average (and minimum) temperature as well as a positive correlation of relative humidity with upper and lower RTIs. In contrast, there was no significant correlation between wind speed and upper or lower RTIs. CONCLUSIONS: The findings suggest that house call visits due to upper and lower RTIs increased as the average temperature in the area of Attica decreased.     

Longitudinal study of intrafamilial mutans streptococci ribotypes

To explore the intrafamilial homology and longitudinal stability of colonization by early acquired mutans streptococci, genomic fingerprinting was performed on 254 strains (192 Streptococcus mutans and 62 Streptococcus sobrinus strains) collected from 16 families (16 mother-child pairs, seven fathers and four siblings). Genomic DNA was digested by the restriction endonuclease HindIII, followed by gel electrophoresis, Southern blotting, and hybridization with a digoxigenin-labeled 16S rDNA probe, and hybrid detection by enhanced chemiluminescence. One to five ribotypes were identified per person, and between two and nine (median five) within each family. Fourteen of the 16 mother-child pairs showed homology for at least one ribotype (range 1-4). Six of the seven father-child pairs had one ribotype in common. Ten of the 13 longitudinally examined children showed persistence of at least one ribotype over a period of up to 16 yr. The results support the notion of intrafamilial transfer of mutans streptococci, and suggest that colonization of early acquired strains persists into young adulthood.     

A 10–year retrospective study of periodontal disease progression

The purpose of this study was to record the rate of periodontal disease progression over a 10-year period with respect to individual subject, age and tooth type. 283 subjects, who had undergone a full-mouth radiographic examination in 1974-76 and at that time were 25-70 years old, were randomly selected from a larger patient sample for a new radiographic examination in 1985-86. 201 subjects (71%) agreed to participate. For each respondent, tooth loss over the 10-year period was calculated. The radiographic bone height at the mesial and distal aspect of all teeth was assessed by measuring the distance between the cemento-enamel junction and the bone crest. Difference in periodontal bone height between the 2 examinations was calculated for each tooth site. The results revealed that the mean number of teeth lost over the 10-year period was 3.8 (SD 4.6). Tooth mortality, expressed as a % of the no. of teeth present at the initial examination, increased with age and varied between 2.9%-28.5%. In all age groups, molars had the highest and canines the lowest rate of tooth mortality. The frequency of subjects with loss of greater than 10 teeth was highest for the initially 45-year old individuals (20%). 7 individuals (3%) had become edentulous. The mean annual reduction of alveolar bone height varied between 0.07-0.14 mm in the age groups 25-65 years. The initially 70-year old subjects showed a statistically significant higher annual rate of bone loss (0.28 mm).(ABSTRACT TRUNCATED AT 250 WORDS)     

Noncompaction myocardium imaging with multiple echocardiographic modalities

Noncompaction myocardium of the left ventricle (LV) is a genetically heterogeneous congenital cardiomyopathy, that has only been described during the last two decades. Echocardiography plays a pivotal role as a first line diagnostic tool of this rare abnormality. The present case describes the imaging of the noncompacted myocardium using varying echocardiographic modalities.     

Lipid-lowering (hetero)aromatic tetrahydro-1,4-oxazine derivatives with antioxidant and squalene synthase inhibitory activity

A number of newly synthesized 2-[4-(hetero)aromatic]phenyl-2-hydroxy-tetrahydro-1,4-oxazine derivatives were found to inhibit lipid peroxidation (IC50 of the most potent was 20 microM) as well as rat squalene synthase (IC50 for most between 1-10 microM). Antidyslipidemic action was demonstrated in vivo: the most active compound decreased triglycerides, total cholesterol, and LDL-cholesterol of hyperlipidemic rats by 64, 67, and 82%, respectively, at 56 micromol/kg (ip). Most of the novel compounds are more active than the structurally related and reference biphenyl-morpholine, pointing to useful structural approaches for the design of antiatherosclerotic agents.