Organizational Actions of Sex Hormones on Sexual Partner Preference

EB—for the first 2 weeks posthatch) and unisex housing during juvenile development independently resulted in a preference for females over males in two-choice tests, and only females that experienced both EB treatment and unisex living were more likely than controls to pair with other females in colony tests. In a second experiment, females injected with an estrogen synthesis inhibitor for the first week posthatch preferred to spend time near females instead of males in two-choice tests, unlike control females. These experiments suggest that sexual partner preference may result from organizational hormone actions in this pair-bonding species. Possible neural mechanisms or sites that could underly hormonal organization of sexual partner preference in birds and mammals include the anterior hypothalamic/preoptic area, the corticomedial amygdala, and its avian homologue nucleus taeniae of the archistriatum, the septum, and peripheral sensory processes.     

Prognostic impact of morphology and duration of premature ventricular contractions in a population without structural heart disease

Background

Premature ventricular contractions (PVCs) are a common form of arrhythmia associated with an unfavorable prognosis in patients with structural heart disease. It is unclear whether PVCs site of origin and QRS-width has a prognostic significance in patients without structural heart disease. The aim of this study was to assess the prognostic importance of PVCs morphology and duration in this patient group.

Methods

We included 511 consecutive patients without a history of previous heart disease. They were examined with echocardiography and exercise test with normal findings. We categorized the PVCs from a 12 lead ECG according to morphology and width of the QRS-complex and analyzed the outcome in terms of a composite endpoint of total mortality and cardiovascular morbidity.

Results

During a median follow-up time of 5.3 years, 19 patients (3.5%) died and 61 (11.3%) met the composite outcome. Patients with PVCs originating from the outflow tracts had a significantly lower risk for the composite outcome compared to patients with non-OT-PVCs. Similarly, patients with PVC originating from the right ventricle had a better outcome than patients with left ventricular PCVs. No difference in outcome depending on QRS-width during PVCs was noticed.

Conclusion

In our cohort of consecutively included PVC patients without structural heart disease PVCs from the outflow tracts were associated with a better prognostic outcome than non-OT PVCs; the same was true for right ventricular PVCs when compared to left ventricular ones. The classification of the origin of the PVCs was based on 12-lead ECG morphology. QRS-width during PVC did not seem to have prognostic significance.     

Late bacille Calmette-Guérin infection with a large focal urinary bladder ulceration as a complication of bladder cancer treatment

Study Type – Therapy (case series)
Level of Evidence 4 What's known on the subject? and What does the study add? Intravesical BCG treatment has been used worldwide for many decades but there are only a few published reports on persisting BCG infection of the urinary bladder. This is the first report on large tuberculosis‐like ulcers of the urinary bladder after intravesical BCG treatment. The finding results in a recommendation to take urine cultures for mycobacteriae in patients with unclear inflammatory lesions in the bladder after instillation of BCG.

OBJECTIVE

• ? To report a late bacille Calmette–Guérin (BCG) complication previously not described in the literature.

PATIENTS AND METHODS

• ? We reviewed our database with 858 patients treated with BCG from 1986 to 2008 and identified 13 male patients (1.8% of all male patients) who had a large tuberculous‐like bladder ulcer.

RESULTS

• ? All patients had high‐grade tumours and seven had tumours invading lamina propria before BCG treatment. A solitary ulceration or inflammatory lesion, 10–50 mm in diameter, was seen at routine follow‐up cystoscopy 2–34 months (median 8 months) after the first instillation. Significantly more patients had been treated with BCG‐RIVM than with BCG‐Tice (10/320 vs. three of 454, P < 0.01). BCG was cultured from urine 3–34 months (median 14 months) after the last instillation.
• ? So far, eight patients have been successfully treated with rifampicin and isoniazid. Nine patients are still tumour‐free 15–66 months (median 44 months) after the last transurethral resection before BCG treatment.
• ? Another three patients had one to two non‐invasive recurrences. One patient had an invasive recurrence and underwent cystectomy. The present study is limited by biases associated with its retrospective design.

CONCLUSIONS

• ? This is the first report on persisting BCG infections with large inflammatory lesions in the bladder. Treatment is effective and the oncological outcome is good.
• ? Mycobacterial cultures of the urine should be performed in BCG‐patients with unclear inflammatory lesions in the bladder since a delayed diagnosis of a persistent BCG infection could result in a permanently reduced bladder capacity.
• ? Large studies are warranted to study differences in efficacy and side‐effects between different BCG strains.

     

Chest and abdominal CT during extracorporeal membrane oxygenation: Clinical benefits in diagnosis and treatment

RATIONALE AND OBJECTIVE: This study aims to evaluate the clinical usefulness of thoracic and abdominal computed tomography (CT) as an adjunct to bedside diagnostic imaging in patients on extracorporeal membrane oxygenation (ECMO) therapy because of severe acute respiratory failure. MATERIALS AND METHODS: Imaging records for 118 consecutive thoracic and abdominal CT examinations performed in 63 patients (22 neonates, 15 children, and 26 adults) on ECMO therapy during an 8-year period were retrospectively reviewed. Reported CT findings were compared with concurrent bedside radiographs and ultrasounds. The clinical importance and effect on treatment of each CT finding was determined by reviewing the medical records. RESULTS: CT showed 30 clinically important complications in 20 different patients that directly impacted on the treatment, but were not diagnosed with bedside imaging. Of the 30 complications, 15 (50%) were surgically treated, 11 (37%) required percutaneous invasive procedures, and 4 (13%) were managed conservatively. Despite the serious complications, 13 of 20 patients (65%) survived. CONCLUSION: Both chest and abdominal CT have an important clinical role in patients on ECMO therapy because of acute respiratory failure, as a complement to bedside imaging, to exclude or show complications and expedite early invasive treatment, when needed.