Correlation of mycoplasma with unexplained infertility

Background  

The role of genital mycoplasmas, particularly Ureaplasma urealyticum, in the etiology of infertility has been very controversial. An attempt has been made to explore the role of mycoplasma in unexplained infertility.     

Reducing work disability in Ankylosing Spondylitis – development of a work instability scale for AS

Background  

The Work Instability Scale for Rheumatoid Arthritis (RA-WIS) is established and is used by physicians to identify patients at risk of job loss for rapid intervention. The study objective was to explore the concept of Work Instability (a mismatch between an individual's abilities and job demands) in Ankylosing Spondylitis (AS) and develop a Work Instability Scale specific to this population.     

The role of the microfracturetechnique in the treatment of full-thickness chondral injuries

Microfracture is indicated for both traumatic and degenerative full-thickness chondral defects. The technique isuseful for both unipolar and “kissing” (bipolar) lesions in both the primary treatment and revision settings. There are no contraindications to the technique based on the size or location of the lesion, although smaller (<400 mm²), acute (<12 weeks from injury) femoral and trochlear lesions have the most predictable results. Relative contraindications to microfracture include chondral defects greater than 5 to 10 mm deep and the presence of a malaligned limb. Clinical studies have shown significant (P < .05) improvement in all functional parameters studied following the use of microfracture for the treatment of full-thickness, traumatic chondral defects. Of note, improvement in symptoms of pain and swelling continue to be seen until 2 years after surgery following microfracture. The microfacture technique is a cost-effective, technically feasible, highly efficacious procedure available to all surgeons who perform arthroscopy of the knee. It is a reasonable first approach to the treatment of chondral defects, because it does not burn any bridges with regard to future procedures such as a mosaic-plasty or autologous chondrocyte transplantation if the microfracture should fail.     

Emmetropisation in normal and strabismic children and the associated changes of anisometropia

The purpose of this study was to measure whether emmetropisation failed in children who had strabismus irrespective of their refraction in infancy, and to record simultaneous changes in anisometropia. We also report how often hypermetropia increased before these children presented with esotropia. A total of 2920 infants had a cycloplegic retinoscopy at age 5-7 months and again at 42 months or when defective vision was identified. Changes of refraction in 210 children with strabismus are compared with the remaining 2710 who did not. When the spherical equivalent of the fixing eyes was &gt; +2.75 D in infancy, hypermetropia decreased less in both eyes of those who had microtropia (p &lt;. 001) and heterotropia (p &lt;. 001) than in normal children. When it was &lt; +2.75 D, the spherical and/or cylindrical refraction more often remained outside the ‘normal’ range in both eyes of those who had microtropia and heterotropia (p &lt;. 05). Emmetropisation was deficient in both eyes of at least 80% of these strabismic children irrespective of their refraction in infancy. Furthermore, in the strabismic children, the mean change of refraction was less (p &lt;. 05) in their fellow eyes than in their fixing eyes, the difference between the two eyes being on average three times greater than that in those who had normal vision. Thus, anisometropia increased in 53% of those who had strabismus but remained within normal limits (&lt; ca. 0.75 D spherical equivalent) in 94 % of those who did not.‘Abormal’ anisometropia in infancy did not, per se, permanently affect vision because 72% of all those who had it did not have strabismus. Finally, the spherical hypermetropia of fixing eyes increased in only 35% of the children with esotropia – similar to the incidence in those who had a microtropia (p =. 36). This does not obviously support the concept that increasing hypermetropia causes accommodation to increase before convergence.     

ENTERING THE WORLD OF PSYCHOTHERAPY: GENERAL PSYCHIATRIC TRAINEES TAKE THEIR FIRST STEPS

ABSTRACT Publication of the Royal College of Psychiatrists'guidelines for provision of psychotherapy training for general psychiatric trainees led to the implementation of the pilot scheme described in this paper. The scheme offered an experience of individual psychodynamic therapy, with group supervision, for the beginning therapist. The authors describe the induction programme, the group experience, the experience of being supervised, working with the patient and ending. A personal view is offered, aiming to provide an understanding of the nature and quality of this experience, highlighting its benefits and difficulties. Conclusions are drawn as to the usefulness of the scheme in personal and professional spheres and in relation to the Royal College guidelines.