Association between Mycoplasma genitalium and acute endometritis

Up to 70% of cases of pelvic inflammatory disease do not have a known cause. We recruited 115 women who had presented to a clinic for sexually transmitted diseases in Nairobi, Kenya with pelvic pain that had persisted for 14 days or less, to look for an association between Mycoplasma genitalium and endometritis. With PCR, we detected M genitalium in the cervix, endometrium, or both in nine (16%) of 58 women with histologically confirmed endometritis and in one (2%) of 57 women without endometritis (p=0.02). Our results suggest that infection with M genitalium is strongly associated with acute endometritis in this population.     

Differential effects of the CCKA receptor ligands PD-140,548 and A-71623 on latent inhibition in the rat

Latent inhibition (LI) is a behavioural paradigm in which repeated exposure to a stimulus without consequence inhibits the formation of any new associations with that stimulus. To the extent that LI reflects a process of leaming to ignore irrelevant stimuli, disrupted LI has been suggested as an animal model for the attentional deficits observed in schizophrenia. The antipsychotic potential of cholecystokinin (CCK) stems from its colocalization with dopamine (DA) in the mesolimbic pathway, where it demonstrates both excitatory and inhibitory effects on dopaminergic activity. This may be explained by mediation through different receptor subtypes. A variety of hypotheses has emerged regarding the potential clinical application of subtype-selective CCK-based drugs. The present experiments examined the effects on LI of two selective CCK(A) ligands: PD-140,548 (a CCK(A) antagonist, Experiment 1: 0.001, 0.01, and 0.1 mg/kg) and A-71623 (a CCK(A) agonist, Experiment 2: 0.02, 0.05, and 0.1 mg/kg). In both experiments, the effects of haloperidol (0.1 mg/kg) were also investigated. Animals receiving 0.1 mg/kg of haloperidol or 0.001 or 0.1 mg/kg (but not 0.01 mg/kg) of PD-140,548 treated the preexposed stimulus as irrelevant after a low number of preexposures. In contrast, no facilitatory effect on LI was detectable at any of the A-71623 doses. The finding that A-71623 failed to enhance LI indicates that it is unlikely that this compound would have any antipsychotic effect within the clinical setting. Considering the facilitatory effect exerted by PD-140,548 on LI, it is probable that the inhibition of CCK activity might prove a more promising strategy for the pharmacological treatment of schizophrenia.     

Peripheral nerve regeneration in galactosaemic rats

The use of galactosaemia as a model for some aspects of diabetic polyneuropathy allows the influence of glycation to be studied independently of other effects. There are well-studied abnormalities of the peripheral nerves in galactosaemic rats, one of which is that the efficiency of regeneration is initially reduced. One possible cause could be that glycated myelin debris in macrophages is less degradable and interferes with macrophage function. Macrophage recognition and ingestion of myelin glycosylated in vitro increases with the duration of incubation in a sugar-rich medium. This study was performed to investigate a possible correlation between galactosaemia and regeneration, together with the role of macrophages. Galactosaemia was induced by adding galactose to the rats' diet for 2 months before injury. Following a crush lesion to the sciatic nerve, regeneration was found to be delayed, demonstrated by a reduction in mean myelinated fibre size and density 1 month after crush, although, 2 and 3 months later, the differences did not reach statistical significance. There were also more macrophages in the galactosaemic rats than in the control animals at all time points. The initial delay in regeneration in galactosaemic rats was therefore only temporary and there was little evidence of long-term deleterious effects. In addition to the morphometric results, immunohistochemistry showed that there were more macrophages in the galactosaemic rats than in the control animals at all time points. Correlating macrophage and myelinated fibre counts suggests that the persistence of debris-containing macrophages does not appear to have a significant inhibitory effect on nerve regeneration. No evidence was found for persistent basal laminal tubes around the regenerating clusters.     

Novel glucocorticoid and cAMP interactions on the CRH gene promoter

The report focuses on the role of estrogens in human male, dealing with two human models of congenital estrogen deficiency: estrogen resistance and aromatase deficiency. Similarities and differences of clinical phenotypes of these models are described and progresses of estrogen treatment of aromatase-deficient men are reported. Finally, the putative use of estrogen in men and the use of aromatase inhibitors and antiestrogen for male disorders are discussed.     

Predictors of success of intervention programs for persons with fibromyalgia

OBJECTIVE: To determine which sociodemographic, psychological, and behavioral characteristics of persons with fibromyalgia (FM) will predict a positive response to treatment; and to determine if subjects classified according to the Multidimensional Pain Inventory (MPI) responded differently to the interventions. METHODS: One hundred twenty-eight women with FM underwent baseline testing and were randomized into one of 3 intervention groups or a control group. After the 12 week program, the subjects were reexamined on the same pretest measures. Stepwise regression analyses were conducted to determine the variables that could significantly predict the change in the dependent variables. A reliability of change index was calculated to determine the proportion of responders and nonresponders. RESULTS: The stepwise regression revealed significant predictor variables for change for all dependent variables except the Fibromyalgia Impact Questionnaire; however, the percentage of the variance in the change scores explained by the independent variables ranged from 4 to 15%. Results from the reliability of change index indicated that no MPI subgroup responded more than another group on any measure. CONCLUSION: Select sociodemographic and psychosocial variables and type of intervention were not strong predictors of improvement in a variety of measures after a treatment program. The low percentage of explained variance may be due to the heterogeneity of FM. Additionally, the low percentage of responders suggests that current forms of treatment are not effective for a large portion of the FM population.     

Clinical usefulness of genetic information for predicting radiographic damage in rheumatoid arthritis

OBJECTIVE: To determine whether knowledge of genetic information aids the prediction of radiographic damage for patients with rheumatoid arthritis (RA) in whom extensive sociodemographic, family history, clinical, and immunologic information is available. METHODS: Subjects included 146 Caucasian women who were participants in a community based longitudinal study of RA. Our primary outcome measure was the severity of erosive disease. Nongenetic covariates included age at RA onset, disease duration, family history of RA, education level, family income, baseline values of function, painful and swollen joint groups and pain rating, and rheumatoid factor positivity. All women were genotyped for the HLA-DRB1 shared epitope (SE) and the tumor necrosis factor a (TNFa) microsatellite. Likelihood ratio tests (LRT) were performed to evaluate the usefulness of genetic information for predicting radiographic damage in RA, after adjusting for nongenetic covariates. Receiver operating characteristic (ROC) curves displaying the sensitivity and specificity of combinations of nongenetic and genetic information were derived, and the areas under the curves (AUC) were compared. RESULTS: Genetic information contributed significantly to the prediction of radiographic damage in RA even after adjusting for all nongenetic covariates (p value for LRT = 0.0019). The odds ratio describing the risk of severe erosive disease among individuals who had inherited both the SE and TNFa allele 11 (TNFa11) was 7.6 compared to individuals who were SE and TNFa11 negative. Analysis of ROC curves confirmed the usefulness of genetic information. CONCLUSION: Genetic information is useful for predicting radiographic damage in RA even for patients in whom extensive sociodemographic, family history, clinical, and immunologic information is available.     

Telephone-assisted counseling for physical activity

Different methods of intervention have been tested to promote physical activity at the individual level. The telephone is an excellent form of media for delivering exercise counseling and advice. This review highlights important clinical trials that have documented the success of telephone-assisted exercise counseling for promoting physical activity in a variety of populations.     

Pitfalls in diagnosis of early stage malignant peritoneal mesothelioma: a case report

Malignant peritoneal mesothelioma (MPM) is a rare condition with an overall incidence of one to two cases per million [Arch. Surg. 123 (1988) 765.]. It is a tumour that arises from the mesothelium of a serosal cavity. While simultaneous peritoneal and pleural involvement is found in 30-45% of cases of mesothelioma, solitary peritoneal involvement is found only in 10-20%. The disease usually presents late. As a result, most reported cases in the radiological literature describe features of the advanced disease only. We report the radiological findings in early stage of MPM in a patient who was successfully treated by surgery. The diagnostic pitfalls in early stage disease are discussed and the radiological literature of MPM is reviewed.     

Combination of a new composite biocampatible skin graft on the neodermis of artificial skin in an animal model

Introduction: There have been very limited and inconsistent attempts at combining the cultured epidermal autograft (CEA) with the neodermis of artificial skin (Integra). The reasons for this remain unknown. The basement membrane proteins of conventional CEA sheets are easily damaged by the dispase treatment during the harvesting of the CEA from the culture flask. The damage of the basement membrane proteins may affect the anchorage of CEA onto the neodermis of Integra. A new Composite Biocompatible Skin Graft (CBSG) was recently developed. Methods: Composite biocompatible skin graft consists of autologous keratinocytes cultivated on a pliable hyaluronate‐derived membrane (Laserskin) which has been pre‐seeded with allogenic dermal fibroblasts. Basement membrane proteins of CBSG are protected from the dispase treatment because the keratinocytes are directly seeded onto Laserskin. The engraftment of CBSG was evaluated on 20 wounds of 10 rats. Integra was grafted on two freshly excised full‐thickness wounds (3 cm in diameter) in the dorsum of each animal. A polypropylene ring was applied to each wound to prevent the migration of epithelium from the edges. Composite Biocompatible Skin Graft was used to cover the neodermis of Integra after the silicone membrane was removed 14?21 days postgrafting. Results: Fourteen (70%) of 20 skin biopsies taken at day 21 from the centre of the grafted wounds revealed regenerated epithelium. Conclusion: A feasible delivery system of cultured keratinocytes onto the neodermis of Integra is demonstrated in this animal ­experiment.