Bacterial vaginosis (BV) and the risk of incident gonococcal or chlamydial genital infection in a predominantly black population

OBJECTIVE: The objective of this study was to assess in prospective data whether bacterial vaginosis (BV) is associated with gonococcal/chlamydial cervicitis. STUDY: A total of 1179 women at high risk for sexually transmitted infections was followed for a median of 3 years. Every 6 to 12 months, vaginal swabs were obtained for Gram stain, culture of microflora, and Neisseria gonorrhoeae and Chlamydia trachomatis. A Gram stain score of 7 to 10 based on the Nugent criteria categorized BV. RESULTS: Baseline BV was associated with concurrent gonococcal/chlamydial infection (adjusted odds ratio, 2.83; 95% confidence interval [CI], 1.81-4.42). However, the association between BV and subsequent, incident gonococcal/chlamydial genital infection was not significant (adjusted relative risk [RR], 1.52; 95% CI, 0.74-3.13). Dense growth of pigmented, anaerobic Gram-negative rods (adjusted RR, 1.93; 95% CI, 0.97-3.83) appeared to elevate the risk for newly acquired gonococcal/chlamydial genital infection. CONCLUSIONS: BV was common among a predominantly black group of women with concurrent gonococcal/chlamydial infection but did not elevate the risk for incident infection.     

The role of anisometropia in the development of accommodative esotropia.

PURPOSE: To determine whether anisometropia increases the risk for the development of accommodative esotropia with hypermetropia. METHODS: Records of all new patients with a refractive error of +2.00 D or more (mean spherical equivalent of both eyes) over a 42-month period were reviewed. Three hundred forty-five patients were thus analyzed to determine the effect of anisometropia (>or=1 D) on the relative risk of developing accommodative esotropia and of developing unsatisfactory control with spectacles once esotropia was present. RESULTS: Anisometropia (>or=1 D) increased the relative risk of developing accommodative esotropia to 1.68 (P < .05). Anisometropia (>or=1 D) increased the relative risk for esotropia to 7.8 (P < .05) in patients with a mean spherical equivalent less than +3.00 D and increased it to 1.49 (P < .05) in patients with a mean spherical equivalent of +3.00 D or more (P = .016). In patients with esotropia and anisometropia (>or=1 D), the relative risk for a deviation that was unsatisfactorily controlled with spectacles was 1.72 (P < .05) compared with patients with esotropia but without anisometropia. Unsatisfactorily controlled esotropia was present in 33% of patients with anisometropia versus 0% of patients without anisometropia, with a mean hypermetropic spherical equivalent of less than +3.00 D (P = .003); however, anisometropia did not significantly increase the relative risk of unsatisfactory control of esotropia with spectacles in patients with a hypermetropic spherical equivalent of +3.00 D or more. Although amblyopia and anisometropia were closely associated, anisometropia increased the relative risk for esotropia to 2.14 (P < .05), even in the absence of amblyopia. CONCLUSIONS: Anisometropia (>or=1 D) is a significant risk factor for the development of accommodative esotropia, especially in patients with lower overall hypermetropia (>+3.00 D). Anisometropia also increases the risk that an accommodative esotropia will not be satisfactorily aligned with spectacles.     

Giant aneurysm treated by bilateral cervical carotid artery to proximal middle cerebral artery bypass and balloon embolisation: a case report

The authors describe a case of a 59 year-old Chinese lady with a history of spontaneous left caroticocavernous fistula in 1988 treated by left internal carotid artery clipping and muscle embolisation. She subsequently presented with a subarachnoid haemorrhage in November 1997 secondary to rupture of an unclippable giant right internal carotid artery aneurysm. This was treated satisfactorily with bilateral cervical carotid artery to proximal middle cerebral artery bypass followed by balloon occlusion. Postoperatively, the patient has no neurological deficit and CT angiogram shows good patency of both grafts 6 months after surgery.     

Perfused rat intrahepatic bile ducts secrete and absorb water, solute, and ions

BACKGROUND & AIMS: We report a novel approach to study biliary water, bile acid, and HCO(3)(-) transport: the microperfusion of intrahepatic bile duct units (IBDUs) isolated from normal rat liver. METHODS: To study water transport, IBDUs were perfused in vitro with a membrane-impermeant fluorescent volume marker, fluorescein sulfonate; net water movement (J(v)) and osmotic water permeability (P(f)) were then calculated. To study solute transport, IBDUs were perfused with taurocholic acid (TCA) and bile acid uptake was calculated from the concentrations of TCA in the perfused and collected solutions. To study ion transport, IBDUs were perfused with the cell-impermeant pH-sensitive dye BCECF dextran; luminal pH was determined from fluorescence excitation ratios. RESULTS: When inward (secretory) or outward (absorptive) osmotic gradients were established across IBDUs, water movement was observed from bath to lumen (i.e., secretion) and from lumen to bath (i.e., absorption). The perfused IBDUs absorbed TCA in a saturable, sodium-dependent manner; in addition, TCA absorption was blocked in a dose-dependent fashion by S0960, a specific inhibitor of the Na(+)/bile acid cotransporter. Addition of forskolin to HCO(3)(-)-containing (but not HCO(3)(-)-free) bath buffer resulted in lumen alkalinization reflecting HCO(3)(-) transport into the lumen of perfused IBDUs. CONCLUSIONS: The results provide direct functional evidence that intrahepatic bile ducts both secrete and absorb water in response to osmotic gradients, actively absorb bile acid, and transport HCO(3)(-).     

Association of Overweight and Obesity with Breast Cancer in India

Background:

In women, cancer of the breast is one of the most common incident cancer and cause of death from cancer. Anthropometric factors of weight, height, and body mass index (BMI) have been associated with breast cancer risk.

Objectives:

To study the association of overweight and obesity with breast cancer in India.

Materials and Methods:

A hospital-based matched case-control study was conducted. Three hundred and twenty newly diagnosed breast cancer patients and three hundred and twenty normal healthy individuals constituted the study population. The subjects in the control group were matched individually with the patients for their age ±2 years and socioeconomic status. Anthropometric measurements of weight and height were recorded utilizing the standard equipments and methodology. The paired ‘t’ test and univariate logistic regression analysis were carried out.

Results:

It was observed that the patients had a statistically higher mean weight, body mass index, and mid upper arm circumference as compared to the controls. It was observed that the risk of breast cancer increased with increasing levels of BMI. Overweight and obese women had Odd''s redio of 1.06 and 2.27, respectively, as compared to women with normal weight.

Conclusions:

The results of the present study revealed a strong association of overweight and obesity with breast cancer in the Indian population.