Clinical aspects of pelvic inflammatory disease

Pelvic inflammatory disease (PID) is a common and poorly managed condition. Untreated or inadequately treated, it leads to tubal infertility, ectopic pregnancy and chronic pelvic pain. Diagnostic difficulties are compounded by the wide variety of clinical presentations and the insensitivity and poor specificity of laboratory tests. Better recognition of mild and atypical disease needs a high index of suspicion whenever young, sexually active women present with gynaecological symptoms. Laparoscopy supplemented by microbiological tests and fimbrial minibiopsy should be regarded as the diagnostic 'gold standard' for research studies; new studies are required to identify techniques which might reduce under- and over-diagnosis. Early treatment reduces the risk of an adverse effect on fertility. Any therapeutic regimen selected should be effective against the common aetiological agents Chlamydia trachomatis, Neisseria gonorrhoeae, genital mycoplasmas and aerobic and anaerobic bacteria. Since at least 60% of cases of PID can be attributed to infection with a sexually transmitted organism, partner notification forms an essential part of management.      

A gene expression analysis in rat kidney following high and low salt intake

BACKGROUND : The effects of salt intake on renal regulation have been investigated for decades. To find new pathways and to demonstrate the utility of oligonucleotide expression arrays, we studied whole kidneys. METHODS : Eight Sprague-Dawley rats were divided into two groups. One group received a 6% salt (by weight) diet, while the other group received a 0.3%, otherwise identical, salt diet for 7 days. The rats were sacrificed after 7 days and the left kidney was subjected to RNA extraction. Oligonucleotide expression arrays (Affymetrix) were used to determine downregulation and upregulation, comparing high with low salt intake. Four rats from each group were studied separately. RESULTS : The experiments were reproducible. Thirty genes were downregulated with the high-salt diet, while 35 genes were upregulated. The renin gene, beta-2 glycoprotein-1, retinol binding protein, annexin VI, and the PTP2C protein tyrosine phosphatase were among the downregulated genes. The angiotensin II receptor type 1B receptor, HMG-CoA reductase, B7 antigen, and the rat calcium channel beta subunit III were among the upregulated genes. Differentially regulated were the p55 subunit (upregulated) and the p50 subunit (downregulated) of the phosphatidyl inositol 3-kinase enzyme complex. We verified our results by selecting a high-salt downregulated gene (renin) and an upregulated gene (B7 antigen) and subjecting these genes to real-time polymerase chain reaction. The results were consistent. CONCLUSION : Oligonucleotide expression arrays can detect novel genes encoding for proteins not generally associated with responses to varied salt intake. Experiments of this nature have substantial limitations and require detailed verification. However, overall, the utility is promising.     

White matter hyperintensity volume in late-onset and early-onset schizophrenia

BACKGROUND. Late life onset schizophrenia (sometimes termed "late paraphrenia") has been theorized to be due to neuro-degenerative processes affecting individuals with latent vulnerability to schizophrenia. However, neuro-imaging studies using computed tomography (CT) and magnetic resonance imaging (MRI) investigating possible degenerative anatomic correlates (atrophy, white matter disease, and strokes) to late onset psychoses have yielded conflicting findings. The variation in these findings may be due to differences in study design, case ascertainment, and measurement methods. OBJECTIVE. The present study compares a continuous measure of total volume of white matter hyperintensities (WMHs) in age, race, and gender-ratio matched groups of late-onset schizophrenic, elderly, early-onset schizophrenic and control subjects. METHOD. Our method of WMH measurement yielded an explicit volume and is an alternative to frequently used ordinal measures. RESULTS. We found no significant differences in the WMH volumes between these three groups. This finding is consistent with a prior study (Symonds et al., 1997. J Neuropsychiat Clin Neurosci 9: 251 - 258), that used ordinal measures.     

EEG frequency profiles of idiopathic generalised epilepsy syndromes

The objective of this study was to investigate EEG frequency profiles (topographic distribution of spectral power data) in well-defined idiopathic generalised epilepsy (IGE) syndromes: juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME), epilepsy with grand mal seizures on awakening (EGMA), and in the unified 'common IGE' (CIGE) group of these patients. Methods: Absolute and relative (percent) power values were computed from waking EEG activity by Fast Fourier Transform (FFT). Each patient group was compared to an age-matched group of healthy control persons. Results: There was a general tendency for diffuse (absolute and relative) delta-theta-alpha power excess and relative beta power deficit in all IGE groups as compared to controls. Statistically significant (P相似文献   

Model of normal prepubertal growth

Overheating may cause terminal apnoea and cot death. Rectal temperature and breathing patterns were examined in normal infants at home during the first 6 months of life. Twenty one infants had continuous overnight rectal temperature and breathing recordings for 429 nights (mean 20.4 nights, range 7-30) spaced over the first six months of life. Periods when breathing was 'regular' were directly marked on single night records. Sleep state was determined from respiratory variables. 'Regular' breathing was a reliable marker of 'quiet' sleep (specificity 93%). The duration of 'quiet' sleep increased from 6 to 22 minutes from two weeks to three months of age and then remained static, as did the proportion of sleep spent in the quiet phase (9% to 34%). Rectal temperature fell during 66% of quiet sleep and usually rose during rapid eye movement (REM) sleep. The drop in rectal temperature was maximal at the start of quiet sleep, whereas the maximum rise during REM sleep was reached after 10 to 15 minutes. Oscillations in rectal temperature are associated with changes in sleep and breathing state. The maturation of rectal temperature patterns during the first six months of life are closely related to a maturation of sleep state and breathing patterns.