Nontuberculous mycobacterial infection in AIDS: clinical, pathologic, and radiographic features

The medical records, radiographs, and pathologic specimens of ten patients with the diagnoses of nontuberculous mycobacterial infection and acquired immunodeficiency syndrome (AIDS) were examined. The radiographic findings of alveolar or nodular infiltrates and adenopathy were relatively nonspecific but in most cases led to bronchoscopic study or open-lung biopsy, which established the diagnosis. Bronchoscopic washings or sputum cultures, which frequently provided the first confirmation of infection, were always followed by positive blood or tissue cultures. In contrast to nontuberculous infection in immunocompetent hosts, disseminated infection was common, with evidence of extrapulmonary involvement in nine patients. On the basis of these findings, we recommend that any AIDS patient with sputum or bronchoscopic washings demonstrating nontuberculous mycobacterial organisms be tentatively classified as having disseminated infection while being evaluated with blood, bone-marrow, stool, and urine cultures, even if the chest radiograph shows no disease.     

Pulmonary microlithiasis-analysis of a case

The pulmonary microlithiasis is a very rare disease, and each new patient present a special interest. It is given an opportunity to discuss some new aspects of the etiology and pathogenesis which are unclear. This case concerns a woman (42 years old) in whose case some particularities in the clinical course have been analyzed and discussed. The essential in the clinical course was practically lack of clinical manifestation and disturbances during a very long period--about 25 years from the beginning of the disease, and very fast development during last year, manifested by the pulmonary deficiency. It was also marked the absence of respiratory infection during this long unmanifested period. The lack of the familial tendency and occupational noxious in this case rise the question about some new aspects of the etiology and pathogenesis of the disease. Namely, the disturbances in the recyclation of the pulmonary surfactant as a clue moment in the development of the disease.     

Protection of mice with recombinant influenza virus neuraminidase

Contemporary influenza vaccines are standardized with respect to their content of hemagglutinin, the major virus antigen. Although the immunizing effect of viral neuraminidase--the less abundant of the 2 major surface glycoproteins--has been well documented in experimental animals, the importance of the purified recombinant protein has not yet been adequately assessed in animals or humans. We demonstrate that different lots of a baculovirus-derived recombinant N2 protein, in the absence of other influenza virus proteins, can induce neuraminidase-specific antibodies, reduce the replication of both homologous and heterovariant virus in mice, and suppress disease, as it is manifested by total body weight loss.     

Switch to mania upon discontinuation of antidepressants in patients with mood disorders: a review of the literature.

OBJECTIVE: To review the literature for reported cases of mania related to discontinuing antidepressant treatment, as well as for possible explanations of this phenomenon, and to present a case report. METHOD: We undertook a literature review through the PubMed index, using the key words mania, antidepressant withdrawal, and antidepressants in bipolar disorder. We reviewed 11 articles featuring 23 cases. Where available, we noted and tabulated certain parameters for both bipolar disorder (BD) and unipolar depression. We use a case example to illustrate the phenomenon of mania induced by antidepressant withdrawal. RESULTS: For patients with unipolar depression, we found 17 reported cases of mania induced by antidepressant withdrawal. Antidepressants implicated included tricyclic antidepressants (TCAs) (12/17), monoamine oxidase inhibitors (MAOIs) (2/17), trazodone (1/17), mirtazapine (1/17), and paroxetine (1/17). For patients with BD, we found 19 reported cases of mania induced by antidepressant withdrawal, including our own case example. Of these, selective serotonin reuptake inhibitors (SSRIs) (10/19), TCAs (4/19), MAOIs (2/19), and serotonin norepinephrine reuptake inhibitors (SNRIs) (2/19) were implicated. CONCLUSION: Our case report supports the observation of antidepressant withdrawal-induced mania in patients with BD. It is distinguishable from antidepressant-induced mania, physiological drug withdrawal, and mania as a natural course of the illness. Many theories have been put forward to explain this occurrence. Noradrenergic hyperactivity and "withdrawal-induced cholinergic overdrive and the cholinergic-monoaminergic system" are the 2 most investigated and supported models. The former is limited by poor clinical correlation and the latter by its applicability only to anticholinergic drugs.     

Perceptions of Single vs. Partnered Adult Gravidas in the Midtrimester

Perceptions of the pregnancy experience, pregnancy intendedness, and partner status were compared in a sample of 30 women in the midtrimester. Half of the sample defined themselves as single and half as partnered. Interview data showed a full range in pregnancy intendedness and partner status, and shared areas of concern among the sample as a whole and areas of concern specific to single women. Single women's concerns clustered into four categories: decision-making, disclosure, social support, and legal issues.