A clinical trial of adjunctive oestrogen treatment in women with schizophrenia

Summary A double-blind, 28-day, placebo-controlled study was conducted with three groups of women of child-bearing age (N = 12 in each group) who received standardised antipsychotic medication plus a) 50 μg transdermal estradiol or b) 100 μg transdermal estradiol or c) transdermal placebo. Preliminary analyses show that women receiving 100 μg of estradiol made greater improvements in the symptoms of schizophrenia than either the 50 μg estradiol or placebo groups. The addition of 100 μg adjunctive transdermal oestrogen significantly enhanced treatment responsivity of acute, severe psychotic symptoms in women with schizophrenia. The positive impact of oestrogen treatment on psychotic symptoms via a multiplicity of possible actions (see accompanying articles in this issue) may prove clinically useful in the overall treatment of women with schizophrenia. Accepted June 2002, Published online September 16, 2002 Correspondence: Prof. Jayashri Kulkarni, Alfred Psychiatry Research Centre, Alfred Hospital, Commercial Road, Prahran. Vic. 3181, Australia; e-mail: jayashri.kulkarni@med.monash.edu.au     

Confirmation of trisomy 22 by trypsin-giemsa staining.

A small-for-dates male infant with mental retardation, microcephaly, malformed ears, preauricular sinuses, epicanthal folds, micrognathia, congenital heart diseases, micropenis, and micropolygyria of the parietal and occipital lobes of the cerebral cortex was shown to have a 47,XY,+22 karyotype by trypsin-giemsa banding. Review of reported cases confirms that there may be distinctive trisomy 22 syndrome.     

Social interactions between children with cancer and their peers: teacher ratings

Compared children (ages 8-18) with cancer (n = 24) and matched classroom control children (n = 24) using a modified version of the Revised Class Play (RCP). A wide variety of malignancies were represented, except brain tumors. Childrens' classroom teachers completed the RCP, an instrument modified to obtain teachers' impressions of three fundamental dimensions of interpersonal style: sociability-leadership, aggressive-disruptive, sensitive-isolated. Relative to the matched controls, children with cancer were perceived by teachers as (a) less sociable and prone towards leadership and (b) more socially isolated and withdrawn. These findings suggest a need for long-term psychosocial interventions oriented towards peer relationships of children with cancer.     

Epithelioid hemangioendothelioma of bone--a clinicopathologic and immunohistochemical study of 7 cases

Epithelioid hemangioendothelioma is a rare vascular tumor of bone. Between 1987-1999, seven cases of epithelioid hemangioendothelioma were recorded. The histopathological evaluation was done with hematoxylin and eosin stain and immunohistochemical stains along with the analysis of clinical data and X-ray findings. There were 4 males, 3 females between 15 to 48 years of age with complaints of pain and swelling. Long bones were involved in five of the seven patients and one was multifocal. Radiologically all seven patients showed osteolytic lesions. The histologic hall mark was the presence of eosinophilic, epithelioid cells with intracytoplasmic vacuoles. The tumor may be histologically confused with metastatic carcinoma, chondromyxoid fibroma and osteogenic sarcoma. Immunohistochemical reactivity was as follows: Vimentin (6/6 cases), Factor VIII related antigen (4/6 cases), Ulex Europeaus (5/6 cases), CD31 (3/5 cases), CD34 (3/5 cases), epithelial membrane antigen (1/6 cases), cytokeratin (none). Treatment comprised curettage (4 cases), wide excision (2 cases), below knee amputation (1 case) and post operative radiotherapy (2 cases). At follow-up, (available in 4 patients) two were without disease at 18 months and 120 months. Of the remaining two, one developed local recurrence after 36 months; while the other died of lung metastasis (18 months). A lytic bone shadow, the presence of plump eosinophilic often vacuolated cells on a myxoid background and immunohistochemistry together help in the correct recognition of this tumor.     

Cross-reactions in cell mediated immunity induced by atypical mycobacteria

Cross-reactivity in the delayed hypersensitivity response to mycobacteria of different Runyon groups was tested in Swiss white mice immunised with live mycobacteria. All the strains tested gave cross-reactions and, generally, slow growers gave stronger cross-reactions with other slow growers than with rapid growers and vice versa. Sonicates of cross-reacting mycobacteria were also tested for their ability to generate activated macrophages in mice immunised with Mycobacterium avium. All the mycobacterial sonicates generated activated macrophages but a sonicate of Salmonella typhi did not. The sonicate of M. tuberculosis H37Rv also generated activated macrophages, which indicates that there might be protective cross-reactions between M. tuberculosis and atypical mycobacteria.     

Antibiotics sensitivity pattern of N. gonorrhoeae with special emphasis on norfloxacin and ciprofloxacin

The current study is carried out to find the in-vitro susceptibility of N. gonorrhoeae to Ciprofloxacin, Norfloxacin, Gentamycin etc. in 110 isolates obtained from acute gonococcal urethritis confirmed by smear examination. The isolates obtained are from the patients attending the Skin and STD Clinic of a teaching hospital, clinically diagnosed as suffering from acute gonococcal urethritis. Antibiotic susceptibility test was done by Kirby Bauer disc diffusion technique. Four to five similar well isolated colonies of the gonococcal strains were picked up with a wire loop and transferred to 5 cc of sterile trypticase soya broth (TSB). Tubes were incubated at 36 degrees C. GC agar base plates were inoculated with suspensions using a sterile cotton swab. Antibiotic discs were placed on these plates. The plates were incubated at 35 degrees C for 18-24 hours in a candle jar with 5-10% CO2. The plates were then observed to note the zones of inhibition around the discs. 87.27% of isolated strains were inhibited by norfloxacin at an MIC of 0.06 mu gm/ml; 89.08% of the strains were inhibited by ciprofloxacin at an MIC of 0.025 mu gm/ml. All the strains (110) were inhibited by ciprofloxacin at a concentration of 0.2 mu gm/ml. Gentamycin sensitivity was 86.36%. Out of 110 patients, 85 were treated with norfloxacin of which 81 (95.29%) were cured. Twenty five were treated with ciprofloxacin of which 24 (96%) were cured. This study shows high sensitivity of N. gonorrhoeae to norfloxacin and ciprofloxacin.