Sensitivity of direct versus concentrated sputum smear microscopy in HIV-infected patients suspected of having pulmonary tuberculosis

Background  

Sputum concentration increases the sensitivity of smear microscopy for the diagnosis of tuberculosis (TB), but few studies have investigated this method in human immunodeficiency virus (HIV)-infected individuals.     

A rare presentation of mucocele and irritation fibroma of the lower lip

The effects of chronic local irritation have been seen commonly in the form of fibroma or mucocele in children. We report a nine year old girl with the chief complaint of multiple swellings in the lower lip which was diagnosed both clinically and histologically as fibroma and mucocele. Surgical excision was done under local anesthesia with no post-operative complications. To our knowledge there was no other occurrence, either at the same site or at different locations, involving these two lesions in the oral mucosa.     

Laparoscopically assisted total daVinci aorto bifemoral graft bypass with a unique system of graft delivery

We report the first known example of a fully robotic aortobifemoral graft and aortic endarterectomy using the daVinci Surgical System and a unique method for graft delivery using the Endo-Vein Harvester.     

Effects of ageing and streptozotocin‐induced diabetes on connexin43 and P2 purinoceptor expression in the rat corpora cavernosa and urinary bladder

OBJECTIVE

To investigate whether ageing and diabetes alter the expression of the gap junction protein connexin43 (Cx43) and of particular purinoceptor (P2R) subtypes in the corpus cavernosum and urinary bladder, and determine whether changes in expression of these proteins correlate with development of erectile and bladder dysfunction in diabetic and ageing rats.

MATERIALS AND METHODS

Erectile and bladder function of streptozotocin (STZ)‐induced diabetic, insulin‐treated and age‐matched control Fischer‐344 rats were evaluated 2, 4 and 8 months after diabetes induction by in vivo cystometry and cavernosometry. Corporal and bladder tissue were then isolated at each of these sample times and protein expression levels of Cx43 and of various P2R subtypes were determined by Western blotting.

RESULTS

In the corpora of control rats ageing was accompanied by a significant decrease in Cx43 and P2X₁R, and increase in P2X₇R expression. There was decreased Cx43 and increased P2Y₄R expression in the ageing control rat bladder. There was a significant negative correlation between erectile capacity and P2X₁R expression levels, and a positive correlation between bladder spontaneous activity and P2Y₄R expression levels. There was already development of erectile dysfunction and bladder overactivity at 2 months after inducing diabetes, the earliest sample measured in the study. The development of these urogenital complications was accompanied by significant decreases in Cx43, P2Y₂R, P2X₄R and increase in P2X₁R expression in the corpora, and by a doubling in Cx43 and P2Y₂R, and significant increase in P2Y₄R expression in the bladder. Changes in Cx43 and P2R expression were largely prevented by insulin therapy.

CONCLUSION

Ageing and diabetes mellitus markedly altered the expression of the gap junction protein Cx43 and of particular P2R subtypes in the rat penile corpora and urinary bladder. These changes in Cx43 and P2R expression provide the molecular substrate for altered gap junction and purinergic signalling in these tissues, and thus probably contribute to the early development of erectile dysfunction and higher detrusor activity in ageing and in diabetic rats.     

Review of Psychodynamic diagnostics manual (PDM)

Reviews the book, Psychodynamic diagnostics manual (PDM) by Alliance of Psychoanalytic Organizations (2006). This volume is divided into three major sections, Part 1--Classification of Adult Mental Heath Disorder, Part 2--Classification of Child and Adolescent Mental Health Disorder, and Part 3--Conceptual and Research Foundations for a Psychodynamically Based Classification System for Mental Health Disorders. Unlike the standard DSM which highlights the patient's presenting symptom (Axis I) with secondary consideration given to an underlying personality disorder (Axis II), the major thesis of classification scheme of this volume is that diagnostic evaluation should provide a more patient centered and a more clinically useful picture of the individual by understanding the symptom(s) through the essential dimensions of the patient's personality and mental functions (interpersonal and cognitive capacities). Part 3, which could stand on its own as a separate volume, is a thorough critique of psychotherapy outcome research in which the authors delineate how major design flaws have derived from "favoring what is measurable over what is meaningful." The authors cogently demonstrate that diagnostic assessment is a continuous effort toward providing individualized and clinically relevant evaluations. (PsycINFO Database Record (c) 2010 APA, all rights reserved).