Interaction of microbiology and pathology in women undergoing investigations for infertility

BACKGROUND: Cases of endometriosis with no tubal damage are associated with infertility, suggesting an immunological rather than mechanical barrier to reproduction. Laparoscopy and falloposcopy results of clinically asymptomatic women undergoing investigation of infertility were correlated with the outcomes of microbiological screening for Chlamydia trachomatis, Mycoplasma pneumoniae, Mycoplasma hominis, ureaplasma species, Neisseria gonorrhoeae, Neisseria meningitidis and Chlamydia pneumoniae. METHODS: A total of 44 women presenting to a hospital IVF service for laparoscopic or laparoscopic/falloposcopic investigation of infertility provided endocervical swabs, fallopian tube washings, and peripheral whole blood for analysis. RESULTS: Of these 44 women, 15.9% (7) showed evidence of C. trachomatis infection as detected by either PCR or EIA serology. Of these 7 women, 5 (71%) had no or mild endometriosis and 2 (29%) had moderate or severe endometriosis. Of the remaining 37 women who showed no evidence of chlamydial infection, 15 (40.5%) had no or mild endometriosis. CONCLUSION: Women with infertility, but without severe endometriosis at laparoscopy, showed a trend towards tubal damage and a higher rate of previous C. trachomatis infection. Although not statistically significant, this trend would suggest that, where moderate to severe tubal damage is found to be the primary cause of infertility, C. trachomatis infection could be a likely cause for such tubal damage.     

Efficient construction of the securine A carbon skeleton

Securamine A is a structurally intriguing alkaloid possessing a pyrroloindole core joined via a modified isoprene subunit to a functionalized imidazole ring. Recent synthetic efforts in this laboratory have resulted in the efficient construction of key lactone 36, which undergoes tandem azide reduction/ring expansion to macrolactam 37. Macrolactam 37 possesses the complete macrocyclic core of securamine A.     

Factors influencing the selection of appropriate pain assessment tools

Pain is one of the most complex human experiences. Nurses have a moral, ethical, humanitarian and professional responsibility to provide an adequate standard of pain assessment and documentation. In order to obtain an accurate pain assessment from patients, they need to feel that their expression of pain will be listened to, accepted and acted on. It is therefore vital that nurses are educated in the process of pain assessment.     

Inlet and outlet devices for rotary blood pumps

The purposes of inlet and outlet devices for rotary blood pumps, including inducers and diffusers for axial pumps, inlet and exit volutes for centrifugal pumps, and inlet and outlet cannulas, are to guide the blood into the impeller, where the blood is accelerated, and to convert the high kinetic energy into pressure after the impeller discharge, respectively. The designs of the inlet and outlet devices have an important bearing on the pump performance. Their designs are highly dependent on computational fluid dynamics (CFD) analysis, guided by intuition and experience. For inlet devices, the design objectives are to eliminate separated flow, to minimize recirculation, and to equalize the radial components of velocity. For outlet devices, the design goals are to reduce speed, to minimize energy loss, and to avoid flow separation and whirl. CFD analyses indicate the velocity field and pressure distribution. Geometrical optimization of these components has been implemented in order to improve the flow pattern.