Uterine adenomyoma associated with infertility. A report of three cases

Adenomyosis and its localized, tumorlike variant, the adenomyoma, usually afflict multiparous, perimenopausal women and are not considered to cause infertility. Three cases of adenomyoma occurred in young, infertile women. The adenomyoma was not deemed solely responsible for the infertility, although in two cases it could have been contributory. The preoperative diagnosis was leiomyoma, and adenomyoma was not even considered; it was recognized during "myomectomy" in one case. Adenomyoma should be included in the differential diagnosis of a localized uterine tumor in an infertile woman. This preoperative recognition allows the gynecologist to discuss the lesion with the patient, pointing out that the operation may be technically difficult and may result in incomplete removal or hysterectomy and that excision of the tumor may not cure her infertility. It also prepares the gynecologist for the technical problems that may arise intraoperatively. Additional cases of adenomyoma in infertile women need to be reported on before light is shed on its causal relationship to infertility as well as on its diagnosis and management.     

Antenatal detection of grossly distended bladder owing to absence of the urethra in a fetus with trisomy 18.

An ultrasonic examination revealed a grossly distended fetal abdomen. Amniocentesis at 19 weeks' gestation showed raised amniotic fluid alphafetoprotein, a second band of specific acetylcholinesterase, and a fetal karyotype 47,XY,+18. The pregnancy was terminated and the necropsy examination showed absence of the urethra, grossly distended bladder, hydroureters, and congenital heart anomalies.     

Promotion of healthy weights at preschool public health vaccination clinics in Calgary: an obesity surveillance program

OBJECTIVE: To evaluate the acceptability and feasibility of a surveillance program of overweight and obesity in preschool children in Calgary, and to provide advice for families to promote healthy weights. PARTICIPANTS AND SETTING: Children (mean age 4.9+/-0.6 years) attending pilot-site clinics in September 2002 and all clinics in Calgary between February 2003-December 2003 (n=7048). INTERVENTION: The growth assessment protocol and resources supported a three-pronged approach to promote healthy weights (healthy eating, active living and positive body image). Public health nurses were trained in standardized measurement techniques and information resources. Links with physicians were made to facilitate continuity of care. Children's weight and height measurements were plotted on the Weight-for-Stature growth chart and used to identify children as obese (> or =95th percentile), healthy weight (> or =5th, <95th) or underweight (<5th). Subsequent analysis calculated the Body Mass Index (BMI)-for-Age to identify overweight children (> or =85th, <95th percentile). The protocol was pilot tested and subsequently implemented in all Calgary public health clinics. OUTCOMES: The majority (98%) of parents were either very happy or happy with information received during the visit. Public health nurse counselling confidence significantly improved after the pilot (p<0.001). Data indicated that 9% of children were obese, 15% were overweight and 3% were underweight. INTERPRETATION: This approach to identifying children's weight status appeared satisfactory to stakeholders, maximized use of existing resources to establish a surveillance program for Calgary, and provided an opportunity to give parents health-promoting advice on healthy weights.     

Interpretation of the BBT chart: using the "Gap" technique compared to the Coverline technique

OBJECTIVE: The aim of the study was to compare the accuracy of the Gap and Coverline techniques of interpreting the basal body temperature chart. METHODS: We compared the proportion of menstrual cycles for which the Gap and Coverline techniques accurately identified the post-ovulatory final fertile phase (FFP) and the initial infertile phase (IIP) and the median number of days each overestimated the fertile period, using urinary LH testing as the gold standard. RESULTS: The Gap and Coverline techniques identified the FFP within +/-1 day of that identified by LH testing in 13/33 (39%) and 10/33 (30%) cycles (chi2=0.6; p=.44), respectively, and the IIP within +1 day of that of LH testing in 13/33 (55%) and 4/33 (12%) cycles, respectively (chi2=13.4; p<.001). The Gap and Coverline techniques overestimated the fertile period by 1 and 4 days, respectively (p=.0002). CONCLUSION: Based on this small study, the Gap technique appears to be more accurate than the Coverline technique in identifying the post-ovulatory IIP.     

Detoxication of zinc and cadmium by the freshwater protozoan Tetrahymena pyriformis: I. The effect of water hardness

Estimated 8-hr LC₅₀ values of zinc and cadmium were less than 1 ppm in the absence of soluble calcium and magnesium, but were raised, for example, to 24 ppm of zinc and 19 ppm of cadmium by the addition of calcium plus magnesium at a concentration (500 ppm) equivalent to that of very hard water. Experiments with ⁶⁵Zn showed that uptake of this element from sublethal concentrations over 8 hr was reduced from approximately 50 × 10^?2 μg liter^?1 to 10 × 10^?2 μg liter^?1 per 10⁶ cells by the addition of 500 ppm of calcium and magnesium. Diminished uptake may partly explain the antagonism observed in the toxicity tests.