Characterization of ompA genotypes by sequence analysis of DNA from all detected cases of Chlamydia trachomatis infections during 1 year of contact tracing in a Swedish County

In this study we aimed to characterize the ompA gene by sequencing DNA from all detected cases of Chlamydia trachomatis infection in a Swedish county during 2001, in order to improve the efficiency of contact tracing. Approximately 990 bp of the ompA gene was amplified, and sequence analysis was achieved in 678 (94%) of 725 C. trachomatis-positive cases in this unselected population. The most prevalent genotype was serotype E (39%), followed by F (21%), G (11%), D (9%), K (9%), J (7%), H (2%), B (1%), and Ia (1%). Serotype E was found in five genotype variants, with the reference sequence comprising 96% of all E cases. Serotype D was the most variable, and of seven sequence variants, three were identified as recombinants with serotype E. Altogether 29 genetic variants were detected, and mutations and recombination events are discussed. Clinical manifestations were not associated with genotypes. Sequence variation was linked to sexual networks identified by contact tracing and improved epidemiological knowledge but was of limited benefit.     

Blue Cross of California goes for the gold--WellPoint Health Networks, Inc

After a half-dozen years of bold, successful restructuring, a once nearly bankrupt Blue Cross of California launches a for-profit managed care organization.     

NEW SUSPENSION DEVICE FOR LARYNGEAL ENDOSCOPIC PROCEDURES

In view of the economic constraints in acquiring sophisticated equipments in service hospitals, a new suspension device for endolaryngeal surgery using anaesthetic laryngoscope and routinely available tonsillectomy instruments has been developed. This device is a modification of Ijadoula''s suspension laryngoscope.KEY WORDS: Suspension laryngoscope, Laryngeal endoscopy     

A tale of two cities: health system reform in Little Rock and Houston

Health care providers are not waiting for federal legislation to pass Congress before getting on with the business of reforming health care. Here is a close-up of provider-generated health system reform in a large and a small city where things are happening in the marketplace.     

Rehabilitation's quiet surge

Post-acute rehabilitation care is growing by the day. A few large companies, born in the 1980s, are bringing a once obscure niche of care into its financial and clinical maturity. Here is what's happening and an analysis of why.     

Practicability and clinical relevance of routine psychological screening of patients in general internal medicine units

In medical patients, anxiety and depression are frequent but often undiagnosed problems. The aim of the present study was to test and evaluate a psychological screening in medical in-patients. Using the Hospital Anxiety and Depression Scale (HADS), we screened 454 out of 743 consecutive medical in-patients. Physical symptoms and diagnoses were also recorded. Elevated scores for anxiety and depression were found in 20.8% and 23.9%, respectively. They were relatively independent of physical findings but correlated with subjective symptoms. In a subgroup who completed the questionnaire twice, HADS scores remained constant until discharge. Cardiological patients with abnormal baseline anxiety stayed significantly longer in hospital than those who were not anxious. Over a one-year follow-up, initially depressed patients had a risk of in-hospital death that was 2.5 times higher. This effect remained stable after controlling for baseline diagnoses and indices of severity of the disease.     

ELISA-quantitation of phosphorylated tau protein in the Alzheimer's disease brain

A reliable, sensitive and specific sandwich ELISA for the quantitation of paired helical filament (PHF) tau in human brain was developed using well-defined monoclonal antibodies. We examined rapid-autopsy-derived brain tissue from 21 neuropathologically confirmed Alzheimer's disease (AD) patients and 14 nondemented controls, matched for age, sex and postmortem delay times. We demonstrated significant elevations of phosphorylated tau levels in the frontal and parietal cortex as well as in the hippocampus of AD patients as compared to the nondemented controls. No difference was observed in the cerebellum. Phosphorylated tau levels measured by ELISA were significantly correlated with the presence or absence of neurofibrillary tangles.