Etretinate-induced skeletal muscle damage

Three patients who received etretinate, two for psoriasis vulgaris and one for exfoliative dermatitis, developed clinical and electromyographic features of muscle damage during treatment. In one patient histological and ultrastructural findings indicated segmental muscle necrosis. Withdrawal of the drug led to clinical recovery and normalization of muscle enzyme levels and electromyogram. To the best of our knowledge, this is the first report to show etretinate-induced reversible skeletal muscle damage.     

Effect of Policosanol on Isoprenaline-induced Myocardial Necrosis in Rats

Abstract— Policosanol is a mixture of higher aliphatic primary alcohols isolated from sugar cane (Saccharum officinarum L.) and octacosanol represents its main component. This study was conducted to examine the effects of policosanol on myocardial necrosis induced by subcutaneous injection of isoprenaline in rats. A significant reduction (P < 0·01) of infarct size, polymorphonuclear cells and mast cells was observed in animals treated with policosanol at 5 or 25 mg kg^?1, while animals receiving only acetysalicylic acid pretreatment showed a significant decrease in the infarct area (P < 0·05). No significant differences in polymorphonuclear and mast cells were obtained when compared with positive control data. It is concluded that policosanol delays the evolution of infarction, showing a protective effect on the myocardial necrosis induced by isoprenaline in this experimental model.     

Comparison of methods of DNA extraction for real‐time PCR in a model of pleural tuberculosis

Santos A, Cremades R, Rodríguez JC, García‐Pachón E, Ruiz M, Royo G. Comparison of methods of DNA extraction for real‐time PCR in a model of pleural tuberculosis. APMIS 2010; 118: 60–5. Molecular methods have been reported to have different sensitivities in the diagnosis of pleural tuberculosis and this may in part be caused by the use of different methods of DNA extraction. Our study compares nine DNA extraction systems in an experimental model of pleural tuberculosis. An inoculum of Mycobacterium tuberculosis was added to 23 pleural liquid samples with different characteristics. DNA was subsequently extracted using nine different methods (seven manual and two automatic) for analysis with real‐time PCR. Only two methods were able to detect the presence of M. tuberculosis DNA in all the samples: extraction using columns (Qiagen) and automated extraction with the TNAI system (Roche). The automatic method is more expensive, but requires less time. Almost all the false negatives were because of the difficulty involved in extracting M. tuberculosis DNA, as in general, all the methods studied are capable of eliminating inhibitory substances that block the amplification reaction. The method of M. tuberculosis DNA extraction used affects the results of the diagnosis of pleural tuberculosis by molecular methods. DNA extraction systems that have been shown to be effective in pleural liquid should be used.     

Real‐time PCR with internal amplification control for detecting tuberculosis: method design and validation

Flores E, Rodríguez JC, Garcia‐Pachón E, Soto JL, Ruiz M, Escribano I, Royo G. Real‐time PCR with internal amplification control for detecting tuberculosis: method design and validation. APMIS 2009; 117: 592–7. Real‐time PCR has been a major development in the diagnosis of tuberculosis. However, most tests do not include an internal amplification control (IAC), which therefore limits it clinical application. In this study a new, easy to perform real‐time PCR test with IAC was designed and validated in clinical samples. The primers amplified a 163‐bp fragment of IS6110 of Mycobacterium tuberculosis and the IAC was designed with a fragment of a different microorganism (Chlamydia trachomatis). The interassay and intraassay variation of this test were very low (0.45–1.65% and 0.18–1.80%, respectively). The detection accuracy was validated in 50 samples (25 urine, 25 sputum) with different concentrations of M. tuberculosis, 18 clinical isolates of non‐tuberculous mycobacteria and 148 samples with clinical suspicion of pulmonary tuberculosis. The specificity was 100%. The detection limit of this PCR test without IAC was approximately 15 bacteria and with IAC approximately 32 bacteria. This real‐time PCR with IAC assay can improve the detection of M. tuberculosis and contribute to standardization of this diagnostic technique.     

Book Reviews

Mental Health Work in the Community: Theory and Practice in Social Work and Community Psychiatric Nursing Michael Sheppard Basingstoke, The Falmer Press, 1991 Price £25.00

Training and Supervision for Counselling in Action Windy Dryden &; Brian Thorne, (Eds) 1991 London, Sage Publications Price £8.95

Comparing Psychoanalytic Psycotherapies James F. Masterson, Marin Tolipin &; Peter E. Sifneos New York, Brunner/Mazel, 1991 298 pp.

Pyschiatry Speciality Board Review William M. Eassson &; Nichholas L. Rock Series Editor: Gene Usdin New York, Brunner/Mazel, 1991 145 p. £19.95

The Mental Health Professional and the Legal System Formulated by the Committee on Psychiatry and the Law Group for the Advancement of Psychiatry. New York, Brunner/Mazel, 1990

Personal Construct Counselling in Action F. Fransella &; P. Dalton London, Sage Publications ISBN 0-8039-8231-X 150 pp. £8.95 (paperback)     

The anterior to midaxillary line between the 4th or 5th intercostal space (Buelau position) is safe for the use of thoracostomy tubes in preterm and term infants

Objectives:  Thoracostomy tubes are widely used in neonatology. Complications occurred significantly more frequently in infants, especially neonates, than in adults. Principally, the access is the modified Buelau position which takes place in the anterior axillary line at the 4th or 5th intercostal space above the margin of the ribs.
Aim:  This study seeks to determine the characteristics and topographic conditions of the anatomical structures at the ventral and lateral thoracic wall in the preterm and term neonate.
Background:  Fifteen formalin-fixed stillborns were prepared (nine male, six female, 28–43 weeks gestational age).
Methods/Materials:  The anatomical preparation involved the complete thoracic wall region.
Results:  In all preparations, a venous vessel was detected at the lateral wall and was identified as v. thoracoepigastrica without accompanying artery. Arteria (a.) and vena (v.) thoracica interna were regularly found close to the sternal plate on both sides between rib and fascia. With increasing gestational ages the course of the v. thoracoepigastrica varied significantly between the left and right thoracic wall. It was demonstrated that the v. thoracoepigastrica regularly arose within the abdominal or thoracic subcutaneous fat and drained into the v. subclavia. The variance between its course was almost 5–12 mm to the lateral or medial side. At both thoracic sides, no other organs or organ structures except lung parenchyma could be detected when using the Buelau position.
Conclusions:  The anterior to midaxillary line between the 4th or 5th intercostal space (Buelau position) is safe for the use of thoracostomy tubes in preterm and term infants.