Comparative case contamination: Three disinfection systems

This prospective single-masked clinical study analyzes the microbial contamination of the overnight storage solution and biofilm in contact lens cases. Thirty-one masked subjects were divided into three groups and assigned to use either AOSept,® ReNu,™ or OptiFree™ lens care systems for 6 weeks. They followed manufacturers' instructions and returned for microbial sampling at 4- and 6-week visits. The cases were sampled without opening the seal following disinfection the night before. Despite a large variability within the ReNu and OptiFree groups, the level of solution contamination was significantly lower with the AOSept system at the 6-week visit. The incidence of biofilm contamination was significantly worse for the ReNu group at the 4-week visit, and the AOSept group was significantly better than were ReNu and OptiFree at the 6-week visit. There was a trend toward increasing contamination with time in the chemical soaking systems and a strong correlation between solution contamination and biofilm contamination.     

Acute neuropsychiatric findings in a patient receiving fentanyl for cancer pain

A 62-year-old man receiving subcutaneous fentanyl for the management of cancer pain developed generalized central excitation after an overdose of 5000 μg of fentanyl. The patient developed acute confusion, restlessness, generalized myoclonus, visual hallucinations, and hyperalgesia and tremors upon tactile stimulation of the arms or legs. These symptoms rapidly disappeared after the administration of 0.2 mg of naloxone. Within an hour the symptoms reappeared and once again, responded immediately after a second injection of 0.2 mg of naloxone. Our findings suggest that fentanyl overdose can occasionally present with general central irritability that responds to naloxone.     

Negative signaling in B cells: SHIP Grbs Shc

Negative signaling in B cells is initiated by co-crosslinking of the antigen receptor and the Fcy receptor, resulting in cessation of B-cell signaling events and, in turn, inhibiting B-cell proliferation and antibody secretion. Here, a competitive role is proposed for SHIP in blocking the interaction of Shc with the Grb2-Sos complex of proteins that lead to Ras activation in B cells.     

Pott's disease of the cervico-occipital junction in an AIDS patient

Pott's disease of the cervical spine is relatively rare despite the fact that tuberculous spondylitis is still the most common manifestation of bone and joint infection. We describe a case, the first to our knowledge, of sub-occipital Pott's disease associated with a retropharyngeal abscess in an acquired immune deficiency syndrome (AIDS) patient. Neurological signs were the main clinical findings. The patient was successfully treated with anti-tuberculosis drugs combined with external stabilization of the spine.