Comparison of redox and D29 phage methods for detection of isoniazid and rifampicin resistance in Mycobacterium tuberculosis

Rapid, accurate and inexpensive methods are essential to detect drug-resistant Mycobacterium tuberculosis and allow timely application of effective treatment and precautions to prevent transmission. The proportion method, the MTT and Alamar Blue redox methods, and the D29 mycobacteriophage assay, were compared for their ability to detect resistance to isoniazid and rifampicin. When tested against a panel of known M. tuberculosis strains, the redox methods and the D29 assay showed good sensitivity and specificity compared to the proportion method, suggesting that they could be useful alternatives for identifying multidrug resistance in M. tuberculosis.     

The Relationship Between Psychogenic Cough and the Diagnosis and Misdiagnosis of Asthma: A Review

The differential diagnoses of persistent nonproductive cough include numerous pulmonary and nonpulmonary organic disorders as well as functional illnesses. Many diseases can cause cough, and several studies have shown asthma among the most common etiologies associated with chronic cough in adult nonsmokers, as well as children. Psychogenic cough and its relationship to asthma and other asthma-like illnesses is complex since distinct maladies with similar features may coexist individually or in combination in any given patient. While chronic cough may occur as a sole presenting manifestation of bronchial asthma in all age groups, recent findings suggest that most children with persistent cough without other respiratory symptoms do not have asthma. Since several organic, as well as functional diseases, may present with persistent cough as their sole manifestation in either adults or children, cough should not be used as a single or major determinant to diagnose and treat asthma, especially when empirically focused therapy trials fail. Given the range of illnesses causing cough, no single management guideline can be expected to be universally effective.     

加强质量体系建设,提高技术监督水平

本文对药品检验机构建立和完善质量体系的重要性，质量体系的内涵，建立和完善质量体系应注意的主要问题进行了分析并提出了建议。     

Mefenamic acid-induced bilateral transient myopia, secondary angle closure glaucoma and choroidal detachment

Drug-induced secondary angle closure is quite common and in the majority of cases simply stopping the medication leads to rapid reversal of the condition and resolution of glaucoma. We describe here a patient who presented with secondary angle closure glaucoma and myopia following mefenamic acid ingestion which was managed successfully by stopping the medication, symptomatic treatment and reassurance.     

精子尾部低渗肿胀试验、DNA荧光染色有效精子计数在精液分析中的意义

本文对１６０名有正常生育力的男性精液标本同时进行了精子尾部低渗肿胀率（ＨＯＳ）、精子头部ＤＮＡ荧光染色的有效精子计数（ＥＳＣ）、前向运动精子百分率（ＰＭＳ）、活动精子百分率（ＭＳ）的检测，分析它们之间的一致性。结果发现：ＨＯＳ与ＰＭＳ或ＭＳ间的符合率分别为７４％与８８％；ＥＳＣ与ＰＭＳ或ＭＳ间的符合率分别为６３％与６６％；ＥＳＣ与ＨＯＳ间的符合率为６７％。提示ＨＯＳ或ＥＳＣ可从不同角度去反映被测精子的生育力。     

Effects of the antimigraine compound zolmitriptan ('Zomig') on psychomotor performance alone and in combination with diazepam in healthy volunteers

Zolmitriptan (Zomig^TM) is a 5HT_1B/1D agonist which has the ability to cross the intact blood-brain barrier to access central as well as peripheral receptors. Because of the potential for central nervous system side effects, this randomized, double-blind, placebo-controlled, 6-period crossover study evaluated the effects of 2.5 and 5 mg doses of zolmitriptan on psychomotor performance and investigated any pharmacodynamic or pharmacokinetic interaction with diazepam. Twelve healthy volunteers received the following "treatments" as single doses: zolmitriptan 2.5 mg, zolmitriptan 5 mg, diazepam 10 mg, zolmitriptan 2.5 mg+diazepam 10 mg, zolmitriptan 5 mg+diazepam 10 mg and placebo. Pre-dose and at 1, 4, 8, and 24 h post-dose, the following validated battery of psychomotor tests was performed: Bond-Lader visual analogue scales (calmness, contentedness, and alertness factors), critical flicker fusion test, choice reaction time (recognition, motor, and total reaction times), finger-tapping test, number cancellation test and digit symbol substitution test. Plasma concentrations of zolmitriptan, its active metabolite, and diazepam and its active metabolites were measured at the same timepoints. Zolmitriptan 2.5 and 5 mg had no effect on psychomotor function when given alone. In contrast, diazepam 10 mg had profound effects, consistent with its sedative properties, but there was no synergism on concomitant administration of either dose of zolmitriptan. Plasma concentrations of zolmitriptan, diazepam, and their respective active metabolites were similar when the two drugs were given alone or in combination.     

Predictive testing for Huntington's disease: I. Predictors of uptake in South Wales

In Wales, predictive testing for Huntington's disease (HD) has not been offered proactively to families and uptake of testing is low in comparison to other centres. Little is known of those not requesting testing, particularly those not in direct contact with the genetics service. This study examined differences between a cohort of 22 test applicants and a random group of 32 'non-requesters', drawn from the South Wales HD register. Respondents were interviewed by means of a semi-structured schedule in their own homes. The study groups differed significantly on a number of variables including: knowledge of the availability of testing; perceived attitudes of family members and significant others to testing; length of knowledge and perceived stressfulness of being at risk; and perceived ability to cope with an unfavourable result. Overall, knowledge of testing procedures was poor and at-risk individuals' understanding of genetic terminology was at odds with scientific distinctions. Discussion focuses on the organisational and psychological factors associated with lack of knowledge of the availability of testing and the interpretation of reported coping capacities.     

115例腹会阴直肠切除术会阴伤口一期缝合的评估

本文就115例腹会阴直肠切除术,对会阴伤口的两种不同处理方法进行分析比较.在年龄、性别、病理分期及恶性程度无明显差异的情况下,会阴伤口一期缝合组的平均愈合时间为16.90±4.35天,伤口敞开组为37.04±15.44天,差异显著(P<0.002).术后局部复发率分别为3/69例和2/46例,均为4.35%(P>0.05).一期缝合组的平均住院费用约为敞开组的46.87%～76.52%.作者指出,鉴于直肠癌逆行向下的淋巴扩散极为罕见,仅发生于高恶性或伴广泛淋巴转移的病例,因而对癌肿远端需切除2cm～3cm正常肠管而同时切除肛直肠环、不得不作手术者,会阴部清除范围无需太大,会阴伤口可分层完全缝合;对位于肛管内或侵及肛直肠环的癌肿,须彻底清除坐骨直肠窝脂肪结缔组织.本文两组术后局部复发率无差异,进一步表明这一认识的正确性.本组结果充分表明了会阴伤口一期缝合法的合理性与可行性.     

Maschineller und manueller Bronchusverschluß —ergebnisse einer konsekutiven untersuchungsserie

Zusammenfassung Experimentelle Untersuchungen haben für den maschinellen Bronchusverschluß nach Lobektomie und Pneumonektomie im Vergleich zu anderen Nahtmaterialien die geringste Entzündungsrate und die höchste Zugfestigkeit ergeben. In einer konsekutiven Serie von 233 Lungenresektionen der Chirurgischen Kliniken Köln-Lindenthal und der Klinik für Allgemein- und Abdominalchirurgie der Johannes Gutenberg-Universität Mainz ging die Häufigkeit einer Bronchus-stumpfinsuffizienz von 7,1% nach manuellem Bronchusverschluß auf 2,0% und die insuffizienzbedingte Letalität auf 0,7% bei Anwendung des Klammergeräts zurück. Die wesentlichen Vorteile des maschinellen Bronchusverschlusses sind die Einfachheit der Anwendung, die Schnelligkeit und die Gleichmäßigkeit des Verschlusses. Damit stellen die Klammernahtgeräte bei Lungenresektionen eine wertvolle Ergänzung der Operationstechnik dar.

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Mechanical and manual bronchial closure —results of a consecutive trial

Summary After lobectomy and pneumonectomy in experimental evaluations stapled bronchial closures showed the lowest incidence of inflammatory reaction and the highest strength determined by leakage pressure compared with other suture material. A total of 233 lung resections - performed at Surgical University Clinic Köln-Lindenthal and the Clinic for General and Abdominal Surgery of the Johannes-Gutenberg-Universität Mainz — were reviewed. Mechanical stapling reduced the rate of bronchopleural fistulas to 2.0% compared with 7.1 % after manual suturing. In parallel, mortality related to bronchial stump leakage decreased to 0.7%. Main advantages of bronchial closure with staplers are the simplicity of their use, the speed and the uniformity of the closure. Thereby stapling devices are valuable completions in pulmonary surgery.