Is endometrial infection with Candida albicans a cause of recurrent vaginal thrush?

OBJECTIVE--It was hypothesised that the endometrium might act as a reservoir for candida, thus infecting the vagina as the endometrium is shed during menstruation. DESIGN--A prospective study of women with recurrent vulvo-vaginal candidiasis. The endometrium was sampled and cultured for candida species. SETTING--Central London STD clinic. SUBJECTS--26 women were enrolled, of whom 20 completed the study. RESULTS--One patient had a positive endometrial culture for candida species, the isolate being Candida krusei. CONCLUSIONS--The endometrium is not a common resevoir for candida species and therefore, infection at this site is an unlikely cause of recurrent vaginal candidiasis.     

High Parity and Adverse Birth Outcomes: Exploring the Maze

Abstract: Background : Despite extensive literature on the topic, it is uncertain if grand (para ≥ 5) and great grand (para ≥ 10) multiparity are associated with adverse birth outcomes. We critically evaluate the evidence for and against the existence of adverse maternal and/or fetal outcomes in high parity women. Methods : An electronic search of MEDLINE and other bibliographic databases (Current Contents, EMBASE, and CAB) was conducted, and all relevant articles in English language were retrieved. Results : Findings on the association between high parity and maternal‐fetal birth outcomes are not consistent. Although the older literature tends to suggest that multiparity is a risk factor for negative birth outcomes, more recent reports are not supportive. Comparison across studies was further complicated by confounding factors like maternal age, socioeconomic status, and levels of prenatal care, as well as by variations in study designs and in the definition of parity itself. Furthermore, most studies that examined women of extreme parity (para ≥ 10) were handicapped by inadequate power. Conclusions : After accounting for quality, culture, and degrees of associations, the preponderance of evidence seems to point to possible existence of heightened risk for certain medical complications and placental pathologies among women of extreme parity. The literature also provides reasonable evidence for a higher‐than‐expected likelihood for occurrence of fetal macrosomia with advanced parity.     

Isolated human hepatocytes in culture display markedly different gene expression patterns depending on attachment status

In vitro human hepatocyte cultures are a key tool in the investigation of xenobiotic toxicity and metabolism. In most in vitro hepatocyte studies, the cells are allowed to adhere to an extracellular matrix, such as collagen. Unfortunately, the ability of freshly isolated hepatocytes to adhere to collagen varies from donor to donor. We used microarray analysis to determine what gene expression differences exist between hepatocytes in suspension and hepatocytes attached to collagen. Results from different donors showed a considerable difference in gene expression patterns between the two hepatocyte populations. In addition, we also compared the gene expression profiles of hepatocytes in culture with liver tissue. The results showed that both hepatocytes in suspension and hepatocytes attached to collagen display significant gene expression differences compared with liver tissue. Finally, we show that both populations of hepatocytes are responsive to dexamethasone and regulate some of the same genes. Overall, our results suggest that either significant gene expression changes occur in isolated hepatocytes or that suspended and attached cells represent different populations of hepatocytes found in intact livers.     

Promotion of mouthguards among amateur football players in Victoria

Abstract: Wearing mouthguards while playing contact sports reduces the prevalence and severity of orofacial injuries. We report on a 1991–92 promotion of mouthguard use among amateur football players in Melbourne. Four questionnaires were completed by players (1991 season: middle: n =638, 49 per cent response; late: n =770, 51 per cent; 1992: early: n =505, 26 per cent; late: n =698, 54 per cent), in four age groups (16–19, 20–23, 24–29, 30–44 years), about perceived mouthguard value and usage, injury experience, and awareness of a promotional message. Over the two seasons, mouthguard ownership and consistent wear increased and dental injuries decreased. Ownership of mouthguards increased among: 20–23 year olds and 30–44 year olds (13 and 16 per cent); managers, tradespersons, salespersons, labourers and the unemployed (14–19 per cent); residents of northern and western regions (12 and 13 per cent); those with 6 to 10 years of education (29 per cent); players in old boys' networks (13 per cent); and those with English as a first language (8 per cent). Consistent wear was high at matches (89 per cent) but low at training (13 per cent), owing to perceived lack of physical contact. Of dental injuries reported by 25–31 per cent, fractures predominated over luxations and avulsions. Fractures and avulsions were more common at matches than training; luxations predominated at training. When a mouthguard was not worn, the likelihood of a fractured or avulsed tooth was at least twice that when a mouthguard was worn. Some injuries occurred despite the wearing of mouthguards. The promotional message appeared effective in increasing mouthguard use; newspapers and football journals provided effective message locations for players, and ground signs and the electronic scoreboard for spectators.     

Diagnostic, prognostic and therapeutic value of Doppler echocardiography in pulmonary embolism. Apropos of 41 cases

In 41 patients with acute or recent pulmonary embolus (PE), a prospective study was conducted with cardiac Doppler sonography (CDS). The test is performed first in all patients, then immediately following a treatment fibrinolytics in 10 of them. The PE is confirmed by pulmonary angiography in 39 patients and embolectomy for the 2 patients who presented a mobile thrombus in the right atrium. A tricuspid insufficiency (TI) is almost always recorded by continuous Doppler: the systolic pulmonary artery pressure (sPAP) is calculated from the maximum velocity of the regurgitating tricuspid flow, using Bernouilli's equation. The correlation between Doppler sPAP and sPAP obtained by catheterization is: r = 0.95 (n = 34; p less than 0.001). A severe pulmonary hypertension, corresponding to a TI exceeding 3.5 m/s is related to a pulmonary migration occurring on a pathological heart. There is a satisfactory relationship between the elevation of the Doppler sPAP and the degree of pulmonary obstruction in the "Pe on healthy heart" population: r = 0.6 (n = 29; p less than 0.001). The dilated right ventricle observed on the sonogram (RV) is proportional to the severity of the angiographic image: correlation between the RV/LV ratio and the percentage of vascular obstruction is r = 0.73 (n = 27; p less than 0.001). The drop in the sPAP and the regression of the symptoms of pulmonary heart noted on CDS after fibrinolysis, correspond to a significant improvement of the pulmonary perfusion. The CDS seems to be absolutely necessary in PE because of the major and reliable informations it provides.