Clinical aspects of pelvic inflammatory disease

Pelvic inflammatory disease (PID) is a common and poorly managed condition. Untreated or inadequately treated, it leads to tubal infertility, ectopic pregnancy and chronic pelvic pain. Diagnostic difficulties are compounded by the wide variety of clinical presentations and the insensitivity and poor specificity of laboratory tests. Better recognition of mild and atypical disease needs a high index of suspicion whenever young, sexually active women present with gynaecological symptoms. Laparoscopy supplemented by microbiological tests and fimbrial minibiopsy should be regarded as the diagnostic 'gold standard' for research studies; new studies are required to identify techniques which might reduce under- and over-diagnosis. Early treatment reduces the risk of an adverse effect on fertility. Any therapeutic regimen selected should be effective against the common aetiological agents Chlamydia trachomatis, Neisseria gonorrhoeae, genital mycoplasmas and aerobic and anaerobic bacteria. Since at least 60% of cases of PID can be attributed to infection with a sexually transmitted organism, partner notification forms an essential part of management.      

Adrenocorticosteroid injection vs. conservative therapy in the treatment of chalazia

Three methods of treating chalazia were compared in a controlled trial. Group A (conservative therapy of warm soaks and lid hygiene) consisted of six patients with seven chalazia. Group B (intralesional adrenocorticosteroid injection) had five patients with five chalazia. Group C (conservative therapy with intralesional steroid injection) included nine patients with ten chalazia. Success rates after six weeks of follow-up were: Group A: 3 of 7 (43%), Group B: 4 of 5 (80%), and Group C: 9 of 10 (90%). Intralesional steroid injection with or without concurrent conservative therapy was more effective than conservative management alone.     

Expression of a suppressive p15E-related epitope in colorectal and gastric cancer.

mRNA for the suppressive epitope of p15E was found to be present in 24 of 30 samples of human colorectal cancer and in all four specimens of gastric cancer. mRNA for p15E was seldom seen in nonmalignant colonic or gastric mucosa but, when present, was associated with inflammatory or pre-malignant conditions of the digestive tract. Synthetic peptides derived from the conserved p15E sequence were found to suppress some aspects of the immune response implicated in anti-tumour activity. These data suggest that a p15E-related material with immunomodulatory properties is elaborated within human tumours, either by the tumour itself or as a normal component of the endogenous anti-tumour reaction.     

Actions of the phorbol ester, PMA, on ATP-induced fluctuations in cytoplasmic calcium in single isolated bovine aortic endothelial cells.

Agonist-evoked rises in [Ca2+]i were recorded from single bovine aortic endothelial cells in the middle of confluent monolayers by dual-wavelength microspectrofluorimetry. Low doses of ATP (1-5 microM) induced a transient rise in [Ca2+]i followed by a maintained plateau phase upon which were superimposed irregular fluctuations in [Ca2+]i. The mechanism underlying these fluctuations is not known. Addition of the phorbol ester, phorbol 12-myristate 13-acetate (PMA), to single cells displaying ATP-induced fluctuations reduced the amplitude and frequency of these fluctuations but the maintained plateau phase was unaffected. Elevation of intracellular cAMP by activation of adenylate cyclase with forskolin, or application of dibutyryl cAMP did not affect the ATP-induced fluctuations. These results suggest a possible role for the diacylglycerol limb of the phosphoinositide hydrolysis pathway, via activation of protein kinase C, but not cAMP, in the mechanism responsible for generating ATP-induced fluctuations in [Ca2+]i.     

Feasibility of School-Based Smoking Cessation Programs

ABSTRACT: This study obtained input from Australian student smokers approximately 15 years old, which may be useful in designing school-based smoking cessation programs. The sample was analyzed by previous quitting experience and intentions to quit. The order of preference for assistance options and incentives for quitting was similar across all groups: however, those who previously attempted to quit (previous quitters) and those who intended to quit (intenders) in the future were significantly more likely than non-quitters and non-intenders to find assistance options for quitting acceptable. The potential for saving money emerged as an important variable in convincing all groups of smokers not to smoke, and using personal willpower and cutting down slowly were identified as important in actual attempts to quit. The need for programs to be free and for friends to be supportive also was evident across all groups.