Bladder dysfunction and neurosyphilis

Neurosyphilis today is a rare problem. We describe a man who presented with organic brain syndrome, psychosis and incontinence, and diagnosis was neurosyphilis with resultant bladder dysfunction. Urodynamic studies defined the voiding dysfunction as detrusor areflexia with a positive bethanechol test. This case reminds us of the necessity of obtaining a test for venereal disease to rule out neurosyphilis in patients with idiopathic voiding dysfunction.     

To what extent does IQ 'explain' socio-economic variations in function?

Background  

The aims of this study were to examine the extent to which higher intellectual abilities protect higher socio-economic groups from functional decline and to examine whether the contribution of intellectual abilities is independent of childhood deprivation and low birth weight and other socio-economic and developmental factors in early life.     

Children's frequency of consumption of foods high in fat and sodium

We administered a food frequency instrument to third-fifth grade students (n = 943) in four Texas schools. Comparison of foods reported on the food frequency questionnaire and on 24-hour dietary recalls (n = 7) produced a percent agreement of 83.3. The most frequent 25 foods accounted for 64.0% of food choices across all meals, 93.5% of breakfast choices, 76.4% of lunch choices, 70.5% of supper choices, and 76.0% of snack choices. Breads, milk, hamburger or steak, soda pop, tomato sauce or tomatoes, and cheese were the most frequently consumed foods. Fruits and juices accounted for 6.1% of total selections for boys and 6.6% for girls, while vegetables accounted for 15.7% of total selections for boys and 16.2% for girls. Fruit was more likely to be consumed for snacks than for meals, and vegetables were consumed in about the same frequency at lunch and supper and for snacks. We analyzed the total fat, saturated fat, and sodium content of the most frequently consumed foods. Seventeen of the top 25 foods for the total day and 13-16 for each meal or snack exceeded by at least 50% the recommended levels for fat, saturated fat, or sodium. The pattern of consumption was one of frequent consumption of a relatively small number of foods, many of which are high in fat or sodium.     

Discordant repeat size and phenotype in Kennedy syndrome

Previous reports in the literature have described correlation of increasing repeat length with severity of the phenotype, in Kennedy syndrome. We describe male siblings with different repeat lengths, with lack of expression of the phenotype in the sibling with the longer repeat length. The phenotype was identical to motor neurone disease. There is variability of expression in Kennedy syndrome and repeat length even in siblings cannot be taken as a conclusive indicator of severity. CAG repeat length cannot be used to predict the natural history of Kennedy disease. The diagnosis of Kennedy syndrome should be considered in male patients presenting with atypical motor neurone disease.     

INTERFERONS IN ONCOLOGY

SUMMARY The interferons are natural glycoproteins secreted in response to various stimuli, including viral infection. They have antiviral, antiproliferative and immunomodulatory effects on different target cell populations. Since recombinant human interferons have become available, they have been tested in a wide range of malignancies. They are well established in the treatment of hairy cell leukaemia, chronic myelogenous leukaemia and multiple myeloma. Although they have documented activity against lymphoma, melanoma, renal cell cancer and carcinoid tumours, their role in the treatment of these tumours is less clear. In the common solid tumours, such as lung cancer and colorectal cancer, the use of interferons remains experimental. Here we will summarise their practice applications in oncology, using randomised studies where available to establish their place in multi-modality treatment. We will not discuss their use as antiviral or immunomodulating agents in viral and autoimmune diseases, multiple sclerosis or after organ transplantation.