Postmenopausal HRT is not independent risk factor for dural sinus thrombosis

While a dural sinus thrombosis (DST), is a well-known consequence of the use of oral contraceptives, the role of hormone replacement therapy (HRT) in DST was not previously evaluated. We report two postmenopausal women, presenting with DST under HRT. Antiphospholipid antibodies in one case and borderline protein S deficiency in another were diagnosed. Only five cases of DST under HRT were previously reported and in two of them additional prothrombotic risk factors were found. According to these and previous cases, HRT is not an independent risk factor for DST.     

An alternative approach to classifying and measuring residential education and group care and treatment programs: Internal totality and community orientation as separate components

Internal totality and community orientation are two pivotal components, difficult to measure, in the literature on residential education (including both residential schools for the elite and group or congregate care and education programs for marginal youth). We propose a two-dimensional model based on historical research and contemporary study to define and differentiate these concepts. Internal totality can be measured through the links and balance between the formal curriculum, extra curriculum, and out of school (nonformal) activities; community orientation through links between the residential and ideological community, the local community, and the wider community. Implications for practice, policy, and further research are suggested.Oranim is the School of Education of the Kibbutz Movement, affiliated with the University of Haifa.     

Evaluation of an accelerated protocol for detection of extended-spectrum beta-lactamase-producing gram-negative bacilli from positive blood cultures

We evaluated a protocol for the accelerated detection of extended-spectrum beta-lactamases (ESBLs) in gram-negative bloodstream pathogens. Two hundred eighty-three blood culture bottles were subjected to direct ESBL testing by inoculating samples directly from blood culture bottles onto agar plates containing cefotaxime and ceftazidime disks, with and without clavulanate. Standard ESBL testing in accordance with the NCCLS guidelines after subculturing on agar plates was performed in parallel. Results of the direct ESBL testing were reported 2.3 days sooner and were comparable to those of the standard NCCLS method with sensitivity, specificity, and positive and negative predictive values of 100, 98, 94, and 100%, respectively.     

Sequential respiratory syncytial virus cytomegalovirus pneumonia following bone marrow transplantation

A 6-month-old child with familial hemophagocytic lymphohistiocytosis (FHL) experienced early sequential pneumonia due to respiratory syncytial virus (RSV) and cytomegalovirus (CMV) following bone marrow transplantation (BMT). The patient was deficient in natural killer (NK) cell activity (as found frequently in patients with FHL), and this risk factor may have played a major role in the concomitant infection by the two viral pathogens. Rapid diagnostic methods for both viruses are essential and early specific treatment may serve to ameliorate RSV- and CMV-induced lung injury in these life-threatening infections. © 1995 Wiley-Liss, Inc.     

Leishmaniasis in the Jordan Valley: differential attraction of dispersing and breeding site populations of Phlebotomus papatasi (Diptera: Psychodidae) to manure and water

The response of Phlebotomus papatasi Scopoli to traps baited with manure or water was used to compare the behavior of flies near rodent burrows (breeding sites) and dispersing flies in fallow fields. The degree of response in each biotype was defined for each bait by the difference between catches in baited and unbaited traps. Manure bait attracted twice as many flies near the burrows and 2.7 times more flies in the field compared with unbaited traps. In both locations, the manure bait increased the capture of males and nongravid females, whereas gravid females were attracted only near burrows and not in the fields. The catch in the fields with water bait was similar to the unbaited control. However, near burrows, water bait captured more males and gravid females, but not nongravid females. These results demonstrate specific behavioral patterns of the dispersing P. papatasi population.     

Myophosphorylase deficiency: the course of an unusual congenital myopathy

A 59-year-old man had proximal weakness and wasting that started in early childhood. EMG was "myopathic," serum CK activity was increased, and muscle biopsy showed accumulations of glycogen. Biochemical studies revealed elevated glycogen concentration and absence of myophosphorylase activity. This unusual presentation of a long-standing, painless, and quite static weakness due to myophosphorylase deficiency represents another example of clinical heterogeneity.     

Inhibition of gastrointestinal motility by MPTP via adrenergic and dopaminergic mechanisms

The neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) was injected intraperitoneally in mice and caused an acute inhibition (of over 60%) of gastrointestinal motility, which was measured by the transit of charcoal. This inhibition was not related to conversion of MPTP to MPP⁺. Administration of the -adrenergic blocker propranolol significantly reduced, but did not completely block, the effect of MPTP. The dopaminergic blocker haloperidol also partly reversed the effects of MPTP. When these blockers were administered together, the action of MPTP was fully blocked. The results indicate that the toxin acted by releasing catecholamines (presumably norepinephrine and dopamine), thereby inhibiting motility.Supported by a grant from the Joint Research Fund of the Hebrew University and Hadassah.