Pneumothorax in women and thoracic endometriosis

Thoracic endometriosis has been considered a rare clinical condition but it is probably underestimated in the literature. Various clinical symptoms may occur but the most frequent are catamenial pneumothoraces. Four main clinical conditions may reveal thoracic endometriosis: catamenial pneumothorax, catamenial haemothorax, catamenial haemoptysis and endometrial nodules in the lung. Catamenial pneumothoraces are the most frequent manifestation, characterized, in the majority of the cases, by right side localization and diaphragmatic abnormalities (perforations and/or nodules). The resection of suspected areas of visceral or parietal pleural endometriosis, as well as partial resection of the diaphragm in the case of nodules and/or perforations, allows the histological diagnosis of endometriosis. Because of the high recurrence rate, treatment of catamenial pneumothoraces should combine surgery and hormonal therapy.     

Molecular characterisation of Giardia intestinalis assemblages from human isolates at a tertiary care centre of India

Purpose: The aim of the study was to determine the genetic heterogeneity of Giardia intestinalis isolates detected in stool samples of the study population using polymerase chain reaction assay and restriction fragment length polymorphism. We also tried to correlate the association/differences between the clinical symptomatology and infection by different assemblages (genotypes) of G. intestinalis. Materials and Methods: This cross-sectional study was conducted from April 2008 to June 2010. A total of 40 adults (n = 40) and 42 children (n = 42) below the age of 12 years with the clinical suspicion of giardiasis and with the onset of one or more of the following five symptoms, i.e., loose stool, nausea, weight loss, fatigue and foul smelling faeces and confirmed laboratory diagnosis of giardiasis at least once during the current episode of diarrhoea were included in this study. Results: Of the 82 patients (males 66) enrolled in the study, 70 (85%) presented with diarrhoea (56 males) and 12 (15%) without diarrhoea (10 males). Out of 70 diarrheic patients, 61 (87%) had chronic diarrhoea, 8 (11.5%) had acute diarrhoea and 1 (1.5%) had persistent diarrhoea. Of the total patients, 63 (77%) were clinically assessed and were apparently immunocompetent, whereas, 19 (23%) immunocompromised patients had different underlying conditions besides giardiasis. Genotyping identified all 82 (100%) isolates as assemblage B. Conclusion: We found that assemblage B of G. intestinalis presents with all kinds of clinical features ranging from asymptomatic carriage to acute, persistent or chronic diarrhoea.     

DNA sequence analysis of the triose phosphate isomerase gene from isolates of Giardia lamblia

目的：为了探讨来源于中国和其它国家不同地理位置贾第虫分离株之间的遗传学关系。方法：从贾第虫滋养体和包囊提取总DNA。对磷酸丙糖异构酶基因进行PCR扩增。PCR产物经限制性内切酶消化、序列测定及分析。对所得DNA序列数据用DNAstar软件处理并与登录基因库虫株的序列比较。结果：在来自我国（C1、C2、CH2、CH3）,柬埔寨（CAM）、澳大利亚（A1、A2）和美国（BP、CDC）的9株蓝氏贾第虫中,A1、A2和CAM属于第1型（WB）;CH2和CH3属于第2型（JH）;C1、C2、BP和CDC属于第3型（GS）。结论：贾第虫分离株基因型的确定可分为本虫分子系统进货和分子流行病学研究提供重要资料。     

Toxicity of flavoglaucin from Aspergillus chevalieri in rabbits

Female rabbits were injected intraperitoneally (i.p.) with purified flavoglaucin from Aspergillus chevalieri. After 2 h the rabbits were bled and the livers removed for enzyme assays. No changes were found for plasma lactate dehydrogenase (LDH) and its isozymes or liver transketolase (TK) activities. A small but not statistically significant increase was found in plasma glutamate pyruvate transaminase activity. A highly significant increase in plasma glutamic oxaloacetate transaminase activity was observed along with an increase in liver LDH which was, however, not quite significant. The liver also showed some histological evidence of hepatic damage.     

基于磷酸丙糖异构酶基因序列的蓝氏贾第鞭毛虫分子系统发育的研究

[目的 ]探讨蓝氏贾第鞭毛虫种内系统发育及遗传多样性。 [方法 ]对不同来源虫株的磷酸丙糖异构酶(tim)基因进行 PCR扩增、序列测定后 ,用简约法和 NJ法构建分子系统树进行系统学分析。 [结果 ]在所测序列中共有 12 4个位点存在变异 (2 3% ) ,且大多数为发生在第三密码子的同义突变 ,两种构树方法所得两树的分枝结构相似 ,均将受试的 16株蓝氏贾第鞭毛虫分为明显的两组。 [结论 ]tim基因可作为研究蓝氏贾第鞭毛虫群体遗传结构一个有效的遗传标记     

Guidelines for the management of painful endometriosis

Objectives

To establish guidelines for the medical and surgical management of painful endometriosis.

Material and Methods

An exhaustive review on Medline and Cochrane Database between 1980 and 2006 was performed.

Results

GnRH agonists, progestins, continuous monophasic oral contraceptives and danazol have a suppressive effect on dysmenorrhoea, nonmenstrual pain and dyspareunia (grade A). Surgical treatment is effective in painful endometriosis (grade B). Complete surgical excision of deep endometriotic lesions with conservation of uterus and ovaries has a limited term efficacy on pain relief (grade C). A multidisciplinary approach is recommended (grade C). The use of the psychotherapy improves the management of chronic pain (grade A). There is a lack of information concerning the therapeutic strategy able to prevent recurrences. Whether endometriosis recurrences occur, medical treatment should be the first line approach (expert opinion). A hysterectomy with salpingo-oophorectomy and complete excision of the lesions is efficient in women with pain recurrence who no longer desire pregnancy (grade C).

Conclusion

Medical and surgical treatments have a limited term efficacy on painful endometriosis (grade A). The benefit/risk relationship, depending on secondary effect therapy, should be assessed on a case to case basis.     

Endometriosis anatomoclinical entities

The aim of this literature review is to precise definition, anatomoclinical entities and natural history of endometriosis to allow clinical guideline establishment. DEFINITION: Endometriosis is defined as the presence of endometrial tissue (glands and stroma) outside the uterus. This histologic definition does not implicate symptoms. Macroscopic lesions supposed to be endometriosis are not always confirmed by histology. Histology is recommended to confirm endometriosis. Negative histology does not exclude endometriosis. ANATOMOCLINICAL ENTITIES: Three endometriosis entities are described: peritoneal endometriosis, ovarian endometrial cyst, and deeply infiltrating endometriosis. There is no evidence to establish a different pathogenesis of theses entities. ENDOMETRIOSIS NATURAL HISTORY: It is not well known. It may progress or regress with or without treatment. There is no evidence of treatment in case of asymptomatic endometriosis. There is an association between endometriosis and ovarian cancer. The risk of endometriosis malignant transformation is still a subject of controversy. There is no evidence for a specific oncologic follow-up of woman having endometriosis.