A case of hyperreactio luteinalis in an otherwise normal pregnancy is reported. Ascites was present, but no peritoneal implants or adenopathy were seen. Findings that would have suggested the correct diagnosis are the symmetrical and bilateral pattern of the mass, as well as the rather uniform size of the loculi, which were 1 to 3 cm in diameter.

Adult↗

PubMedDate not supplied

[Jugular vein thrombosis: report of six cases].

Venous thrombosis in superior extremities and neck represent less than 5% of the total of venous thrombosis. Internal jugular vein thrombosis is associated with intravenous drug abuse, long term venous catheterization, local infection or spontaneous occlusion. The clinical findings are cervical swelling, progressive inflammatory signs overlying sternomastoid muscle, and an important functional limitation. Diagnosis is confirmed by cervical ultrasounds and contrast-enhanced computer tomography. Usual treatment involves anticoagulation and antibiotics, surgery is not frequently needed. We described the management and outcome of six cases of internal jugular vein thrombosis.

Adult↗

PubMedDate not supplied

Gastrodiscus aegyptiacus in horses in Guyana.

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Animals↗

PubMedDate not supplied

Relationship between sex differences in onset of schizophrenia and puberty.

Some neurodevelopmental hypotheses of schizophrenia have postulated that sex differences in onset of illness could be explained by sexual dimorphism in onset of puberty, suggesting that early maturation accounts for the later onset of illness in women. The objective of this study was to analyse the relationship between age of menarche and age of onset of schizophrenia in a sample of Chilean patients. The medical records of 105 schizophrenic women diagnosed according to DSM-III-R criteria were studied. In all cases age of onset (first psychotic symptoms) and age of menarche were obtained. Pearson's correlation and student's t-test were used to analyse the data. The mean age of menarche in the sample of female patients (12. 98 years, S.D.=1.49) was significantly different from that of the general population of Santiago, Chile (12.53 years, S.D.=1.32) (t=2. 38; P<0.05). The mean age of onset of schizophrenia in female patients (19.92 years, S.D.=5.13) was significantly earlier in the Chilean sample than that reported in European and North American samples (P<0.05). No differences were observed when comparing the mean age at menarche. The subtypes with the earliest onset presented the earliest age of menarche and the subtypes with the latest onsets showed the latest ages at menarche. However, no correlation was observed between the age at onset of illness and the age at menarche, both in the total sample and in the analysis by subtype. The results of this study do not support a correlation between puberty and age of onset of illness.

Adult↗

PubMedDate not supplied

An outbreak of plague including cases with probable pneumonic infection, Ecuador, 1998.

During February and March of 1998, 12 sudden deaths were reported among residents of a high-Andean community in Ecuador. All 12 fatalities were members of the same extended family and some had apparent exposure to sick guinea-pigs. Following an initial investigation by public health officials, an additional death was reported in a nearby community in April, also associated with exposure to sick guinea-pigs. Blood samples from humans, dogs, and a rodent were tested for antibody to the F1 antigen of Yersinia pestis by passive haemagglutination assay. Tissue from rodents was subjected to direct fluorescent antibody staining using fluorescein-labelled monoclonal antibody to Y. pestis F1 antigen. Formalin-fixed specimens from the 2 autopsies were evaluated using a 2-step alkaline phosphatase immunoassay with a monoclonal antibody to Y. pestis F1 antigen, and tissues that had not been embedded in paraffin were tested for the presence of DNA encoding the F1 structural antigen by polymerase chain reaction. Serological evaluation of close contacts of the fatalities revealed positive titres to F1 antigen of Y. pestis, the aetiological agent of plague, in 3 contacts from the first community and 1 from the second. Immunohistochemical staining of tissues collected from 2 of the fatalities provided evidence that both had pneumonic plague. Five of 14 dogs found in the communities were seropositive for plague antibody, providing evidence of a recent epizootic plague in the area.

Adolescent↗

PubMedDate not supplied

Validity, reliability and ease of use in the field of five rapid tests for the diagnosis of Plasmodium falciparum malaria in Uganda.

A study was conducted to measure the overall performance of several rapid diagnostic tests for Plasmodium falciparum infection, in order to select the most appropriate test to be used in the field. A total of 742 patients attending the out-patient department of Mbarara Hospital with a clinical suspicion of malaria were included in the study. For each patient, a thick/thin film and 5 rapid tests based on the detection of histidine-rich protein II (HRP-II) (Paracheck Pf dipstick and device, ParaHIT f, Malaria Rapid and BIO P.F.) were performed. Outcomes were validity, inter-reader reliability and 'ease of use in the field', measured by both the general characteristics of the test and by the opinion of the readers. About half (57%) of the patients were positive for P. falciparum. The Paracheck Pf (dipstick and device) was considered as the most appropriate for the use in the field, being sensitive (97%), moderately specific (88%), reliable (kappa coefficient = 0.97), easy to use and cheap (about US$ 0.5/test). The ParaHIT f represented a good alternative.

Adolescent↗

PubMedDate not supplied

[Fast method of labelling leukocytes with 99mTc HM PAO].

OBJECTIVE: To modify the method of labelling leukocytes with 99mTc HM-PAO by centrifuging 15 minutes at low gravity (g) instead of sedimentation at a variable time (30-90 minutes) to obtain leukocytic rich plasma (LRP). METHODS: The g number recovering the greatest number of leukocytes was determined. The cellular composition of LRP obtained by centrifugation and sedimentation was analyzed. Lastly, labelling results in two groups of patients (p) were compared: one group of 118 p using the traditional sedimentation method (SM) and another of 124 p using the proposed centrifugation alternative (CM). RESULTS: Centrifugation at 5xg produced the greatest recovery of leukocytes (93.1 5.1%). No significant difference was observed in leukocyte recovery in LRP obtained either by centrifugation or by sedimentation. However, red blood cell contamination was greater in centrifugation (12.8 4.9 x 108) than in sedimentation (7.7 3.5 x 108) (p < 0.0001). The comparison of the SM and the CM gave the following results:The number of leukocytes recovered in both methods was similar (73.9 15.1% vs 76.5 12.7%) with approximately the same platelet contamination (8.0 6.2 vs 8.4 6.5%). The number of red blood cell contaminants per leukocyte was 3.0 1.0 for the MS and 5.1 2.6 for the MC (p < 0.001). Labelling yield (LY) was somewhat higher for the CM (57.8 11.9%) than for the SM (50.8 12.6%) as a result of greater red blood cell contamination and superior radiochemical purity of the 99mTc HM-PAO used in the labelling by CM (90,9 5,9%) with regard to the SM (87.9 9.5%). No difference was observed in the scintigraphic images obtained with either of the methods, given the scarce uptake of the radiopharmaceutical by the red blood cells (3-7%) in comparison with the leukocyte uptake (70-90%). CONCLUSION: The proposed MC considerably reduces the labelling time of leukocytes with 99mTc HM-PAO without affecting the quality of scintigraphic images and represents an important labelling alternative of great interest to the Radiopharmacy Units of Nuclear Medicine Services.

Blood Cell Count↗

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The relationship between crime and drugs: what we have learned in recent decades.

The focus of this article is criminal drug users and their changing behavior. Two important considerations are addressed within this topic. First, an overview of drug use is given, including a brief historical perspective on its treatment as well as its implications on crime. The article also discusses why substance abuse treatment in the criminal population is necessary and on what scale. Specifically, the etiology of the relationship between crime, violence and substance abuse is explored. It then delves into what has worked and what hasn't. Finally, recommendations are made regarding where the research indicates we should go from here.

Adolescent↗

PubMedDate not supplied

Evolution of the mojavensis cluster of cactophilic Drosophila with descriptions of two new species.

The mojavensis cluster of the repleta species group of Drosophila (Drosophilidae: Diptera) consists of three species. One is newly described as D. navojoa. A second species, described here as D. arizonae, replaces D. arizonensis, which has become a junior subjective synonym for D. mojavensis, the third species in the cluster. A phylogeny of the three species is presented, based on chromosomal inversions, morphology, and the ability to produce hybrids. Breakage points are assigned for all inversions, and male genitalia are figured; 186 crosses were made from 225 possible combinations among 15 geographic strains from the southwestern United States, Mexico, and Guatemala. It is confirmed that D. mojavensis and D. arizonae are very closely related and shown that D. navojoa is more distantly related in regard to all criteria. This relationship is supported by the geographical positions of the ancestral gene sequences in each species, which show a sequential northwest movement (D. navojoa----D. arizonae----D. mojavensis) from southern Mexico to southern California and northern Arizona. The relationship is also supported by the fact that D. navojoa breeds in Opuntia cactus, an ancestral behavior, whereas the other two species breed chiefly in Stenocereus cacti, a derived behavior. The possible role of this host plant shift in speciation is discussed.

Animals↗

PubMedDate not supplied

MR of Toxoplasma encephalitis: signal characteristics on T2-weighted images and pathologic correlation.

PURPOSE: Our goal was to determine if there are any T2-weighted MR signal characteristics of Toxoplasma encephalitis that might be useful in diagnosis and/or in gauging the effectiveness of medical therapy. METHOD: We retrospectively analyzed the MR, CT, thallium-201 SPECT brain scans, and medical records of 27 patients with medically proven (26) and biopsy proven (1) Toxoplasma encephalitis, supplemented by autopsy findings in 4 additional patients, 2 of whom had postmortem MR correlation. The neuropathologic literature was also reviewed. RESULTS: Among the 27 patients, we discovered three distinct imaging patterns. Ten (37%) patients had predominantly T2-weighted hyperintense lesions and had been on medical therapy an average of 3 days (excluding one outlier). Ten (37%) patients had T2-weighted isointense lesions and had received medical therapy an average of 61 days. Seven (26%) patients had lesions with mixed signal on T2-weighted images and had been on treatment an average of 6 days. Analysis of autopsy material from the four additional patients revealed the presence of organizing abscesses in three and necrotizing encephalitis in one, while the patient who had a brain biopsy demonstrated both types of pathologic lesions. In both cases having postmortem MRI, organizing abscesses appeared isointense to hypointense on T2-weighted images. CONCLUSION: There is a definite variation in the appearance of lesions of Toxoplasma encephalitis on T2-weighted images that precludes a definitive diagnosis based on signal characteristics alone. Pathologically, our data suggest that T2-weighted hyperintensity correlates with necrotizing encephalitis and T2-weighted isointensity with organizing abscesses. Furthermore, in patients on medical therapy the T2-weighted MR appearance may be a transition from hyperintensity to isointensity as a function of a positive response to antibiotic treatment, indicating that the signal change might be used to gauge the effectiveness of medical therapy.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Dentate nuclei involvement in AIDS patients with CNS cryptococcosis: imaging findings with pathologic correlation.

PURPOSE: Our goal was to describe the involvement of the dentate nuclei in AIDS patients with CNS cryptococcosis since this finding has not been emphasized in previous radiological literature. METHOD: Plain and contrast-enhanced CT of the brain (10 and 10), MR studies (1 premortem and 1 postmortem), and autopsy findings in 11 AIDS patients with CNS cryptococcosis were reviewed. The imaging studies and pathological specimens were analyzed for signs of meningitis, presence of dilated Virchow-Robin spaces, gelatinous pseudocysts, cryptococcoma, ventriculomegaly, choroid plexus, and ependymal lesions. RESULTS: Five of 11 patients were found at autopsy to have macroscopically visible "cystic" lesions in the dentate nuclei that were not detected on CT (10 patients), but were seen on premortem MR (1 patient). Macroscopic supratentorial (basal ganglia, thalamic, midbrain) lesions were detected by CT in 5 of 11 patients and by MR in 2 of 2 patients. Enhancement of the leptomeninges was seen in only 1 patient by CT despite pathological evidence of cryptococcal meningitis in all 11 patients. Dilated Virchow-Robin spaces were seen in all 11 pathologic specimens and in the 2 MR studies but not on CT. Communicating hydrocephalus was detected by CT in two patients. CONCLUSION: CT scans of the brain underestimate infratentorial parenchymal cryptococcal disease. MR is a more sensitive procedure to evaluate cerebellar and brainstem cryptococcosis, including the dentate nuclei, which in our autopsy series was not an uncommon site to be infected with cryptococcal gelatinous pseudocysts.

AIDS-Related Opportunistic Infections↗