Sex hormone binding globulin and free levonorgestrel index in the first week after insertion of Norplant implants

The annual pilgrimage to Makkah (Mecca), Hajj, is a very stressful endeavour and requires strenuous physical effort, especially for the diabetic, the elderly and persons with other chronic illnesses. To identify the complications and to assess the needs of the Omani diabetics during Hajj (DOH), a special diabetes clinic was established in the camping site of Omani pilgrims (Hajjees) in Mina, where all Omani Hajjees convene for three days. The socio-demographic characteristics, the diabetes profile and the knowledge about complications of diabetes of all DOH were ascertained; their random blood sugar (RBS) was tested. Of 10,800 Omani who performed the Hajj in 1996, the 169 Hajjees with diabetes mellitus (prevalence rate 16 per 1000) included four per cent insulin dependent (IDDM), seven per cent on dietary control, and 89% on oral hypoglycaemic agents. Almost all DOH (98%) were medically examined before their departure for Hajj. All Hajjees with IDDM and 96% on oral hypoglycaemic agents brought their medicines with them. During the Hajj period, 2.4% of DOH had RBS < 75 mg/dl, 14% 75-110 mg/dl, and 49% were hyperglycaemic (RBS > 200 mg/dL). About half of the DOH (48%) knew the clinical presentation of hyperglycaemia, a fourth (24%) about symptoms of hypoglycaemia. Only 9.5% were trained to test themselves for blood sugar. The median age of DOH was 54 years (inter-quartile range 50-62). Some 7.5% females and 4.9% of males were obese (body mass index > 30). Forty seven (28%) of the DOH had other coronary heart diseases, hypertension or both. DOH moved between Holy places (four journeys; 5-15 km long) on foot (40%), by car or bus (31%), or both (29%). All DOH except one were not wearing protective shoes, 70% did not have identification wrist bands that show their diabetic status and regimen for treatment. Four per cent lost their way during Hajj, four per cent suffered from heat exhaustion, three per cent had cut wounds, 1.2% had pneumonia, and two per cent went into coma. There is a need for a special health education programme and for special services for the diabetics during Hajj. Hajjees should learn about symptoms and signs of hypoglycaemia, were protective shoes and identifying wrist bands. Specialised services for the diabetics would alleviate a lot of the stress during Hajj among the diabetics.     

p53 expression is of independent predictive value in lymph node-negative breast carcinoma

OBJECTIVES: To compare the diagnostic accuracy of the most widely available tests for diagnosis of Helicobacter pylori infection after antibiotic treatment. METHODS: A total of 59 H. pylori-positive, duodenal ulcer patients (mean age, 40.7 +/- 11.7 yr; 40 male and 19 female) were treated for 2 wk with either amoxicillin-metronidazole (n = 36) or omeprazole-amoxicillin-tinidazole (n = 23), and after 4 wk, were tested for H. pylori infection by [14C]urea breath test (UBT), serum IgG antibody level, and multiple antral biopsies for rapid urease testing, histology, Warthin-Starry stain, and polymerase chain reaction to detect H. pylori DNA. Infection status was established by a concordance of test results. RESULTS: H. pylori was eradicated in 47 patients (80%). UBT and rapid urease testing had the best sensitivity and specificity, although not statistically different to Warthin-Starry stain and polymerase chain reaction. Serology and histology had little diagnostic value in this setting due to high proportion of false-positive results. CONCLUSIONS: Noninvasive UBT is as accurate in predicting H. pylori status after antibiotic treatment as rapid urease testing and Warthin-Starry stain. Especially for duodenal ulcer patients, UBT could be considered the gold standard to confirm eradication of H. pylori.     

Propagation of intense microwave pulses in air and in a waveguide

The state of research on intense electromagnetic pulse propagation in air and in waveguides is reviewed. Some results obtained from recent investigations of the propagation of intense electromagnetic pulses in the atmosphere and in an air-filled waveguide when the field strength is above the threshold for air breakdown are presented. It is shown how the air breakdown affects the shape of the pulse. In addition, the accuracy of the calculational models is discussed, comparing calculations with experimental data     

A Framework for Spectral Artifact Corrections in X-Ray CT

The spectral artifact problem in X-ray computed tomography (CI) is well known. Many techniques have been suggested to correct for this problem, including linearization methods, iterative methods, and dual spectrum methods.     

Reactive airways dysfunction syndrome: two case reports

The antimicrobial susceptibilities of 1058 Staphylococcus aureus and 2,163 coagulase-negative staphylococci (CNS) isolates obtained from clinical specimen between 1988 and 1995, were determined against 13 anti-staphylococcal antibiotics. During the study period the resistance of Staphylococcus aureus to ciprofloxacin, ceftazidime, and norfloxacin increased significantly by 7%, 4%, and 6%, respectively (p < or = 0.001). By comparison, the antibiotic resistance of CNS to ceftazidime, oxacillin, norfloxacin, ciprofloxacin, fusidic acid, and cefoxitin increased by 20%, 17%, 15%, 14%, 12% and 10%, respectively (p < or = 0.001). Invasive and noninvasive S. aureus had similar antibiotic resistance, whereas CNS invasive isolates were more resistant than noninvasive isolates to every antibiotics, except vancomycin and fusidic acid. These differences were significant (p < 0.001) for oxacillin, cefoxitin, and clindamycin. Our observations confirm that staphylococci and particularly CNS isolates show an important rate of increased resistance to the standard antimicrobials used for therapy, and that the rate of emergence of resistance differ considerably between coagulase-positive and coagulase-negative staphylococci.     

Hydrocele and testicular tumors in infancy

A long-term schistosomiasis control programme was initiated on Pemba Island, Tanzania in 1986 with the aim of eliminating morbidity due to Schistosoma haematobium infection. The programme used haematuria as a community indicator of morbidity for surveillance and for identifying individuals for selective population chemotherapy. Analysis of the first 3 evaluation studies showed that the prevalence of microhaematuria was linearly related to the prevalence of infection, and that visually detectable haematuria was a marker of the intensity of infection and risk of morbidity in a community. These relationships remained consistent during repeated community-based chemotherapy, suggesting that measures of haematuria may be useful tools for surveillance.     

Formation of spin trap adducts during the decomposition of peroxynitrite

To investigate Ca2+ handling in compensated hypertrophied cardiomyocytes, we measured Ca2+ transients and contraction of hypertrophied rat left ventricular myocytes induced by aortic constriction (AC). The fluorescence ratio (I405/I480) after indo-1/AM loading and circumferential length were simultaneously measured in isolated myocytes. The amplitude of Ca2+ transients (Ca-Amp) was higher in rats with AC than in sham-operated rats (Sham) (0.25 +/- 0.08 vs 0.17 +/- 0.05). There was a positive correlation between Ca-Amp and fractional shortening (FS) in both AC and Sham rats, whereas the ratio of FS/Ca-Amp was smaller in AC rats. These observations suggest that compensated hypertrophied cardiomyocytes exhibit an adaptive increase in Ca-Amp, associated with reduced myofilament responsiveness to an increase in Ca2+. Isoproterenol and forskolin increased Ca-Amp and FS, and decreased time to 50% decline of Ca2+ transients. Although myocytes from AC rats exhibited reduced responsiveness to isoproterenol, responses to forskolin did not differ between the 2 groups. The reduced beta-adrenergic response in Ca2+ handling was probably due to altered beta-adrenoceptor numbers, G-protein function and/or their coupling process.     

Resistant Mycobacterium tuberculosis: its relation with coinfection with human immunodeficiency virus. 5-year study

BACKGROUND: To analyze the situation of resistance to antituberculous drugs among strains of Mycobacterium tuberculosis recovered in our environment during a five-year period and its relationship with HIV co-infection. PATIENTS AND METHODS: Review of the Mycobacterium tuberculosis strains recovered from patients aged older than 14 years in Hospital Joan March from 1992 to 1996 of which a susceptibility testing study by means of the multiple proportions method was available. The initial or secondary resistance was considered according to the previous antituberculosis treatment antecedent. RESULTS: The susceptibility testing was available from 179 cases (136 males and 43 females) out of a total of 214. The overall resistance rate to any of the tested drugs was 10.1% (18 cases) with a 4% (6 cases) of initial and 38.7% (12 cases) secondary resistances. Co-infection with HIV showed not to be a risk factor for the development of resistance. No significant increase was observed analyzing the temporal trend through the five years studied. CONCLUSIONS: At present, the situation of resistance to Mycobacterium tuberculosis seems not to be alarming in our environment. Co-infection with HIV has not been shown to be associated with an increase in resistance rates.     

Modified plasma and abomasal disposition of albendazole in nematode-infected sheep

The influence of gastrointestinal nematode infection on the kinetics of albendazole (ABZ) and its metabolites, albendazole sulphoxide (ABZSO) and sulphone (ABZSO2) in plasma and abomasal fluid was investigated in sheep. A micronised suspension of ABZ was administered intraruminally at 7.5 mg kg-1 to the following groups of sheep: (a) non-parasitised (control); (b) artificially infected with Haemonchus contortus; (c) naturally infected with Haemonchus contortus and other species of gastrointestinal nematodes. Plasma and abomasal fluid samples were obtained serially over 72 h post-treatment and they were analysed by HPLC for ABZ and its metabolites. The ABZ parent drug was not detected in plasma at any time post-treatment, however the metabolites ABZSO and ABZSO2 were recovered in the bloodstream. The active metabolite ABZSO was recovered in plasma between 0.5 and 48 (uninfected), 60 (H. contortus infected) or 72 h (naturally infected sheep) post-administration. The area under the plasma concentration vs time curve (AUC) values for ABZSO were higher in both artificially infected (64.0 micrograms h ml-1) and naturally infected (79.3 micrograms h ml-1) sheep as compared with non-infected animals (41.8 micrograms h ml-1). Peak plasma concentrations for ABZSO and ABZSO2 were higher in both artificially and naturally infected sheep than in non-parasitised animals. No changes in the half-lives and mean residence times for these metabolites were observed in infected sheep. ABZ and its metabolites were found in the abomasum between 0.5 and 48 (infected animals) or 72 h (uninfected) post-treatment. The availability (total AUCs) of ABZ and its metabolites in abomasal fluid were lower in H. contortus infected sheep than in the uninfected control animals. The increased abomasal pH induced by the presence of the H. contortus infection may reduce the plasma/abomasum pH gradient, which results in a decreased ionic-trapping of ABZ and its metabolites in the abomasum. Such a phenomenon correlates with: (a) the higher total AUC values obtained for ABZ metabolites in the bloodstream of the infected compared to the control sheep, (b) the lower concentration profiles of the ABZ parent drug and its metabolites found in the abomasal fluid of the infected animals.