Animals can assign novel odours to a known category.

The ability to identify a novel stimulus as a member of a known category allows an organism to respond appropriately towards it. Categorisation is thus a fundamental component of cognition and an essential tool for processing and responding to unknown stimuli. Therefore, one might expect to observe it throughout the animal kingdom and across sensory domains.

Tuberculosis culture testing at a tertiary care hospital: options for improved management and use for treatment decisions.

Setting: Chris Hani Baragwanath Hospital, a tertiary care hospital in Johannesburg, South Africa.

Objectives: To determine the proportion of patients with positive Mycobacterium tuberculosis cultures and whether those who were positive were on treatment.

Design: Tuberculosis (TB) culture results were obtained from the laboratory for a 3-month period.

Tuberculosis at Chris Hani Baragwanath Hospital: an intervention to improve patient referrals to district clinics.

Setting: A study in 2001 described the process of managing tuberculosis (TB) at Chris Hani Baragwanath hospital, the numbers of patients diagnosed and poor outcomes of referring patients to clinics in the adjacent sub-districts. The present study describes and evaluates an intervention to address the problems.

Objectives: To describe the intervention process (education and referral of TB patients) and the subsequent results over a 2-year period from 2003 to 2005.

Membranous obstruction of the inferior vena cava and its causal relation to hepatocellular carcinoma.

Although rare in most countries, membranous obstruction of the inferior vena cava (MOIVC) occurs more frequently in Nepal, South Africa, Japan, India, China, and Korea. The occlusive lesion always occurs at approximately the level of the diaphragm. It commonly takes the form of a membrane, but may be a fibrotic occlusion of variable length.

Tuberculosis at Chris Hani Baragwanath Hospital: numbers of patients diagnosed and outcomes of referrals to district clinics.

Setting: Chris Hani Baragwanath Hospital, in Johannesburg. South Africa is experiencing a serious epidemic of tuberculosis (TB), with a measured rate of 500 cases per 100,000 population. Patients in public hospitals are referred for treatment to district clinics or to specific TB hospitals.

Sister Joseph's nodule in hepatocellular carcinoma.

We describe three black South African patients in whom hepatocellular carcinoma metastasized to the umbilicus. Sister Joseph's nodule has previously been reported in only two patients with this tumour. A number of routes for this spread are possible: malignant hepatocytes in the portal venous system may reach the umbilicus via a patent umbilical vein; the tumour may propagate directly along the ligamentum teres hepatis to the umbilicus; contiguous spread of the tumour to the umbilicus from anterior peritoneal tissue, either directly infiltrated by hepatocellular carcinoma or the site of metastatic nodules, may occur; embolization of malignant hepatocytes to the umbilicus might take place by way of its arterial blood supply; or hepatocellular carcinoma might reach the umbilicus as a result of retrograde lymphatic spread from para-aortic lymph nodes or from the anterior abdominal wall, to which the tumour has metastasized.

Osteoporosis and genetic influence: a three-generation study.

We have studied 27 triads of mother, daughter and grandmother for possible genetic influence on distal and proximal forearm bone density, measured by single photon absorptiometry. We found a significant correlation of bone density at the proximal forearm between the mothers and grandmothers (r = 0.499, P < 0.

Climacteric symptoms in healthy middle-aged women.

The incidence of climacteric symptoms was determined in 247 healthy premenopausal women in a community setting. These volunteers had been recruited to a longitudinal study of bone density. Of these subjects, 46 ceased to menstruate during the study, and in this subgroup symptoms were compared before and after cessation of menstruation.

Determinants of forearm bone density in premenopausal women: a study in one general practice.

Predictors of distal and proximal forearm bone density, measured by photon absorbtiometry, were investigated in 248 premenopausal women aged 39-56 years. Only one strong predictor of lower bone density was found--history of previous fracture at any site (P less than 0.001).

Gastric mucormycosis.

A case of gastric mucormycosis proven on culture and histologic examination and successfully treated with resectional surgery and Amphotericin B is described.

Relationships between happiness, behavioural status and dependency on others in elderly patients.

Feelings of dependency on others were measured, by different scales, in two different samples of elderly people: 33 acute in-patients and 25 attenders at a geriatric day hospital. Findings were similar in each location. Dependent attitudes increased with the duration of patients' previous in-patient experience, and correlated negatively with subjective well-being but not at all with behavioural status.

Pityriasis rotunda as a cutaneous marker of hepatocellular carcinoma: a comparison with its prevalence in other diseases.

In an attempt to substantiate the claim that pityriasis rotunda may be a useful cutaneous marker of hepatocellular carcinoma in South African Blacks, the prevalence of the rash in 63 unselected South African Blacks with this tumour was compared to that in 63 matched patients with active tuberculosis, 63 with other malignant tumours, and 63 with various forms of chronic benign hepatic disease. The prevalence of pityriasis rotunda in hepatocellular carcinoma was 15.9%, which was appreciably greater (P = 0.

Horner's syndrome and tuberculosis. A case report.

Horner's syndrome and recurrent laryngeal palsy are rare complications of cervical tuberculous lymphadenopathy. A case, which mimicked malignant disease, is reported.

Quantification of dietary intake in long-stay geriatric patients: do we need seven days observation?

Nutrient intake was assessed for 15 long-stay elderly patients by 7-d weighed inventory. Analysis revealed neither significant day-to-day nor weekday/weekend variations for any studied nutrient except fibre. It would appear that acceptable indications of customary intake in this population can be achieved by measurement over a shorter period than 7 d, such as 3 or 4 consecutive weekdays.

The first year of a geriatric-orthopaedic liaison service: an alternative to 'orthogeriatric' units?

The use of orthopaedic beds by large numbers of elderly patients with multiple pathology will increase and already exceeds the provision of orthopaedic-geriatric rehabilitation units. A cross-specialty multidisciplinary ward round improved the quality of care of orthopaedic patients without requiring expenditure on equipment, facilities or staff, and abolished the need to transfer patients to geriatric beds for rehabilitation, this being achieved on the orthopaedic unit. The liaison service provided excellent medical training in acute and rehabilitative aspects of geriatric medicine, enhanced the role of other disciplines in the care of the elderly orthopaedic patient and facilitated communication between departments.

Multiple liver abscesses caused by Yersinia enterocolitica. A case report.

Yersinia enterocolitica is an important cause of multiple liver abscesses in iron-overloaded or debilitated patients. The condition has a high mortality rate and causes diagnostic and therapeutic problems. The successful management of an iron-overloaded patient presenting with jaundice and chronic renal failure is described.

Anticonvulsant drugs and bone disease in the elderly.

Elderly psychiatric inpatients were studied to find the prevalence of osteomalacia in those taking anticonvulsant medication (n = 19) and a comparison group not taking these drugs (n = 37). Only one biopsy-proven case was discovered among the anticonvulsant group, and none in the comparison group. This was an unexpectedly low rate.

Confirming long-stay status.

This paper discusses an assessment procedure for the formal identification of patients requiring long-stay geriatric care. It was introduced immediately prior to the reorganization of geriatric in-patient care at St Pancras Hospital which saw the abolition of mixed wards of acute, rehabilitation, and long-stay patients and their replacement by six specialized wards, three of which are long-stay wards accommodating 51 patients. The formal assessment and referral for long-stay care is itself one outcome of deliberations made by a multidisciplinary panel formed a few months before the hospital reorganization to examine the kind of care and environment that might best enable the long-stay elderly to enjoy, within the limits of their disabilities, as dignified and worthwhile lives as possible.

Obstructive jaundice in the South African black population.

We report the causes of obstructive jaundice in 56 black South African patients. Chronic pancreatitis and malignant biliary obstruction occurred with equal frequency. These two conditions may be difficult to differentiate clinically and radiologically, and only operative pancreatic biopsy may be diagnostic.

Real-time measurement of serum C-reactive protein in the management of infection in the elderly.

The serum concentration of C-reactive protein (CRP), a nonspecific acute phase reactant which responds sensitively to bacterial infection, was measured by homogeneous enzyme immunoassay in all patients admitted to a general hospital geriatric unit. It was then monitored frequently in those in whom infection was suspected. Results were reported rapidly to the clinical team and particularly in the context of a patient population with complex multisystem pathology, often without pyrexia, leucocytosis or other classical signs of infection, they made a significant contribution to patient management.