Evaluation of three commercial agar preparations for the presumptive identification of significant urinary isolates.

Three commercially available pre-poured chromogenic preparations--chromogenic urinary tract infection (UTI) medium (chromogenic UTI, Oxoid), CHROMagar Orientation (Becton Dickinson) and CPS ID2 (bioMérieux)--are evaluated in comparison to routine urine microbiology using cysteine lactose electrolyte-deficient (CLED) medium and conventional methods of identification and susceptibility testing by Vitek 1 for the majority of isolates. Most isolates were Escherichia coli, and a chromogenic medium has been shown to be a reliable, rapid and more economic medium on which to presumptively identify these organisms due to the substrates the strain utilises in the plate and the chromogen subsequently produced. However, the opacity of chromogenic UTI made the medium difficult to inoculate and read, although the colours were clear and strong.

Clinical value of C-reactive protein measurements in HIV-positive patients.

The acute-phase protein C-reactive protein (CRP) is a sensitive marker of inflammation and tissue damage. We measured CRP in 109 HIV-1 antibody-positive patients admitted to hospital for investigation. In 67 patients with intercurrent infection (of whom 27 were afebrile at presentation) CRP levels were 2.

Increased vanilloid receptor VR1 innervation in vulvodynia.

Vulvodynia is characterised by painful burning sensation, allodynia and hyperalgesia in the region of the vulval vestibulus. While in many patients the cause of vulvodynia remains uncertain, we and others have previously shown increased intraepithelial and papillary innervation in vulvodynia. The vanilloid receptor VR1 (TRPV1) is expressed by nociceptors, and is triggered by capsaicin, noxious heat, protons, and chemicals produced during inflammation.

Palliative care in adolescents.

Specialist Palliative Care's involvement in adolescent cancer is relatively new. The challenges are not so much to do with the technicalities of symptom control, but in walking the fine line with patients and families as they wrestle with transitions into an adulthood that will not happen and attempts to pack a lost future into a few months or years whilst coping with arduous and often futile treatments that attempt to buy some more time. The article explores some underlying principles and the model of care that has emerged at this specialist centre for adolescent care.

A new technique of laparoscopic ovariopexy before irradiation.

Objective: To report a new technique of laparoscopic ovarian transposition to preserve ovarian function in women who require pelvic irradiation for musculoaponeurotic fibromatosis (extra abdominal desmoid).

Design: Case report.

Setting: University teaching hospital.

Progesterone receptor-positive eruptive syringoma associated with diabetes.

Syringoma is a benign eccrine tumor that generally forms asymptomatic papules on facial skin. Eruptive forms of the tumor are uncommon and of uncertain cause. We report a case in which eruptive syringoma with clear cell morphology was found to express progesterone receptors, suggesting the possibility of hormonal control of the tumor.

Data protection. Get in on the act.

Informed consent for any use of data beyond immediate care and treatment is fundamental to meeting the requirements of the Data Protection Act. It is important to identify data owners and controllers and to ensure they are aware of their responsibilities to ensure that data is held securely. No data should be passed to third parties without written agreements and unless EU equivalent data protection can be ensured.

Cutaneous larva migrans: clinical features and management of 44 cases presenting in the returning traveller.

Background: Cutaneous larva migrans (CLM) is the result of a nematode infection, and shows a characteristic creeping eruption. As travel to the tropics increases, many British citizens may be returning with this infection, which is often misdiagnosed or treated incorrectly.

Objectives: To perform a retrospective survey of 44 cases of CLM presenting to the Hospital for Tropical Diseases in London over the last 2 years.

Spiral CT pneumocolon: applications, status and limitations.

CT pneumocolon is a promising new technique in the diagnosis and management of colon pathology. CT pneumocolon can detect (sensitivity >95%) and stage (accuracy 79%) colorectal cancer and is very accurate in the differentiation of malignant from benign colonic pathologies. It has excellent detection rates for polyps >10 mm in diameter.

Dentistry. Open wide.

The government's plan to invest 18 m Pounds to encourage dentists to do more NHS work is not likely to arrest the move towards private practice. Although health authorities are to be made accountable for delivering a dental strategy they will have no control over the work of dentists in their area. Dentistry remains out of line with the NHS's founding principle of providing free care at the point of access.

Standardization of nutritional support: are protocols useful?

This paper reviews the benefits that a structured format such as a protocol can bring to the delivery of nutritional support. The four main areas of influence are: (1) patient selection, in which indications for feeding and evaluation of the risk/benefit ratio are discussed; (2) timing of nutritional support, in which guidelines for initiating feeding are proposed; (3) delivery of nutrition, in which protocols to limit complications and optimize delivery are reviewed; and (4) feed content, in which guidelines for appropriate nutrients and formulation for special considerations are identified. The importance of an evidence base is stressed and some of the evidence supporting specific recommendations is reviewed.

MR angiographic diagnosis of cerebral venous sinus thrombosis following allogeneic bone marrow transplantation.

Allogeneic bone marrow transplantation is frequently associated with neurological complications, particularly intracerebral bleeds and infections. Cerebral venous sinus thrombosis has only rarely been reported following allogeneic transplants. We report three cases of cortical venous thrombosis following allografting for acute lymphoblastic leukaemia.

Tooth surface loss. 11. Surgical crown lengthening.

Restoration of worn teeth can be made easier by surgical crown lengthening. It improves appearance and facilitates tooth preparation. Anatomical features can limit the height that can be gained.

Acute pulmonary embolism in patients with HIV disease.

Objectives: To determine the incidence, mode of presentation, and outcome of pulmonary embolism (PE) in patients with HIV infection.

Methods: Retrospective review of clinical case records, imaging department database, and necropsy reports of patients admitted to the specialist HIV/AIDS unit at UCL hospitals from April 1993 to August 1997 in order to identify those with a diagnosis of PE.

Results: During the study period there were 3792 admissions of whom 10 (0.

The posterior interosseous nerve and the posterolateral approach to the proximal radius.

We dissected 21 cadaver elbows to determine the relationship of the posterior interosseous nerve to the posterolateral approach to the elbow and head of the radius. At the distal end of the exposure the first branches at risk, those to extensor carpi ulnaris, were on average 6.0 +/- 1.

Radiology of pulmonary tuberculosis.

Pulmonary tuberculosis (TB) is a considerable health problem throughout the world, and has increased in incidence over the past 10 years. This article reviews the typical radiographical findings in post-primary TB and reactivation, and describes the less common manifestations of the disease in nonimmuno-compromised and immuno-compromised individuals. Indications for plain radiography, computed tomography and high-resolution computed tomography are also discussed.

Portable chest radiology in intensive care: a comparison of a new dual characteristic film-screen system (Insight) incorporating a flexible grid with a standard film-screen system.

Insight (Insight, Kodak, UK) is a new dual image receptor system which utilizes an asymmetric film screen combination. Conventional radiography was compared with the Insight system, in combination with a cassette incorporating a flexible grid, in fifty patients on the intensive care unit. Radiographs were analysed by intensive care junior medical staff, nursing staff and two groups of radiologists.

Sub-cortical white-grey matter contrast on MRI as a quantitative marker of diffuse HIV-related parenchymal abnormality.

White matter change occurs in human immunodeficiency virus (HIV) encephalopathy, which may be difficult to assess subjectively especially in the early stages of disease. This study applies a quantitative approach to the assessment of this finding. Sixty-three HIV seropositive subjects, 47 seronegative blood donors and 17 seronegative homosexual men underwent axial T2 weighted MRI of the brain at 1.

Cerebral magnetic resonance relaxometry in HIV infection.

A prospective, cross-sectional study was designed to determine the magnetic resonance relaxation times of cerebral white matter in human immunodeficiency virus (HIV) infected individuals. T1 and T2 were estimated at 1.5 T using four-point methods.

Toxoplasmosis and primary central nervous system lymphoma in HIV infection: diagnosis with MR spectroscopy.

Purpose: To differentiate intracranial lymphoma from Toxoplasma gondii lesions in patients infected with the human immunodeficiency virus, by means of localized spin-echo proton magnetic resonance (MR) spectroscopy.

Materials And Methods: Twenty-seven lesions were studied (18 T gondii lesions, nine lymphoma lesions) at 1.5 T.