Role of cervical cerclage and prolonged antibiotic therapy with azithromycin in patients with previous perinatal loss amnionitis.

In the group of 35 patients with cerclage, intermediate fetal mortality was reduced from 37.1% to 0 (p < 0.001); late fetal mortality rate from 8.5% to 2.8% (p = 0.606); prematurity from 65.7% to 5.7% (p < 0.001); newborn underweight from 11.4% to 5.7% (p = 0.671); newborns with very low weight from 34.2% to 0 (p < 0.001) and the abortion rate from 8.5% to 0 ( p < 0.001). In the group of 19 patients without buckling, intermediate fetal mortality was reduced from 26.3% to 10.5% (p = 402); late fetal mortality from 63.1% to 0 (p < 0.001); prematurity 78.9% to 31.5% (p < 0.009); the newborn of low weight from 31.5% to 10.5% (p = 0.234); newborns with very low weight from 68.4% to 15.7% (p < 0.003) and the abortion rate from 36.8 to 0 (p < 0.001). In conclusion, we believe the results of this study demonstrate the effectiveness of therapeutic and prophylactic cervical cerclage associated with prolonged antibiotic therapy.

Hypersensitivity pneumonitis and antigen identification--An alternate approach.

OBJECTIVES: Identification of the causal antigen for patients with hypersensitivity pneumonitis (HP) is challenging in a standard clinical setting. The purpose of this pilot study was to determine whether it was possible to evaluate the home/workplace of patients, and identify the causal antigen. METHODS: Using a case-control study design we compared the presence of antibody to antigen collected in the environment of individuals with HP and controls consisting of family members/co-workers. Based on patient interviews, homes/workplaces were evaluated and suspected sources of antigen collected for use in immunoassays. RESULTS: Nineteen individuals with HP participated with 15 classified as having fibrotic disease. Up to 54 bulk samples were collected from each patient's environment, with multiple isolates (antigens) cultured from each. Of the seven individuals who tested positive to one or more environmental samples, three had a positive response to more than 1 antigen from the environmental sample (range 1-9). Twelve individuals tested positive to antigen(s) on a standard panel, with only one overlapping with the antigen from the home/workplace sample. A significant association existed between results of interviews/site evaluations, and ability to collect antigen eliciting a positive response (p < 0.001). CONCLUSION: Antigen identification was successful for patients with 'active' disease. Antigens for which patients test positive on standard panels may not be present in their environment. One benefit to patient-centered testing is the ability to develop recommendations specific to their environment. As most individuals tested positive for >1 antigen, further investigation is warranted to determine the actual antigen responsible for disease.

Fractional step methods applied to a chemotaxis model.

A fractional step numerical method is developed for the nonlinear partial differential equations arising in chemotaxis models, which include density-dependent diffusion terms for chemotaxis, as well as reaction and Fickian diffusion terms. We take the novel approach of viewing the chemotaxis term as an advection term which is possible in the context of fractional steps. This method is applied to pattern formation problems in bacterial growth and shown to give good results. High-resolution methods capable of capturing steep gradients (from CLAWPACK) are used for the advection step, while the A-stable and L-stable TR-BDF2 method is used for the diffusion step. A numerical instability that is seen with other diffusion methods is analyzed and eliminated.

[Diagnosis of inflammatory sacroiliitis. Comparison of complementary examinations]. / Diagnostic des sacro-iliites inflammatoires. Comparaison des examens complémentaires.

In order to test the sensitivity of different techniques in the diagnosis of sacroiliitis, we have made a prospective and non-controlled study of 22 patients using standard radiography of the sacroiliac joint; conventional tomography and axial scintigraphy (calculation of an ISI sacroiliac index). The normal upper limit of the sacroiliac index (1.42) was studied in parallel, using a group of 63 control subjects. Correlation between the radiological examinations was average, but was very poor between radiology and scintigraphy. Conventional tomography and calculation of the sacroiliac index were of equal value diagnostically. Clear images of juxta-articular geodes were seen during scanning, but were not taken into account in the diagnosis. They may represent the onset of larger erosions and need to be verified.