Interobserver reliability of microscopic assessment of saline-prepared vaginal fluid.

OBJECTIVE: To determine the interobserver reliability of microscopic assessment of saline-prepared vaginal fluid. MATERIALS AND METHODS: Blind-paired microscopic assessments of saline-prepared vaginal fluid collected from women presenting for gynecologic care were compared using concordance and weighted chance-corrected agreement statistics (κ). RESULTS: Vaginal fluid from 105 women was collected and examined by 65 distinct observer pairs. The mean age of participants was 39 years, with vaginal itch (29%) followed by discharge (21%) as the most common presenting complaints. The κ value for microscopic findings ranged from 0.28 (normal flora) to 0.50 (clue cells >20%). The κ value for vaginitis diagnoses ranged from 0.25 (atrophic vaginitis) to 0.45 (bacterial vaginosis). CONCLUSIONS: Interobserver agreement in the microscopic assessment of vaginal fluid is at best moderate. The value of microscopy in the diagnosis of vaginitis is uncertain, and effort should be directed to improve the precision of this tool.

A natural form of learning can increase and decrease the survival of new neurons in the dentate gyrus.

Granule cells born in the adult dentate gyrus undergo a 4-week developmental period characterized by high susceptibility to cell death. Two forms of hippocampus-dependent learning have been shown to rescue many of the new neurons during this critical period. Here, we show that a natural form of associative learning, social transmission of food preference (STFP), can either increase or decrease the survival of young granule cells in adult rats. Increased numbers of pyknotic as well as phospho-Akt-expressing BrdU-labeled cells were seen 1 day after STFP training, indicating that training rapidly induces both cell death and active suppression of cell death in different subsets. A single day of training for STFP increased the survival of 8-day-old BrdU-labeled cells when examined 1 week later. In contrast, 2 days of training decreased the survival of BrdU-labeled cells and the density of immature neurons, identified with crmp-4. This change from increased to decreased survival could not be accounted for by the ages of the cells. Instead, we propose that training may initially increase young granule cell survival, then, if continued, cause them to die. This complex regulation of cell death could potentially serve to maintain granule cells that are actively involved in memory consolidation, while rapidly using and discarding young granule cells whose training is complete to make space for new naïve neurons.