Atypical Psoriatic Arthritis Presenting as Presumed Septic Monoarticular Arthritis.

The authors present a case of monoarticular psoriatic arthritis affecting the knee of a woman with no previously identified manifestations of psoriasis. At time of symptom onset, joint aspirates were initially sterile with predominantly neutrophilic leukocytosis; however, repeat aspiration and culture was positive for Candida parapsilosis. Despite appropriate antifungal treatment, symptoms continued to worsen and other large joint manifestations including the contralateral elbow raised suspicions for alternative etiology. Ultimately new onset skin excoriations on the palms suggested psoriatic arthritis, which was subsequently treated with immunosuppressive therapy.

Deletion of v-chiA from a baculovirus reduces horizontal transmission in the field.

Nucleopolyhedroviruses (NPVs) can initiate devastating disease outbreaks in populations of defoliating Lepidoptera, a fact that has been exploited for the purposes of biological control of some pest insects. A key part of the horizontal transmission process of NPVs is the degradation of the larval integument by virus-coded proteins called chitinases, such as V-CHIA produced by the v-chiA genes. We used recombinant and naturally occurring strains of the Lymantria dispar NPV (LdMNPV) to test horizontal transmission in the field, release of virus from dead larvae under laboratory conditions, and cell lysis and virus release in cell culture. In the field, strains of LdMNPV lacking functional v-chiA genes showed reduced horizontal transmission compared to wild-type or repaired strains. These findings were mirrored by a marked reduction in released virus in laboratory tests and cell culture when the same strains were used to infect larvae or cells. Thus, this study tests the pivotal role of liquefaction and the v-chiA gene in field transmission for the first time and uses complementary laboratory data to provide a likely explanation for our findings.

International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related to native tissue female pelvic floor surgery.

INTRODUCTION AND HYPOTHESIS: A terminology and standardized classification has yet to be developed for those complications related to native tissue female pelvic floor surgery. METHODS: This report on the terminology and classification combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS) and a Joint IUGA/ICS Working Group on Complications Terminology, assisted at intervals by many external referees. A process of rounds of internal and external review took place with decision-making by collective opinion (consensus). RESULTS: A terminology and classification of complications related to native tissue female pelvic floor surgery has been developed, with the classification based on category (C), time (T), and site (S) classes and divisions, that should encompass all conceivable scenarios for describing operative complications and healing abnormalities. The CTS code for each complication, involving three (or four) letters and three numerals, is likely to be very suitable for any surgical audit or registry, particularly one that is procedure-specific. Users of the classification have been assisted by case examples, color charts, and online aids (www.icsoffice.org/ntcomplication). CONCLUSIONS: A consensus-based terminology and classification report for complications in native tissue female pelvic floor surgery has been produced. It is aimed at being a significant aid to clinical practice and particularly to research.

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related to native tissue female pelvic floor surgery.

INTRODUCTION AND HYPOTHESIS: A terminology and standardized classification has yet to be developed for those complications related to native tissue female pelvic floor surgery. METHODS: This report on the terminology and classification combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS) and a Joint IUGA/ICS Working Group on Complications Terminology, assisted at intervals by many external referees. A process of rounds of internal and external review took place with decision making by collective opinion (consensus). RESULTS: A terminology and classification of complications related to native tissue female pelvic floor surgery has been developed, with the classification based on category (C), time (T), and site (S) classes and divisions that should encompass all conceivable scenarios for describing operative complications and healing abnormalities. The CTS code for each complication, involving three (or four) letters and three numerals, is likely to be very suitable for any surgical audit or registry, particularly one that is procedure-specific. Users of the classification have been assisted by case examples, colour charts and online aids ( www.icsoffice.org/ntcomplication ). CONCLUSIONS: A consensus-based terminology and classification report for complications in native tissue female pelvic floor surgery has been produced. It is aimed at being a significant aid to clinical practice and particularly to research.

Developing evidence-based standards for diagnosis and management of lower urinary tract or pelvic floor dysfunction.

The International Continence Society (ICS) has a key role in standardizing terminology related to lower urinary tract and pelvic organ dysfunction. The ICS Standardization Steering Committee (SSC) presents the new structure and process by which future ICS Standards will be developed. The new processes aim to meet present-day evidence-based practice requirements, and to foster unbiased, inclusive, and transparent development. For each new ICS Standard, the SSC will oversee a dedicated ad hoc Working Group (WG). Applications to chair or contribute to a WG will be invited from the ICS membership. The SSC will select the Chairperson, and work with him or her to select the WG composition, balanced to represent key disciplines, stakeholders, and regions. Consultants can be invited to contribute to the WG where specific need arises. Every WG will review current knowledge, adhering to evidence-based medicine requirements. Progress reports will be reviewed by the SSC, and amendments recommended, culminating in a first draft. The draft will be offered to the ICS membership and additional relevant experts for comment. Further revision, if needed, will result in a document, which the SSC will submit to the ICS Trustees, as arbiters of whether the document should be adopted as an ICS Standard. The SCC will then coordinate with the WG to ensure that the new ICS Standard is published and disseminated. Implementation strategies, such as education, audit, accreditation, and research initiatives will be linked to the Standards where appropriate. Revisions of ICS Standards will be undertaken to maintain contemporaneous relevance.

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery.

INTRODUCTION AND HYPOTHESIS: A terminology and standardized classification has yet to be developed for those complications arising directly from the insertion of synthetic (prostheses) and biological (grafts) materials in female pelvic floor surgery. METHODS: This report on the above terminology and classification combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS) and a Joint IUGA/ICS Working Group on Complications Terminology, assisted at intervals by many expert external referees. An extensive process of 11 rounds of internal and external review took place with exhaustive examination of each aspect of the terminology and classification. Decision-making was by collective opinion (consensus). RESULTS: A terminology and classification of complications related directly to the insertion of prostheses and grafts in female pelvic floor surgery has been developed, with the classification based on category (C), time (T) and site (S) classes and divisions, that should encompass all conceivable scenarios for describing insertion complications and healing abnormalities. The CTS code for each complication, involving three (or four) letters and three numerals, is likely to be very suitable for any surgical audit or registry, particularly one that is procedure-specific. Users of the classification have been assisted by case examples, colour charts and online aids (www.icsoffice.org/complication). CONCLUSION: A consensus-based terminology and classification report for prosthesis and grafts complications in female pelvic floor surgery has been produced, aimed at being a significant aid to clinical practice and research.

An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) & grafts in female pelvic floor surgery.

INTRODUCTION AND HYPOTHESIS: a terminology and standardized classification has yet to be developed for those complications arising directly from the insertion of synthetic (prostheses) and biological (grafts) materials in female pelvic floor surgery. METHODS: this report on the above terminology and classification combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS) and a Joint IUGA/ICS Working Group on Complications Terminology, assisted at intervals by many expert external referees. An extensive process of 11 rounds of internal and external review took place with exhaustive examination of each aspect of the terminology and classification. Decision-making was by collective opinion (consensus). RESULTS: a terminology and classification of complications related directly to the insertion of prostheses and grafts in female pelvic floor surgery has been developed, with the classification based on category (C), time (T) and site (S) classes and divisions, that should encompass all conceivable scenarios for describing insertion complications and healing abnormalities. The CTS code for each complication, involving three (or four) letters and three numerals, is likely to be very suitable for any surgical audit or registry, particularly one that is procedure-specific. Users of the classification have been assisted by case examples, colour charts and online aids ( www.icsoffice.org/complication ). CONCLUSIONS: a consensus-based terminology and classification report for prosthess and grafts complications in female pelvic floor surgery has been produced, aimed at being a significant aid to clinical practice and research.

Multifocal symptomatic intracerebral metastases as the first manifestation of prostatic carcinoma: a report and literature review.

We report an unusual case of prostatic carcinoma in a middle-aged man with symptomatic multifocal intracerebral metastases as its initial manifestation to highlight the importance of its accurate diagnosis and implications on its management and review relevant literature.

Evaluation of five trapping systems for the surveillance of gravid mosquitoes in Prince Georges County, Maryland.

Five mosquito trapping systems were evaluated in a large wildlife research center containing extensive and diverse mosquito-breeding habitat. The systems evaluated included Centers for Disease Control (CDC) New Standard Miniature Light traps with and without CO2 (dry ice), CDC gravid traps, partially open 1.8-m3 cages, and Fay-Prince traps baited with CO2. The first 4 trap systems were evaluated for 17 periods, while the Fay-Prince trap was evaluated on 5 trapping dates. Parameters recorded for each species were total catch, percent males, total females, and whether blood-fed/gravid. Fourteen of the 23 species caught yielded over 50 individuals in the 5 trapping systems (range of 71-2,524 specimens per species). Both light and CO2 were powerful attractants for 12 of the 14 commonly caught species. However, for most species, the majority of captured females were nongravid. Gravid traps caught fewer mosquitoes than did light- or CO2-baited traps, but the catch consisted of a higher percentage of gravid females. The open cages caught substantial numbers (>100 individuals) of 5 species, and for 2 species, this was the most productive trap. While light- and CO2-baited traps tended to catch few males or gravid females, the open cages caught an eclectic mixture of males, gravid females, and nongravid females, perhaps representative of the true percentages of each in nature.

Increased mortality of gypsy moth Lymantria dispar (L.) (Lepidoptera: Lymantriidae) exposed to gypsy moth nuclear polyhedrosis virus in combination with the phenolic gycoside salicin.

Second instar gypsy moth, Lymantria dispar (L.) (Lepidoptera: Lymantriidae), larvae suffered significantly greater mortality from aerially applied gypsy moth nuclear polyhedrosis virus (Gypchek) when the virus was consumed on quaking aspen, Populus tremuloides Michx., versus red oak, Quercus spp. L., foliage. Laboratory assays in which various doses of Gypchek and salicin (a phenolic glycoside present in aspen foliage) were tested in combination demonstrated that salicin significantly increased total larval mortality and lowered the LD50 estimates (dose of Gypchek that resulted in 50% population mortality) for the virus, although not significantly. While salicin did not impact larval survival in the absence of Gypcek, it did act to significantly deter feeding when it was present in high concentrations (up to 5.0%) within the treatment formulations. The enhanced activity of Gypchek in the presence of salicin is similar to prior reports of enhanced activity of the bacterial pathogen Bacillus thuringiensis when consumed concurrently with phenolic glycosides commonly present in aspen foliage. The enhancement of viral activity is in contrast to the inhibitory effects on the virus reported for another common group of phenolic compounds, tannins.