Microscopic characterisation of filamentous microbes: towards fully automated morphological quantification through image analysis.

Mycelial morphology is a critically important process property in industrial fermentations of filamentous microorganisms, as particular phenotypes are associated with maximum productivity. The morphological form that develops in a given process results from the combination of various environmental factors, together with the genotype of the organism itself. The design of systems capable of rapidly and accurately characterising morphology within a given process represents a significant challenge to biotechnologists, as the complex phenotypes that are manifested are often not easily quantified. Over the last two decades, the proliferation of high-power personal computers and high-resolution digital cameras has enabled scientists to apply digital image analysis to this challenge. Although several fully automated systems have been designed for this purpose, manual analysis of images is still commonplace, together with qualitative, subjective descriptions of morphologies. This review describes the complex morphologies that can develop in fermentations of filamentous microbes and the application of microscopy and image analysis techniques to the quantification of such structures.

Treatment outcomes in an integrated civilian and prison MDR-TB treatment program in Russia.

SETTING: Multidrug-resistant tuberculosis (MDR-TB) is a major problem in countries of the former Soviet Union in both the civilian and prison sectors. OBJECTIVE: To evaluate outcomes of the MDR-TB treatment program (DOTS-Plus) in Tomsk, Russia. DESIGN: Retrospective case series of all patients enrolled in this program between 10 September 2000 and 10 September 2002. The program involves both the civilian and penitentiary TB services in Tomsk. Poor treatment outcome was defined as death, default and treatment failure. RESULTS: Among the 244 patients who received treatment, 77% were cured, 5% died, 7% failed, and 12% defaulted. In a multivariable analysis, alcohol consumption during treatment and the presence of both cavitary and bilateral disease were found to be the strongest predictors of poor treatment outcome. CONCLUSIONS: The integration of civilian and penitentiary TB services in the Tomsk MDR-TB treatment program has resulted in high cure rates and low rates of default. However, alcohol use among patients with MDR-TB is associated with poor treatment outcomes. Better understanding and programmatic alcohol interventions are needed if large-scale treatment of MDR-TB is to be successful in areas with high rates of alcohol use disorders.

An algorithm for the treatment of schizophrenia in the correctional setting: the Forensic Algorithm Project.

The Forensic Algorithm Project (FAP) was born of the need for a holistic approach in the treatment of the inmate with schizophrenia. Schizophrenia was chosen as the first entity to be addressed by the algorithm because of its refractory nature and high rate of recidivism in the correctional setting. Schizophrenia is regarded as a spectrum disorder, with symptom clusters and behaviors ranging from positive to negative symptoms to neurocognitive dysfunction and affective instability. Furthermore, the clinical picture is clouded by Axis II symptomatology (particularly prominent in the inmate population), comorbid Axis I disorders, and organicity. Four subgroups of schizophrenia were created to coincide with common clinical presentations in the forensic inpatient facility and also to parallel 4 tracks of intervention, consisting of pharmacologic management and programming recommendations. The algorithm begins with any antipsychotic medication and proceeds to atypical neuroleptic usage, augmentation with other psychotropic agents, and, finally, the use of clozapine as the common pathway for refractory schizophrenia. Outcome measurement of pharmacologic intervention is assessed every 6 weeks through the use of a 4-item subscale, specific for each forensic subgroup. A "floating threshold" of 40% symptom severity reduction on Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale items over a 6-week period is considered an indication for neuroleptic continuation. The forensic algorithm differs from other clinical practice guidelines in that specific programming in certain prison environments is stipulated. Finally, a social commentary on the importance of state-of-the-art psychiatric treatment for all members of society is woven into the clinical tapestry of this article.

Use of depo-provera in the treatment of aggressive sexual offenders: preliminary report of three cases.

PIP: A preliminary report of the use of Depo-Provera (medroxyprogesterone acetate) in the treatment of 3 aggressive sexual offenders is presented. The 3 males, ages 20, 30, and 16, were treated with 300 mg of Depo-Provera every 10 days; after 1 month of treatment their plasma testosterone levels dropped from 461, 810, and 760 to 28, 110, and 207 ngs%, respectively. The 2 married men initially reported loss of energy but this complaint left them within a few weeks. They were able to continue sexual relations with their spouses to a satisfactory degree. The 16-year-old claimed that he had no interest in sex and no longer masturbated. All 3 were quite pleased with the results of the treatment, both with regard to the defusing of their destructive sexual energy and the concomitant mellowing of their temperaments. It is concluded that this new therapeutic opportunity must be promulgated so that families, judges, and others who were previously without hope may extend that hope to the smallggroup of now treatable patients.^ieng