Prevalence of positive syphilis serology and meningovascular neurosyphilis in patients admitted with stroke and TIA from a culturally diverse population (2005-09).

The study aims were to determine the prevalence of positive syphilis serology and meningovascular neurosyphilis (NS) in patients admitted with transient ischaemic attack (TIA) and stroke to a tertiary hospital serving a culturally diverse community. A retrospective cohort analysis was conducted using routinely collected administrative data and medical records to identify patients admitted with TIA, stroke and other conditions, with positive syphilis serology, between 2005 and 2009. Direct medical record review confirmed diagnoses of meningovascular NS. Syphilis serology was requested in 27% (893/3270) of all patients with TIA and stroke (2005-09) of whom 4% (38/893) were positive. Thirty-seven patients with positive serology had clinical characteristics consistent with meningovascular NS. Their mean age was 72±13 years; 65% were male and 68% had a recorded place of birth in South-East Asia or the Pacific Islands. One of 12 patients with suspected meningovascular NS with cerebrospinal fluid (CSF) analysis had a positive CSF Venereal Disease Research Laboratory (VDRL) test. Three patients (8%) met diagnostic criteria for "definite or probable" meningovascular NS. All three patients with a "definite or probable" meningovascular NS and 15 (44%) of the remainder who had positive serology without confirmation of NS were treated with intravenous or intramuscular penicillin. Lumbar puncture (LP) and penicillin were underutilised in patients with TIA and stroke with positive serology. In conclusion, syphilis testing should be considered part of the diagnostic work-up of TIA and stroke, particularly in ethnically diverse populations. In patients with TIA and stroke with positive syphilis serology, it would seem appropriate to further pursue diagnosis and treatment and in patients unable to undergo LP, empiric treatment for NS should be considered.

Membership survey of the Australasian College of Legal Medicine: Quality assurance.

INTRODUCTION: The Council of the Australasian College of Legal Medicine (ACLM) considered it timely to survey its membership to determine how to best accommodate its members' needs. METHODS: A questionnaire was devised, piloted and circulated amongst the 219 College members (excluding the 13 Honorary Fellows). Yield was maximised with 4 direct mailings, 4 questionnaire insertions in the quarterly College newsletter, 3 targeted emails and follow-up phone calls. RESULTS: The survey achieved 160 (73%) response rate of whom ∼40% were substantially involved in legal and forensic medicine and ∼40% were occasionally involved. Thirty-five participants (23%) specialised in forensic medicine and 101 (63%) held Fellowship status in other recognised medical specialities. Equal ⅓ of the members had been so for >10 years, 5-10 years or <5 years, demonstrating the dynamic nature of the College. Of them 53% were Fellows, 26% Members and 21% Associates with 50% of the latter groups willing to train towards Fellowship. About half the respondents (48%) regularly attended the Annual Scientific Meeting (ASM) and favoured the Eastern border for such meetings. The collegiate nature of the College was deemed its most positive aspect with a dichotomy of views regarding seeking alternative strand affiliation for specialist recognition, although 80% indicated they would retain College membership even if such affiliation occurred. Those who attended College educative programs found them useful but attendance was between 32 and 49%, depending on the course. DISCUSSION: There appeared widespread satisfaction with College performance and activities but a low uptake of educative courses, other than Annual Scientific Meetings, thereby identifying marketing of courses as needing extra attention.

Determination of trans- and cis-resveratrol in Serbian commercial wines.

Resveratrol (trans-3,5,4'-trihydroxystilbene) is a phytoalexin produced by grapevines in response to fungal infection, particularly to Botrytis cinerea. It has been shown that it possess various biological effects such as prevention of cardiovascular diseases and anti-inflammatory and anticancerogenic properties. Red wines are a primary source of resveratrol. Although a number of investigations have focused on the determination of resveratrol in wines of different countries, there is no similar study about the wines produced in Serbia. As authors are aware, the only study concerning resveratrol content in wine in the Balkan region was conducted in Greece. In this study, the trans- and cis-resveratrol content in samples obtained from 18 commercial Serbian wines (10 red, 7 white, and 1 rose) were analyzed. Analyses were performed after solid-phase extraction by high-performance liquid chromatography with a diode array detection system using an RP-C(18) column with gradient elution [solvent A: acetonitrile-acetic acid-water (20:2:78 v/v), solvent B: acetonitrile-acetic acid-water (90:2:8 v/v)]. Detection of trans- and cis-resveratrol was performed on 306 and 286 nm, respectively. It was clearly established that there was a presence of trans-resveratrol isomers in all analyzed wines (0.11-1.69 mg/L) except in one white wine. Cis-resveratrol was present in 12 from 18 samples in different amounts (0.12-1.49 mg/L).