Skinks (Reptilia: Scincidae) have highly conserved karyotypes as revealed by chromosome painting.

Skinks represent the most diversified squamate reptiles with a great variation in body size and form, and are found worldwide in a variety of habitats. Their remarkable diversification has been accompanied by only a few chromosome rearrangements, resulting in highly-conservative chromosomal complements of these lizards. In this study cross-species chromosome painting using Scincus scincus (2n = 32) as the source genome, was used to detect the chromosomal rearrangements and homologies between the following skinks: Chalcides chalcides (2n = 28), C. ocellatus (2n = 28), Eumeces schneideri (2n = 32), Lepidothyris fernandi (2n = 30), Mabuya quinquetaeniata (2n = 32). The results of this study confirmed a high degree of chromosome conservation between these species. The main rearrangements in the studied skinks involve chromosomes 3, 5, 6 and 7 of S. scincus. These subtelocentric chromosomes are homologous to the p and q arms of metacentric pair 3 and 4 in C. chalcides, C. ocellatus, L. fernandi, and M. quinquetaeniata, while they are entirely conserved in E. schneideri. Other rearrangements involve S. scincus 11 in L. fernandi and M. quinquetaeniata, supporting the monophyly of Lygosominae, and one of the chromosomes S. scincus 12-16, in M. quinquetaeniata. In conclusion, our data support the monophyly of Scincidae and confirm that Scincus-Eumeces plus Chalcides do not form a monophyletic clade, suggesting that the Scincus-Eumeces clade is basal to other members of this family. This study represents the first time the whole genome of any reptile species has been used for cross-species chromosome painting to assess chromosomal evolution in this group of vertebrates.

Characteristics of males over 50 years who present with a fracture: epidemiology and underlying risk factors.

Osteoporosis and fragility fractures in men constitute a considerable burden in healthcare. We have reviewed 2035 men aged over 50 years with 2142 fractures to clarify the epidemiology of these injuries and their underlying risk factors. The prevalence of osteoporosis ranged between 17.5% in fractures of the ankle and 57.8% in those of the hip. The main risk factors associated with osteoporosis were smoking (47.4%), alcohol excess (36.2%), body mass index < 21 (12.8%) and a family history of osteoporosis (8.4%). Immobility, smoking, self-reported alcohol excess, a low body mass index, age >/=72 and loss in height were significantly more common among men with fractures of the hip than in those with fractures elsewhere.

Dissociative identity disorder and the nurse-patient relationship in the acute care setting: an action research study.

This paper presents the results of an action research study into the acute care experience of Dissociative Identity Disorder. The study, which was grounded in principles of critical social science, utilized focus group interviews and narrative construction. Nurses and patients are under-represented in all clinical evaluation and their voices need to be heard if services are to be truly collaborative. Findings of the study extend intrapsychic theories of trauma to emphasize the interpersonal relationship between nurse and person who can work together to facilitate recovery from trauma, make connections both intra and interpersonally and build resilience.

Can scintimammography reduce "unnecessary" biopsies?

99Tc-sestamibi prone scintimammography (SMM) is a new, noninvasive method of imaging breast tumors. A pilot study has suggested that SMM increases the specificity of mammography, and that SMM could be used as an adjunct to mammography to reduce the number of mammographically indicated biopsies. The goal of this study was to further evaluate the efficacy of SMM in diagnosing or excluding breast carcinoma. This was a prospective case series with each patient serving as her own control. All subjects who had an abnormal mammogram, a palpable breast mass, or both were eligible for inclusion. All patients underwent breast examination, conventional mammography, SMM, and breast biopsy. Of the 81 women originally enrolled, 79 women with 80 lesions completed the study. SMM produced the following results: a sensitivity of 81 per cent, a specificity of 81 per cent, a positive predictive value of 61 per cent, and a negative predictive value of 92 per cent. These values were significantly lower than the pilot study results at a power of 80 per cent and P = 0.05. Our results indicate that SMM does not increase the specificity of conventional mammography and has a low negative predictive value. We would not recommend it as a screening technique to avoid biopsy.

Radiological seminar CCXLIV: Wegener's granulomatosis.

This case was a typical presentation for Wegener's granulomatosis with respect to the pulmonary and renal findings. Over the course of the past ten years this patient has done relatively well with only two major exacerbations requiring hospitalization. His renal function has apparently not been compromised to date. The finding of limited or no significant upper respiratory involvement is interesting in this case and is rather atypical for this disease. This may well represent a limited variant of Wegener's granulomatosis or possibly an excellent response of the Wegener's syndrome to cytotoxic chemotherapy. Finally, this case illustrates how appropriate clinical and pharmacological management has greatly improved the morbidity and mortality of this once uniformly fatal disease.

Reliability of clinical measurements of lumbar lordosis taken with a flexible rule.

The purpose of this study was to examine the intratester and intertester reliability of lumbar lordosis measurements taken with a flexible rule. Two physical therapists (Tester 1 and Tester 2) took measurements on 40 subjects without low back pain (LBP) and on 40 subjects with LBP. Intraclass correlation coefficients (ICCs) were used to determine the degree of agreement between repeated measurements taken by the same therapist and between measurements taken by the two therapists. The ICC values for intratester reliability of Tester 1 were .84 for subjects without LBP and .94 for subjects with LBP. The ICC values of Tester 2 were .73 for subjects without LBP and .83 for subjects with LBP. Intertester reliability generally was poor, with ICC values of .41 for subjects without LBP and .50 for subjects with LBP. The results suggest that measurements of lumbar lordosis with a flexible rule may be reliable if taken by the same physical therapist. The degree of reliability, however, may vary from therapist to therapist. The intertester reliability of these measurements appears to be poor, but these conclusions must be interpreted carefully because of the limited number of therapists participating in this study.

Autoerotic asphyxial death following television broadcast.

How individuals who engage in autoerotic asphyxial activities first become aware of its purported erotic potential is debated. The case of an adult male who died from autoerotic asphyxiation shortly after watching a television show that discussed sexual asphyxiation is reported. A request is made that medical examiners and coroners report other accidental autoerotic deaths that are temporally associated with this television broadcast.

Trial of a new acellular pertussis vaccine in healthy adult volunteers.

Immunogenicity and reactogenicity of a new acellular pertussis vaccine were tested in healthy adults. The vaccine contained three constituents of Bordetella pertussis; filamentous haemagglutinin, pertussis toxin (PT) and fimbriae bearing agglutinogens 2 and 3. The constituents were separately purified, treated with formaldehyde and combined with one of two aluminium adjuvants. Subjects received one dose of vaccine or an appropriate adjuvant-only preparation and were monitored for clinical responses for 7 days. Results with the two forms of vaccine were similar. Of 35 vaccinees, none had a temperature higher than 37 degrees C or a severe reaction, one had a moderate reaction (possibly due in part to intercurrent infection) and nine had mild reactions confined to localized discomfort and/or erythema or induration at the injection site. All vaccinees had good serum antibody responses to vaccine antigens measured by ELISA and for PT, by neutralization of its effects on Chinese hamster ovary cells.

Effects of microwave radiation on living tissues.

Prompted by an alleged case of child abuse resulting from microwave oven burns and the discovery of one other case, an animal model was chosen to explore microwave burn characteristics upon living, perfusing tissue. Anesthetized piglets were exposed to radiation from a standard household microwave oven for varying lengths of time, sufficient to result in full-thickness skin and visceral burns. Characteristic burn patterns were grossly identified. Biopsies studied with both light and electron microscopy demonstrated a pattern of relative layered tissue sparing. Layered tissue sparing is characterized by burned skin and muscle, with relatively unburned subcutaneous fat between these two layers. These findings have important forensic and patient care implications.

Implications of trombiculid mite bites: report of a case and submission of evidence in a murder trial.

Bites of Trombiculid mites implicated a suspect during a homicide investigation. Clinical documentation of the bites, correlation with entomological studies, and submission of evidence at trial are reported. Insects that have a discrete geographic distribution and leave bites of a characteristic nature may have important forensic science implications.

1-Aryl-3-azabicyclo[3.1.0]hexanes, a new series of nonnarcotic analgesic agents.

A series of 1-aryl-3-azabicyclo[3.1.0]hexanes was synthesized by hydride reduction of 1-arylcyclopropanedicarboximides. Hydroxyphenyl analogues 20, 22, and 24 were prepared by EtSNa--DMF ether cleavage of the corresponding methoxyphenyl analogues 2m, 2n, and 23, respectively, with the secondary amines 20 and 22 going through the N-formyl intermediate 19 and 21. The p-ethoxy analogue 26 was obtained by O-ethylation of 19, followed by base hydrolysis of the amide 25. The greatest analgesic potency in mouse writhing and rat paw-pain assays was observed for para-substituted compounds. Bicifadine, 1-(4-methylphenyl)-3-azabicyclo[3.1.0]hexane (2b), was the most potent member of the series and is presently undergoing clinical trials in man. Analgesic activity of 2b is limited to the (+) enantiomer 2v, which has the 1R,5S absolute configuration as determined by single-crystal X-ray analysis. The N-methyl analogue (27d) of 2b showed significant analgesic potency, whereas the N-allyl (27a), N-(cyclopropylmethyl) (27b), and N-(n-hexyl) (27c) analogues were inactive. Bicifadine (2b) showed a nonnarcotic profile different from analogous azabicycloalkane and 3-phenylpyrrolidine analgesics.