Tubular ectasia of the rete testis associated with azoospermia: a case report.

Tubular ectasia of the rete testis (TERT) is a rare benign condition of the testis due to dilatation of the tubules of the rete testis. It must be differentiated from neoplastic disease of the testis clinically by patient's age, mode of presentation, tumour marker status and characteristic ultrasound and colour Doppler findings. Awareness and diagnosis of TERT should prevent unnecessary surgical intervention such as orchidectomy or biopsy. We report a case of severe bilateral tubular ectasia of the rete testis associated with azoospermia and review the relevant literature. This association has not been reported before in the literature to the best of our knowledge.

Self-monitoring dysfunction and the positive symptoms of schizophrenia.

Frith has proposed that symptoms of alien control in schizophrenia result from a defect in a metarepresentational process leading to a failure to properly monitor self-willed intentions and actions. To examine this hypothesis, a group of 40 schizophrenic patients, all meeting DSM-III-R criteria, and rated for current symptoms on the basis of a detailed clinical interview, were compared with 36 non-patient controls, using a battery of tests which included measures of self-monitoring, general cognitive function and attention. In comparison with controls, patients were impaired on two tests of self-monitoring. These differences were preserved when measures of current IQ, attention, and recognition memory were entered as covariates. Amongst patients, self-monitoring performance was related to the severity and extent of positive symptoms. These findings provide further experimental support for the proposal that positive symptoms of schizophrenia arise as a result of deficiencies in self-monitoring.

Clinical and chest radiographic features of tuberculosis associated with human immunodeficiency virus in Zimbabwe.

In the developing world, the diagnosis of tuberculosis is dependent on clinical and radiologic features as culture facilities are not readily available. It has been reported that tuberculosis in HIV-positive persons can present with atypical clinical and radiographic features. The object of this study was to examine how often atypical features occur in HIV-positive compared with HIV-negative persons and how these findings correspond to sputum-smear findings. Detailed demographic, clinical, and chest radiographic features of tuberculosis were assessed in 202 HIV-positive adults and 220 HIV-negative patients admitted consecutively. Using univariate analysis, several of these features were found to be significantly associated with being HIV-positive, but after multiple regression analysis only, age group (15 to 42 yr), a negative tuberculin response, intrathoracic lymphadenopathy, and lack of cavitation but not sputum-smear status remained significant.

Acute lower respiratory tract infection in hospitalized children in Zimbabwe.

A descriptive study was undertaken to document clinical and socio-demographic features and also to identify risk factors for mortality in children hospitalized with acute lower respiratory tract infection (ALRI). A total of 704 children aged from 1 month to 5 years admitted to Harare Central Hospital were studied. The peak age group was between 1 and 6 months. Seventy per cent of the children were found to have normal nutrition and 12% severe malnutrition. Seventy-eight per cent had severe and the remainder moderate ALRI (WHO classification). Clinical HIV infection was diagnosed in 219 (31%) children. One hundred and four children died, an overall case fatality rate (CFR) of 15%. In the clinically HIV-infected children, a CFR of 28% occurred, which constituted 60% of the overall ALRI mortality. A much lower CFR of 9% was found in the clinically non-HIV-infected children. Malnutrition, severe ALRI, age of 1 to 6 months, concurrent diarrhoea, duration of cough > or = 14 days and previous history of admission for ALRI were significant risk factors for mortality in ALRI. Low birthweight was not found to be a risk factor in this study. The impact of HIV infection on mortality in children with ALRI is of major concern in Zimbabwe and should be an important component of the national ALRI programme.

Calcaneal spurs in a black African population.

The radiological incidence of calcaneal spurs in a black African population was studied. Our findings show that spur incidence increased with age and was greater in females than in males. These results, the first from a large, exclusively African population, are similar to those from previous studies of individuals from other continents.

Complications in percutaneous transluminal angioplasty: relationships with patient age.

Five hundred consecutive attempted lower limb angioplasties for ischaemic disease (370 patients, mean age 65.6 years, range 33-91 years) were reviewed. Significant complications occurred in 44 cases (8.8%). Nine patients (1.8%) underwent emergency surgery related to a complication. A further 12 patients (2.4%) underwent elective surgery related to a complication. In addition, four patients died within 30 days of the procedure; one following surgery performed because of a complication of angioplasty, one following a myocardial infarction, one following severe bleeding associated with subsequent thrombolytic therapy and one during emergency surgery related to a complication of angioplasty. A correlation was found between complication rate and age. This relationship was independent of the approach to, the position of, and the severity of the treated lesion. Elderly patients are at increased risk of complication in lower limb angioplasty.