A clinical approach to dysuria in women

No Abstract

A rapid method for determining chlorobenzenes in dam water systems

A method using direct immersion solid phase microextraction (DI-SPME) coupled to gas chromatography equipped with a flame ionisation detector (GC-FID) was developed for the analysis of 7 chlorinated benzenes in dam water. The main parameters affecting the DI-SPME process were optimised. The optimised method comprises the use of a 100 μm polydimethylsiloxane (PDMS) fibre coating; 5 mℓ sample size; 700 r/min rate of agitation and an extraction time of 30 min. The calibration curve was linear with correlation coefficients ranging from 0.9957–0.9995 for a concentration range of 1–100 ng/mℓ. The limits of detection and quantification ranged from 0.020–0.265 ng/mℓ and 0.204–2.65 ng/mℓ, respectively. Recoveries ranged from 83.6–107.2% with relative standard deviation of less than 9.2%, indicating that the method has good precision. The method is reliable and is free of matrix interferences. Water samples collected from Grootdraai Dam were analysed using the optimised conditions to assess the potential of the method for trace level screening and quantification of chlorobenzenes. The method proved to be efficient, as 1,3 dichlorobenzene, 1,4-dichlorobenzene and pentachlorobenzene were detected at concentrations of 0.429 ng/mℓ, 1.685 ng/mℓ and 1.433 ng/mℓ, respectively.Keywords: chlorobenzenes, Grootdraai Dam, water, dam, SPME, DI-SPME, GC-FI

Pseudomonas aeruginosa LPS or Flagellin Are Sufficient to Activate TLR-Dependent Signaling in Murine Alveolar Macrophages and Airway Epithelial Cells

BACKGROUND:The human lung is exposed to a large number of airborne pathogens as a result of the daily inhalation of 10,000 liters of air. Innate immunity is thus essential to defend the lungs against these pathogens. This defense is mediated in part through the recognition of specific microbial ligands by Toll-like receptors (TLR) of which there are at least 10 in humans. Pseudomonas aeruginosa is the main pathogen that infects the lungs of cystic fibrosis patients. Based on whole animal experiments, using TLR knockout mice, the control of this bacterium is believed to occur by the recognition of LPS and flagellin by TLRs 2,4 and 5, respectively. METHODOLOGY/PRINCIPAL FINDINGS:In the present study, we investigated in vitro the role of these same TLR and ligands, in alveolar macrophage (AM) and epithelial cell (EC) activation. Cellular responses to P. aeruginosa was evaluated by measuring KC, TNF-alpha, IL-6 and G-CSF secretion, four different markers of the innate immune response. AM and EC from WT and TLR2, 4, 5 and MyD88 knockout mice for were stimulated with the wild-type P. aeruginosa or with a mutant devoid of flagellin production. CONCLUSIONS/SIGNIFICANCE:The results clearly demonstrate that only two ligand/receptor pairs are necessary for the induction of KC, TNF-alpha, and IL-6 synthesis by P. aeruginosa-activated cells, i.e. TLR2,4/LPS and TLR5/flagellin. Either ligand/receptor pair is sufficient to sense the bacterium and to trigger cell activation, and when both are missing lung EC and AM are unable to produce such a response as were cells from MyD88(-/-) mice

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Role of imaging in urogynaecology and pelvic floor dysfunction

No Abstract Keywords: Urogynaecology; Pelvic floor reconstruction; Imaging; Ultrasound; MRI O & G Forum Vol. 18 (3) 2008: pp. 73-7

Use of prosthetic material in gynaecological surgery

No Abstract Available. Obstetrics & Gynaecology Forum Vol. 15 (3) 2005: 19-2

The role of urodynamics in women with stress urinary incontinence

Stress urinary incontinence (SUI) is a common condition with no standardized evaluation prior to surgery. The role of urodynamic studies (UDS) in the assessment of SUI has been the subject of considerable debate over the years. The Royal College of Obstetricians and Gynaecologists recommends urodynamic testing prior to surgery for SUI. This review gives an overview and discusses the evidence of UDS prior to surgery. It is apparent from the literature that UDS provides the clinicians with a wealth of information which may be used to refine treatment decisions in complex cases. However, its use in “pure stress incontinence” continues to be a source of controversy. There is a need for improved standardization of urodynamic studies such as abdominal leak point pressures and urethral pressure profiles before any further conclusions can be drawn about their utility in predicting the success of surgery in SUI. Prospective randomized controlled trials to evaluate the clinical efficacy, cost effectiveness, and effect on quality of life issues of a full preoperative UDS compared to no UDS studies trials is urgently neededbefore any firm conclusion can be drawn regarding the superiority of UDS