Diagnosis of culture-negative female genital tract tuberculosis with peritoneal involvement by polymerase chain reaction.

BACKGROUND: Female genital tract tuberculosis (TB) is a common cause of infertility in developing countries. It is a paucibacillary form of the disease of which smears and cultures are usually negative. CASE: We were able to use polymerase chain reaction (PCR) amplification of Mycobacterium tuberculosis DNA to support a clinical and histologic diagnosis of a typical case of culture negative female genital tract TB. CONCLUSION: PCR may be a useful adjunct to diagnostic efforts in gynecologic tuberculosis.

Reduction in human immunodeficiency virus patient hospitalizations and nontraumatic mortality after adoption of highly active antiretroviral therapy.

Highly active antiretroviral therapy (HAART) has been recommended for human immunodeficiency virus (HIV)-positive patients with a detectable viral load; it typically consists of two reverse transcriptase inhibitors combined with a protease inhibitor. In 1996, Madigan Army Medical Center began offering HAART to HIV-positive patients with a detectable viral load. We retrospectively reviewed the records of our HIV patients before and after the initiation of HAART to determine the impact of HAART on hospitalizations, mortality, and outpatient pharmacy expenditures. Comparing 1997 with 1994 and 1995, we found a greater than 700% increase in the average expenditure on antiretroviral agents after institution of HAART. At the same time, we found a dramatic reduction in hospitalizations and nontraumatic mortality. Therefore, the increase in expenditures on antiretroviral agents may be offset by a reduction in hospitalizations and mortality.

A riparian wildlife habitat evaluation scheme developed using GIS.

To evaluate riparian habitat for wildlife, we used a geographic information system (GIS) that prioritized individual streams (for acquisition or management) by habitat ranking. We demonstrate this methodology for the Vermilion River basin in east-central Illinois, USA. Three data sets were used to evaluate land cover encompassing 300 m on either side of the streams: (1) the US Geological Survey's land use and land cover information (LUDA), (2) land cover manually digitized from the National High Altitude Photography (NHAP) program, and (3) Landsat Thematic Mapper (TM) data classified into land cover. Each of 30 tributaries in the study area was ranked for habitat according to the data contained in each data set, and results were compared. Habitat ranking schemes were devised and analysis performed for three species guilds: forest, grassland, and mixed successional species. TM and NHAP each differentiated habitat scores (for forest, grassland, and mixed successional guilds) among tributaries in a similar and suitable way, while LUDA was not suitable, due to the coarse resolution of the data. Overall, it was shown that the methodology is suitable to rank streams based on riparian habitat quality. Even though more work is needed to test and verify the method, the project has shown the potential for such techniques to assist in evaluating, tracking, and improving the management of riparian wildlife resources. The method can easily be applied over large areas such as states if TM-based land cover and stream data are available.