Increased prevalence of autoimmune diseases in functional gastrointestinal disorders: case-control study of 23471 primary care patients.

BACKGROUND: There is increasing evidence that impaired mucosal defence mechanisms are implicated in the pathogenesis of the functional gastrointestinal disorders (FGIDs), allowing inappropriate immune activation. AIM: To test the hypothesis that an excess of autoimmune disorders among sufferers, using a large primary care database to examine this. METHODS: Cases were diagnosed with FGIDs - irritable bowel syndrome (IBS), functional dyspepsia (FD), chronic idiopathic constipation (CIC), and multiple FGIDs. Controls were those without FGIDs. Prevalence of autoimmune disorders was compared between cases and controls using odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: We included 23,471 patients (mean age 51.4 years, 66.1% female). Prevalence of autoimmune disorders was greater among all FGIDs, compared with controls without. In those with FD (OR 1.35; 95% CI 1.12-1.63), CIC (OR 1.75; 95% CI 1.11-2.75), or multiple FGIDs (OR 1.49; 95% CI 1.25-1.77) this was statistically significant after controlling for age and gender. Rheumatological autoimmune disorders were significantly more frequent in those with FD (OR 1.44; 95% CI 1.15-1.80), CIC (OR 1.84; 95% CI 1.08-3.13), or multiple FGIDs (OR 1.53; 95% CI 1.24-1.88), after controlling for age and gender. However, endocrine autoimmune disorders were no more frequent in those with FGIDs, after controlling for age and gender. CONCLUSIONS: In a large sample of primary care patients, there was a significantly higher prevalence of autoimmune disorders among those with FD, CIC, or multiple FGIDs not explained by differences in age or gender. We were unable to control for concomitant drug use, which may partly explain this association.

Use and rationale of a multicompartment microcassette for site-specific biopsies of the prostate in a consecutive cohort of men.

The collection of prostate biopsies into individual or site-specific specimen containers has not been performed routinely because of concerns of time, cost and lack of additional clinical value. This report evaluates the first ever use of a multicompartment microcassette for the collection and processing of site-specific prostate biopsies.Site-specific prostate biopsies were taken in sequential men suspected to have prostate cancer and collected in a multicompartment microcassette, which holds six biopsies and fits within a standard specimen container. Estimates were made of the cost and time savings compared with biopsies collected in individual specimen containers. In 88 men evaluated, use of the multicompartment microcassette saved time (72% reduction) and cost (83% reduction) with the added ability of easy identification of the site of each prostate biopsy. The multicompartment microcassette is a convenient, time- and cost-effective container for the collection of site-specific prostate biopsies.

Evidence that fin whales respond to the geomagnetic field during migration.

We challenge the hypothesis that fin whales use a magnetic sense to guide migration by testing for associations between geophysical parameters and the positions where fin whales were observed over the continental shelf off the northeastern United States. Monte Carlo simulations estimated the probability that the distribution of fin whale sighting was random with respect to bottom depth, bottom slope and the intensity and gradient of the geomagnetic field. The simulations demonstrated no overall association of sighting positions with any of these four geophysical parameters. Analysis of the data by season, however, demonstrated statistically reliable associations of sighting positions with areas of low geomagnetic intensity and gradient in winter and fall, respectively, but no association of sighting positions with bathymetric parameters in any season. An attempt to focus on migrating animals by excluding those observed feeding confirmed the associations of sighting positions with low geomagnetic intensity and gradient in winter and fall, respectively, and revealed additional associations with low geomagnetic gradients in winter and spring. These results are consistent with the hypothesis that fin whales, and perhaps other mysticete species, possess a magnetic sense that they use to guide migration.

A study of the use of gloves in a large teaching hospital.

A study was conducted in the wards and laboratory of a 900-bed teaching hospital to determine the appropriateness of glove use. In the wards the rate of appropriate use was 59%, and in the laboratory it was 90%. In general, in the patient areas gloves were used for specific tasks (70%) whereas in the laboratory use for a specific task was only 32%. Financial savings could be realized by educational programs in infection control directed toward a more rational use of gloves.