Curatorship applications: The role of neuropsychology.

This article highlights ethical issues that may arise in the relationship between curatorship applications and neuropsychology. In South Africa (SA), curatorship applications for the elderly diagnosed with dementia require substantiation from two medical professionals, one of whom should be a practising psychiatrist deemed competent to provide this. Concurrently, there is often a request for a psychologist to conduct a neuropsychological assessment and to produce a relevant report. The process may result in ethical issues at various stages of the assessment. The balance between protecting the patient's rights v. freedom of autonomy becomes a central issue. Psychiatrists and psychologists are cautioned to adhere to best practices throughout the assessment, maintaining a critical and reflective stance. The limitations of cognitive assessment as a predictor of functionality should be considered. Furthermore, neuropsychological training in SA differs across institutions, resulting in variable practitioner competency. 'Competency' itself is an ambiguous legal term that may be interpreted variably. This article outlines the definitions and requirements of the curatorship process, as well as the role and limitations of neuropsychology, with emphasis on the ethical dilemmas that may arise.

The role of granules within viscous capture threads of orb-weaving spiders.

Sticky viscous prey capture threads form the spiral elements of spider orb-webs and are responsible for retaining insects that strike a web. These threads are formed of regularly spaced aqueous droplets that surround a pair of supporting axial fibers. When a thread is flattened on a microscope slide a small, opaque granule can usually be seen within each droplet. These granules have been thought to be the glycoprotein glue that imparts thread adhesion. Both independent contrast and standard regressions showed that granule size is directly related to droplet volume and indicated that granule volume is about 15% of droplet volume. We attempted to find support for the hypothesized adhesive role of granules by establishing an association between the contact surface area and volume of these granules and the stickiness of the viscous threads of 16 species in the context of a six-variable model that describes thread stickiness. However, we found that granule size made either an insignificant or a small negative contribution to thread stickiness. Consequently, we hypothesize that granules serve to anchor larger, surrounding layers of transparent glycoprotein glue to the axial fibers of the thread, thereby equipping droplets to resist slippage on the axial fibers as these droplets generate adhesion, elongate under a load, and transfer force to the axial fibers.

Detection of Mycobacterium tuberculosis in serum samples using the polymerase chain reaction.

Conventional methods for the diagnosis of Mycobacterium tuberculosis infections have serious limitations. To determine whether amplification of M. tuberculosis DNA in serum by the polymerase chain reaction (PCR) might be a useful additional diagnostic tool, we tested 329 clinical specimens using primers specific for the IS6110 insertion sequence of the M. tuberculosis complex. The samples consisted of 30 serum samples from healthy controls, 114 serum samples from patients with diagnoses other than tuberculosis (including immunosuppressive disorders), 59 samples from patients with a clinical picture suggestive of tuberculosis, and 78 serum samples from patients with proven M. tuberculosis infection. Both serum, and representative samples from anatomical regions suspected of being infected, were collected from a further 48 patients for comparison with serum PCR. Serum PCR identified 72/78 (92%; 95% confidence interval CI: 84%-97%) patients with proven tuberculosis, and 49/59 (83%; 95% CI: 71%-92%) patients with suspected tuberculosis. In the group of patients with other diagnoses, 30/114 (26%; 95% CI: 18%-34%) tested positive, while none of the specimens from the healthy control group were positive (95% CI: 0%-12%). Serum PCR results also compared favourably with other clinical specimens obtained from the same patient. Serum PCR can, therefore, be a useful additional technique for the early diagnosis of M. tuberculosis infection, but it does not necessarily indicate active infection.

Immunoglobulin G sub-class concentrations in South African adults: ethnic differences and reference ranges.

Serum samples from healthy adult volunteers (n = 149) were selected at random from disputed paternity cases, laboratory staff and volunteers attending clinical trials. Total immunoglobulin G (IgG) and IgG sub-class (IgGSc) concentrations were determined by a radial immunodiffusion technique (RID). Standard statistical analyses were used to determine differences between groups. Reference ranges of IgGSc concentrations were calculated on the resultant groups of data. Total IgG and IgGSc concentrations in men and women of the same racial group were similar, except for IgG4 which was slightly higher in white males than in white females (median: 0.36 g/L vs 0.20 g/L respectively). IgGSc concentrations were higher in blacks than in whites (median values: IgG: 17.1 vs 12.1 g/L; IgG1: 11.1 vs 7.6 g/L; IgG2: 4.3 vs 3.2 g/L; IgG3: 1.2 vs 0.90 g/L respectively) with the exception of IgG4 which was similar in both groups (median: 0.29 g/L). It would appear that IgGSc values differ among the ethnic groups. Ethnicity must therefore be considered when calculating reference ranges. The reference ranges for the IgG sub-classes in the two ethnic groups are intended for use in our laboratory and in others in South Africa that use the RID technique.

Primary pulmonary care of the patient with cystic fibrosis.

This article presents an overview of the pathophysiology, presentation, diagnosis, current therapy, and promising new research of cystic fibrosis. Focus is on the care of the cystic fibrosis patient by the community primary care provider and coordination of care between primary care providers and Cystic Fibrosis Foundation Centers.

Neurofibromatosis (von Recklinghausen's disease)--an unusual cause of parenchymal lung disease. A case report.

Interstitial pulmonary fibrosis and bullae are uncommon findings in neurofibromatosis. A case of this disease with pulmonary parenchymal involvement is presented and the association between the two is discussed.

Collaborative study of temperature-sensitive mutants of herpes simplex virus type 2.

Eighteen complementation groups were identified by complementation tests and by phenotype from twenty temperature-sensitive mutants isolated independently in Glasgow, Scotland, and Houston, Tex.

Ophthalmological findings in AIDS. A case report.

Ophthalmological findings in AIDS include retinal cotton-wool spots, retinal haemorrhages, cytomegalovirus retinitis, conjunctival manifestations of Kaposi's sarcoma, and cranial nerve palsy. About 75% of patients with AIDS have ophthalmological abnormalities. All patients with AIDS, as well as those at high risk who have any ocular symptoms, should have a thorough ophthalmological evaluation. A case study is presented.

Deficiency of the seventh component of complement. A case report.

Deficiency of the 7th component of the complement cascade was diagnosed in a white male with recurrent meningococcal infections. This deficiency has not previously been reported in South Africa.

Impairment of expressive behavior in pediatric HIV-infected patients with evidence of CNS disease.

Rated observations of videotapes were made of 16 variables representing 5 behavioral domains (task orientation, positive social-emotional, motor skills, expressive speech, and activity) on a sample of 83 HIV-infected children. Comparisons were made on the rated behaviors between children classified as either encephalopathic or nonencephalopathic. Analyses were conducted separately for infants (M age = 1.80 years) and older children (M age = 5.15 years). The nonencephalopathic infants exhibited higher activity levels and were superior in motor and verbal skills and showed more social and emotional responsiveness than did the encephalopathic group. The older nonencephalopathic children functioned in a more adaptive and appropriate manner than did the encephalopathic children in all domains of behavior. Independently made Q-sort ratings of behaviors during developmental testing were highly correlated with conceptually congruent ratings of the videotaped behaviors.

C7 M/N protein polymorphism typing applied to inherited deficiencies of human complement proteins C6 and C7.

C7 M/N typing, the determination of the complement component C7 M/N phenotypes, was successfully used in family studies to trace haplotypes bearing C7 deficiency genes. Furthermore, it was shown to be preferable to C7 allotyping based on isoelectric focusing (IEF) since it distinguishes two common alleles (C7*M and C7*N), whereas one common C7 IEF allele (C7*1) predominates in most populations. It is also the more sensitive method, as it enabled detection of very low amounts of abnormal C7 molecules in the third generation of a combined subtotal C6/C7-deficient subject and thus confirmed that this partial deficiency gene is not silent in heterozygotes. In this respect C7 M/N typing is even more informative than DNA restriction fragment length polymorphism typing which will assess the presence but not necessarily the functional status of a gene. C6 and C7 genes are tightly linked and therefore C7 M/N typing was also applied to tracing C6 deficiency genes in families. C6/C7 haplotype analysis of South African C6-deficient (C6Q0) subjects revealed a strong allelic association of C6*Q0 and C7*M.