3% were TB-positive using PCR, while respectively 47.6% and 45.2% were sputum- and culture-positive. Among the HIV-positive individuals, 55.6% were PCR-positive, whereas only 38.9% were sputum-positive and 50% were culture-positive.

CONCLUSION: These results demonstrate that the identification of mycobacteria by PCR using GuHClM is very sensitive and therefore may have wide utility in the diagnosis of TB.”
“Objective: Recent progresses in fetal surgery have raised concern on fetal pain, its long-term consequences

and the risks of sudden fetal movements induced by pain. In several studies, surgeons have directly administered opioids to the fetus, while others have considered sufficient the maternally administered analgesics. We Roscovitine manufacturer performed a review of the literature to assess the state of the art. Methods: We performed a PubMed search to retrieve the papers that in the last 10 years reported studies of human fetal surgery and that described whether any fetal analgesia was administered. Results: We retrieved 34 papers. In three papers, the procedure did not hurt the fetus, being performed on fetal annexes, in two papers, it was performed in the first half of pregnancy, PHA-739358 in vivo when pain perception is unlikely. In 10 of the 29 remaining papers, fetal surgery was performed using direct fetal analgesia, while in 19, analgesia was administered only

to the mother. In most cases, fetal direct analgesia was obtained using i.m. opioids, and muscle relaxant. Rare drawbacks on either fetuses or mothers due to fetal analgesia were reported. Conclusion: Fetal direct analgesia is performed only in a minority of cases and no study gives details about fetal reactions to pain. More research is needed to assess or exclude its possible long-term drawbacks, as well as the actual consequences of pain during surgery.”
“SETTING: The real-time polymerase chain

reaction (RTPCR) has increasingly been used for the detection of various micro-organisms, including mycobacteria.

OBJECTIVE: To determine the role of RT-PCR in confirming the diagnosis of tuberculosis (TB) when acid-fast bacilli (AFB) smear results in sputum samples were not available (i.e., no sputum or negative smear results).

DESIGN: We analysed the data of consecutive AC220 patients whose bronchial aspirate (BA) was tested for RT-PCR for the diagnosis of TB from January 2006 to April 2008. Computed tomography (CT), bronchoscopy and tissue biopsies were performed in all patients for confirmatory diagnosis, and BA was collected for microbiological analyses and RT-PCR. Final diagnoses were based on microbiological or clinicopathological criteria.

RESULTS: Final diagnoses were made in 136 patients, and TB was confirmed in 77 (including 65 culture-positive patients). RT-PCR was positive in 51.9% (40/77) of the confirmed TB patients. More TB patients (20.8%) were detected using RT-PCR than using BA-AFB stain (40 vs. 20, P < 0.001). Of the 77 TB patients, 44 (57.