Male gray treefrogs call to attract females under challenging acoustic conditions. At higher chorus densities, there is considerable background noise and a good chance that a male's calls will often be overlapped by calls of other individuals. Call overlap may reduce the probability of mating because females prefer calls with internal pulse structure that is not obscured. With increases in acoustic stimulation, males lengthen call duration while simultaneously reducing call rate such that "pulse effort" changes little. In our study, we tested the "interference risk hypothesis." This proposes that males change call duration so that, on average, there will be a sufficient number of pulses and interpulse intervals clear of acoustic interference per call to attract a female. However, female choice experiments employing call alternatives of different durations, rates, intensity levels, and degrees of call overlap refuted this hypothesis. Our results leave open the possibilities that the dynamic shift in the two components of pulse effort are related to the problem of call detection in a noisy environment or are responses by males to the perceived threat of competition for females.

Cryptococcus neoformans is commonly associated with meningoencephalitis in immunocompromised patients and occasionally in apparently healthy individuals. Duration and regimen of antifungal treatment vary depending on the nature of the host and extent of disease and CNS shunts are placed in persistently elevated intracranial pressures. Recurrence of infection after initial treatment is not uncommon in HIV positive patients, Kaya et al. (2012) and Illnait-zaragozí et al. (2010). We describe a 39-year-old immunocompetent female that presented with neurologic deficits and increased intracranial pressure (ICP) due to cryptococcal meningoencephalitis that had a complicated course with drug induced hepatitis and persistently increased ICP that ultimately required shunt placement and presented again with relapse of cryptococcal meningoencephalitis after completion of antifungal treatment. Our case shows that recurrent cryptococcal meningitis can be seen in immunocompetent patients due to prolonged placement of CNS shunt and suggests that shunts should be removed after resolution of meningitis.

Patient: Female, 45Final Diagnosis: Urinary bladder paragangliomaSymptoms: Angina pectoris • dyspnea • palpitationsMedication: Phenoxybenzamine • PropanololClinical Procedure: Open partial cystectomySpecialty: Endocrinology and MetabolicObjective:Rare diseaseBackground:Sympathetic urinary bladder paragangliomas are rare catecholamine-secreting neuroendocrine tumors arising from neural crest cells. They are uncommon urinary bladder neoplasms. Symptoms classically include micturition-related or unrelated palpitations and syncope with hypertension, headaches, diaphoresis, and hematuria. Other than being attributable to vasovagal reactions, micturition-induced cardiovascular symptoms should prompt a search for catecholamine-secreting tumors such as a urinary bladder paraganglioma, as in this case.Case Report:A 45-year-old asthmatic African-American female presented with episodic hematuria that began 4 years ago and episodes of micturition-induced palpitations, dyspnea, substernal tightness, sweating, and throbbing headaches. Computed tomography with contrast revealed an enhancing mass along the anterior urinary bladder wall, measuring 2.4×3.5 cm. On Positron emission Tomography with [18F] fluorodeoxyglucose integrated with computed tomography (18F-FDG PET/CT), the urinary bladder mass was 18F-FDG avid. Serum normetanephrine and supine plasma norepinephrine were significantly elevated and there was mild elevation of supine plasma epinephrine.Transurethral resection of the bladder mass revealed a neoplasm with microscopic features and immunohistochemical profile positive for synaptophysin and chromogranin, with negative screening cytokeratin AE1/AE3, suggesting a paraganglioma. Following resection of the paraganglioma, there was complete resolution of micturition-induced cardiovascular symptoms on long-term follow-up.Conclusions:Micturition-related cardiovascular symptoms are commonly attributed to vasovagal reactions. However, urinary bladder pathologies must be ruled out as a cause, as in this rare case of a urinary bladder paraganglioma exhibiting catecholaminergic symptoms.