HLA-DR, DQ and T cell antigen receptor constant beta genes in Japanese patients with ulcerative colitis.

We studied the T cell antigen receptor (TcR) constant beta chain genes on HLA typed Japanese patients with ulcerative colitis (UC). A TcR constant beta EcoRI 6.0-kb fragment was present in all Japanese UC patients (n = 17) but completely absent in the controls (n = 35) (chi2 = 47.6, P less than 0.001). The frequency of HLA-DR2 antigen was significantly higher in UC patients (85% versus 28% in controls, P less than 0.001). Furthermore, HLA-DQw1 antigen was also increased in UC patients (96% versus 60% in controls, P less than 0.001). However, HLA-DR4 antigen was significantly decreased in UC patients (12% versus 37%, P = 0.02). HLA-DR1 antigen was not found in UC patients and was present in only 15% of the controls. These results suggest that TcR beta chain and HLA-DQw1 antigen may be important in the pathogenesis of Japanese UC.     

精神分裂症与代谢综合征的患病率、危险因素及护理管理

目的调查精神分裂症患者代谢综合征的患病率及危险因素,探讨预防和控制代谢综合征的护理管理措施。方法 503名住院精神分裂症患者和60名健康自愿者接受调查,收集人口学资料和病史资料,测量相关生理和生化指标,按IDF标准诊断代谢综合征(M S)。结果精神分裂症患者M S的患病率为28.4%,显著高于对照组(χ2=24.275,P=0.000),女性患者患病率(39.8%)高于男性(22.3%)(χ2=17.120,P=0.000),40岁以上患者的患病率(30.9%)高于39岁以下患者(22.1%)(χ2=3.421,P=0.064);血脂异常(TG增高和HDL-C降低)、肥胖(BM I和腰围)和血糖增高是最重要的危险因素(OR值>6.0),总胆固醇增高、血压增加、LDL-C增高、尿酸增高、女性、在婚和偏执型也是重要的危险因素(OR值>2.0),年龄、教育、首发年龄和蛋白质等也有一定影响。结论精神分裂症患者具有较高M S患病率,血脂异常、肥胖和血糖增高是最重要的危险因素和预测指标。护理管理可以在M S的预防、早期识别和疾病控制中发挥重要作用。     

Validation of a rapid type 1 diabetes autoantibody screening assay for community‐based screening of organ donors to identify subjects at increased risk for the disease

The Network for Pancreatic Organ donors with Diabetes (nPOD) programme was developed in response to an unmet research need for human pancreatic tissue obtained from individuals with type 1 diabetes mellitus and people at increased risk [i.e. autoantibody (AAb)‐positive] for the disease. This necessitated the establishment of a type 1 diabetes‐specific AAb screening platform for organ procurement organizations (OPOs). Assay protocols for commercially available enzyme‐linked immunosorbent assays (elisa s) determining AAb against glutamic acid decarboxylase (GADA), insulinoma‐associated protein‐2 (IA‐2A) and zinc transporter‐8 (ZnT8A) were modified to identify AAb‐positive donors within strict time requirements associated with organ donation programmes. These rapid elisa s were evaluated by the international islet AAb standardization programme (IASP) and used by OPO laboratories as an adjunct to routine serological tests evaluating donors for organ transplantation. The rapid elisa s performed well in three IASPs (2011, 2013, 2015) with 98‐100% specificity for all three assays, including sensitivities of 64–82% (GADA), 60–64% (IA‐2A) and 62–68% (ZnT8A). Since 2009, nPOD has screened 4442 organ donors by rapid elisa ; 250 (5·6%) were identified as positive for one AAb and 14 (0.3%) for multiple AAb with 20 of these cases received by nPOD for follow‐up studies (14 GADA+, two IA‐2A⁺, four multiple AAb‐positive). Rapid screening for type 1 diabetes‐associated AAb in organ donors is feasible, allowing for identification of non‐diabetic, high‐risk individuals and procurement of valuable tissues for natural history studies of this disease.     

Antibodies in some chronic fibrosing lung diseases

Autoantibodies to nuclear and cytoplasmic constitutents and to denatured γ-globulin have been studied in patients with different types of chronic fibrosing lung disease. The prevalence of these antibodies is increased in cryptogenic fibrosing alveolitis but the incidence in extrinsic allergic alveolitis is similar to previous published reports on random populations and a control group included in this series of asbestos workers with normal chest radiographs. In asbestosis there was a lesser increase in ANF and rheumatoid factors but no significant increase in antibodies to cytoplasmic constituents. No evidence of organ-specific autoantibodies to lung have been demonstrated in any group. The presence of non organ-specific autoantibodies cannot necessarily be attributed to a non-specific consequence of all types of chronic destructive pulmonary fibrosis because of their differential distribution in different lung diseases. Because ANF and RF but not precipitins to organic dust are positive in some 60% of patients with cryptogenic fibrosing alveolitis, and precipitins but not autoantibodies are found in chronic extrinsic allergic alveolitis, tests for these two groups of antibodies are complementary in the investigation of patients with widespread chronic radiographic shadows. Tissue antibodies were absent in 40% of patients with cryptogenic fibrosing alveolitis and a more detailed search for other types of antigen should be made in these cases.     

Demonstration of natural autoantibodies against the neurofilament protein alpha-internexin in sera of patients with endocrine autoimmunity and healthy individuals

Serum anti-pituitary antibodies (APAs) to cytosolic antigens have been found in association with autoimmune hypophysitis, idiopathic hypopituitarism, and other autoimmune endocrinopathies. Here, an immunoblot method was used to search for serum autoantibody (AAb) reactivities against pituitary antigens, including nuclear and cytoskeletal proteins, in six patients with idiopathic hypopituitarism, 60 patients with type 1 diabetes, nine patients with autoimmune polyglandular syndrome (APS) type 1, and in 74 healthy controls. Frequent patient serum IgG reactivity was observed against a 60 kDa human pituitary antigen, and the cross-reactive 62 kDa protein from rat brain was identified as alpha-internexin (alpha-INX) by proteomic methods. IgG and IgM AAbs to this neuron-specific type IV intermediate filament (IF) protein were found in most sera of patients with endocrine autoimmunity as well as healthy subjects with no significant differences in frequencies between the groups, but the levels of IgM alpha-INX AAbs were higher in patients with hypopituitarism as compared to healthy controls (P = 0.032, Mann-Whitney U-test). These findings suggest that alpha-INX AAbs are not specifically related to autoimmune endocrine diseases and most probably are a part of the natural AAb repertoire. This is the first demonstration of alpha-INX AAbs as one of the predominant neuronal IF AAbs in human sera.     

A longitudinal cohort study of elderly women with urinary tract infections

AIMS: the prevalence of urinary tract infections (UTI), urinary incontinence (UI), estrogen-use and overall mortality in a cohort of elderly women who had been treated for UTI in 1985-86 was re-assessed 10 years later. MATERIAL AND METHODS: a random sample of 6000 women from the birth cohorts 1900, 1905, 1910, 1915 and 1920 were invited in 1986 to complete a questionnaire about UTI, UI and estrogen use (response rate 70%; n = 4206). Treatment with antibiotics for UTI during 1985-86 was reported by 688 (17%) women. In 1995 a similar questionnaire was sent to the women from this group who were still alive (n = 434). Mortality in the women with a history of UTI was compared with an aged-matched control group of women who did not have UTI during 1985-86. RESULTS: the questionnaire was completed and returned by 361 (83%) women. Treatment for at least one UTI during the last 9 years was reported by 219 (61%) women. The number of episodes varied: 35% had one to two UTI, 28% had three to four UTI, 27% five to ten UTI and 10% had had more than 10 UTI. In 1986, the prevalence of UI was higher in women with a history of UTI than in the total population sample (30 vs. 17%; P < 0.001). The prevalence of UI had increased from 30% in 1986 to 33% in 1995 (P < 0.05). Mortality in the women with a history of UTI was higher than in the aged-matched control group (37 vs. 28%; P < 0.001). A total of 162 (45%) women had received estrogen therapy at some time after the age of 60 years and 140 (39%) reported that they were currently taking low potency estrogens. CONCLUSION: elderly women with a history of UTI had a continued high occurrence of UTI and UI, and overall mortality was higher in these women than in an age-matched control group of women from the total population.     

Deficiency of high-affinity anti-beta-D-galactosidase antibodies in selected low immune responder mice.

Amount and affinity of anti-beta-D-galactosidase-activating antibodies (AAb) were studied in two lines of mice obtained by selective breeding for antibody response to heterologous erythrocytes. These lines, referred to as high (H) and low (L) lines, differ also in their responses to many antigens. Concerning AAb amounts, the maximal titer in H mice is higher than in L mice. However, the AAb levels in H mice decreased with increasing immunizing doses and became lower than in L mice for the highest dose. This fact can be explained in terms of intramolecular competition or suppression. Whereas the usual maturation pattern was observed in H mice, no AAb of high affinity were found in L mice, even after a minimal immunizing dose. At any dose tested, no maturation of AAb occurred until three months after immunization. This deficiency may be ascribed to B lymphocyte or macrophage modifications. A correlation between the deficiency of high-affinity AAb in L mice and their genetically induced low antibody responsiveness cannot be proved.     

High prevalence of anti-cardiolipin and other autoantibodies in a healthy elderly population.

Serum samples from 64 apparently healthy individuals (32 men and 32 women, mean age 81.0 years) were examined for the prevalence of several autoantibodies, including rheumatoid factor (RF), antinuclear antibodies (ANA), antibodies to extracted cellular antigens Ro (SSA), La (SSB), Sm, U1nRNP and Scl-70. IgG and IgM isotype-specific ELISA methods were applied for the detection of antibodies to ssDNA (anti-ssDNA), to dsDNA (anti-dsDNA) and to cardiolipin (anti-CL). The sera of this elderly population were found to contain a plethora of autoantibodies; RF was detected in 14.1%, ANA in 31.3% and anti-Ro (SSA) in 1.6% of the individuals. Precipitating antibodies to La (SSB), Sm, U1nRNP and Scl-70 were absent, while 15.6% of the sera displayed precipitating antibodies to a common undefined human spleen antigen. ELISA methods revealed anti-ssDNA in 17.2% of the individuals, anti-dsDNA in 14.1% and anti-CL in an extremely high incidence (51.6%). Notably, the above autoantibodies were exclusively of IgG isotype. Tests of 261 sera from healthy non-elderly individuals disclosed only anti-CL (IgG and IgM isotypes) in 2.3% of them. The levels of IgA and IgG immunoglobulins were increased in 23.4% and 29.7% of the elderly subjects, respectively. IgM was elevated in 3.1%, but it was also found decreased in 9.4%. This study documents the high incidence of autoantibodies in the healthy elderly, including for the first time, anti-CL antibodies. Furthermore, the relative impairment in IgM autoantibody production observed, possibly indicates the involution of the senescent immune system.     

Risk assessment in elderly for sensitization to food and respiratory allergens

For elderly people, epidemiological data are rare for respiratory allergies and completely missing for food allergies. The aim of this study was to examine the prevalence and risk factors for sensitizations in 109 people with a mean age of 77 years, who are living in a geriatric nursing home. The cross-sectional study included a detailed interview, skin prick tests, and serum tests for specific and total IgE, IFN-gamma, and ST2, a marker for Th2-lymphocyte activity. Almost all study subjects (n=101) suffered from co-morbidity, 14 from type I allergy, 25 from gastrointestinal disorders treated with anti-ulcer drugs, 25 were chronic alcoholics and 21 were smokers. The total IgE levels were significantly higher in men (P=0.025), and not affected by smoking or alcohol consumption. Skin prick tests were positive in 41.7% of tested patients. Specific IgE to respiratory allergens was found in 40.4% of all patients and was elevated in men (P=0.013), with a significant correlation to smoking (P=0.029). Specific IgE to food allergens was detected in 24.8%, apparently without connection to the investigated risk factors. However, positive skin prick tests with food allergens could be correlated with chronic alcohol consumption (P=0.036). The intake of anti-ulcer medication was significantly correlated with elevated ST2 levels as an indirect readout for Th2-cell activity (P<0.001). The risk factors for sensitization in elderly to respiratory allergens were chronic damage of respiratory epithelia due to smoking, and for sensitization to food allergens chronic alcohol consumption.     

Prevalence and predictors of metabolic syndrome among HIV-infected and HIV-uninfected women in the Women's Interagency HIV Study

OBJECTIVES: To assess the prevalence of metabolic syndrome (MetSynd) among participants of the Women's Interagency HIV Study and to describe the association of MetSynd with HIV infection, antiretroviral therapies, and sociodemographic factors. METHODS: Prevalence of MetSynd, defined by updated Adult Treatment Panel III guidelines, was assessed among 2393 (1725 seropositive and 668 seronegative) participants from the Women's Interagency HIV Study seen between October 2000 and October 2004. RESULTS: HIV-1 infection was independently associated with MetSynd [33% vs 22%, P<0.0001 in HIV-seropositive compared with HIV-seronegative women; adjusted odds ratio (OR) 1.79 (95% confidence interval 1.48, 2.16)]. HIV-infected women had higher mean triglyceride (154 vs 101 mg/dL, P<0.0001) and lower mean high-density lipoprotein cholesterol levels (46 vs 55 mg/dL, P<0.0001). Most notable factors associated with higher prevalence of MetSynd among HIV-infected women included older age (OR=1.38 per 5 year increase, P<0.0001); higher body mass index; current smoking; HIV-1 RNA (OR=1.36, P=0.019, for >50,000 vs <80 copies/mL); and use of stavudine (OR=1.28, P=0.009). Nevirapine use was protective (OR=0.75, P=0.016). There was no significant association of MetSynd with ritonavir-boosted protease inhibitors (OR=1.15, P=0.134). CONCLUSIONS: MetSynd is more prevalent in HIV-seropositive than HIV-seronegative women. This increased prevalence was due to dyslipidemias rather than higher blood pressure, glucose, or waist circumference.     

Age-related alteration in the association of microsatellite instability with absent hMLH1 expression and histological types of colorectal carcinoma

Microsatellite instability (MSI) is present in approximately 15-20% of sporadic colorectal cancers. However, despite the increased prevalence of absent hMLH1 expression and MSI in colorectal cancer in the elderly, few attempts have been made to define it in detail. The aim of the present paper was to correlate age-related alterations in absent hMLH1 expression and MSI with various histological types of colorectal carcinoma. hMLH1 expression and microsatellite status were studied in 184 colorectal carcinomas (49 well-differentiated, 49 moderately differentiated, 49 poorly differentiated adenocarcinomas, and 37 mucinous carcinomas). The prevalence of absent hMLH1 expression was higher in poorly differentiated adenocarcinoma (63%) and mucinous carcinoma (43%) than in well- (8%) and moderately (12%) differentiated adenocarcinomas. MSI was found more frequently in poorly differentiated adenocarcinoma (69%) and mucinous carcinoma (41%) than in well- and moderately differentiated adenocarcinomas (8% and 6%, respectively). Age-related differences in absent hMLH1 expression and MSI were found only in poorly differentiated adenocarcinoma, in which the prevalence of medullary-type carcinoma increased with advancing age. These results indicate that an age-related increase of medullary-type tumors in poorly differentiated adenocarcinoma may play an important role in the increase of absent hMLH1 expression and MSI in colorectal carcinoma.     

Association of pelvic organ prolapse and fractures in postmenopausal women: analysis of baseline data from the Women's Health Initiative Estrogen Plus Progestin trial

OBJECTIVE: Testing a hypothesis that pelvic organ prolapse (POP) is a focal manifestation of disordered connective tissue, we evaluated whether there is an association between POP and history of fracture. DESIGN: This was a case-control study. Baseline data were from postmenopausal women aged 60 years or older enrolled in the Women's Health Initiative Estrogen Plus Progestin trial. Distinct variants (cystocele, rectocele, and uterovaginal) and severity (mild, moderate, or severe) of POP were recognized. A history of "fracture after age 55" was considered as the event of interest. RESULTS: Moderate to severe POP was identified in 9% of 11,096 participants aged 60 years or older. Women with moderate to severe rectocele were significantly more likely to report fracture (odds ratio: 1.37, 95% CI: 1.06-1.77, P = 0.02) compared with those with absent to mild prolapse. Of the subset of participants who underwent bone mineral density assessment, those with moderate to severe prolapse demonstrated significantly lower whole-body bone mineral density ([beta] = -0.03, SE 0.02); this difference was of borderline significance (P = 0.05) compared with that for participants with absent to mild POP. Multivariate logistic regression analysis confirmed an independent association between moderate to severe rectocele and fracture (odds ratio: 1.45, 95% CI: 1.08-1.95, P = 0.01). CONCLUSIONS: We demonstrate a relationship between moderate to severe POP and low bone mineral density in postmenopausal women enrolled in the Women's Health Initiative Estrogen Plus Progestin trial. Our findings of an association between clinically significant (moderate to severe) POP, specifically rectocele, and a history of fracture suggest that suboptimal collagen status purported to associate with POP may also involve bone collagen and hence translate into skeletal compromise.     

Depression in old age (75+), the PIKO study

BACKGROUND: Old people (75+) are underrepresented in studies on the prevalence of and risk factors for depression while the number of elderly people suffering from this mood disorder may be considerably higher than previously assumed. The role--if any--of age and gender in 'Geriatric Depression' is still unclear. METHODS: In this community-based study, prevalence of depressive symptomatology and risk indicators were assessed in 2850 participants aged 75 years or more. A clinically relevant level of depressive symptoms was defined as a score of > or =16 on the Centre for Epidemiologic Studies Depression scale (CES-D). Demographic data and questions related to physical and psychological health were recorded. Simple and multiple logistic regression techniques were used to determine the risk indicators (Odds Ratios, OR, with 95% confidence intervals, CI) with apparent importance to this population. RESULTS: The prevalence of depressive symptoms was assessed to be 31.1%. This is considerably higher than what has been found in younger elderly samples. The bivariate age effect was OR 1.05 (95% CI=1.03 to 1.07). Controlling for confounding, the effect of gender and age on depressive symptoms disappeared. CONCLUSIONS: Depressive symptoms are highly prevalent in the elderly population and increase with age. This increase seems to be attributable to age-related changes in risk factors rather than to ageing itself. With regard to the risk factors found, attention should perhaps be paid to functional disability, loneliness and apprehensiveness for falling since these risk indicators are amenable for improvement.     

Age-related effects of novel visual stimuli in a letter-matching task: an event-related potential study

Younger and older participants (n=8 in each age group) performed a letter-matching task, where they had to respond to identical letters (P=0.15). Task-relevant (target and non-target) letters were presented on two corners of an imagery square, while on the other two corners irrelevant letters were presented. In some trials (P=0.05), pictures of visual objects (novels, unrelated to the matching task) were presented. Reaction times were slower and error rates higher for older adults. The amplitude of the N1 event-related potential component was smaller over anterior locations for the older adults. All target stimuli elicited a late positivity over anterior locations for both age groups, but the late positivity (P3b) was absent over posterior scalp for the older adults. For the younger adults, novel stimuli elicited a large negative component (N2(novel)) that was maximal over the central location. No such activity was observed for older adults. Based on the results, processing of novel stimuli is considered to be compromised in the elderly.     

脂肪肝与HBV感染、高脂血症及ALT异常的相关分析

目的 了解广州市体检人群脂肪肝的患病率,探讨脂肪肝与HBV感染、高指血症及ALT导常的关系.方法 回顾性对在中山大学附属第三医院健康体检的4365名人员的临床资料进行分析.结果 4365名体栓者中,共检出脂肪肝793例,脂肪肝患病率18.2%脂肪肝组,男性440例,患病率19.2%,女性353例,患病率17.1%男女患病率差别无统计学意义(P=0.07).乙型肝炎病毒感染人群的脂肪遥远患病率为16.7%,低于非感染人群的18.3%,两者差民无统计学意义,P=0.45. 高脂血症组的脂肪肝患病率为42.1%,显著高于血脂政党组的11.6%,P<0.05.脂肪肝组的ALT异常率为32.5%,显著高于非脂肪肝组的8.6%,P<0.05.结论 广州地区人群中男女的脂肪肝患病率无显著差异.脂肪肝与乙型肝炎病素感染无关,但与年龄、高脂血症密切相关,容易引起ALT升高.     

Prevalence and geographic disparity of depressive symptoms among middle-aged and elderly in China

BACKGROUND: To evaluate the prevalence of and risk factors for depressive symptoms among middle-aged and elderly Chinese in northern and southern China. METHODS: A population-based cross-sectional survey was performed in Beijing and Shanghai. Participants included 3289 community residents aged 50-70. Socio-demographic, lifestyle and health-related information were obtained by a standardized questionnaire. Clinically relevant depressive symptoms were assessed by the Center for Epidemiological Studies of Depression Scale (CES-D). RESULTS: The prevalence of depressive symptoms in the total study population was 9.5% (6.7% for men and 11.7% for women), and it was significantly higher in participants from Beijing than those from Shanghai (14.9% vs. 4.1%, P < 0.001). Multivariate logistic regression analyses indicated that this geographic disparity was independent of gender, age, marital status, living status, education level, health status, mobility, social activities and medical insurance (odds ratio, 3.94; 95% confidence interval, 2.86-5.40). LIMITATIONS: No clinical diagnostic validation was performed and the prevalence might be underestimated due to our exclusion criteria. CONCLUSIONS: Approximately one in ten middle-aged and elderly Chinese might suffer from depressive symptoms. Furthermore, the prevalence is substantially higher among residents in the north of China compared to the south. Prospective studies are required to confirm the results and identify the major risk factors contributing to this geographic disparity.     

不同放疗剂量治疗80岁以上高龄食管癌患者的预后分析

目的:回顾性分析不同放疗剂量治疗80岁以上高龄食管癌临床疗效、安全性和影响因素。方法:回顾性分析2013年7月~2016年9月间行调强放疗的83例80岁以上高龄食管癌的临床资料,Kaplan-Meier法计算总生存率（OS）和无进展生存率（PFS）,Log-rank法检验单因素预后分析和Cox回归模型检验多因素预后分析。结果:中位随访时间37.2月,1、2和3年OS分别为68.7%、46.7%和32.1%,1、2、3年PFS率分别为61.1%、40.0%和24.7%,中位OS和PFS分别为24.1月和19.4月。单因素分析显示影响OS和PFS的临床因素有放疗剂量（P=0.006和0.013）,老年营养风险指数（GNRI）（P=0.002和0.007）和成人合并症评估-27（ACE-27）评分（P=0.018和0.040）。多因素分析显示放疗剂量（P=0.015和0.029）和GNRI（P=0.007和0.019）是OS和PFS的独立预后因素。高剂量“≥60 Gy”组患者3级以上不良反应发生率为57.1%,高于低剂量“<54 Gy”组的25.0%（P=0.037）和较高剂量“54~60 Gy”组的26.2%（P=0.016）。结论:调强放疗治疗80岁以上高龄食管癌患者耐受性尚可,患者营养状态和放疗剂量是影响患者预后的主要因素,较高剂量“54~60 Gy”组预后较好且治疗毒副反应较轻,可作为高龄食管癌优选放疗剂量。     

The occurrence of <Emphasis Type="Italic">Pneumocystis jirovecii</Emphasis> in people from three different age groups of Warsaw (Poland) community

The three age groups of people from Warsaw: children, young adults and elderly people were examined for the prevalence of infection with Pneumocystis jirovecii. Nested PCR was used to amplify fragment of mitochondrial large subunit rRNA of the fungus in samples of oropharyngeal swabs. Nineteen (12.8%) of the 148 examined samples were positive for DNA of P. jirovecii. The samples collected from children were more often positive than the samples from young adults (p = 0.003) or from both groups of adults (p = 0.0029). Moreover, among adults (n = 99) proportion of infected women (n = 6; 12.5%) was significantly higher than men (n = 1; 2%). Results of the research confirm the high prevalence of Pneumocystis infection in children and indirectly point out to children as a possible source of infection for older people.     

P53 autoantibodies in sera from Danish ovarian cancer patients and their correlation with clinical data and prognosis

The p53 gene, a tumour suppressor gene located on the short arm of chromosome 17 (17p13), is frequently mutated in various human tumours. Accumulation of p53 protein in neoplastic cells and its release following tumour necrosis can lead to development of circulating autoantibodies (AAb) against p53. Earlier studies of ovarian cancer (OC) patients reported different frequencies of p53 AAb and conclusions regarding the clinical and prognostic value of these AAb have not been in agreement. We therefore analysed for the presence of p53 AAb in a total of 227 preoperative serum samples from 193 OC patients and 34 patients with ovarian borderline tumours, and, in addition, serum samples from 86 healthy controls. An enzyme-linked immunosorbent assay (ELISA) was used to measure serum IgG antibodies against p53. The p53 protein used in the assay was produced as a hexahistidine-tagged fusion protein by baculovirus-infected Spodoptera frugiperda cells. Cut-off values for p53 AAb were evaluated, and correlations of p53 AAb with clinical-, biochemical data and survival were examined. We found a low sensitivity for p53 AAb alone, and no major additional effect of the detection rate of CA125 was found. No significant associations were found between p53 AAb and clinical stage, age, histological subtype and radicality after primary surgery. In contrast, we found significantly elevated CA125 levels in p53 AAb-positive patients compared to lower CA125 levels in p53 AAb-negative patients (p=0.003). No significant differences were found between p53 AAb-positive and p53 AAb-negative patients in the univariate and multivariate survival analyses. In conclusion, in a screening study for OC serum p53 AAb levels are of no diagnostic value, even if combined with the tumour marker CA125. The presence of increased serum p53 AAb in patients with diagnosed OC could not be correlated with any clinical data and preoperative serum p53 AAb status had no evident value.     

Prevalence of cryoglobulinemia in hepatitis C virus (HCV) positive patients with and without human immunodeficiency virus (HIV) coinfection.

BACKGROUND: Coinfection with human immunodeficiency virus (HIV) has been shown to influence the natural history of hepatitis C infection. OBJECTIVE: Our interest was to determine if HIV coinfection influences the prevalence of cryoglobulinemia in hepatitis C virus (HCV) infected persons. STUDY DESIGN: A total of 384 HCV RNA positive (234 HIV-infected and 150 HIV-uninfected) participants were tested at two visits, 18 months apart, for HCV and HIV RNA, CD4, and liver enzyme levels. Serum cryoglobulin levels were measured at a subsequent visit for a subset of the sample. RESULTS: HIV-infected participants had significantly higher HCV RNA levels (P < 0.0001) and aspartate transaminase (AST) levels (P < 0.0001), but not alanine transaminase (ALT) levels (P > 0.05) as compared with HIV-uninfected participants. These findings were consistent at both visits and no significant changes were observed between visits. Fifty (19%) of the 264 participants tested had detectable cryoglobulins. No difference was observed in HIV seropositivity among participants with or without cryoglobulinemia (68% versus 61%; odds ratio = 1.34, P = 0.37). However, among HIV coinfected participants, elevated AST levels (P = 0.04) and lower CD4 levels (P = 0.02) were associated with cryoglobulinemia. CONCLUSIONS: While previously reported associations were found between HIV and coinfection with HCV in this study, we did not find an association between HIV infection and cryoglobulinemia.