''Gender gap'' in multiple sclerosis: magnetic resonance imaging evidence

The authors evaluated the gender difference in the magnetic resonance imaging characteristics of the lesions occurring in the brain of 413 multiple sclerosis (MS) patients. Men had fewer contrast-enhancing lesions (P = 0.01), but a higher proportion of lesions evolving into 'black holes' (P = 0.001), when compared with women. Thus, our data indicate that men with MS are prone to develop less inflammatory, but more destructive lesions than women. This study results provides support for a modulation of the MS pathological changes by gender.     

Detection of mucus glycoconjugates in human conjunctiva by using the lectin-colloidal gold technique in TEM. III. A quantitative study in asymptomatic contact lens wearers

We characterized the mucus glycoconjugates produced by goblet and non-goblet epithelial cells in asymptomatic contact lens (CL) wearers. We employed four lectins (proteins of vegetal origin which specifically recognize glycosidic residues: WGA, PNA, SBA and ConA) conjugated with colloidal gold as ultrastructural marker, at Transmission Electron Microscopy. A computerized quantitative analysis was carried out in order to compare the results from the CL wearers to those from the control patients. Goblet cells produce different amount of glycosidic residues, in particular, a significant decrease in the distribution of sialic acid, N-acetylglucosamine, N-acetylgalactosamine, galactose-N-acetylgalactosamine and mannose was observed. The content of glycosidic residues in the mucus vesicles of the non-goblet epithelial cells appeared unchanged as to the normal situation. We speculate that the CL could possibly contribute to the failure of the tear film stability by altering the production of mucus.     

The effects of communication skills training on patients' participation during medical interviews

Recent models of physician-patient communication emphasize information exchange in promoting partnership. Although considerable attention has been given to physicians' information exchange, little research has examined patients' communication contributions. The purpose of this research was to test the effectiveness of a training booklet designed to enhance patients' communication skills in information exchange. A nested design was used, such that 25 physicians each saw six patients, two patients in each of three communication skills interventions (i.e. trained, informed, control). The dependent variables included several discourse categories designed to assess patients' information seeking, provision, and verifying. Results indicate that trained patients engaged in more effective and efficient information seeking, provided physicians with more detailed information about their medical condition, and used more summarizing utterances to verify information they received from physicians. Additionally, dyads consisting of trained patients demonstrated a more patient-controlled style of communication than did dyads consisting of informed or untrained patients.     

In vivo isotope study of the thyroid with 99mTcO 4 − in neonatal congenital hypothyroidism

Seventeen patients, screened from a neonatal programme for hypothyroidism were studied. As well as the scintigraphic investigations, serum TSH, T₃, free T₃, T₄, free T₄, and TBG were measured in all patients. Not more than 11.1 MBq (300 Ci) ^99mTcO ₄ ^- was administered IV. A gamma camera with a parallel-hole collimator on line with the computer was used. The method allowed good statistics to be obtained in 5–10 min in a wide field of exploration, thus reducing the problems of positioning and prolonged immobilization of the young patient. The data collected in the computer were elaborated to define better the characteristics of the thyroid image. This kind of in vivo study introduced into a screening programme, enables an anatomic diagnosis of the defect to be obtained before starting the therapy. This is undoubtedly valuable from the epidemiological point of view, enables early determination of the degree of thyroid insufficiency, and contributes to the formulation of a prognosis based on the degree and on the moment in which prenatal harm occurred.     

Safety and immunogenicity of adjuvanted recombinant subunit herpes zoster vaccine in lung transplant recipients

Lung transplant recipients are at high risk for herpes zoster and preventive measures are a significant unmet need. We investigated the safety and immunogenicity of two doses of a recombinant zoster vaccine (RZV) in lung transplant recipients (≥50 years). We enrolled 50 patients of which 49 received at least one vaccine dose. Anti-glycoprotein E (gE) antibody levels (n = 43) increased significantly compared to baseline (median optical density [OD] 1.96; interquartile range [IQR]: 1.17–2.89) after the first (median OD 3.41, IQR 2.54–3.81, p < .0001) and second vaccine dose (median OD 3.63, IQR 3.39–3.86, p < .0001). gE-specific polyfunctional CD4+ T cell frequencies (n = 38) also increased from baseline (median 85 per 10⁶ CD4+ T cells; IQR: 46–180) to the first (median 128 per 10⁶ CD4+ T cells; IQR: 82–353; p = .023) and after the second dose (median 361 per 10⁶ CD4+ T cells; IQR: 146–848; p < .0001). Tenderness (83.0%; 95%CI: 69.2–92.4%) and redness (31.9%; 95%CI: 19.1–47.1%) at injection site were common. One rejection episode within 3 weeks of vaccination was observed. This is the first study demonstrating that RZV was safe and elicited significant humoral and cell-mediated immunity in lung transplant recipients. RZV is a new option for the prevention of shingles in this population.