Differential reproductive efficiency associated with common apolipoprotein e alleles in postreproductive-aged subjects

OBJECTIVE: To investigate the possible impact of apolipoprotein E (APOE) polymorphism on reproductive efficiency. DESIGN: Population study. SETTING: University Departments and a Laboratory of National Research Council. PATIENT(S): One hundred sixty healthy unrelated subjects of postreproductive age. INTERVENTION(S): Peripheral blood collection and questionnaire administration. MAIN OUTCOME MEASURE(S): Apolipoprotein E genotypes were detected after PCR amplification and CfoI digestion; plasma total cholesterol was assayed. RESULT(S): The mean number of children of e*2 allele carriers (2.4) was lower than that of e*3/e*3 and e*4/e*3 subjects (3.9). The trend was similar (2.8 vs. 4.8) when the number of pregnancies was considered. Moreover, there was a clear inverse relationship between number of children and e*2-carrying genotype proportions (chi(2) for trend = 6.3). Conversely, the e*3/e*3 genotype was associated with the highest number of children and pregnancies (3.9 and 4.9, respectively), and the e*4/e*3 genotype, with intermediate values (3.7 and 4.4). Carriers of e*2 allele also showed the lowest levels of total cholesterol. CONCLUSION(S): The e*2 allele seems to be associated with the lowest reproductive efficiency and the e*3 allele, with the highest. The different total cholesterol levels associated with APOE genotypes could have an effect on steroidogenesis and determine as a consequence the observed differential fertility.     

Estrogen-progestogen induced hematocolpometra following allogeneic stem cell transplant

OBJECTIVES: Gynecological manifestation of chronic graft-versus-host disease (cGVHD) has been invariably described in association with its extensive form. We have also observed it in a patient with the limited cGVHD form. DESIGN: We here describe our experience of gynecological complications in a population of 30 women who were followed up in a single center 12-120 months after allogeneic stem cell transplant (allo-SCT) due to hematological malignancies. All of them manifested premature ovarian failure because of the received treatments. RESULTS: Three out of 14 women who were affected by cGVHD developed hematocolpometra after estrogen + progestogen therapy (EPT) introduction, due to uterine and vaginal dystrophy and synecchiae. Extensive cGVHD, including dermal and mucosal localization, was present in two women while the third had only liver involvement. None of our patients had received radiation therapy or had a posttransplant history of infection. Local application of estrogens consistently improved the gynecological complication. However, vaginal synecchiae tended to relapse when local treatment was interrupted, despite no other apparent evidence of active cGVHD. CONCLUSIONS: All women with cGVHD should undergo gynecological examination before introducing EPT, to avoid unpleasant complication as hematocolpometra. Vaginal and cervical synecchiae should be treated with prolonged local treatments, and temporary use of continuous EPT regimens may be preferable in these women. Moreover, close monitoring by pelvic exam and ultrasonography is advisable during the initial cycles to detect any complication caused by possible intrauterine adhesions undetected during the previous gynecological examination.     

Studies on entomological monitoring: mosquito species frequency in riverine habitats of the Igarapava Dam, Southern Region, Brazil

Diversity of mosquito species was evaluated in different habitats before and after the Igarapava reservoir flooding in the Grande River, Southern Cerrado of Brazil. We aimed at verifying changes in these mosquito populations in consequence of the lake formation. Four habitats were selected as sampling stations: peridomiciliary habitat, pasture, "veredas" and gallery forest patch. Bimonthly collections were made with the Shannon trap and human bait, including diurnal, crepuscular and nocturnal period of mosquito activity. The Shannon Index results from the potential vectors were compared using Student t-test. Aedes scapularis, Anopheles darlingi and An. albitarsis senso latu seasonal abundance were described with moving average and compared using chi2 test. There were changes in the mosquito frequency in the habitats, except for the "veredas" that was 13 km away from the catchment area. The altering in mosquito species seasonal abundance suggests breeding places expansion. Diversity indexes can be used to monitor changes in mosquito vector population in environments where abrupt disturbance can alter disease transmission cycles.     

Apophyseal avulsion fracture of the greater trochanter after slipped capital femoral epiphysis: a case report

A 13-year-old boy sustained an avulsion fracture of the left greater trochanter eight months after surgical stabilisation of a slipped capital femoral epiphysis on the same side. In this specific case, avulsion of the greater trochanter after slipping of the capital femoral epiphysis may have been facilitated by weakening of the trochanteric physis.     

Giant cell tumor and Paget's disease of bone in one family: geographic clustering

Giant cell tumor is a rare complication of Paget's disease of bone. Typically, this tumor occurs in the case of polyostotic disease and only in pagetic bones. This tumor rarely has been seen in multiple family members who have Paget's disease, although Paget's bone disease clearly has a hereditary component. Our report documents four cases of polyostotic Paget's bone disease complicated by benign giant cell tumor. In two patients, the giant cell tumor also was multifocal. All patients were from one family. They were born in Avellino and reside in Campania, a Southern Italian region. The ancestors of the patients with familial giant cell tumor in Paget's bone disease were born in the same geographic area. These data suggest that a combination of environmental and genetic factors could be responsible for linkage of the patients born in Avellino with this neoplasm that is highly unusual in patients with Paget's disease of bone.