Allele frequency of three functionally active polymorphisms of the MDR-1 gene in high-risk HIV-negative and HIV-positive Caucasians

Recent data suggest that MDR-1 expression may affect HIV-1 infectivity by modulating the immune response and its cellular permissiveness. We investigated whether three functional MDR-1 polymorphims (T-129C, G2677T/A, C3435T) were associated with the risk of infection in 137 Caucasians highly exposed to HIV (70 infected and 67 uninfected). There was no difference in allelic frequencies for each MDR-1 polymorphic site among both groups. This finding suggests that P-glycoprotein expression does not influence HIV-1 infection per se.     

The emergence and treatment of anorexia and bulimia nervosa. A comprehensive and practical model

The objective was to propose and describe a new bio-psycho-social model of emergence and maintenance of anorexia nervosa and bulimia nervosa, and demonstrate its application to treatment. An original model, based on literature review and our own clinical experience, was created. Therapeutic guidelines were derived from the theoretical model and applied in the treatment of 97 anorexia and bulimia nervosa patients presented at the eating disorders unit at Kaplan Hospital in Israel over 18 months. A team comprising a pediatrician, a child psychiatrist, a dietician, and trained nurses collaborated in a comprehensive systemic therapeutic approach involving parents, schools, and community agents. RESULTS: Ninety-one girls and six boys were treated in the eating disorder unit (55 had AN, 29 had BN and 13 had EDNOS). Thirty-seven patients were hospitalized and sixty were treated in the outpatient clinic. Mean hospitalization time of the first five patients was 108 days. Mean hospitalization time of the remaining 32 patients was reduced to 32 days. The mean number of outpatient clinic interventions was 12. At the one-year follow up, 74 patients were doing well in all respects. Fourteen patients still needed a lot of supervision in eating. Five are still hospitalized and four were lost to follow up. CONCLUSIONS: The proposed model proves to be more than just another theory in that it is successfully applied in treatment. Short systemic therapy is very effective. The longer the delay in drastic, aggressive treatment, the worse the prognosis. Extended hospitalization periods worsen the prognosis. Weakness of the parental unit is a strong indication for inpatient care. The longer the experience in treating eating disorders, the shorter the hospitalization and number of interventions.     

Induced sputum for identifying sarcoidosis in patients with uveitis

OBJECTIVE: To evaluate the value of the induced sputum technique in diagnosing sarcoidosis as the cause of uveitis. DESIGN: Comparative case series. PARTICIPANTS: Seventeen patients with uveitis. Two control groups were used. The first included 10 patients with sarcoid without uveitis; the second included 5 healthy volunteers. TESTING: Sputum was induced by a 20-minute inhalation of 3.5% saline using an ultrasonic nebulizer. Samples were studied by differential counts of 200 cells on cytopreps stained by Giemsa. T lymphocyte subset analyses were done by fluorescence-activated cell sorter using the monoclonal antibodies CD4 (T helper cells) and CD8 (T suppressor-cytotoxic cells). Angiotensin-converting enzyme (ACE) serum levels were obtained. MAIN OUTCOME MEASURES: A CD4/CD8 ratio >2.5 and an ACE level >145 microl/ml/minute were considered to be abnormal. RESULTS: The difference in the CD4/CD8 ratios in the induced sputum examination between the group of patients with an elevated ACE level and the group of patients with an ACE level within normal limits was statistically significant (P = 0.0001). CONCLUSIONS: The induced sputum examination showed increased CD4/CD8 ratios in patients with uveitis who also had elevated ACE levels, suggesting the presence of sarcoidosis.     

Antibubble trajectory during embryo transfers in donor egg IVF does not predict success

Transient motion of embryo transfer-associated antibubbles was observed. This prospective study was performed to determine if this antibubble movement can predict a successful outcome. Transabdominal ultrasound-guided embryo transfers were performed in 187 recipients receiving identical hormone replacement therapy. All embryo transfers were performed by the first author, using the Sureview embryo transfer catheter, in 30 mul of culture media. Observation was made of the catheter placement in relation to the endometrial surface and uterine fundus during embryo transfer. Ultrasound-guided tracking of antibubble within the uterine cavity was done immediately after the piston was depressed at the time of embryo deposition. The antibubble movement was upwards (group A) in 104 embryo transfers and downwards (group B) in 83 transfers. No movement of embryo-associated air out of the uterine cavity, either into the cervix or the intramural portion of the Fallopian tube, was observed. The clinical pregnancy rate was similar in both groups: 47.12% in group A versus 45.78% in group B. The total implantation rate/embryo transferred was 19.34% in group A compared with 20.07% in group B. The movement of the embryo transfer-associated antibubble is unlikely to be a factor in predicting success in donor egg IVF cycles.