Cardiac magnetic resonance in transfusion dependent thalassaemia: assessment of iron load and relationship to left ventricular ejection fraction

Cardiac Magnetic Resonance (CMR) has replaced all other surrogate measurements in the determination of transfusional cardiac iron overload in patients with thalassaemia major. We aimed to determine the diagnostic value of CMR T2* with respect to cardiac dysfunction (CD) as determined by CMR‐derived left ventricular ejection fraction (LVEF). Cardiac T2* values and LVEF measured by CMR were recorded in 303 patients with thalassaemia major, at the time of their first CMR. T2* was correlated with LVEF (regression coefficient: 0·57, P < 0·001). The prevalence of CD was 32·9% in patients with T2* ≤ 8 ms, 12·5% in patients with T2* > 8 ms and ≤14 ms and reduced to 9·1% in patients with T2* between 14–20 ms. As the probability of CD is progressively, and not suddenly, reduced with increasing values of T2*, CMR has a limited diagnostic value for CD (Receiver operating characteristic analysis, area under the curve = 0·68). Patients with cardiac T2* ≤ 8 ms require careful and intensive management. This risk decreases with increasing values of T2* but even in mildly loaded patients the probability of impaired LVEF is not negligible.     

Post-exposure prophylaxis after non-occupational exposure to HIV in Greece

Aim:  To assess the use of post-exposure prophylaxis after a non-occupational exposure to HIV in Greece.
Methods:  We analysed the data that were reported to the Hellenic Centre for Disease Control and Prevention by physicians who requested non-occupational post-exposure to HIV prophylaxis (NONOPEP) .
Results:  During the period January 1996–June 2005 inclusive, 159 persons received NONOPEP (116 males, 42 females and 1 unknown). Fifty-three per cent of the males sought NONOPEP because of an exposure to sperm and vaginal secretions, while 35.7% of the females were exposed to sperm. Unprotected sex was the main reported cause of exposure to HIV (38.36%) followed by condom rupture (35.85%). For 110 (69.18%) persons, it was the first time they were prescribed NONOPEP.
Conclusion:  The current surveillance system in Greece should be further developed to include the documentation of potential drug-toxicity, side effects and adherence to the prophylaxis. The health educational role of the nurse in HIV prevention in Greece should be developed.     

The effect of the plasminogen activator inhibitor-1 4G/5G polymorphism on the thrombotic risk

Plasminogen activator inhibitor (PAI-1), is the central component of the fibrinolytic system. A deletion/insertion (4G/5G) polymorphism in the promoter region of the PAI-1 gene has been correlated with levels of plasma PAI-1. The 4G allele is associated with higher levels of PAI-1, and might increase the risk for intravascular thrombosis. However, the contribution of this genetic variant to the risk for thrombosis, both arterial and venous, has not been clearly established. A broad spectrum of findings regarding the effect of the 4G allele on thrombotic risk in different target organs has been reported. Our aim is to summarize the variable influence of this polymorphism on thrombotic events in different tissues or organs and explain the underlying mechanisms accounting for these differences.     

Publications in vascular journals: contribution by country.

The geographical origin of all published papers in four major vascular journals as well as the "vascular papers" in two high impact "general" surgical journals during a four year period (2003-2006) were examined by search of their electronic editions. As an index of high quality papers, the randomized controlled trials (RCT's) by country were also examined. A total of 3422 papers were searched in the four vascular journals (115 RCT's) while 144 "vascular" papers (19 RCT's) were located in the two "general" surgical journals. It was not surprising that USA and western European countries were having the largest contribution to the vascular literature.     

AIDS in pregnancy, part I: epidemiology, testing, effect on disease progression, opportunistic infections, and risk of vertical transmission

Contribution of acquired immunodeficiency syndrome/human immunodeficiency virus (HIV) infection to pregnancy mortality rates is difficult to estimate; however, it appears to be one of the leading causes of death, at least in developing countries. Prenatal HIV testing affords the best opportunity for the prevention of perinatal HIV transmission. Rapid HIV testing substantially increases the proportion of women who obtain HIV results compared with conventional enzyme-linked immunosorbent assay testing, thus maximizing perinatal HIV interventions. Pregnancy appears to have no effect on the course of HIV disease. Infections due to a variety of pathogens influence the clinical course of the HIV infection and may complicate pregnancy and increase maternal mortality. The main risk factors for mother-to-child HIV transmission are high maternal viral load and CD4 cell count <700 cells/mm3. The main protective factor is antiretroviral therapy.     

Imaging the Bio-Distribution of Fluorescent Probes Using Multispectral Epi-Illumination Cryoslicing Imaging

Purpose  

The increasing availability of fluorescent probes for in vivo optical imaging enables the interrogation of complex biological processes in small animals serving as models for human-like tissue function and disease. However, the validation of probe bio-distribution during their development or the study of different disease models, in support of in vivo imaging studies, is not straightforward.