HLA Antigens in 16 Families with Xeroderma Pigmentosum

Xeroderma pigmentosum is an autosomal recessive disease. HLA-A and -B typing was performed on peripheral blood lymphocytes and platelets. Sixteen Tunisian families were typed with 37 patients and 108 relatives. Genetic transmission of the disease and of the HLA system seemed to be independent in this study. Comparison of HLA gene frequencies between (unrelated) parents of patients and a control population showed no difference, proving that there is no clear association in populations between deleterious XP genes and a particular HLA gene. However, an excess of identical HLA among pairs of diseased siblings would suggest that the disease is polymorphic and a form of the XP could be linked to HLA.     

Molecular and serological evaluation of surface antigen negative hepatitis B virus infection in blood donors from Venezuela

Surface antigen negative hepatitis B virus (HBV) infection was evaluated in Venezuela, by molecular characterization of blood samples positive for antibodies to core antigen (anti-HBc) and negative for surface antigen (HBsAg) in blood donors (residual infections). HBV DNA was found in 11/258 samples (4.3%), and was significantly associated with high levels of anti-HBc antibodies (>25 UI/ml, P < 0.05), while no correlation was found between the presence of HBV DNA and the levels of anti-HBs. Synonymous and non-synonymous mutations were found in the HBV surface region (but not vaccine escape mutants) and in the precore/core region (precore mutants in 2/7 samples and 33-45 bp deletions near the N-terminal core region in 4/19 samples). While HBV genotype F prevails among HBsAg positive samples from blood donors in Venezuela, residual infection isolates were mainly genotypes A and D. Phylogenetic analysis of viral surface and core region revealed discrepancies in genotype designation in 6/9 samples, suggesting the presence of mixed infection or recombination. In conclusion, HBV residual infection in Venezuela does not seem to be frequently observed in HBV genotype F. This type of infection is frequently associated with variants exhibiting mutations in the surface gene that might be affecting the correct recognition by commercial tests, with precore mutants and with core internal deletions. These variants do not seem to cause severe liver disease, and on the contrary, were found circulating at low viremia.     

Bronchiolitis obliterans-organizing pneumonia (BOOP) containing asbestos bodies: clinico-pathological study of a case]

We describe a case of bronchiolitis obliterans-organizing pneumonia (BOOP) with asbestos bodies. A 65-year-old man, treated in the past for gastric lymphoma and with an history of asbestos exposure, presented with fever and two nodular opacities in the lower lobe of the left lung. Histologic examination revealed a BOOP pattern; in the inflammatory tissue some asbestos bodies were present. Patients exposed to asbestos may rarely present with localized inflammatory pulmonary lesions. In these cases, the possible etiopathogenetic role of asbestos needs further studies.     

Mind-Body Innovations—An Integrative Care Approach

Integration of behavioral health and medicine has gained increased support recently within the new field of complementary medicine. Providers from both disciplines are acknowledging the mind-body connection and recognizing the value of treating the whole patient through working within an integrative delivery model. This paper describes two treatment programs which were developed using the principles of the mind-body connection and implemented within an integrative setting at a large HMO. The results of research studies are presented and discussed to demonstrate the efficacy of these programs.     

Pelvic organ prolapse surgery in women aged more than 70 years: a literature review

OBJECTIVE: The purpose of the study was to report surgical techniques for pelvic organ prolapse and complications in women aged more than 70 years. PATIENTS AND METHODS: A Medline search was made for articles indexed between 2000 and 2006 and dealing with operative techniques for pelvic organ prolapse. Seven articles in English and French were included. RESULTS: Three hundred and ninety-four women were treated for pelvic organ prolapse. Transvaginal repairs were reported in 97% (384 women). Vaginal function was preserved in 57% (207 women) and vaginal obliteration techniques represented 40% (145 women) of all prolapse surgery. The death rate was 1% (four deaths). The blood transfusion rate was 12%. The mean complication rate was 3.8% with cardiovascular prevalence (seven pulmonary embolisms, two myocardial infarctions, two congestive heart failures, one prolonged angina, two transient arrhythmias, one cerebrovascular accident, one acute renal failure). The temporospatial disorientation rate was 4.6%. DISCUSSION AND CONCLUSION: Vaginal hysterectomy with colpo-perineorrhaphy and sacrospinous ligament fixation are alternative procedures instead of colpocleisis to treat pelvic organ prolapse in women aged more than 70 years. For all pelvic prolapse surgery, the overall perioperative morbidity and mortality rate in elderly women are acceptable. This surgery needs a good collaboration between anesthetist and surgeon team and vigilance during postoperative follow-up.