Association of programmed cell death 1 polymorphisms and systemic lupus erythematosus: a meta-analysis.

Programmed cell death 1 (PDCD1 or PD1) polymorphisms have been inconsistently reported to be associated with systemic lupus erythematosus (SLE). The aim of this study was to explore whether the PDCD1 polymorphisms confer a susceptibility to SLE and lupus nephritis (LN). We conducted a meta-analysis on the association of PDCD1 polymorphisms with SLE in overall and specific ethnic populations. A total of 15 separate comparisons were included in this meta-analysis consisting of nine Europeans, two Latin Americans, two Africans, one Asian and one unknown participant. In subgroup analysis, the PD1.3A allele was significantly associated with SLE in Latin Americans (OR = 3.073, 95% CI = 1.416-6.461, P = 0.003), but not in patients of European and African decent. The PD1.3A allele was a risk factor for LN in European descendants (OR = 2.207, 95% CI = 1.488-3.467, P < 0.001). The PD1.5C allele was a risk factor for SLE in Europeans (OR = 1.297, 95% CI = 1.024-1.643, P = 0.031). In conclusion, this meta-analysis demonstrated an association of the PD1.3A allele with LN in European and SLE in Latin-American populations. Furthermore, the PD1.5C allele was associated with SLE susceptibility in Europeans.

Invasive streptococcal infections. Report of four cases occurring in Trinidad.

Many countries are reporting a resurgence of virulent streptococcal strains but there is little information from the Caribbean. Four cases of severe invasive streptococcal infections, three of them fatal, are reported. The portal of entry was infected scabatic lesions in one patient and infected mosquito bites in another patient who developed cellulitis and gangrene; but no portal of entry was detected in the other patients. Group A beta haemolytic Streptococcus (GAS) was isolated from the blood of three patients, one of them GAS M type 3, which had the genome for streptococcal pyrogenic exotoxins A (SPeA) and B (SPeB). GAS M type 72, which had the genome for SPeB and SPeC, were isolated from the tissues (but not from the blood) of the patient who developed cellulitis and who was the sole survivor. Physicians in the Caribbean must be alerted to the presence of these virulent streptococcal strains, and must be prepared to manage serious invasive disease.

Invasive streptococcal infections: report of four cases occurring in Trinidad

Many countries are reporting a resurgence of virulent streptococcal strains but there is little information from the Caribbean. Four cases of severe invasive streptococcal infections, three of them fatal, are reported. The portal of entry was infected scabatic lesions in one patient and infected mosquito bites in another patient who developed cellulitis and gangrene; but no portal of entry was detected in the other patients. Group A B haemolytic Streptococcus (GAS) was isolated from the blood of three patients, one of them GAS M type 3, which had the genome for streptococcal pyrogenic exotoxins A (SPeA)and B (SPeB). GAS M type 72, which had the genome for SPeB and SPeC, were isolated from the tissues (but not from the blood) of the patient who developed cellulitis and who was the sole survivor. Physicians in the Caribbean must be alerted to the presence of these virulent streptococcal strains, and must be prepared to manage serious invasive disease.

Invasive streptococcal infections: report of four cases occurring in Trinidad

Many countries are reporting a resurgence of virulent streptococcal strains but there is little information from the Caribbean. Four cases of severe invasive streptococcal infections, three of them fatal, are reported. The portal of entry was infected scabatic lesions in one patient and infected mosquito bites in another patient who developed cellulitis and gangrene; but no portal of entry was detected in the other patients. Group A B haemolytic Streptococcus (GAS) was isolated from the blood of three patients, one of them GAS M type 3, which had the genome for streptococcal pyrogenic exotoxins A (SPeA)and B (SPeB). GAS M type 72, which had the genome for SPeB and SPeC, were isolated from the tissues (but not from the blood) of the patient who developed cellulitis and who was the sole survivor. Physicians in the Caribbean must be alerted to the presence of these virulent streptococcal strains, and must be prepared to manage serious invasive disease. (AU)

ICAM-1 and E-selectin expression in lesional biopsies of psoriasis patients responding to systemic FK 506 therapy.

FK 506 is a new immunosuppressive agent with a similar molecular action to cyclosporin A. We have investigated immunohistochemical changes in lesional biopsies of seven patients with severe recalcitrant chronic plaque psoriasis receiving systemic FK 506 therapy. Within 4 weeks of start of treatment, there was a striking reduction in psoriasis area and severity index (mean reduction 87.4%), accompanied by marked reductions in dermal and epidermal CD4+ and CD8+ cells. Investigation of biopsies obtained 4-8 weeks after start of treatment revealed a significant fall in the numbers of activated mononuclear cells expressing CD25 (IL-2 receptor alpha-chain), HLA-DR, or CD11a (lymphocyte function-associated antigen-1, LFA-1 alpha chain). In contrast, the number of epidermal CD1+ (Langerhans) cells increased in response to FK 506 therapy. Study of leukocyte adhesion-related epitopes in active disease revealed strong expression of CD54 (intercellular adhesion molecule-1, ICAM-1) and E-selectin (previously known as endothelial leukocyte adhesion molecule-1) both on microvascular endothelial cells and of ICAM-1 on infiltrating mononuclear cells; ICAM-1 was also expressed weakly on epidermal keratinocytes. Vascular cell adhesion molecule-1 (VCAM-1) was either absent or expressed rarely on vascular endothelium. In response to FK 506 treatment, both ICAM-1 and E-selectin expression on blood vessels was reduced consistently but nevertheless persisted, even in individuals exhibiting total clearance of psoriatic lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Human papilloma virus infections and other risk factors as determinants of cervical intraepithelial neoplasia in Trinidad and Tobago - abstract

Human Papilloma Viruses (HPV) are considered to play a key role in the induction of malignant neoplasms of the cervix uteri but there have been no published reports on the prevalence of genital HPV infections among women in this region where the incidence of cervical cancer is high. The objectives of this study were to assess the overall and type-specific prevalence of HPV infections of the uterine cervix in a sample of urban and rural women with and without cytologically or histologically defined cervical intraepithelial neoplasia (CIN) in this population of non-hysterectomized, non-pregnant females aged 18 - 60 years. One hundred and sixty-nine urban women, roughly half of whom had abnormal cytological diagnoses and 159 rural women were examined colposcopically and directed cervical biopsies performed. Cases and controls were identified on the basis of results of examinations of these specimens. Z-tests, kappa statistic, chi-square, odds ratio and confidence limits and multivariate logistic techniques were used where appropriate. Overall prevalence of HPV infection was 6.7 per cent, HPV DNA was detected in 5.6 per cent of controls and only 6.3 per cent of cases. HPV type 16 was the commonest isolate (54.5 per cent). HPV positivity was not an independent predictor of the risk of CIN. Early coital onset, high parity, multiple sexual partners and high gravidity were the most significant, independent predictors of the risk of CIN (AU)

Primary nongestational choriocarcinoma of the ovary

Primary choriocarcinoma of the ovary arising, presumably, from a germ cell is extremely rare. The patient, a 16 year old girl who presented with dysuria and frequency of micturition developed fatal haemoperitoneum due to rupture of a pure primary nongestational ovarian choriocarcinoma.(AU)

Achondroplasia and pregnancy

A pregnant achondroplastic dwarf whose mother was also dwarfed, was delivered of a live infant with achondroplastic features. To the author's knowledge, there has been no previously published report of the occurence of dwarfism in three successive generations. This is probably because of a high perinatal loss due either to a lethal homozygous gene, hydrocephaly or to respiratory failure (AU)