Transfusion-mediated Yersinia enterocolitica septicemia in an adult patient with beta-thalassemia.

We report a case of transfusion-mediated Yersinia enterocolitica septicemia in a 43-y-old woman with homozygous beta-thalassemia. Two h after transfusion of 3 units of red blood cells the patient suffered high-grade fever and shaking chills. Y. enterocolitica serotype O3 grew in blood cultures. Prolonged treatment with i.v. ceftriaxone plus ciprofloxacin led to a favorable outcome. Transfusion-associated Y. enterocolitica septicemia has not previously been reported in an adult beta-thalassemic patient from the Mediterranean area. Our report is particularly important, because of the high incidence of chronically transfused thalassemic patients in Mediterranean countries.

Role of serum ceruloplasmin and its ferroxidase activity on preterm labor.

The role of serum ceruloplasmin and its ferroxidase activity on preterm labor with or without rupture of the membranes was studied. Thirty-seven primigravid women between 31 and 35 weeks of gestation were investigated. Our material is divided into 3 groups. Group A consisted of 12 patients with premature rupture of the membranes; group B consisted of 10 patients with preterm labor but intact membranes, and group C consisted of 15 non-laboring patients. Patients with rupture of the membranes presented with statistically significantly higher serum ceruloplasmin levels compared to those with preterm labor but intact membranes (p < 0.05) as well as to non-laboring patients (p < 0.01). On the contrary, the mean ferroxidase activity level or ceruloplasmin was 518.2+/-183.42, 460.9+/-198.8 and 517.5+/-142.01 micromol/l/min in groups A, B and C, respectively. These values were not significantly different. Our results show a loss of ferroxidase activity of ceruloplasmin in patients with rupture of the membranes and probably suggest a defect in the maternal defense mechanisms.

Effect of smoking on ceruloplasmin and its ferroxidase activity in pregnant women.

This study deals with the effects of smoking on serum ceruloplasmin and its ferroxidase activity in pregnant women. The mean value (+/- SD) of serum ceruloplasmin in women smokers during pregnancy is significantly higher (p < 0.01) in comparison to that of nonsmokers, whereas the ferroxidase activity of ceruloplasmin in smokers is not significantly different from that of nonsmokers. These findings suggest that ceruloplasmin in women smokers loses part of its ferroxidase activity.

Immune dysfunction in patients with unexplained repeated abortions.

OBJECTIVES: To examine the immunological profiles by antiphospholipid antibodies IgG, IgM, IgA immunoglobulins ACA, as well as C3, C4 complement component levels. METHODS: A group of 44 women with a history of three or more consecutive pregnancy losses was compared with 34 normal women. RESULTS: Our results showed lower levels of IgG immunoglobulins for the patient group (P < 0.001) while the C3, C4 complement component levels remained unaltered. Anticardiolipin antibodies were positive in ten patients for IgG or IgM isotypes or for both presenting a prevalence of 22.7% while none of the control subjects had ACA positive titers. The lupus anticoagulant was not detected in either group. Ten patients (22.7%) presented positive autoantibody tests as compared with only 3 (8.8%) of the control group. No statistical differences were found between the two groups when the frequency of each autoantibody's positive tests were examined separately. CONCLUSIONS: An inconsistent immune derangement seems to be present in recurrent aborters with the presence of anticardiolipin antibodies as the stronger representative marker of immune alteration.

Clinical evaluation of four tumor markers in malignant and benign pleural effusions.

Total sialic acid (TSA), lipid-bound sialic acid (LSA), ferritin and carcinoembryonic antigen (CEA) were evaluated in 55 patients with malignant pleural effusions and in 32 patients with benign (exudative) pleural effusions. No significant differences were found in the pleural fluid TSA, LSA and ferritin levels between malignant and benign conditions. CEA levels in malignant effusions were significantly higher than those in benign effusions (43.13 +/- 72.8 ng/ml versus 2.6 +/- 5.56 ng/ml, p less than 0.01). At a cut-off level of 5 ng/ml, 60% of the patients with cancer showed elevated pleural fluid CEA levels. The specificity and diagnostic accuracy of CEA in distinguishing malignant from benign pleural exudates were both very high (91% and 71% respectively). Therefore, of the four markers investigated, only CEA could be a valuable tool in the detection of pleural malignancy.