[Intra-familial graft. Respecting public health regulation and professional confidentiality may be incompatible]. / Greffes intra-familiales. Respects des règles sanitaires et du secret professionnel parfois incompatibles.

Under specific conditions, French law authorizes organ donation despite the donor's seropositivity for certain infectious conditions. The recipient must however be informed of the potential risk of graft-related infection. Anonymous donation being the rule, the rights of the donor are respected since his/her serological status remains a medical secret. However, an exception to the rule of anonymous donation is allowed for organ donation between family members. In such a situation--often justified by the urgent nature of the transplantation--the donor's serological status would have to be revealed to the recipient, breaking the rule of medical secrecy. The physician who breaks the rule is simply implementing legal regulations (with the subsequent protection against any penal or disciplinary measures) but nevertheless performs an ethically questionable act. The recompense for donation would be an incongruent violation of personal rights. At the present time, there does not appear to be a satisfactory solution to this dilemma. The only solution that could be put forward would be to ask the donor to voluntarily inform the recipient of his/her seropositivity.

[Patient information: management in the beginning of the XXIth century]. / L'information du patient: bilan à l'aube du XXIe siècle.

The Conseil d'Etat, the supreme jurisdiction on legislative matters in France, rendered its decree on January 5, 2000, founding its decision on jurisprudence established in 1997 and 1998 by the supreme Court of Appeals. In accordance with this decision, physicians have a legal obligation to inform patients of all possible risks, including very exceptional risks. The information may be given to the patient in any appropriate form. Proof that information was delivered to the patient is incumbent upon the physician. When proof of information delivery is provided, any injury compensation can only be awarded on the grounds of ill-fate. We conducted an objective review of the jurisprudence on patient information and report the three basic aspects observed in the current situation in France. In application of the Court of Appeals judgments of February 25, 1997 and October 14, 1997, proof of delivery of information to the patient is incumbent upon the physician. The question is whether the physician must retain written documents as necessary proof against future claims. The answer to this question is not straightforward. A written document is not the only proof accepted by the court and could even be of debatable legal value if used inappropriately. The solution retained by the Conseil d'Etat is a good example. The real debate concerns the information content. It now appears that the physician is required to inform his/her patient of all risks susceptible of influencing the patient's decision, particularly serious or life-threatening risks, but also, and most certainly, risks that in the past have been considered frequent but benign. Finally, the judges recall that failure to provide information does not in itself assert the physician's civil responsibility, proof of real damage is also needed. But the reality of damage (ill-fate) depends on the reality of the choice open to the patient had he/she been informed. And the true nature of the choice open to the patient is simply the expression of the dispensable or indispensable nature of the envisaged act. One could say the old adage primum non nocere is making a comeback.

Variations in Echinococcus granulosus of bovine origin identified by enzyme electrophoresis.

Hydatid cysts of bovine, equine, porcine, ovine, caprine and human origin and also from gerbils used to passage cysts of human origin were obtained from various geographical locations. Extracts from these cysts were compared for the electrophoretic forms of glucose phosphate isomerase. Equine and porcine cyst extracts had identical zymogram patterns. These differed markedly from the zymogram patterns of cysts of ovine, caprine and human origin which appeared identical to the ovine strain. In contrast both types of zymogram patterns were found in extracts from cysts obtained from cattle. This variation seemed to be associated with both geographical location and the fertility of the cysts.

An epidemiological study of helminthiasis in cattle in subtropical Argentina.

Nine farms were each visited regularly for a year in 1979 and 1980 in Salta Province in the subtropics of Argentina. A necropsy was done at each visit and faecal and blood samples were taken from other animals mostly aged between 6 and 18 months. Ninety necropsies were done and nearly 1,500 faecal samples collected. Gastro-intestinal helminthiasis was most general and severe in autumn when calves were about 9 months old and this was followed by a dramatic fall in numbers of worms by the end of winter. Helminths were found in other organs but were not considered important. At peak periods 20% of the animals had worm egg counts of more than 750 epg and contained more than 1,000 Haemonchus worms. This species was considered to be the most important but other frequently encountered species were Oesophagostomum, Cooperia and Trichostrongylus spp. A list is given of all species found. Tracer calves were used to determine the periods of infestation. No hypobiosis was encountered. It was concluded that the sharp fall in numbers of worms after the autumn peak was due to the development of immunity by the majority of the young animals.

Fascioliasis in beef cattle in north-west Argentina.

Two thousand and ninety beef cattle livers from north-west Argentina were inspected at a large slaughterhouse in Salta; 13% were found to have lesions of fascioliasis and these were classified according to their severity. Of the livers condemned 182 (67.2%) were lightly affected, 77 (28.4%) moderately affected and only 12 (4.4%) severely affected. In a field survey 85 animals, mainly between 6 and 18 months old, were slaughtered and 12 (14%) had lesions of fascioliasis. The influence of Fasciola hepatica on weight gain in beef cattle was assessed on 2 farms. Infected animals were divided into 2 groups and I group was treated monthly. Only on 1 farm were the animals exposed continuously to infection. No differences in weight gain were found over 7 and 14 months respectively when compared to untreated controls. It was concluded that fascioliasis is widespread but at a low level in beef cattle.

Decontamination of bacterial infection of monolayer cultures with a specific bacteriophage.

A few cell lines and primary monolayer cultures were accidentally infected by bacteria. These cultures were successfully decontaminated by means of the specific bacteriophage virus after quick identification of the responsible bacteria. This method presents a practical interest for preservation of valuable cultures.

Identification of Echinococcus granulosus strains by enzyme electrophoresis.

Hydatid cysts were collected from camels, horses, oxen and sheep in various geographical locations. Extracts from them were compared for electrophoretic forms of glucose phosphate isomerase. All horse cyst extracts had identical zymogram patterns. These differed markedly in mobility from those of cattle and sheep cysts, all of which were identical to one another. Extracts from camels were compared indirectly and may show a third type of pattern.

Differentiation of Taenia saginata and Taenia solium by enzyme electrophoresis.

Forty-four Taenia saginata and seven T. solium specimens were collected in Nigeria. Extracts of these worms and of their metacestodes were compared by enzyme electrophoresis. The mobility of glucose phosphate isomerase was consistently faster with T. saginata than with T. solium. Extracts of the strobilate and cysticercus forms of the same species gave identical results. It was thus possible to distinguish clearly between material of either species.