Human leucocyte antigen profile in patients with aids and cytomegalovirus retinitis with and without macular involvement

Introduction: Cytomegalovirus retinitis is one of AIDS ocular manifestations. The objective of the present study was to determine possible associations between class I and II HLA antigens and alleles in patients with AIDS and cytomegalovirus retinitis (CMV-R) with macular involvement.Method: The study population consisted of 22 patients with AIDS and CMV-R with macular involvement (Group I), 19 patients with AIDS and CMV-R without macular involvement (Group II), and 202 individuals with negative serology for human immunodeficiency virus (Group III - control). Class I HLA antigens were typed by classical serology. Class II alleles were identified using sequence-specific oligonucleotide primers hybridized with amplified DNA. Results: HLA-DRB1*14 and  HLA-DRB1*10 specificities were more frequent among patients with macular involvement, possibly indicating greater susceptibility to this condition. In contrast, the HLA-B35 antigen may be associated with protection against macular involvement since it was significantly more frequent among patients without this involvement.Conclusions: The HLA-DRB1*14 and HLA-DRB1*10  alleles may favor the development of CMV-R with macular involvement, whereas the HLA-B35 subtype may be associated with protection against macular involvement

Pasquale del Pezzo, Duke of Caianello, Neapolitan mathematician

This article is dedicated to a reconstruction of some events and achievements, both personal and scientific, in the life of the Neapolitan mathematician Pasquale del Pezzo, Duke of Caianello

Does the "Silver bullet" lose its shine over the time? Assessment of loss of lithium response in a preliminary sample of bipolar disorder outpatients

Background: Though often perceived as a "silver bullet" treatment for bipolar disorder (BD), lithium has seldom reported to lose its efficacy over the time. Objective: The aim of the present study was to assess cases of refractoriness toward restarted lithium in BD patients who failed to preserve maintenance. Method: Treatment trajectories associated with re-instituted lithium following loss of achieved lithium-based maintenance in BD were retrospectively reviewed for 37 BD-I patients (median age 52 years; F: M=17: 20 or 46% of the total) over an 8.1-month period on average. Results: In our sample only 4 cases (roughly 11% of the total, of whom F: M=2: 2) developed refractoriness towards lithium after its discontinuation. Thirty-three controls (F: M=15: 18) maintained lithium response at the time of re-institution. No statistically significant difference between cases and controls was observed with respect to a number of demographic and clinical features but for time spent before first trial ever with lithium in life (8.5 vs. 3 years; U=24.5, Z=-2.048, p=.041) and length of lithium discontinuation until new therapeutic attempt (5.5 vs. 2 years; U=8, Z=-2.927, p=.003) between cases vs. controls respectively. Tapering off of lithium was significantly faster among cases vs. controls (1 vs. 7 days; U=22, Z=-2.187), though both subgroups had worrisome high rates of poor adherence overall. Conclusion: Although intrinsic limitations of the present preliminary assessment hamper the validity and generalizability of overall results, stating the clinical relevance of the topic further prospective research is warranted. The eventual occurrence of lithium refractoriness may indeed be associated with peculiar course trajectories and therapeutic outcomes ultimately urging the prescribing clinicians to put efforts in preserving maintenance of BD in the absence of any conclusive research insight on the matter. © Fornaro et al

Association of nucleolar organizing regions and Ki-67 expression with recurrence rate of hair follicle tumor in dogs Associação das regiões organizadoras de nucléolos e da expressão do Ki-67 com a taxa de recorrência dos tumores de folículo piloso em cães

Mitotic index, nuclear diameter, number of nucleolar organizing regions, and Ki-67 expression, in hair follicle tumors of 82 dogs were evaluated. Tissue specimens were used to prepare sections for histological staining for number of nucleolar organizing region and immunohistochemical staining for Ki-67. Tumors were classified as trichoblastoma (n=32), benign trichoepithelioma (n=30), pilomatricoma (n=7), malignant trichoepithelioma (n=6), infundibular keratinizing acanthoma (n=5), and tricholemmoma (n=2). Head, dorsum, and limbs were the most affected sites. Malignant trichoepithelioma presented significantly higher mitotic index, number of nucleolar organizing regions and Ki-67 expression. Regarding benign neoplasms, trichoblastoma presented significantly higher mitotic index and number of nucleolar organizing regions. Ki-67 expression did not differ among hair follicle benign neoplasms. Recurrence was only observed in two cases, with one benign trichoepithelioma and one malignant trichoepithelioma. In the two cases, nodules have not been removed with clean surgical margin. It was concluded that in benign neoplasms of hair follicles, the number of nucleolar organizing regions and Ki-67 expression were significantly smaller than in malignant neoplasm. Clean surgical margins are suggested to be more responsible to tumor recurrences than the number of nucleolar organizing regions, expression of Ki-67, and the mitotic index.<br>O objetivo deste trabalho foi avaliar o índice mitótico, o diâmetro nuclear, o número de regiões organizadoras de nucléolos e a expressão do Ki-67 em 82 tumores de folículo piloso de cães, entre 2000 e 2006. Os tumores foram classificados como tricoblastoma (n=32), tricoepitelioma benigno (n=30), tricoepitelioma maligno (n=6), pilomatricoma (n=7), acantoma infundibular ceratinizante (n=5) e tricolemoma (n=2). A cabeça, o dorso e os membros foram os locais mais frequentemente acometidos. O tricoepitelioma maligno apresentou índice mitótico, número de regiões organizadoras de nucléolos e expressão do Ki-67 significativamente maiores quando comparado aos outros tipos de tumores. Dentre as neoplasias benignas, o tricoblastoma apresentou índice mitótico e número de regiões organizadoras de nucléolos significativamente maiores. A expressão do Ki-67 não diferiu entre os tumores benignos de folículo piloso. A recorrência foi observada apenas em dois casos, incluindo um tricoepitelioma benigno e um tricoepitelioma maligno. Em dois casos, os nódulos não foram removidos com margem cirúrgica completa. Desta forma, conclui-se que nas neoplasias benignas de folículo piloso, o número das regiões organizadoras de nucléolo e da expressão de Ki-67 foram significativamente menores que em neoplasias malignas. Além disto, sugere-se que a margem cirúrgica completa está mais associada à recorrência dos tumores que as regiões organizadoras de nucléolo, a expressão de Ki-67 e o índice mitótico