A social validation assessment of the use of microswitches with persons with multiple disabilities

The purpose of this two-part study was to conduct a social validation assessment of microswitches versus interaction/stimulation conditions used with persons with multiple disabilities. In Part I, 32 teacher-assistant trainees were shown video-tapes reporting the use of microswitches versus interaction conditions for six children. In Part II, 40 teacher-assistant trainees or classroom aides and 44 rehabilitation staff were presented with video-tapes showing the use of microswitches versus systematic stimulation strategies for four adults. Raters scored the microswitch and the interaction or stimulation conditions on a 7-item questionnaire covering social/emotional and practical aspects. The microswitch condition was viewed as generally more positive than or comparable to the interaction or stimulation conditions. Main features of the findings and their implications are discussed.     

Primary leiomyosarcoma of broad ligament

BACKGROUND: Primary broad ligament leiomyosarcoma (LMS) is an extremely rare tumor with few well-documented cases. We are aware of 15 previously reported observations. AIM: Report of a new case. CASE: In this report we report a case of a right pelvic sidewall leiomyosarcoma with involvement of the appendix in a 49-year-old woman. A hysterectomy, bilateral salpingo-oophorectomy, omentectomy and appendicectomy were done, without complications. The patient died five months later. The case illustrates the difficulty of correct diagnosis before intervention. On this occasion, review of the literature confirms that this site remains unusual and the management is difficult.     

Erythropoietin in cancer patients with anemia

OBJECTIVE: The aim of this study is to evaluate the endogenous erythropoietin production in cancer patients with anemia. METHODS: Our prospective study interested 99 cancer patients with anemia from 17 to 80 years old, during the period going from March 2002 to December 2004, and 31 healthy individuals with anemia caused by iron deficiency. A blood sample was collected from each patient, as well as healthy individuals to measure serum erythropoietin, C reactive protein and ferritin. RESULTS: The increase of serum erythropoietin was significantly lower in patients than in healthy individuals (P < 0.05). 25.2% of our cancer patients have inflammatory anemia and 74.7% presented microcytic anemia associated with increase of serum ferririn and CRP. These values were significantly higher than in healthy individuals (p < 0.05). CONCLUSION: Anemia in cancer patients results from activation of inflammatory system, which inhibit erythropoietin production. Apart from etiologic treatments, anemia can be treated with recombinant human erythropoietin.     

Association of the insertion/deletion gene polymorphism of the apolipoprotein B signal peptide with myocardial infarction in Tunisian patients

BACKGROUND: Numerous polymorphisms of the apolipoprotein B (APOB) gene have been described. Particularly, the insertion/deletion (Ins/Del) polymorphism located in the coding part of the signal peptide of apoB, associated with modification of lipid concentrations and the risk of coronary artery disease and/or myocardial infarction (MI), has been reported in the general population. Moreover, conflicting results emerge from the literature and suggest that the effect is context-dependent. In the present study, the first investigation of the Ins/Del polymorphism of the APOB gene in Tunisian patients with MI, we examined a possible association between this polymorphism and MI in a subgroup of the Tunisian population. METHODS: A total of 318 Tunisian patients with MI and 368 healthy controls were included in the study. Genomic DNA was extracted from white blood cells, and the Ins/Del polymorphism was determined by electrophoresis in polyacrylamide gels after PCR amplification. A binary logistic regression analysis was performed to test how the association between MI and Ins/Del polymorphism is independent from confounding factors. RESULTS: A significant difference in genotype distribution and allele frequency was observed between patients and controls. Patients with MI had a frequency of 7.2% for the Del/Del genotype, 39.6% for the Ins/Del genotype, and 53.1% for the Ins/Ins genotype. Controls had a frequency of 3.0% for the Del/Del, 32.1% for the Ins/Del and 64.9% for the Ins/Ins genotype (chi2=12.93, p=0.002). The MI patient group showed a significantly higher frequency of the Del allele compared to controls (27.1% vs. 19.1%; chi2=12.50, p=0.0004). In comparison to the Ins/Ins homozygotes, the odds ratio (95% confidence interval) for MI was 1.51 (1.09-2.07) for Ins/Del heterozygotes and 2.95 (1.40-6.22) for Del/Del homozygotes. In multivariate analysis, age (p=0.001), smoking (p<0.001), hypertension (p=0.001), diabetes mellitus (p<0.001), and dyslipidemia (p=0.01) were independent correlates of the presence of MI, whereas the Ins/Del polymorphism (p=0.330) was not an independent predictor of MI. CONCLUSIONS: The present study shows a significant but not independent association between the Ins/Del polymorphism of the APOB gene and MI in the Tunisian population.