Routine prenatal screening for HIV in a low-prevalence setting

BACKGROUND: The objectives of this study were to assess the effect of British Columbia''s June 1994 guidelines for prenatal HIV screening on the rate of maternal-fetal HIV transmission and to estimate the cost-effectiveness of such screening. METHODS: The authors conducted a retrospective review of pregnancy and delivery statistics, HIV screening practices, laboratory testing volume, prenatal and labour management decisions of HIV-positive women, maternal-fetal transmission rates and associated costs. RESULTS: Over 1995 and 1996, 135,681 women were pregnant and 92,645 carried to term. The rate of HIV testing increased from 55% to 76% of pregnancies on chart review at one hospital between November 1995 and November 1996. On the basis of seroprevalence studies, an estimated 50.2 pregnancies and 34.3 (95% confidence interval 17.6 to 51.0) live births to HIV-positive women were expected. Of 42 identified mother-infant pairs with an estimated date of delivery during 1995 or 1996, 25 were known only through screening. Of these 25 cases, there were 10 terminations, 1 spontaneous abortion and 14 cases in which the woman elected to carry the pregnancy to term with antiretroviral therapy. There was one stillbirth. One instance of maternal-fetal HIV transmission occurred among the 13 live births. The net savings attributable to prevented infections among babies carried to term were $165,586, with a saving per prevented case of $75,266. INTERPRETATION: A routine offer of pregnancy screening for HIV in a low-prevalence setting reduces the rate of maternal-fetal HIV transmission and may rival other widely accepted health care expenditures in terms of cost-effectiveness.     

Aneuploidy and polyploidization in haploid tissue cultures of Larix decidua

Haploid embryogenic lines of Larix decidua which had been maintained on medium free of plant growth regulatiors were screened for chromosomal abnormalities. Chromosome squashes were prepared from fast-growing suspension culture. alternatively, a method using burst protoplasts was devised for improving chromosome spreads. One line showed polyploidization with chromosome mumbers ranging from haploid to tetraploid. This line is presently predominantly diploid. Aneuploidization also occurred. The most effective method for counting chromosomes was from burst protoplasts. It is recommended that long-term cultures of conifer tissues be checked for genetic stability.     

Consequences a long terme de la vasectomie: Revue de la litterature

Since 20 years, many contradictory data have been reported about vasectomy in animals and in humans, as regards its efficacy and safety. We have examined the main experimental and clinical reports, published these last 20 years. In particular experimental conditions, in animals subject to hypercholesterolemic diets, vasectomy would cause negative effects, particularly an increased atheroma risk. But, none of the large epidemiologic inquiries performed until now in several developed and on developing countries, showed an increased vascular and infarction risk in vasectomized males.     

Apolipoprotein A-V is a potential target for treating coronary artery disease: evidence from genetic and metabolomic analyses

Triglyceride (TG)-lowering LPL variants in combination with genetic LDL-C-lowering variants are associated with reduced risk of coronary artery disease (CAD). Genetic variation in the APOA5 gene encoding apolipoprotein A-V also strongly affects TG levels, but the potential clinical impact and underlying mechanisms are yet to be resolved. Here, we aimed to study the effects of APOA5 genetic variation on CAD risk and plasma lipoproteins through factorial genetic association analyses. Using data from 309,780 European-ancestry participants from the UK Biobank, we evaluated the effects of lower TG levels as a result of genetic variation in APOA5 and/or LPL on CAD risk with or without a background of reduced LDL-C. Next, we compared lower TG levels via APOA5 and LPL variation with over 100 lipoprotein measurements in a combined sample from the Netherlands Epidemiology of Obesity study (N = 4,838) and the Oxford Biobank (N = 6,999). We found that lower TG levels due to combined APOA5 and LPL variation and genetically-influenced lower LDL-C levels afforded the largest reduction in CAD risk (odds ratio: 0.78 (0.73–0.82)). Compared to patients with genetically-influenced lower TG via LPL, genetically-influenced lower TG via APOA5 had similar and independent, but notably larger, effects on the lipoprotein profile. Our results suggest that lower TG levels as a result of APOA5 variation have strong beneficial effects on CAD risk and the lipoprotein profile, which suggest apo A-V may be a potential novel therapeutic target for CAD prevention.     

GST among issues raised during CMA workshop on political lobbying

A recent CMA-sponsored workshop on political lobbying attracted many more physicians than anticipated. Dr. Bill Acker, chair of the Political Action Committee, said this is a sign of physicians'' growing interest in lobbying and politics.