HBsAG transmission from a cardiac surgeon incubating hepatitis B resulting in chronic antigenemia in four patients

A cardiac surgeon experienced an uneventful course of acute hepatitis B. HBsAg was transmitted to 11 persons: 5 of 72 patients operated on during his incubation of hepatitis B, three relatives of the infected patients, one laboratory technician, and two of the surgeon's family members. Two years later, 4 of the 5 operated patients are still infectious, whereas the 7 non-operated persons have cleared their antigenemia. This study demonstrates the significant risk of hepatitis B transmission from a cardiac surgeon incubating the disease. Furthermore, it indicates that patients who have been infected during open heart surgery and cardiopulmonary bypass run a particular risk of becoming chronic HBs antigen carriers.

[Diagnosis and treatment of infections of the digestive system in HIV-infected patients]

Patients with HIV infection often suffer from opportunistic and bacterial infections of the digestive tract. The most common agents are Candida albicans, Herpes simplex and Cytomegalovirus, Mycobacterium avium intracellulare, Cryptosporidium parvum, and enteropathogenic bacteria such as Salmonella, Shigella and Campylobacter. The diagnosis is established by means of microbiological examination of blood and faeces, often supplemented by gastrointestinal endoscopy, with mucosal biopsies for culture and histology. Most patients respond well to specific treatment, but the infections tend to relapse after withdrawal of drugs.

Reversal by interleukin-2 of the T cell unresponsiveness of lepromatous leprosy to Mycobacterium leprae

In some subjects Mycobacterium leprae causes disseminated (lepromatous) disease. Such subjects show both in vivo and in vitro deficient T cell responses to M. leprae, but not to other antigens. We have recently shown that lepromatous peripheral blood mononuclear cells (PBMC) failed to produce interleukin 2 (IL-2) in response to M. leprae and that T cell-conditioned media (TCM) can reverse the T cell unresponsiveness in a majority of lepromatous leprosy patients (Haregewoin et al. 1983). Here we show that highly purified and recombinant IL-2 had effects similar to TCM. On the other hand, lepromatous PBMC produced IL-1, and IL-1 had no restorative effect. These findings provide further evidence that the unresponsiveness in lepromatous leprosy often results from a deficiency in IL-2 production. After initial stimulation with TCM + M. leprae, lepromatous PBMC could be restimulated with M. leprae alone, providing clear evidence that M. leprae-reactive lymphocytes were generated in the presence of TCM. The present findings are discussed in relation to the possible mechanisms involved in the failure of IL-2 production. If our findings can be reproduced in vivo, IL-2 may offer a novel approach to therapy in lepromatous leprosy.

Long-term anticoagulant therapy after myocardial infarction in women

A multicentre trial from five medical departments in Oslo has been carried out to determine the value in women patients of one year's long-term anticoagulant therapy. Follow-up long-term laboratory control and anticoagulant dosage were performed at one centre (the Rikshospitalet). One hundred and fifty-nine patients were assigned randomly into two similar well-matched groups (control and treatment). Dosage was controlled by Thrombotest, aiming at 10-20% levels, and 50% of the tests were less than 14%. Compared with the control group, the treatment group showed a significant reduction in mortality and in reinfarction rate. No serious bleeding complications occurred. It is concluded that women benefit as much as men from long-term anticoagulant therapy.