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Disease genes: flattery and deception.

Completion of the human genome project raises the possibility of genetically based treatments for a multitude of human diseases. As yet only a handful of patients have benefited clinically from this approach. Why gene transfer is such a complex issue is discussed in this article. Theoretically, the easiest diseases to treat are single gene recessive diseases, where, presumably, gene delivery to somatic cells is all that is required. Two prime candidates for gene therapy are severe combined immunodeficiency disease (SCID) and cystic fibrosis (CF). Attempts to treat both of these diseases by gene therapy commenced in the late 1980s. Some clinical benefit has been recorded with SCID, but none, as yet, has been recorded with CF.

Animals↗

Saphenous vein thrombophlebitis (SVT): a deceptively benign disease.

PURPOSE: The association between deep vein thrombosis (DVT) and the hypercoagulable state is a well-established entity. However, the association between saphenous vein thrombophlebitis and coagulation abnormalities has not been investigated. Although thrombosis of varicose veins typically runs a benign course, phlebitis of the saphenous system may propagate to the deep system or saphenofemoral junction that requires more aggressive therapy. Given the potential similarity in clinical outcome between saphenous vein thrombophlebitis (SVT) and DVT, we have investigated the coagulation profile of patients presenting with isolated SVT. METHODS: Seventeen consecutive patients who presented to our vascular laboratory with isolated SVT had a coagulation profile performed that included antithrombin III (AT III), protein C (PC), protein S (PS) antigen and activity levels, activated protein C (APC) resistance, factor V DNA mutation, and coagulation factors II and X. All patients had duplex scans performed on both the superficial and deep venous systems. Patients with SVT only were treated with nonsteroidal antiinflammatory drugs (NSAIDs) and warm soaks as outpatients, whereas those patients found to have DVT or a clot at the saphenofemoral junction were fully anticoagulated with heparin and coumadin therapy. All 17 patients had at least one repeat coagulation profile performed up to 5 months after their SVT occurrence to ensure that the results of hypercoagulability were not transient. RESULTS: Ten (59%) of the 17 patients with SVT had abnormal coagulation profiles on initial presentation. All 10 patients who were hypercoagulable had repeat tests and 6 (35%) remained abnormal. Four patients who had abnormal results converted to normal values. Seven patients with normal coagulation profiles on initial presentation had repeat tests and all remained normal. CONCLUSION: The incidence of the hypercoagulable state in patients with SVT is high. Thirty-five percent of patients with isolated SVT had consistently abnormal coagulation profiles. Patients with SVT may be prone to the development of DVT or saphenofemoral junction thrombophlebitis and should be closely followed after the initial diagnosis of hypercoagulability.

Adult↗

Hepatitis C virus infection: when silence is deception.

Hepatitis C virus (HCV) uses complex and unique mechanisms to prevent, evade or subvert innate and adaptive immune responses and to establish persistent infection and chronic hepatitis. Recently developed experimental systems have significantly facilitated the analysis of HCV replication, virus-host interaction and pathogenesis of chronic hepatitis and have provided new insights into the mechanisms of HCV clearance and persistence.

Animals↗

Will the truth come out? the effect of deception, age, status, coaching, and social skills on CBCA scores.

The impact of Veracity, Age, Status (witness or suspect), Coaching (informed or uninformed regarding CBCA), and Social Skills (social anxiety, social adroitness, and self-monitoring) on Criteria-Based Content Analysis scores was examined. Participants (aged 5-6, 10-11, 14-15, and undergraduates) participated in a "rubbing the blackboard" event. In a subsequent interview they told the truth or lied about the event. They were accused of having rubbed the blackboard themselves (suspect condition) or were thought to have witnessed the event (witness condition), and were or were not taught some CBCA criteria prior to the interview. CBCA scores discriminated between liars and truth tellers in children, adults, witnesses, and suspects. However, truth tellers obtained higher CBCA scores than liars only when the liars were uninformed about CBCA. CBCA scores were correlated with social skills. It is argued that thesefindings should caution those who believe that the validity of CBCA has been conclusively demonstrated.

Adolescent↗