An historical approach to the genetic distribution of KIR and HLA ligands in Eastern Sicilians compared to modern descendants of their invaders

A geographical stratification of Killer Immunoglobulin-like Receptors (KIR) has been reported worldwide. We first analyzed the distribution of 15 KIR genes in a sample of 50 East-Sicilians (ES). We used a Principal Component Analysis (PCA) to compare the KIR genetic content among ES and 10 modern populations who are descendants of the ancient invaders of Sicily: Spanish, French, Norwegians, Swedes, Finns, Tunisians, Moroccans, Arabs, Greeks, Turks. We also included a sample of Sardinians, and Senegalese (as outlier group). Then, we also compared the HLA-A, HLA-B and HLA-C allelic frequencies among ES and the same populations investigated for KIR. As to HLA-A and HLA-B polymorphisms, ES are close to Greek population who invaded the island for long time until 827 CE; while HLA-C and KIR distribution in ES are close to Spanish population that invaded Sicily (and Sardinia) starting from 1283. As to KIR, ES are close to Spanish and Sardinians. The immunogenetic fingerprint of ES may be the finely balanced result of the invasions that overwhelmed Sicily over the centuries.     

Does chair type influence outcome in the timed “up and go” test in older persons?

Objective  

To test the effects of the use of a collapsible, portable chair (chair B), as opposed to a ‘standard’ chair (chair A), on the outcome of the timed “Up and Go” (TUG) test.     

Management of older patients presenting after a fall--an accident and emergency department audit.

BACKGROUND: It is common for older patients to present to accident and emergency (AE) departments after a fall. Management should include assessment and treatment of the injuries and assessment and correction of underlying risk factors in order to prevent recurrent falls. OBJECTIVES: To determine management of older patients presenting after a fall to the AE department of Groote Schuur Hospital in Cape Town, South Africa. METHOD: Hospital records were reviewed for a random sample of 100 patients aged 65 years and older presenting to the AE department after a fall, between December 2001 and May 2002. RESULTS: The mean age of the sample was 78.6 years (range 65-98 years); 72% of subjects were female. History of a previous fall, and history of drug or alcohol intake, were recorded in less than 20% of cases. Blood pressure and pulse rate were recorded in approximately 90% of cases, and pulse rhythm and postural blood pressure in 2%. Examination of the musculoskeletal system was done in 86% of cases and that of other systems in less than 50%; cognitive assessment was conducted in less than 30%. Radiological investigations were performed in 89% of cases, glucose and haemoglobin in 32%, renal profile and electrocardiogram in 5%, and urinalysis in 4%. Three-quarters of the patients were referred for further management: 52% to orthopaedic surgery, 12% to other surgical subspecialties, 6% to the general medical department, and 6% to other hospitals and clinics. No referrals were made to geriatric medicine, physiotherapy or occupational therapy. CONCLUSIONS: In managing elderly patients after a fall, the AE department focused on injuries sustained. Little effort was made to establish and manage risk factors, hence to prevent recurrent falls. Guidelines are needed for the management of such patients in AE departments.     

EARLY CHANGES IN CEREBRAL ANEURYSMS IN THE INTERNAL CAROTID ARTERY/POSTERIOR COMMUNICATING ARTERY JUNCTION

In order to obtain information about preaneurysmal changes, the junction of the internal carotid artery/posterior communicating artery (ICA/PComA) in the circles of Willis in subjects with aneurysms at sites other than the junction, and in control subjects without aneurysms, were studied by light microscopy.
Small evaginations and thinnings of the media with and without dilatation were observed at the apical areas of the forks with a significantly higher incidence in the aneurysm series than in the control, suggesting some predisposing factor in subjects with aneurysms. As well as funnel-shaped dilatations previously described as the only type of ICA/PComA preaneurysmal change, other more localized types were observed. All the small evaginations and about half of the thinnings and dilatations were observed at the apex in association with a medial gap, but the other half occured at some distance from the apex. The thinned arterial wall showed degenerative changes of the elastic lamina and media. Intimal pads were observed at the apex, the ICA/PComA lateral angle and the ICA stem/branch curve. Their combination with preaneurysmal changes was more frequent in the aneurysm series in comparison with the control.
Degenerative changes of the elastic lamina and media caused by hemodynamic stress due to branching structures including intimal pads are thus presumed to be the initial lesions existing prior to aneurysm formation.     

Health expenditure and catastrophic spending among older adults living with HIV

Introduction: The burden of HIV is increasing among adults aged over 50, who generally experience increased risk of cormorbid illnesses and poorer financial protection. We compared patterns of health utilisation and expenditure among HIV-positive and HIV-negative adults over 50. Methods: Data were drawn from the Study on global AGEing and adult health in South Africa with analysis focusing on individual and household-level data of 147 HIV-positive and 2725 HIV-negative respondents. Results: HIV-positive respondents reported lower utilisation of private health-care facilities (11.8%) than HIV-negative respondents (25.0%) (p?=?.03) and generally had more negative attitudes towards health system responsiveness than HIV-negative counterparts. Less than 10% of HIV-positive and HIV-negative respondents experienced catastrophic health expenditure (CHE). Women (OR 1.8; p?p?Conclusions: These findings suggest that although HIV-positive and HIV-negative older adults in South Africa are protected to some extent from CHE, inequalities still exist in access to and quality of care available at health-care services – which can inform South Africa’s development of a national health insurance scheme.     

Field trial of two dual vaccines against Mycoplasma agalactiae and Mycoplasma mycoides subsp. mycoides (large colony type) in goats

Two vaccines against Mycoplasma agalactiae and Mycoplasma mycoides subsp. mycoides (LC type) were developed using inactivated strains selected in previous characterization studies. The vaccines differed in terms of the adjuvants used: aluminium hydroxide (vaccine A) or aluminium hydroxide plus purified saponin (vaccine B). These vaccines were tested on 60 pregnant goats and 60 seronegative kids that were challenged by placing in a herd with a history of caprine contagious agalactia (CCA). Our findings indicate the effectiveness of the vaccines in preventing the appearance of new clinical signs such as mastitis, abortion, pneumonia and polyarthritis in CCA affected herds.     

"In vitro" postnatal expression of 5-HT7 receptors in the rat hypothalamus: an immunohistochemical analysis

The neurotransmitter serotonin (5-HT) is involved in various physiological functions via multiple receptor subtypes. These have been classified in seven receptor families (5-HT1-7) on the basis of their structures and functional characteristics. In this study, we examined the expression of 5-HT7 receptors in the rat hypothalamic neurons cultured "in vitro" during postnatal development. Neuronal cultures were prepared from postnatal pups P2, P3 and P5, were treated with bFGF and processed by means of immunofluorescence technique using a polyclonal 5-HT7 receptor antibody. In P2, we found a low density of 5-HT7 labeled hypothalamic bFGF-treated neurons and no 5-HT7 immunolabeling in control cultures; in P3, a moderate number of bFGF-treated neurons were observed but they were not bright. No 5-HT7 immunolabeling was found in controls. In P5, a heavy labeling of small sized bipolar neurons was seen in bFGF-treated neurons, while in control cultures, few labeled neurons with a low stained density were observed. These results suggest that 5-HT7 receptors in hypothalamic neurons begin to appear at P5 and then could be involved in many physiological implications that are not exerted at P2 and P3. This indicates that 5-HT7 receptors have a potential significance in the rat hypothalamus during early postnatal development.