Human bilharziasis in the Near-East Mediterranean countries. Historical aspects and current distribution

The countries surrounding the mediterranean share geographical ethnic, historical and pathological features. Bilharziasis infectious found in these countries include S. haematobium infection in North Africa, Egypt and Near East and S. mansoni infection in Egypt and Arabian peninsula. The origin of two bilharziasis is probably West and East Africa, Egypt.     

The immune system in familial Mediterranean fever.

Familial Mediterranean fever (FMF) is a genetic disorder with an obscure aetiology. In attempts to investigate a possible immunoregulatory imbalance involved in this disease we tested 24 FMF patients for suppressor T cell activity and for chemotaxis of mononuclear cells. The suppressor T cell activity and chemotaxis were decreased in untreated FMF patients as compared to colchicine treated patients or normal controls. Amyloid FMF patients manifested significantly increased chemotactic activity, while the suppressor T cell activity was normal. This finding may extend our knowledge concerning the immune mechanism involved in FMF.     

The role of the general physician in present-day medical care in Mexico

The issue of how medical specialization does not represent a novelty is discussed. The authors also approach the question of how the advantages and shortcomings of medical care provided by both general practitioners and medical specialists have been equally addressed previously by the ancient Greek classics as well as by outstanding Mexican specialists more than 50 years ago. A short review is made of the main current demographic, social, and health-related conditions of Mexico's society and of the public health system built up in the last 60 years. Some relevant data pertaining to the number of physicians and medical specialists and their distribution Mexico's 32 states are presented. The paper also includes a short argumentation of views on medical education in Mexico, and sets forth aproposal regarding the professional profile of the general practitioner and its role within Mexico's health system, as well as the need to enhance and reconsider the role played by general physicians. Authors conclude that within a comprehensive medical assistance model, both general practitioners and medical specialists are required.     

Malaria in Guiana. II. The characteristics of different foci and antimalarial control

In French Guiana, the distribution of malaria in foci inhabited by quite different ethnic groups calls for specific studies. Along the Oyapock on the Brasilian border and along the Litani on the Surinam border, incidence among American Indians and Creoles ranges from 300 and 900 per thousand; Plasmodium falciparum accounts for 65% and P. vivax for 35%. Along the middle and lower Maroni on the Surinam border, the Boni and Ndjukas Negroes move freely through the frontier and since the civil strife Surinamese used to attend health centres of Guiana. Therefore it is difficult to find the sources of contamination and the incidence among French citizens; P. falciparum is the only parasite recorded in this focus. In 1987 a small outbreak mainly due to P. vivax, occurred in a Lao refugees village in the hinterland. The coastal foci harbour large communities of Haitian and Brazilian migrants. The vector is Anopheles darlingi and up to now there is no evidence that other species could be involved. The rise of malaria despite of control measures involves several factors: the house spraying is no more accepted by a large percentage of house holders and the alternative larviciding has only a limited efficacy; the houses of American Indians have no walls to be sprayed; there is a continuous introduction of parasites by migrants. It has been said that vectors have change their behaviour toward exophily but such a statement has not yet been supported by evidence. All these factors should be taken in account to improve malaria control.     

APOE distribution in world populations with new data from India and the UK

BACKGROUND: The APOE gene and its protein product is associated with a number of plasma proteins like very-low density lipoprotein (VLDL), high density lipoprotein (HDL) chylomicrons, chylomicron remnants, and plays a crucial role in lipid metabolism. The APOE gene is polymorphic and common alleles (*E2, *E3 and *E4) have been associated with a number of common and complex diseases in different populations. Due to their crucial role in metabolism and clinical significance, it is imperative that allelic variation in different populations is analysed to evaluate the usage of APOE in an evolutionary and clinical context. AIM: We report allelic variation at the APOE locus in three European and four Indian populations and evaluate global patterns of genetic variation at this locus. The large, intricate and unexpected heterogeneity of this locus in its global perspective may have insightful consequences, which we have explored in this paper. SUBJECT AND METHODS: Apolipoprotein E genotypes were determined in four population groups (Punjabi Sikhs, Punjabi Hindus, Maria Gonds and Koch, total individuals = 497) of India and three regionally sub-divided British populations (Nottinghamshire, East Midlands and West Midlands, total individuals = 621). The extent and distribution of APOE allele frequencies were compared with 292 populations of the world using a variety of multivariate methods. RESULTS: Three alleles, APOE*E2, APOE*E3 and APOE*E4, were observed with contrasting variation, although *E4 was absent in the tribal population of Koch. Higher heterozygosities (>43%) in British populations reflected their greater genetic diversity at this locus. The overall pattern of allelic diversity among these populations is comparable to many European and Indian populations.At a global level, higher frequencies of the *E2 allele were observed in Africa and Oceania (0.099 +/- 0.083 and 0.111 +/- 0.052, respectively). Similarly, *E4 allele averages were higher in Oceania (0.221 +/- 0.149) and Africa (0.209 +/- 0.090), while Indian and Asian populations showed the highest frequencies of *E3 allele. The coefficient of gene differentiation was found to be highest in South America (9.6%), although the highest genetic diversity was observed in Oceania (48.7%) and Africa (46.3%). APOE*E2 revealed a statistically significant decreasing cline towards the north in Asia (r = -0.407, d.f. = 70, p < 0.05), which is not compatible with the coronary heart disease statistics in this continent. APOE*E4 showed a significant increasing cline in North European populations. Spatial autocorrelation analysis shows that the variation at this locus is influenced by 'isolation by distance' with a strong positive correlation for lower distances up to 1313 km. CONCLUSION: Overall APOE allelic variation in UK and Indian populations is comparable to previous studies but in tribal populations *E4 allele frequency was very low or absent. At a global level allelic variation shows that geography, isolation by distance, genetic drift and possibly pre-historical selection are responsible for shaping the spectrum of genetic variation at the APOE gene. Overall, APOE is a good anthropogenetic and clinical diagnostic marker.     

Malaria infection in transplant recipient.

A case of P. malariae infection occurring in a kidney transplant recipient is reported. The diagnosis was delayed because of atypical clinical presentation secondary to altered immune response. Serologic tests for antimalarial antibody are not reliable and diagnosis is established by visualization of the parasites in the peripheral blood smear. We can only guess what role this infection played in rejection of the transplant and whether earlier diagnosis and treatment would have saved it.     

Paternal lineages in southern Iberia provide time frames for gene flow from mainland Europe and the Mediterranean world

Background: The geography of southern Iberia and an abundant archaeological record of human occupation are ideal conditions for a full understanding of scenarios of genetic history in the area. Recent advances in the phylogeography of Y-chromosome lineages offer the opportunity to set upper bounds for the appearance of different genetic components.

Aim: To provide a global knowledge on the Y haplogroups observed in Andalusia with their Y microsatellite variation. Preferential attention is given to the vehement debate about the age, origin and expansion of R1b-M269 clade and sub-lineages.

Subject and methods: Four hundred and fourteen male DNA samples from western and eastern autochthonous Andalusians were genotyped for a set of Y-SNPs and Y-STRs. Gene diversity, potential population genetic structures and coalescent times were assessed.

Results: Most of the analysed samples belong to the European haplogroup R1b1a1a2-M269, whereas haplogroups E, J, I, G and T show lower frequencies. A phylogenetic dissection of the R1b-M269 was performed and younger time frames than those previously reported in the literature were obtained for its sub-lineages.

Conclusion: The particular Andalusian R1b-M269 assemblage confirms the shallow topology of the clade. Moreover, the sharing of lineages with the rest of Europe indicates the impact in Iberia of an amount of pre-existing diversity, with the possible exception of R1b-DF27. Lineages such as J2-M172 and G-M201 highlight the importance of maritime travels of early farmers who reached the Iberian Peninsula.     

Breastfeeding and health in the Western world.

Considerable evidence suggests that infant feeding practices are associated with variations in health. This paper reviews research relating to the health of infants who receive breast milk, and of women who breastfeed, in the developed world. Obstacles to breastfeeding are examined, and current initiatives to increase breastfeeding levels are discussed.