HIV/AIDS infection control enforcement: a comparison between Nigeria and the United States

We examined differences in approaches to HIV-related infection control practices in two university teaching hospitals in the United States and Nigeria. Health care workers (n = 202 in Nigeria and 186 in the USA) responded to a previously validated measure of infection control practices. There were significant differences in the estimated probability of treating a person with HIV disease (higher in USA), and a greater probability of peer ridicule as a way of enforcing group norms on infection control in Nigeria. Peer enforcement of norms was significantly lower in the USA. In both countries, more precautions would be taken if it was known that the patient was HIV infected. Infection control practices were more likely to be followed in the USA compared with Nigeria if they were praised for this activity, if appropriate facilities (sharps containers, gloves, etc.) were nearby, and if they felt that infection control procedures were effective. These data point to the importance of normative social pressures in Nigeria and of knowing the patient is HIV infected in the USA and feeling that infection control procedures are effective ways of avoiding occupational HIV infection. The role of normative pressures and assumptions about HIV infection status as well as cues and availability of facilities for infection control appear to differ between these health care workers in Nigeria and the USA.     

阿片受体拮抗剂在TNF－α所致体温升高中的作用

为探索细胞介素ＴＮＦ－α升体温效应与下丘脑前部、视前区（ＰＯＡＨ）中的阿片受体的关系。应用脑神经核团微量注射方法给自由状态下的雄性ＳＤ大鼠ＰＯＡＨ区微量注射ＴＮＦ－α致热源。给药前３０ｍｉｎ分别用通常阿片受体拮抗剂Ｎａｌ（１０～２０μｇ）和特异性阿片受体μ、δ和κ的拮抗剂ＣＴＡＰ（１．０～２．５μｇ）、ＮＴＩ（０．２５～０．５μｇ）和ｎｏｒ－ＢＮＩ（０．１～３μｇ）对ＰＯＡＨ做预处理。结果：单独给ＴＮＦ－α可致剂量相关的体温升高△Ｔ（１℃～１．４℃）；经Ｎａｌ１０μｇ，ＣＴＡＰ１．０μｇ和ＮＴＩ０．５μｇ处理后使ＴＮＦ－α的升体温效应减弱；用Ｎａｌ２０μｇ，ＣＴＡＰ２．５μｇ和ＮＴＩ０．２５μｇ处理后可完全阻断ＴＮＦ－α所致的体温升高；ｎｏｒ－ＢＮＩ（０．１～３μｇ）对ＴＮＦ－α的升体温效应无影响。     

Long-term follow-up of autoantibody profiles in black female lupus patients and clinical comparison with Caucasian and Asian patients

The aim was to determine whether the autoantibody profile in Black female lupus patients is associated with clinical subsets, fluctuates over time and/or reflects disease activity. A clinical comparison with Caucasian and Asian patients matched for age of onset and disease duration was also undertaken. Up to seven serial bleeds from Black female lupus patients who had been followed up for periods of 3.15 yr were tested for antibodies to Ro/SSA, La SSB. Sm, RNP and ribosomal P using ELISA research assays. Significant differences in both clinical and serological profiles between the ethnic groups were found. Varying aspects of disease activity were linked to anti-DNA (renal, cardiovascular, global score), anti-ribosomal P (musculoskeletal, haematology) and anti-Sm (general) antibodies. There are differences in clinical and serological profiles amongst systemic lupus erythematosus patients of different ethnic origin. However, using the BILAG system, relatively few antibodies were found to reflect disease activity accurately in serial measurements.      

Effect of halothane on myocardial infarct size in rats

The effect of halothane on myocardial infarction caused by ligation of the left descending coronary artery was studied in rats. The extent of infarction was quantified 48 hours after ligation of the artery by planimetric measurement of left ventricular slices stained with nitrobluetetrazolium. Animals exposed to halothane one per cent for three hours after the coronary ligation were compared with a control group which received halothane for only 5-7 minutes during surgery. It was found that halothane caused a small increase in infarction size (31.3 ± 1.5 per cent of the left ventricle compared to 25.7 ± 2.3 percent, p < 0.05). This effect was accompanied by a decrease in systolic blood pressure (91 ± 2 mmHg compared to 113 ± 3 mm Hg, p < 0.001). Heart rate did not change significantly. Analysis of our results in comparison to previously reported data on the effect of halothane on myocardial ischaemia in different experimental conditions shows that halothane may produce beneficial as well as detrimental effects on ischaemic injury to the myocardium. The latter can result when the drug causes marked hypotension in the absence of a significant decrease in heart rate.     

Morphine-halothane interaction in rats

The effects of morphine, halothane, and their various combinations on the purposeful movement (PM) response and the heart rate (HR) increase caused by noxious stimulation were studied in 250 rat experiments. Doses that block the PM and HR responses for the single agent and for combinations were determined with a probit procedure and compared with an isobolographic analysis. As was evidenced by the PM response, the combined anesthetic effect of morphine and halothane, with some deviations, may be defined as additive. It also was found that the combined administration of morphine and halothane results in an antagonism for suppression of the HR increase to noxious stimulation. Halothane antagonized morphine to a much greater extent than morphine to halothane.     

Reserpine-induced changes in anesthetic action of fentanyl

The effect of prior administration of reserpine on fentanyl dose-response curves for loss of the righting reflex and prevention of purposeful movement response to noxious stimulation was studied in rats. It was found that reserpine (5 mg X kg-1, 3 h before the tests) antagonized the effect of fentanyl on purposeful movement response to the tail clamp and, at the same time, strengthened its effect on the righting reflex. As a result, reserpine pretreatment reversed the order of fentanyl potency regarding these two effects. Reserpine changed fentanyl ED50 values for the purposeful movement response from 8.2 to 20.3 micrograms X kg-1 (P less than 0.0001) and for the righting reflex from 20.5 to 13.7 micrograms X kg-1 (P less than 0.0001). The results suggest that reserpine dissociates the analgesic action of fentanyl from its anesthetic action, defined as a loss of the righting reflex. This may be regarded as an indication that the analgesic action of narcotics may not adequately reflect their anesthetic potency.