Global plagues and the Global Fund: Challenges in the fight against HIV,TB and malaria

Background  

Although a grossly disproportionate burden of disease from HIV/AIDS, TB and malaria remains in the Global South, these infectious diseases have finally risen to the top of the international agenda in recent years. Ideal strategies for combating these diseases must balance the advantages and disadvantages of 'vertical' disease control programs and 'horizontal' capacity-building approaches.     

MR imaging of the acutely injured patient with cervical traction

Magnetic resonance (MR) imaging of the patient with acute cervical injury is important because of the potential prognostic significance of the appearance of the spinal cord at the time of injury. However, cervical traction may involve equipment incompatible with the magnetic environment, and transferring the patient to the imaging table may make it difficult to maintain traction. The authors describe a simple, inexpensive, and reliable method for providing cervical traction within the magnet room.     

Using Intervention Mapping to develop a programme to prevent sexually transmittable infections,including HIV,among heterosexual migrant men

Background  

There is little experience with carefully developed interventions in the HIV/STI prevention field aimed at adult heterosexual target groups in the Netherlands. The ability to apply intervention development protocols, like Intervention Mapping, in daily practice outside of academia, is a matter of concern. An urgent need also exists for interventions aimed at the prevention of STI in migrant populations in the Netherlands. This article describes the theory and evidence based development of HIV/STI prevention interventions by the Municipal Public Health Service Rotterdam Area (MPHS), the Netherlands, for heterosexual migrant men with Surinamese, Dutch-Caribbean, Cape Verdean, Turkish and Moroccan backgrounds.     

Human endothelial cells synthesize protein S

Human umbilical vein endothelial cells were analyzed for the presence of prothrombin, factor VII, protein C, and protein S in culture supernatants and cell extracts using specific radioimmunoassays. Only protein S was detected. Conditioned medium from 24-hour cultures and cell lysates contained 21.7 ng/mL and 88.8 ng/10(7) cells of protein S, respectively. Intrinsic labeling and immunoprecipitation indicated that protein S was synthesized and secreted as a 75,000 molecular weight protein. Vitamin K, phorbol myristate acetate, and thrombin increased the production or specific activity (determined from activity/antigen ratios of 0.99 to 1.07, 0.93 to 1.04, and 0.90 to 1.04, respectively) of protein S. While untreated cells secreted a partially active protein S (activity/antigen = 0.40), warfarin greatly decreased the specific activity (less than 0.10) of this molecule, suggesting that endothelial cells contain the enzymes required for the carboxylation of selected glutamic acid residues. The production of protein S by these cells supports the hypothesis that cofactor production and expression by the endothelial cells may play a significant regulatory role in the initiation, propagation, and suppression of hemostasis and thrombosis.     

Increased release of plasminogen activator inhibitor type 2 accompanies the human mononuclear cell tissue factor response to lipopolysaccharide

Human peripheral blood mononuclear cells (PBM) respond to lipopolysaccharide (LPS) with increased release of a plasminogen activator (PA) inhibitor. This response is dose dependent and parallels the LPS-induced expression of PBM tissue factor activity. The PA inhibitors of control and LPS-stimulated PBMs appear identical as both are identified by antibodies to PA inhibitor type 2 of human placenta, but not by antibodies to type 1 inhibitor of bovine aortic endothelial cells. The PA inhibitor is specific for urokinase type PA as determined by the 125I-fibrin plate assay, and direct cleavage of 125I- plasminogen; it does not effectively inhibit tissue-type PA. The inhibitor forms an active site-dependent complex with 125I-urokinase, which then demonstrates an increase in mol wt from 33 kd to 68 kd on reduced sodium dodecyl sulfate (SDS) polyacrylamide gels. PBMs neither secrete nor express active PA. Hence, the exposure of PBMs to LPS results in conditions highly favorable to fibrin deposition and persistence: increased procoagulant and antifibrinolytic activities, accompanied by no measurable PA. Such modulation of these effectors may be important in the pathogenesis of fibrin characteristically found in tissue lesions of endotoxin-initiated processes.