Sub-cellular pathology of scrapie: coated pits are increased in PrP codon 136 alanine homozygous scrapie-affected sheep

Sub-cellular studies of transmissible spongiform encephalopathies (TSEs) have been carried out on several animal species and human beings. However, studies of optimal perfusion-fixed tissues have largely been confined to examination of rodents. Using a recently developed technique, heads of scrapie-affected sheep and controls were perfusion fixed with mixed aldehydes. The obexes were immunohistochemically labelled with PrP antibodies, and the dorsal motor nucleus of the vagal nerve was examined by electron microscopy. Irregular neuritic profiles with highly invaginated membranes, associated with coated pits were found in all scrapie-affected sheep, but not in controls. Interestingly, they were consistently more frequent in the homozygous A(136) sheep. This is the first report describing sub-cellular differences in pathology associated with different PrP genotypes. Rarely, amorphous material, or sparse fibrillar structures, were present in the extracellular space. The changes were often associated with irregular plasmalemma and frequent coated pits. Vacuolation typical of TSEs, dystrophic neurites and variable gliosis were present. Herniation of membranes and organelles from apparently healthy processes into adjacent vacuoles and dendrites was also observed. We suggest that the increase in coated pits and plasmalemma invagination is related to an attempted internalisation of aggregated disease-specific PrP, or protofilaments, from the extracellular space.     

Inducible expression of FGF2 by a rat oligodendrocyte precursor cell line promotes CNS myelination in vitro

Transplantation of glial cells into the central nervous system (CNS) may be a promising approach for the treatment of myelin disorders such as multiple sclerosis (MS). Myelination by transplantation of oligodendrocyte precursors has been obtained in different animal models of demyelination. A strategy to favor CNS remyelination is to enrich the lesioned areas in growth factors to stimulate the quiescent population of oligodendrocyte precursors. In this context, we have developed a genetically modified CG4 cell line (CG4-FGF2), which are able to release significant amounts of fibroblast growth factor 2 (FGF2) in a controlable fashion in vitro. The data presented here demonstrate that upon induction with Dox, CG4-FGF2 cells retain their capacity to differentiate in vitro. Additionally, we provide evidence that FGF2 release by engineered cells enhance proliferation and migration of cells of the oligodendrocyte lineage without preventing them to differentiate and myelinate axons in vitro.     

The social organization of commercial sex work in Moscow,Russia

BACKGROUND: Increased poverty, unemployment, and migration place the Russian population at high risk for sexually transmitted infections (STIs). A qualitative study was undertaken to clarify the organization of sex work and describe the likely contributions of different types of sex work to disease transmission. GOAL: The goal of the study was to describe the social-organizational patterns of sex work in Moscow, Russia. STUDY DESIGN: Four qualitative data collection methods were used: semistructured telephone interviews, semistructured face-to-face individual and group interviews with key informants, systematic and unobtrusive naturalistic observations, and geomapping. RESULTS: Intermittent, truck stop, and railway station sex workers may be the most important groups in the dissemination of STIs. Sex work is widely disseminated throughout the city. Identifiable positions in the social organization of street sex work include pimps, assistant female pimps, guards, drivers, "indicators," the sex workers themselves, and recruitment "pluckers." CONCLUSION: The Moscow sex market may be an adjustive response of the social system to the economic pressures in Russia. Sex work in Moscow has great potential for disseminating STIs throughout Russia and beyond. Understanding of these issues may enhance the impact of STI prevention programs.     

Increasing clinical,satisfaction, and financial performance through nurse-driven process improvement

Providers and regulatory agencies are increasing their demands for hospitals to document clinical quality and customer satisfaction at a decreased cost. Nurse leaders search for ways to meet these requirements while retaining their most valuable resource: healthcare workers (especially nurses). First-line leadership struggles with balancing quality, cost-effectiveness, and staff retention. The author discusses the planning, methodology, implementation, and outcomes of a staff driven process improvement initiative.     

State substance abuse treatment gaps

This study estimated the adequacy of state substance abuse treatment rates relative to treatment needs. The investigators created composite drug and alcohol treatment need indexes from explicit-mention mortality and substance-defined arrest rates. The indexes were reliable and had evidence of construct validity, but alternative population-at-risk and survey-based need measures did not fair as well. States varied substantially in per capita alcohol and drug treatment needs, although the two did not correlate with each other. While the need indexes correlated significantly with state treatment rates, the adequacy of state treatment rates varied greatly. States with the largest treatment gaps were in the South, Southwest, and northern plains and mountain regions. The failure of the Block Grant formula to reflect the needs of rural states with high-risk minority populations may contribute to disparities in access to services.     

Overview of injection practices in two governorates in Egypt

OBJECTIVE: To describe the extent and characteristics of injection use and injection providers in Egypt, given that unsafe injections are associated with blood-borne pathogen transmission. METHODS: Household surveys of a population-based sample of residents in the Nile Delta and in Upper Egypt; focus group discussions and in-depth interviews with community target groups, formal and informal medical providers. RESULTS: Of 4197 persons interviewed, 26.2% reported receiving an injection in the past 3 months. Of these, 77% reported it was for therapeutic indications. The age-sex specific prevalence of injections was highest among children 0-2 years of age and among older adults. Women were more likely to report having an injection than men, particularly at the age above 20 years. Overall, respondents reported receiving on average 4.2 injections per year, indicating that up to 281 million injections are provided per year in Egypt. Injection administrators were public and private sector physicians, pharmacists, barbers, doctor assistants, housekeepers, relatives and friends. Injection prescribers were mostly private and public sector physicians. Of the 1101 respondents who received an injection in the past 3 months, 92 (8.4%) reported that the provider did not use a syringe taken from a closed sealed packet. CONCLUSION: The frequency of therapeutic injection use is high in Egypt and may contribute to blood-borne pathogen transmission. The Ministry of Health and Population (MOHP) is developing interventions targeted towards promotion of injection safety and reduction of injection overuse on community basis as part of a comprehensive strategy to prevent blood-borne pathogen transmission in Egypt.