Risk factors for HIV–1 seroprevalence among drug injectors in the cocaine–using environment of Rio de Janeiro

To determine risk factors for HIV–1 among drug injectors in Rio de Janeiro, where cocaine is the dominant drug of injection, subjects were recruited using the criteria and interview instrument of the World Health Organization's Cross–National Study of HIV infection and risk behaviour in injecting drug users. HIV antibody test results were derived both from serum tests and from self–reports of previous tests (documented evidence of self–reported seropositivity was required). The analytical sample consists of 123 subjects, recruited both at drug abuse treatment sites and at street locations. Of 27 subjects with both serological and self–reported antibody status data, 20 reported previous negative tests; of these three had positive sera and may have seroconverted. Seven subjects reporting prior positive serostatus all tested positive. For the 123 subjects, seroprevalence was 34%. Independent significant risk factors in multivariate logistic regression with backwards elimination are: years of injection greater than 5; being a male who has had sex with men in the previous 5 years; and not having taken deliberate steps to protect oneself against AIDS. These findings indicate that homosexual/bisexual male drug injectors may be a bridge group through which HIV is entering drug–injecting networks in Rio de Janeiro. Efforts by drug injectors to reduce their risk of infection seem to have protective effects. This underscores the importance of HIV prevention efforts aimed at drug injectors.     

Antibodies to the serine rich Entamoeba histolytica protein (SREHP) prevent amoebic liver abscess in severe combined immunodeficient (SCID) mice

Amoebic liver abscess caused by Entamoeba histolytica is a major cause of morbidity and mortality worldwide. We used mice with severe combined immunodeficiency (SCID mice) to study the role of antibody in protection from amoebic liver abscess, and to identify protective antigens of E. histolytica. Antisera to recombinant versions of two major surface antigens of E. histolytica, the serine rich E. histolytica protein (SREHP) and the 170 kDa adhesin were used in this study. We found that 100% of SCID mice passively immunized with antiserum to the recombinant SREHP molecule were protected from developing amoebic liver abscess after intrahepatic challenge with virulent E. histolytica trophozoites. In contrast, preimmune serum, antiserum to a portion of the 170 kDa adhesin, and antiserum to the trpE fusion partner of SREHP did not protect SCID mice from amoebic liver abscess. Our study demonstrates that antibodies to a recombinant version of the amoebic SREHP molecule can protect against amoebic liver abscess, and suggest the recombinant SREHP molecule should be considered as a possible vaccine candidate to prevent amoebic liver abscess.     

ST segment depression in lateral limb leads in inferior wall acute myocardial infarction: Implications regarding the culprit artery and the site of obstruction

We examined whether the pattern of ST segment depression inlateral leads (I, aVL, V5, V6) in the initial electrocardiogramof patients (n=88) with inferior wall acute myocardial infarction(ST segment elevation of 1 mm in 2 inferior leads) correlateswith the site of obstruction, as determined angiographicallyduring acute hospitalization. Of the 62 patients in which the culprit artery could be determinedunequivocally, in 46 the culprit artery was the right coronaryartery (20 proximal to the first right ventricular branch and26 distal), and in 16 the left circumflex coronary artery (sevenproximal to the first marginal branch or involving a high firstmarginal branch, and nine with distal obstruction). SignificantST segment depression (ST1 mm) in leads I and aVL was more commonin right coronary artery obstruction (P<0.05 and P<0.0001,respectively). The absence of significant ST segment depressionin lead a VL was most common in proximal circumflex obstruction(P<0.0001), with a similar trend for lead I (P<0.11).ST segment depression patterns in leads V₅ and V₆ were not indicativeof the infarct-related artery or the site of obstruction. Thus,significant ST segment depression in leads I and aVL indicatesright coronary artery-associated inferior wall acute myocardialinfarction with a sensitivity of 70% and 100%, and a specificityof 63% and 38%, respectively, whereas the lack of ST segmentdepression in these leads indicates proximal circumflex obstructionwith a sensitivity of 71% and 86%, and a specificity of 65%and 100%, respectively.     

One-Month Inhalation Toxicity Study of Tulobuterol Hydrochloride in Rats and Dogs

Tulobuterol hydrochloride (HCl) has ß₂-adrenergicagonist activity and is under development for use in the treatmentof chronic obstructive lung disease. The purpose of this studywas to determine the toxicity of inhaled tulobuterol HCl inrats and dogs. Rats were whole-body exposed to aerosol gravimetricconcentrations of 0, 0.03, 0.22, or 1.1 mg/ liter of tulobuterolHCl, 60 min/day for 28 days. Dogs were exposed (via insufflation)to estimated daily doses of 0, 0.2, 1.0, or 6.0 mg/kg for anequal period. Plasma levels of tulobuterol were determined followingexposure on Days 1, 8, and 28 using a high-pressure liquid chromato-graphicmethod developed for this study. Results indicated that plasmatulobuterol levels were highly correlated with tulobuterol doses(p < 0.0001 for rats and dogs). No dose-related changes inbody weight food consumption, hematological, or serum chemistryparameters were observed in either species. Anterior nasal cavitylesions were observed by light microscopy in rats exposed to0.22 and 1.1 mg/liter tulobuterol HCl at an incidence of 14and 93%, respectively. These lesions involved the nasal septum,turbinates, and/or the dorsolateral wall of the nasal cavityand consisted of suppurative rhinitis and necrosis. The correspondingmean plasma tulobuterol levels on Day 28 in mid- and high-doserats were approximately 1000 and 15,000 ng/ml. Nasal lesionswere not observed in rats allowed to recover for 2 weeks. Nogross or microscopic lesions were detected in lungs or othertissues of either species. These results indicate that the insufflationof high doses of tulobuterol HCl aerosol for 1 month was generallywithout toxicity in dogs and that the local nasal ussue injuryobserved in rats exposed to high concentrations of aerosolizedtulobuterol HCl was reversible.     

Myocardium of the Superior Vena Cava,Coronary Sinus,Vein of Marshall,and the Pulmonary Vein Ostia: Gross Anatomic Studies in 620 Hearts

Anatomy of Myocardial Extensions in Thoracic Veins. Introduction: Radiofrequency ablation for atrial fibrillation (AF) frequently involves energy delivery at the ostia of the thoracic veins. Detailed evaluation of the myocardium extending into the caval veins, vein of Marshall, as well as at the pulmonary vein ostia has not been completely evaluated. Methods and Results: Post‐mortem assessment of 620 formalin‐fixed hearts (mean age 60 ± 23 years, 44% female) was performed. The hearts were examined for integrity of venous structures and their atrial connections. Systematic gross anatomic evaluation including measurements on myocardial extensions in these veins was performed. Macroscopic myocardial extensions into pulmonary veins were noted in 99% of specimens evaluated and were circumferentially symmetric (99.6%). Myocardial extensions into the superior vena cava (SVC) occurred in 78% with the majority being circumferentially asymmetric (61%). Occasionally, myocardium extended into the azygos vein (6%). There were no myocardial extensions in the inferior vena cava (IVC). In some cases, the right atrial pectinate muscle extended into the coronary sinus (7%). The vein of Marshall was consistently located anterior to the left‐sided pulmonary veins and posterior to the left atrial appendage, overlying the left atrial endocardial ridge. Conclusions: Myocardial extensions into the pulmonary veins are usually circumferential at the ostia validating the necessity for wide area rather than segmental ablation to isolate these veins during AF ablation. Myocardial extensions into the SVC are common and less likely to be circumferential, whereas extensions into the IVC are not present. The left atrial ridge is a reliable endocardial target for radiofrequency ablation of the vein of Marshall. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1304‐1309, December 2012)     

OCCURRENCE OF BRUCELLA INFECTION AMONG THE DAIRY HERDS OF NORTH CHINA

Previous studies in this laboratory have -revealed the presence of natural Brucella infections among the human population of Peiping This conclusion was reached firstly by finding of patients from whom Brucella organisms have been identified (1, 2) and secondarily by a study of the specific agglutinin of over 2000 specimens of normal human serum (3). However, it was pointed out that in spite of the apparent ly relatively frequent contact to the Brucella antigen as manifested by the comparatively high percentage of serum giving positive agglutina tion, no clue as to the sources of this infection has so far been disclosed. Continued efforts have been made in attempting to discover possible reservoirs in some animal hosts as this disease is well known to be prevalent among cattle, goats, and pigs. We are now able to report in a preliminary way the occurrence of Brucella infection among several dairy herds, which may be as considered as one of the sources of local infection.