Prevalence of Human T Cell Leukaemia Virus amongst Blood Donors

Background

Human T cell leukaemia virus (HTLV) I/II are retroviruses implicated in transfusion transmitted infection. Present study was undertaken to assess seroprevalence of HTLV in voluntary blood donors along with pattern of blood utilisation. Methods: A total of 258 healthy blood donors who were free from infectious markers in transfusion as per current transfusion guidelines were enrolled. They were screened for HTLV-I/II antibodies by commercially available enzyme immuno assay (EIA) and their blood utilisation data was analysed.

Result

Five (1.9%) donors were found seropositive for HTLV-I/II of which 1.2 % were first time and 0.9% were repeat donors. Blood utilisation data revealed 20.9% and 38.8% units were utilised within 5 and 6–14 days of collection respectively. 45.9% recipients were transfused with single blood unit. 42.9% recipients were immunosuppressed due to underlying disease. Conclusion: The high prevalence of HTLV in blood donors, coupled with single unit transfusion, use of fresh blood, non availability of acellular blood products and immunosuppression in recipients can lead to significant transfusion transmitted HTLV infection. We suggest judicious use of blood products and screening of blood donors in prevention of transfusion transmitted HTLV-I/II.Key Words: HTLV-I/II, Blood donors; Transfusion transmitted infection; Retrovirus     

Frozen red blood cells in transfusion

Red blood cells (RBCs) can be cryopreserved with shelf life of 10 years. However, shelf life of deglycerolized RBCs in conventional open system is just 24 hours, resulting in sporadic use of Frozen RBC (FS-RBC). Recently Naval Blood Research Laboratory (NBRL) method using ACP 215 (ACPTM 215 Haemonetics Cell Processing System) has been introduced, where shelf life of deglycerolized RBC is 14 days. FS-RBC unit is prepared from single blood donation, which needs to be glycerolized and deglycerolized. NBRL method using ACP 215 in FS-RBC is described. Deglycerolized unit weighed between 325–350 gm with haemoglobin of 15–18 gm/dl and freeze- thaw- wash RBC recovery of 87%. Transfusion of deglycerolized RBC offered advantages such as elimination of need of crossmatching in emergent situations and reduction of transfusion reactions. FS-RBC by NBRL method using ACP 215 has advantages such as long shelf life, meeting unexpected high blood demand in mass casualties situations or availability of rare blood group requirement of individual patient. FS-RBC can be a potential candidate for Indian Armed Forces Blood programme for uninterrupted blood supply during peace and war.     

Twin births in the university of Portharcourt teaching hospital Portharcourt: a 6 year review

Objective:To provide information on twin births and associated factors in Port barcourt South South Nigeria.Methods:Data on twin deliveries from 1st January 2003 to 31st December 2008 were collected and analysed.This included the maternal age and parity,gestation age,Apqar scores,sex and birth weight of twins.Results:A total of 11042 deliveries occurred over the study period with 333 being twins giving a twin rate of 1∶33.Male twins constituted 48% of twin births with male to female ratio of 1∶1.08.The mean age and parity of mothers were 29.6 years and 2.5 respectively.Presentation of the cephalic/cephalic for the first and second twins was the most common(63.4%).Severe birth asphyxia(first minute Apgar score 1-3)occurred in 3.9% of twins.Male-male twin pair occurred in 28.5% of twins,male-female in 39% while female-female occurred in 32.5%.The Caesarian section rate was 48%.Conclusion:The twining rate in this study is high.In this locality,there is a need for early ultrasound scanning of pregnant women particularly those of parities 1 to 3 and those aged 25-34 years in whom highest rates of twinning occurred to detect twinning when present and refer them to sufficiently equipped centres for adequate antenatal and perinatal care.     

Enhanced sensitivity to group II mGlu receptor activation at corticostriatal synapses in mice lacking the familial parkinsonism-linked genes PINK1 or Parkin

An altered glutamatergic input at corticostriatal synapses has been shown in experimental models of Parkinson's disease (PD). In the present work, we analyzed the membrane and synaptic responses of striatal neurons to metabotropic glutamate (mGlu) receptor activation in two different mouse models of inherited PD, linked to mutations in PINK1 or Parkin genes.Both in PINK1 and Parkin knockout (^−/−) mice, activation of group I mGlu receptors by 3,5-DHPG caused a membrane depolarization coupled to an increase in firing frequency in striatal cholinergic interneurons that was comparable to the response observed in the respective wild-type (WT) interneurons. The sensitivity to group II and III mGlu receptors was tested on cortically-evoked excitatory postsynaptic potentials (EPSPs) recorded from medium spiny neurons (MSNs). Both LY379268 and L-AP4, agonists for group II and III, respectively, had no effect on intrinsic membrane properties, but dose-dependently reduced the amplitude of corticostriatal EPSPs. However, both in PINK1^−/− and Parkin^−/− mice, LY379268, but not L-AP4, exhibited a greater potency as compared to WT in depressing EPSP amplitude. Accordingly, the dose–response curve for the response to LY379268 in both knockout mice was shifted leftward. Moreover, consistent with a presynaptic site of action, both LY379268 and L-AP4 increased the paired-pulse ratio either in PINK1^−/− and Parkin^−/− or in WT mice. Acute pretreatment with L-dopa did not rescue the enhanced sensitivity to LY379268.Together, these results suggest that the selective increase in sensitivity of striatal group II mGlu receptors represents an adaptive change in mice in which an altered dopamine metabolism has been documented.     

Non-Occlusive Small Bowel Necrosis in Association with Feeding Jejunostomy After Elective Upper Gastrointestinal Surgery

INTRODUCTION

Non-occlusive small bowel necrosis (NOSBN) has been associated with early postoperative enteral feeding. The purpose of this study was to determine the incidence of this complication in an elective upper gastrointestinal (GI) surgical patient population and the influence of both patient selection and type of feeding jejunostomy (FJ) inserted, based on the experience of two surgical units in affiliated hospitals.

PATIENTS AND METHODS

The records were reviewed of 524 consecutive patients who underwent elective upper GI operations with insertion of a FJ for benign or malignant disease between 1997 and 2006. One unit routinely inserted needle catheter jejunostomies (NCJ), whilst the other selectively inserted tube jejunostomies (TJ).

RESULTS

Six cases of NOSBN were identified over 120 months in 524 patients (1.15%), with no difference in incidence between routine NCJ (n = 5; 1.16%) and selective TJ (n = 1; 1.06%). Median rate of feeding at time of diagnosis was 105 ml/h (range, 75–125 ml/h), and diagnosis was made at a median of 6 days (range, 4–18 days) postoperatively. All patients developed abdominal distension, hypotension and tachycardia in the 24 h before re-exploratory laparotomy. Five patients died and one patient survived.

CONCLUSIONS

The understanding of the pathophysiology of NOSBN is still rudimentary; nevertheless, its 1% incidence in the present study does call into question its routine postoperative use especially in those at high risk with an open abdomen, planned repeat laparotomies or marked bowel oedema. Patients should be fully resuscitated before initiating any enteral feeding, and feeding should be interrupted if there is any evidence of feed intolerance.     

Functional and ultrastructural analysis of group I mGluR in striatal fast-spiking interneurons

Striatal parvalbumin-containing fast-spiking (FS) interneurons provide a powerful feedforward GABAergic inhibition on spiny projection neurons, through a widespread arborization and electrical coupling. Modulation of FS interneuron activity might therefore strongly affect striatal output. Metabotropic glutamate receptors (mGluRs) exert a modulatory action at various levels in the striatum. We performed electrophysiological recordings from a rat striatal slice preparation to investigate the effects of group I mGluR activation on both the intrinsic and synaptic properties of FS interneurons. Bath-application of the group I mGluR agonist, (S)-3,5-dihydroxyphenylglycine (3,5-DHPG), caused a dose-dependent depolarizing response. Both (S)-(+)-alpha-amino-4-carboxy-2-methylbenzeneacetic acid (LY367385) and 7-(hydroxyimino)cyclopropa[b]chromen-1a-carboxylate ethyl ester (CPCCOEt), selective mGluR1 antagonists, significantly reduced the amplitude of the membrane depolarization caused by 3,5-DHPG application. Conversely, mGluR5 antagonists, 2-methyl-6-(phenylethylnyl)pyridine hydrochloride (MPEP) and 6-methyl-2-(phenylazo)-3-pyridinol (SIB1757), were unable to affect the response to 3,5-DHPG, suggesting that only mGluR1 contributes to the 3,5-DHPG-mediated excitatory action on FS interneurons. Furthermore, mGluR1 blockade significantly decreased the amplitude of the glutamatergic postsynaptic potentials, whereas the mGluR5 antagonist application produced a small nonsignificant inhibitory effect. Surprisingly, our electron microscopic data demonstrate that the immunoreactivity for both mGluR1a and mGluR5 is expressed extrasynaptically on the plasma membrane of parvalbumin-immunoreactive dendrites of FS interneurons. Together, these results suggest that despite a common pattern of distribution, mGluR1 and mGluR5 exert distinct functions in the modulation of FS interneuron activity.     

Cardiovascular effects of apnoea in preterm infants

Cardiovascular reflex responses have been studied in 9 newborn preterm infants with apnoeic episodes and in 2 preterm infants with periodic breathing. Respiration, blood pressure, heart rate, and peripheral blood flow were simultaneously recorded. Peripheral blood flow was measured in the leg by venous occlusion plethysmography. During apnoea, bradycardia and peripheral vasoconstriction occur. There is little change in blood pressure though pulse pressure increases. No cardiovascular changes were seen before the onset of apnoea. Periodic breathing had little effect on peripheral blood flow. Preterm infants with gestations as low as 27 weeks apparently have well developed chemoreceptor reflexes which would tend to preserve blood supply to the brain during conditions of hypoxia.     

Neuropeptide Y plasma levels and immunological changes during academic stress

Academic stress is a good model of psychological stress in humans for studying psychoneuroimmune correlations. We looked for correlations between psychological scores, immune tests and plasma levels of cortisol and neuropeptide Y (NPY). A group of medical students were evaluated at the beginning of the academic year (Baseline) and the day before an examination (Stress). They underwent evaluation by The Profile of Mood States (POMS), The Malaise Inventory, The Self Efficacy Scale and A Global Assessment of Recent Stress (GARS). The lymphocyte subsets, the lymphocyte proliferative response and the cytokine production were also evaluated. We detected modifications of some psychological test scores between the Baseline and Stress evaluation, a significant reduction of lymphocyte proliferation, IL-2 production and percentage of the lymphocyte CD19, and an increase in plasma cortisol levels during stress. The lymphocyte proliferation negatively correlated with the POMS score as well as the percentage of CD16+ cells with NPY plasma levels. NPY levels were not different from Baseline. The emotional and mood states seem to influence immunity. Copyrightz1999S.KargerAG,Basel     

Cardiovascular comorbidities among public health clinic patients with diabetes: the Urban Diabetics Study

Background  

We sought to determine the frequency and distribution of cardiovascular comorbidities in a large cohort of low-income patients with diabetes who had received primary care for diabetes at municipal health clinics.