Dracunculiasis eradication by 1995. Will endemic countries meet the target?

Dracunculiasis continues to be a major public health problemamong many rural communities in Africa and the Indian Sub-continentwhich depend upon unprotected water sources for drinking. Itis a painful and debilitating disease which is exclusively transmittedthrough drinking water from contaminated open sources. Variousrisk factors are implicated in dracunculiasis transmission whichare related to water sources. Dracunculiasis is highly seasonal,with most of the cases appearing in the eariy dry season, endof dry season or early wet season depending upon local conditions.Its social, educational and economic cost to the individual,the household and the community is considerable and well documented.Unfortunately, no drug has been effective for its treatment,but prevention is attainable through water supply provision,when affordable, or health education promoting the filteringof drinking water and avoidance of water sources by sufferersof the disease. Such interventions are presently used as a strategyfor its eradication. International awareness of dracunculiasis has been growing recentlyas a result of the International Water Decade (1981–1990).It was targeted for eradication by 1995 by several internationalorganizations and by national governments in endemic countries. This paper concludes by discussing the different strategiesused in its eradication and the prospect of achieving the eradicationgoal by 1995 as planned.     

A preliminary report on the role of some immunologic factors in persistence of chronic tinea pedis

The phenotypic distribution of HLA antigens was investigated in 29 patients with chronic dermatophyte infections and 558 age controls using a microcytoxicity assay. Statistical analysis of data indicated that there was an increased frequency of HLA antigen A26, and AW33. A26 was present in 24% of the patients and 6% of the controls (P= 0·0006). AW₃₃ was present in 14% of the patients and 2% of the controls (P= 0·0002). Intercellular substance (ICS) antibody and IgE assay were performed on these patients. Thirty-four per cent of the patients produced an ICS antibody and had an increased incidence of A26 (P= 0·002). Sixty-six per cent of the patients who did not produce an anti-ICS antibody had an increased frequency of HLA antigen AW₃₃ (P= 0·0002). DR antigens were studied in 26 patients. DR4 was found in 46% of patients but this was not statistically significant. The frequency of the antigen increased to 83% (corrected P value 0·049) in patients with a personal and/or family history of atopy and increased to 86% in patients with high IgE levels (corrected P value 0·016). It appears that several host factors may play an important role in determining and/or perpetuating chronic tinea pedis infection.     

THE EFFECTS OF COLCHICINE ON A PEYRONIE'S-LIKE CONDITION IN AN ANIMAL MODEL

PURPOSE: We have developed an animal model of Peyronie's disease by injecting transforming growth factor beta (TGF-beta) into the rat penis. Our objective is to study the effects of colchicine on the Peyronie's condition in an animal model. MATERIALS AND METHODS: Thirty-six adult male Sprague-Dawley rats received TGF-beta injections into the tunica albuginea and were divided into two groups (n = 18 each). Rats in the first group were divided into three subgroups (n = 6 each). Each rat in the three subgroups received the following: Subgroup 1 received colchicine, subgroup 2 received ibuprofen, and subgroup 3 received regular water. The rats were euthanized after 6 weeks. Rats in the second group were also divided into three subgroups. These rats received the same treatments as the rats in the first group, but treatments began 6 weeks after TGF-beta injection. These rats were euthanized after 12 weeks. Tunical tissue samples were collected and examined using Hart and trichrome stains, electron microscopy (EM), and western blot analysis for TGF-beta detection. RESULTS: In the first group, the colchicine-treated rats exhibited less collagen deposition and less elastic fiber fragmentation than the untreated or ibuprofen-treated rats. EM confirmed the results and showed normal distribution and shape of both collagen and elastic fibers in the colchicine-treated group. In the second group, the colchicine-treated rats exhibited less crowding of the collagen fibers. However, the elastic fibers remained fragmented and scarce. Western blot analysis showed significant down-regulation of TGF-beta expression (5/6) in the colchicine-treated group after 6 weeks. Down-regulation was observed in only 1/6 in both ibuprofen and non-treated groups. After 12 weeks 2/6, 1/6, and 1/6 rats displayed down regulation in the colchicine treated, ibuprofen treated, and non-treated groups, respectively. CONCLUSION: Early colchicine treatment may suppress a Peyronie's like condition in the rat animal model.     

Not All Pacemakers Are Created Equal: MRI Conditional Pacemaker and Lead Technology

Due to expanding clinical indications and an aging society there has been an increase in the use of implantable pacemakers. At the same time, due to increased diagnostic yield over other imaging modalities and the absence of ionizing radiation, there has been a surge in demand for magnetic resonance imaging (MRI) assessment, of both cardiac and noncardiac conditions. Patients with an implantable device have a 50–75% chance of having a clinical indication for MRI during the lifetime of their device. The presence of an implantable cardiac device has been seen as a relative contraindication to MRI assessment, limiting the prognostic and diagnostic utility of MRI in many patients with these devices. The introduction of MRI conditional pacemakers will enable more patients to undergo routine MRI assessment without risk of morbidity or device malfunction. This review gives a general overview of the principles and current evidence for the use of MRI conditional implantable cardiac devices. Furthermore, we appraise the differences between those pacemakers currently released to market.