The malaria vectors of the Lower Shire valley,Malawi

The aim of this study was to characterise breeding sites and climatic factors that influence the abundance of malaria vectors in the Lower Shire valley, Malawi. We regularly sampled adult and larval mosquitoes over the transition periods between the wet and dry seasons during 2000 and 2001. Three potential malaria vectors, An. arabiensis, An. gambine sensu stricto and An. funestus, and a fourth non-vector species An. quadriannulatus, were identified. (This is the first record of An. quadriannulatus in Malawi). These four species bred predominately in larger water bodies, particularly rice paddies, and to a lesser extent in boreholes and puddles. Smaller temporary pools and puddles evaporated too quickly to permit the completion of larval development. Abundance of An. gambiae s.l. was closely associated with minimum temperatures. We discuss the relevance of the findings to malaria vector control in Malawi.     

Minimal-exposure transfusion and the committed donor

Autologous blood (collected preoperatively or salvaged intraoperatively) is the safest blood available for transfusion, but its use is not always feasible. It may be possible to decrease a patient's exposure to homologous donors. Pediatric cardiac surgery patients frequently are unable to donate autologous blood preoperatively. Since 1984, attempts have been made to provide parental apheresis platelets and intraoperative blood salvage to such patients to decrease their donor exposure. Further decreases in donor exposure have been the object of a program of collecting from one committed donor all the blood a patient is anticipated to need. This article reviews the experience with 50 pediatric cardiac surgery patients on such a program, in whom the mean decrease in homologous-donor exposure was 57 percent (range, 12-93%). Thirteen of these patients received only homologous blood products from one committed donor, for a mean decrease in homologous-donor exposure of 80 percent (range, 50-93%). A comparison of 12 of these 13 recipients with a matched control group showed no significant difference in red cell transfusion practice but a significant difference in the number of homologous-donor exposures per m2 of body surface area (BSA) (mean donor exposures/m2 of BSA: patients = 1.5, controls = 10.5). The use of one committed donor and autologous blood can provide a minimal-exposure transfusion.     

Lack of autologous mixed lymphocyte reaction in patients with chronic lymphocytic leukemia: evidence for autoreactive T-cell dysfunction not correlated with phenotype, karyotype, or clinical status

In the present study, there was a complete lack of autologous MLR between responding T cells or T subsets and unirradiated or irradiated leukemic B cells or monocytes in all 20 patients with CLL, regardless of disease status, stage, phenotype, or karyotype of the disease. The stimulating capacity of unirradiated CLL B cells and CLL monocytes or irradiated CLL B cells was significantly depressed as compared to that of respective normal B cells and monocytes in allogeneic MLR. The responding capacity of CLL T cells was also variably lower than that of normal T cells against unirradiated or irradiated normal allogeneic B cells and monocytes. The depressed allogeneic MLR between CLL B cells or CLL monocytes and normal T cells described in the present study could be explained on the basis of a defect in the stimulating antigens of leukemic B cells or monocytes. The decreased allogeneic MLR of CLL T cells might simply be explained by a defect in the responsiveness of T lymphocytes from patients with CLL. However, these speculations do not adequately explain the complete lack of autologous MLR in these patients. When irradiated CLL B cells or irradiated CLL T cells were cocultured with normal T cells and irradiated normal B cells, it was found that there was no suppressor cell activity of CLL B cells or CLL T cells on normal autologous MLR. Our data suggest that the absence or dysfunction of autoreactive T cells within the Tnon-gamma subset account for the lack of autologous MLR in patients with CLL. The possible significance of the autologous MLR, its relationship to in vivo immunoregulatory mechanisms, and the possible role of breakdown of autoimmunoregulation in the oncogenic process of certain lymphoproliferative and autoimmune diseases in man are discussed.     

Salmon calcitonin nasal spray in the prevention of corticosteroid- induced osteoporosis

The objectives were to determine the efficacy and safety of nasal salmon calcitonin 200 IU daily in the prevention of corticosteroid- induced osteoporosis. A minimized, double-blind, placebo-controlled trial was carried out in corticosteroid-treated patients with polymyalgia rheumatica. The setting was a tertiary care university- affiliated hospital and a total of 31 patients were enrolled. The primary outcome measure was the percentage change in bone mineral density of the lumbar spine in the two treatment groups from baseline to 1 yr of follow-up. The mean +/- S.D. bone mineral density of the lumbar spine in the calcitonin-treated group decreased by 1.29 +/- 6.76% and in the placebo group by 4.95 +/- 3.50% after 12 months. The observed difference of 3.65 +/- 2.10% between groups is statistically significant (P < 0.05). Nasal salmon calcitonin prevented loss of bone in the lumbar spine as measured by dual-energy X-ray absorptiometry.      

Urinary miRNA-377 and miRNA-216a as biomarkers of nephropathy and subclinical atherosclerotic risk in pediatric patients with type 1 diabetes

Background

Urinary microRNAs (miRNAs) play a role in the pathogenesis of chronic kidney disease (CKD).

Effectiveness of a brief condom promotion program in reducing risky sexual behaviours among African American men

Rationale The prevention of human immunodeficiency virus/sexually transmitted diseases remains a significant global public health issue, especially among vulnerable populations. Aims and objectives To promote condom use skills among young urban African American men. Methods As a pilot study, a randomized controlled trial was conducted among 136 African American men aged 18–24 years recruited from urban communities in Chicago. Participants assigned to the intervention received 45–60 minutes of a one‐on‐one single‐session condom promotion program delivered by trained facilitators while those assigned to the attention‐matched comparison condition received a general health program. Longitudinally, 115 (85%) and 120 (88%) participants completed the 3‐month and 6‐month follow‐up surveys, respectively. Results Overall, the study results indicate that positive effects were observed from baseline to 6‐month follow‐up for intervention participants relative to comparison condition participants for prior condom use (1.23–1.82 versus 1.34–0.97); condom use intention (2.51–3.19 versus 2.69–2.21); perceived condom availability (3.44–3.72 versus 3.42–3.38); positive reasons to use condoms (2.82–3.08 versus 2.95–1.99); favourable condom use attitude (2.41–2.69 versus 2.49–1.95); barriers to condom use (1.33–0.79 versus 1.25–1.85); and negative condom use attitude (1.45–0.66 versus 1.33–1.39), respectively. Conclusions We conclude that a brief single‐session condom promotion program is effective in preventing high‐risk sexual behaviours among urban young adult African American men.