Neuroimaging features of heroin inhalation toxicity: "chasing the dragon"

OBJECTIVE: Our objective was to illustrate the dramatic neuroimaging findings of toxic leukoencephalopathy caused by heroin vapor inhalation. CONCLUSION: Symmetric abnormality involving the cerebellar white matter and posterior limb of the internal capsule is characteristic of heroin vapor inhalation toxicity, although involvement may be more extensive, depending on the severity of the condition. MR imaging and CT appear to be essential for making this diagnosis because clinical history is often unreliable and findings at physical examination are nonspecific.     

ApoEε4等位基因与阿尔茨海默氏病的关系

从分子遗传学和分子生物学角度述评了载脂蛋白Eε4 (ApoEε4 )等位基因与阿尔茨海默氏病(AD)及相关疾病关系的研究成果。指出ApoEε4是AD的危险因素之一 ,ApoEε4阳性个体比阴性个体患晚发AD的危险性约高 3倍 ,但ApoEε4远不是AD的诊断指标或预测标志。在具有记忆损害的老人中 ,ApoEε4至少可确认为是痴呆的一种因素。ApoEε2可能是区别Lewybody病和晚发AD的遗传因素之一。ApoEε4和脑血管病对血管性痴呆 (VD)可能具有协同作用。     

Exploring organisational influences on the implementation of gatekeeper training: a qualitative study of the Applied Suicide Intervention Skills Training (ASIST) programme in Wales

Suicide is a public health priority. International guidance on prevention, epidemiology and treatment-based research indicates the potential of gatekeeper training in this area. Whilst there is some evidence to suggest that interventions enhance the knowledge and skill set of gatekeepers, evidence regarding changes to intervention-related behaviour remains unclear. This disruption to the causal pathway between competency and action suggests the need to address contextual mediators of the implementation of gatekeeper training and to consider the individual as a situated agent, who is both enabled and constrained by the discourses and working practices of the organisation in which they work. To explore organisational influences on intervention behaviour, this paper draws upon a qualitative study of the applied suicide intervention skills training (ASIST) gatekeeper intervention in Wales. Thirty-three individual interviews and six focus groups (n?=?25 individuals) with those employed by a range of statutory and non-statutory organisations and networks were included. Three key organisational influences were identified as impacting on gatekeeper’s intervention behaviour. These include: the democratisation of intervention; organisational attempts to enhance opportunities to intervene; and the creation of a positive context for intervention. This study concludes that both policy and practice need to move beyond a reductionist approach to gatekeeper training and attend to the organisational influences and contextual factors affecting intervention-related behaviour.     

Resolution of Persistent COVID-19 After Convalescent Plasma in a Patient with B Cell Aplasia

Journal of Clinical Immunology -     

Malaria in school‐age children in Africa: an increasingly important challenge

School‐age children have attracted relatively little attention as a group in need of special measures to protect them against malaria. However, increasing success in lowering the level of malaria transmission in many previously highly endemic areas will result in children acquiring immunity to malaria later in life than has been the case in the past. Thus, it can be anticipated that in the coming years there will be an increase in the incidence of both uncomplicated and severe malaria in school‐age children in many previously highly endemic areas. In this review, which focuses primarily on Africa, recent data on the prevalence of malaria parasitaemia and on the incidence of clinical malaria in African school‐age children are presented and evidence that malaria adversely effects school performance is reviewed. Long‐lasting insecticide treated bednets (LLIN) are an effective method of malaria control but several studies have shown that school‐age children use LLINs less frequently than other population groups. Antimalarial drugs are being used in different ways to control malaria in school‐age children including screening and treatment and intermittent preventive treatment. Some studies of chemoprevention in school‐age children have shown reductions in anaemia and improved school performance but this has not been the case in all trials and more research is needed to identify the situations in which chemoprevention is likely to be most effective and, in these situations, which type of intervention should be used. In the longer term, malaria vaccines may have an important role in protecting this important section of the community from malaria. Regardless of the control approach selected, it is important this is incorporated into the overall programme of measures being undertaken to enhance the health of African school‐age children.