CHILD HEALTH PROBLEMS AND PROGRAMMES IN TWO UNDERDEVELOPED AREAS OE THE USA

There are areas in the USA where the health problems of children a similar to those of children in some developing countries. Traditional US health programmes have contributed to an improvement in the health status of many of these children but there remains much more to be done.     

Immunological reactivity in dermatophytosis

Patients with Trichophyton mentagrophytes and T. rubrum infections were compared in terms of cutaneous responses and in vitro lymphocyte reactivity to trichophytin and other antigens. Twelve out of fourteen T. mentagrophytes patients exhibited delayed cutaneous hypersensitivity to trichophytin. Most T. rubrum patients (thirty-seven out of forty-nine) lacked delayed reactions to trichophytin specifically, but these patients frequently manifested immediate weal reactions to this antigen. Positive lymphocyte responses correlated with the presence of delayed but not immediate cutaneous reactions. Serum from chronic T. rubrum patients failed to inhibit lymphocyte responses. Possible mechanisms for selective anergy in chronic T. rubrum patients are discussed.     

GUIDELINES FOR AUTOPSY IN HIV POSITIVE CASES

Autopsy on a patient who had died as a consequence of acquired immune deficiency syndrome (AIDS) can be of great value in understanding the disease process. A potential risk to the prosector for acquiring the HIV exists, but if adequate preventive measures are undertaken, the risk is negligible. Indeed there is no documented evidence of a pathologist or an autopsy room attendant acquiring HIV infection while performing autopsy on a patient with AIDS. The procedures to be followed in the autopsy of the patient with AIDS are discussed.KEY WORDS: Acquired immune deficiency syndrome (AIDS), Autopsy in HIV Positive, Autopsy, Hospital acquired infections     

ANEURYSMAL BONE CYST IN THE MANDIBLE (A Case Report)

Aneurysmal bone cyst is commonly seen in the long bones and vertebrae and is rare in the jaws. Its association with other lesions of the bone has been stressed by many workers. Because of its variable radiological appearance, diagnosis of the lesion is established by histopathological examination. A case of aneurysmal bone cyst occurring in the mandible is reported.KEY WORDS: Aneurysmal bone cyst, Mandible     

PRELIMINARY STUDY OF HOW ALCOHOL CONSUMPTION DURING PREGNANCY AFFECTS IMMUNE COMPONENTS IN BREAST MILK AND BLOOD OF POSTPARTUM WOMEN

Human milk has been shown to contain numerous immune componentsthat can potentially protect the infant during the period beforeits own immune system is completely developed. Alcohol consumptionin both experimental animals and humans has been associatedwith alterations to a number of immune parameters. We have investigatedthe possibility that alcohol consumption during pregnancy alterscertain immune components in day 3 postpartum breast milk andperipheral blood of women. Our study group consisted of 10 alcoholicbeverage drinkers (moderate to heavy, most of whom smoked a1/2-1 pack of cigarettes per day), 15 non-drinking/non-smokingcontrols, and 10 non-drinking/smokers (1/2-1 pack per day) controls.The immune parameters measured in these otherwise healthy womenwere: (1) percentage and absolute number of the various subsetsof leukocytes; (2) percentage of T cells, B cells, T helperand cytotoxic/suppressors subsets, and natural killer cells;(3) levels of the cytokines IL-6, IL-8 and TNF-; (4) levelsof IgA in milk and IgG in serum. Milk from the alcohol groupcontained an elevated amount of IL-8 as compared with milk fromnon-smoker controls; however, it did not differ statisticallyfrom that of the smoker controls. Blood from the alcohol groupshowed an increased level of IL-8 when compared with that fromboth smoker and non-smoker controls. The total number of leukocytesin milk was elevated in milk from the alcohol group as comparedto both the smoker and non-smoker control groups. In the leukocytecomponent of milk, neutrophils predominate and are responsiblefor the elevation in total number of cells, as both lymphocyteand macrophage populations did not differ from those of thecontrols. For lymphocytes, B cells were also increased in bloodof the smokers as compared with the alcohol and non-smoker controls.There were no statistical differences in any of the other immuneparameters tested among the three groups. The present studyfound that alcohol consumption during pregnancy could modulatethe production of IL-8 and infiltration of certain leukocytesin milk and blood of postpartum women. Some of these alterationswere also evident in the smoker controls and thus could notbe attributed to alcohol consumption alone.     

A Canine Model of Torsades de Pointes

Although quinidine has been reported to induce QT interval prolongation and torsades de pointes clinically, the only experimental model currently available for quinidine-induced torsades de pointes requires the concurrent use of ischemia, reperfusion and cardiac pacing of the isolated, perfused heart. Our purpose in this study was to determine the circumstances under which quinidine might elicit torsades de pointes consistently in the intact dog. We found that maintenance of therapeutic plasma quinidine concentrations, alone, did not induce the arrhythmia. Rather, arrhythmia induction required the additional application of aconitine, which induces early afterdepolarizations and triggered activity. When aconitine was applied to two epicardial sites in dogs having quinidine-induced QT interval prolongation greater than 10%, torsades de pointes occurred in 80% of instances. When QT prolongation was less than 10%, aconitine-induced torsades de pointes was seen in only 21% of animals. Our results suggest that in a previously healthy heart quinidine-induced QT prolongation is, itself, insufficient to induce torsades de pointes consistently, and two independent sites of ectopic activity are needed as well. The ectopic foci appear to modulate one another's impulse initiation or activation sequence, thereby giving rise to the classical "twisting of the points" associated with the arrhythmia.     

β-defensins and the epididymis: contrasting influences of prenatal,postnatal, and adult scenarios

β-defensins are components of host defense, with antimicrobial and pleiotropic immuno-modulatory properties. Research over the last 15 years has demonstrated abundant expression of a variety of β-defensins in the postnatal epididymis of different species. A gradient of region- and cell-specific expression of these proteins is observed in the epithelium of the postnatal epididymis. Their secretion into the luminal fluid and binding to spermatozoa as they travel along the epididymis has suggested their involvement in reproduction-specific tasks. Therefore, continuous attention has been given to various β-defensins for their role in sperm function and fertility. Although β-defensins are largely dependent on androgens, the underlying mechanisms regulating their expression and function in the epididymis are not well understood. Recent investigation has pointed out to a new and interesting scenario where β-defensins emerge with a different expression pattern in the Wolffian duct, the embryonic precursor of the epididymis, as opposed to the adult epididymis, thereby redefining the concept concerning the multifunctional roles of β-defensins in the developing epididymis. In this review, we summarize some current views of β-defensins in the epididymis highlighting our most recent data and speculations on their role in the developing epididymis during the prenatal-to-postnatal transition, bringing attention to the many unanswered questions in this research area that may contribute to a better understanding of epididymal biology and male fertility.     

Serum eosinophilic cationic protein may predict clinical course of wheezing in young children

Thirty eight children aged between 2 and 4 years with three or more episodes of wheezing were studied to evaluate the role of eosinophil inflammation and its relation to persistence of wheezing two years later. Serum eosinophilic cationic protein, total eosinophil count, total IgE, skin prick test, and clinical features were evaluated at visit 1. Two years later at a second clinical evaluation the children were separated into two groups: group 1, those with persistent wheezing (n = 20); group 2, those who had been asymptomatic over the past six months (transient wheezing) (n = 18). Mean (SEM) eosinophilic cationic protein at visit 1 was higher in group 1 than in group 2 (29.63 (5.16) v 14.42 (2.77) micrograms/l), and the probability of continuing wheezing at age 5 years was greater in children with values > or = 20 micrograms/l at visit 1 than in those with lower values (relative risk = 2.88, 95% confidence interval 1.42 to 5.87, p < 0.001). Eosinophil inflammation is present from the beginning of the disease in the children who are going to continue with wheezing at age 5 years. The measurement of serum eosinophilic cationic protein may help in evaluating which wheezing infants are going to continue with asthma in the future.