Isolation of an abnormal protein C molecule from the plasma of a patient with thrombotic diathesis

Protein C has been purified from the plasma of a patient with thrombotic diathesis. Both before and after isolation, the protein showed reduced capacity to hydrolyze synthetic substrates and to anticoagulate plasma. Proteolysis with the soluble thrombin- thrombomodulin complex proceeded normally and to completion as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting. Approximately one-third of the protein is functional, indicating a heterozygous defect. Indirect studies suggest that the abnormal component can bind to protein S and phospholipids. Both forms of activated protein C can also incorporate radiolabeled diisopropylfluorophosphate.     

Inhibition of tissue factor/factor VIIa activity in plasma requires factor X and an additional plasma component

A study was carried out to explore requirements for the inhibition of tissue factor-factor VIIa enzymatic activity in plasma. Reaction mixtures contained plasma, 3H-factor IX or 3H-factor X, tissue factor (vol/vol 2.4% to 24%), and calcium. Tissue factor-factor VIIa activity was evaluated from progress curves of activation of factor IX or factor X, plotted from tritiated activation peptide release data. With normal plasma, progress curves exhibited initial limited activation followed by a plateau indicative of loss of tissue factor-factor VIIa activity. With hereditary factor X-deficient plasma treated with factor X antibodies, progress curves revealed full factor IX activation. Adding only 0.4 micrograms/mL factor X (final concentration) could restore inhibition. Inhibition was not observed in purified systems containing 6% to 24% tissue factor, factor VII, 0.5 micrograms/mL, factor IX, 13 micrograms/mL, and factor X up to 0.8 micrograms/mL, but could be induced by adding barium-absorbed plasma to the reaction mixture. Thus, both factor X and an additional material in plasma were required for inhibition. The amount of factor X needed appeared related to the concentration of tissue factor; adding more tissue factor at the plateau of a progress curve induced further activation. These results also indicate that inhibited reaction mixtures contained active free factor VII(a). Preliminary data suggest that inhibition may stem from loss of activity of the tissue factor component of the tissue factor- factor VII(a) complex.     

Older is colder: temperature range and variation in older people

OBJECTIVES: To ascertain body temperatures in older people. DESIGN: Analysis of oral temperatures obtained from elderly subjects residing in the community and nursing home. SETTING: A single nursing home, office setting, and community center. PARTICIPANTS: One hundred nursing home residents and 50 subjects residing in the community. MEASUREMENTS: Three oral temperatures were measured in nursing home residents and once in community dwellers using an electronic digital thermometer. RESULTS: The average age of subjects was 80.7. Temperatures ranged from 94.0 degrees F to 99.6 degrees F. In nursing home subjects, the 6 a.m. mean temperature was 97.3 degrees F, 4 p.m. mean was 97.4 degrees F, and 10 p.m. mean was 97.8 degrees F. The single midday mean temperature in community dwellers was 97.7 degrees F. Ninety-seven of 100 (97%), 94 of 100 (94%), and 83 of 96 (86%) recordings were below 98.6 degrees F in nursing home residents at 6 a.m., 4 p.m., and 10 p.m., respectively. Similarly, 45 of 50 (90%) community dwellers had midday temperatures below 98.6 degrees F. Repeated-measures analysis demonstrated an increase in temperature during the day. The increase was greatest in the youngest old, with no significant change in body temperature over the course of the day in the oldest old. CONCLUSION: Older subjects have mean oral body temperatures lower than 98.6 degrees F. Relatively few even achieve this temperature. In nursing home residents, the oldest were coldest and failed to demonstrate a diurnal rise in body temperature.     

Red clover extract for alleviating hot flushes in postmenopausal women: A meta-analysis

The safety and efficacy of red clover for alleviating menopausal hot flushes are yet to be established. The aim of this meta-analysis was to generate evidence from published literature regarding red clover as a treatment option for menopausal hot flushes. The results showed that red clover when compared to placebo was effective in reducing menopausal hot flushes when administered for 3–4 months (MD = −1.34, 95% CI = −1.90 to −0.77, p < 0.00001), but their effect did not persist at 12 months (MD = 0.89, 95% CI = −0.07 to 1.85, p = 0.07).     

Willingness to use HIV pre‐exposure prophylaxis among gay men,other men who have sex with men and transgender women in Myanmar

Introduction : HIV pre‐exposure prophylaxis (PrEP) has emerged as a key component of contemporary HIV combination prevention strategies. To explore the local suitability of PrEP, country‐specific acceptability studies are needed to inform potential PrEP implementation. In the context of Myanmar, in addition to resource constraints, HIV service access by gay men, other men who have sex with men, and transgender women (GMT) continues to be constrained by legislative and community stigma and marginalization. We aimed to determine PrEP acceptability among GMT in Myanmar and explore the factors associated with willingness to use PrEP. Methods : GMT were recruited in Yangon and Mandalay through local HIV prevention outreach programmes in November and December 2014. Quantitative surveys were administered by trained peer educators and collected data on demographics, sexual risk, testing history and PrEP acceptability. A modified six‐item PrEP acceptability scale classified self‐reported HIV undiagnosed GMT as willing to use PrEP. Multivariable logistic regression identified factors associated with willingness to use PrEP. Results : Among 434 HIV undiagnosed GMT, PrEP awareness was low (5%). PrEP acceptability was high, with 270 (62%) GMT classified as willing to use PrEP. GMT recruited in Mandalay (adjusted odds ratio (aOR) = 1.79; 95%CI = 1.05–3.03), who perceived themselves as likely to become HIV positive (aOR = 1.82; 95%CI = 1.10–3.02), who had more than one recent regular partner (aOR = 2.94; 95%CI = 1.41–6.14), no regular partners (aOR = 2.05; 95%CI = 1.10–3.67), more than five casual partners (aOR = 2.05; 95%CI = 1.06–3.99) or no casual partners (aOR = 2.25; 95%CI = 1.23–4.11) were more likely to be willing to use PrEP. The association between never or only occasionally using condoms with casual partners and willingness to use PrEP was marginally significant (aOR = 2.02; 95%CI = 1.00–4.10). GMT who reported concern about side effects and long‐term use of PrEP were less likely (aOR = 0.35; 95%CI = 0.21–0.59) to be willing to use PrEP. Conclusions : This is the first study to assess PrEP acceptability in Myanmar. Findings suggest PrEP is an acceptable prevention option among GMT in Myanmar, providing they are not required to pay for it. Implementation/demonstration projects are needed to explore the feasibility and cost‐effectiveness of PrEP as a prevention option for GMT in Myanmar.