COVID-19 mortality,excess mortality,deaths per million and infection fatality ratio,Belgium, 9 March 2020 to 28 June 2020

BackgroundCOVID-19 mortality, excess mortality, deaths per million population (DPM), infection fatality ratio (IFR) and case fatality ratio (CFR) are reported and compared for many countries globally. These measures may appear objective, however, they should be interpreted with caution.AimWe examined reported COVID-19-related mortality in Belgium from 9 March 2020 to 28 June 2020, placing it against the background of excess mortality and compared the DPM and IFR between countries and within subgroups.MethodsThe relation between COVID-19-related mortality and excess mortality was evaluated by comparing COVID-19 mortality and the difference between observed and weekly average predictions of all-cause mortality. DPM were evaluated using demographic data of the Belgian population. The number of infections was estimated by a stochastic compartmental model. The IFR was estimated using a delay distribution between infection and death.ResultsIn the study period, 9,621 COVID-19-related deaths were reported, which is close to the excess mortality estimated using weekly averages (8,985 deaths). This translates to 837 DPM and an IFR of 1.5% in the general population. Both DPM and IFR increase with age and are substantially larger in the nursing home population.DiscussionDuring the first pandemic wave, Belgium had no discrepancy between COVID-19-related mortality and excess mortality. In light of this close agreement, it is useful to consider the DPM and IFR, which are both age, sex, and nursing home population-dependent. Comparison of COVID-19 mortality between countries should rather be based on excess mortality than on COVID-19-related mortality.     

Body image satisfaction in homosexual and heterosexual women

This study examined the relationship between sexual orientation and eating disorders inwomen using a non-clinical sample of 45 homosexual and 64 heterosexual women, Subjects completed two self-report inventories composed of questions regarding weight, body image satisfaction, eating attitudes, and eating behaviors. Homosexual women were significantly heavier than heterosexual women, desired a significantly heavier ideal weight, were less often concerned with weight and appearance, and had less drive for thinness. Homosexual women of normal weight were more satisfied with their bodies than heterosexual women. Homosexual women's greater body satisfaction and lower concern with weight and appearance may contribute to their lower rates of eating disorders.     

Overeaters anonymous: Impact on bulimia

Patterns of utilization and effects of participation in Overeaters Anonymous (OA) in 40 individuals meeting DSM-III criteria for bulimia are described. All were abstinent from compulsive overeating for a mean of 3 years, with 21 (52.5%) initiating sustained abstinence within the first month of membership. Most attended meetings 5 times per week and called their sponsors daily, and 25 (62.5%) were in psychotherapy concurrently. The authors describe the nature and philosophy of OA and discuss factors which might explain the symptomatic control achieved by this group.     

An endogenous glycosylphosphatidylinositol-specific phospholipase D releases basic fibroblast growth factor-heparan sulfate proteoglycan complexes from human bone marrow cultures

Basic fibroblast growth factor (bFGF) is a hematopoietic cytokine that stimulates stromal and stem cell growth. It binds to a glycosylphosphatidylinositol (GPI)-anchored heparan sulfate proteoglycan on human bone marrow (BM) stromal cells. The bFGF- proteoglycan complex is biologically active and is released by addition of exogenous phosphatidylinositol-specific phospholipase C. In this study, we show the presence of an endogenous GPI-specific phospholipase D (GPI-PLD) that releases the bFGF-binding heparan sulfate proteoglycan and the variant surface glycoprotein (a model GPI-anchored protein) from BM cultures. An involvement of proteases in this process is unlikely, because released proteoglycan contained the GPI anchor component, ethanol-amine, and protease inhibitors did not diminish the release. The mechanism of release is likely to involve a GPI-PLD and not a GPI-specific phospholipase C, because the release of variant surface glycoprotein did not reveal an epitope called the cross- reacting determinant that is exposed by phospholipase C-catalyzed GPI anchor cleavage. In addition, phosphatidic acid (which is specifically a product of GPI-PLD-catalyzed anchor cleavage) was generated during the spontaneous release of the GPI-anchored variant surface glycoprotein. We also detected GPI-PLD-specific enzyme activity and mRNA in BM cells. Therefore, we conclude that an endogenous GPI-PLD releases bFGF-heparan sulfate proteoglycan complexes from human BM cultures. This mechanism of GPI anchor cleavage could be relevant for mobilizing biologically active bFGF in BM. An endogenous GPI-PLD could also release other GPI-anchored proteins important for hematopoiesis and other physiologic processes.     

Comparison of a new enzyme-linked immunosorbent assay method with counterimmunoelectrophoresis for detection of teichoic acid antibodies in sera from patients with Staphylococcus aureus infections

Ribitol-teichoic acid antibodies were measured by a new enzyme-linked immunosorbent assay (ELISA) and by counterimmunoelectrophoresis in serum samples from 47 patients with serious Staphylococcus aureus infections, 63 infected patients, and 177 healthy controls. The same antigen was used for both tests. The group of patients with S. aureus endocarditis (6 patients) had significantly higher ELISA readings than the patients with other deep-seated infections (26 patients) or with an uncomplicated S. aureus bacteremia (15 patients). The patients with other serious gram-positive (40 patients) or gram-negative (23 patients) infections did not differ from the healthy control group. There were only three (7.5%) low-level cross-reactions among the infections caused by gram-positive organisms other than S. aureus. Of 46 initially ribitol-teichoic acid antibody-negative patients followed up for 2 weeks or more, only those developing a serious S. aureus infection showed a significant rise of the ELISA reading. There was a good correlation between ELISA and counterimmunoelectrophoresis. Both tests could be useful in the diagnosis and the management of complicated S. aureus infections. The ELISA method is, however, more sensitive and usually reflects the antibody rise after an infection earlier than does counterimmunoelectrophoresis.