Failure to Detect Hepatitis A Virus RNA in Factor VIII Concentrates Using the Polymerase Chain Reaction: Results of a Preliminary Study

The transmission of hepatitis A virus (HAV) infection to recipients of some batches of Factor VIII has recently been reported. The polymerase chain reaction (PCR) was used for the detection of HAV RNA in factor VIII concentrates. Primer sequences used were derived from a consensus of published sequences in the 5' non coding region; a nested PCR was used to increase sensitivity and specificity and the resulting fragment was 151 base pairs in length. The PCR was initially validated in clinical samples and only IgM anti-HAV positive patient samples and a sample of liver tissue from a patient who required liver transplantation for fulminant hepatitis A were HAV PCR positive. Other samples tested included those that were IgG anti-HAV positive; these were found to be PCR negative. In an investigation of coagulation factor VIII concentrates by HAV PCR, 40 batches of solvent/detergent-treated high-purity concentrate from four different manufacturers, including one batch of factor VIII possibly implicated in HAV transmission, and a further 3 batches of monoclonal antibody purified factor VIII were all HAV PCR negative. Gel chromatography material, before and after use in factor VIII purification, and eluates from this material were also negative for HAV RNA. Our preliminary results therefore suggest that either the contamination of factor VIII concentrates by HAV RNA is an extremely rare event or that the PCR is insufficiently sensitive to detect an infective HAV dose since each batch of factor VIII concentrate would have been derived from a plasma pool consisting of 10,000 donations, or more and the resulting concentration of virus may be 10² or less.     

The use of 7-amino actinomycin D in identifying apoptosis: simplicity of use and broad spectrum of application compared with other techniques

The detection and quantitation of apoptotic cells is becoming increasingly important in the investigation of the role of apoptosis in cellular proliferation and differentiation. The pathogenesis of hematologic disorders such as aplastic anemia and the development of neoplasia are believed to involve dysregulation of apoptosis. To quantitate accurately the proportion of apoptosis cells within different cell types of a heterogeneous cell population such as blood or bone marrow, a method is required that combines the analysis of large numbers of cells with concurrent immunophenotyping of cell surface antigens. In this study, we have evaluated such a method using the fluorescent DNA binding agent, 7-amino actinomycin D (7AAD), to stain three diverse human cell lines, induced to undergo apoptosis by three different stimuli. Flow cytometric analysis defines three populations on the basis of 7AAD fluorescence and forward light scatter. We have shown by cell sorting and subsequent morphological assessment and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling that the populations defined by 7AAD represent live, apoptotic, and late-apoptotic/dead cells. This method is quick, simple, reproducible, and cheap and will be a valuable tool in the investigation of the role of apoptosis in normal physiology and in disease states.     

A targeted response to the COVID-19 pandemic: analysing effectiveness of remote consultations for triage and management of routine dermatology referrals

During the UK’s COVID-19 pandemic lockdown there was national guidance to suspend routine dermatology work. As a consequence, over 800 patient appointments in a district general dermatology department were temporarily suspended. Remote consultations were carried out to triage and manage referrals, via telephone or video consultations. Data were prospectively recorded on 488 patient interactions. Outcomes included advice/treatment, discharge, surgery or clinic review; 25% of patients were either uncontactable or their problem had resolved. Over a third of referrals were discharged with advice/treatment initiated remotely; 56% of referred dermatoses required further clinical review; 25% of lesion referrals were booked directly to surgery. This process was time-intensive for the clinicians involved, and triage mechanisms could be improved. Sufficient referral information allows remote diagnosis; implementation of management plans and appropriate discharge of patients. This process has been shown to be feasible, and may be a temporary solution for other COVID-19 impacted dermatology departments.     

The usefulness of dye-penetration studies reexamined

An in vitro study to determine the usefulness of dye-penetration studies was conducted. In part I, teeth were prepared through the foramen and then left open, either apically, coronally, or at both ends. In all cases, the dye did not penetrate the full length of the canal. The only exception was when both ends were left open and the teeth were placed into the dye in an upright position. In part II, a measurable defect in a canal filling the length of the canal was created and left open apically. When the tooth was immersed in dye, the penetration was incomplete. When the air was removed by vacuum pump prior to placement in the dye, the penetration was total. The validity of dye studies that do not consider entrapped air is open to question.     

Therapeutic uses of Aloe L. (Asphodelaceae) in southern Africa

Ethnopharmacological relevance

The African-Arabian succulent genus Aloe L. (Aloaceae/Asphodelaceae) is represented by approximately 120 infrageneric taxa in southern Africa, including A. ferox Mill., a species long used in commercial natural products.

Aims of the study

To assess the documented ethnobotanical knowledge and biocultural value of utility in the genus in southern Africa.

Materials and methods

A survey of over 350 multidisciplinary publications was undertaken.

Results

Local uses for medicine and wellbeing were identified for over half the species of Aloe occurring in the Flora of Southern Africa region. The most frequently cited medicinal uses were the treatment of infections and internal parasites, digestive ailments and injuries. Numerous species were recorded for their social uses, notably as ingredients in tobacco snuff.

Conclusion

The exceptional infrageneric diversity of Aloe, and extensive therapeutic uses in southern Africa, indicate its cultural importance in the subcontinent. These factors highlight the need for the conservation of the species as well as their potential as a source of natural products.     

Über chronische Thyreoiditis und fibröse Atrophie der Thyreoidea

Ohne ZusammenfassungMit 7 Textabbildungen.     

Über das Vorkommen von Riesenzellen in der Hypophyse

Zusammenfassung 1. Es kommen in seltenen Fällen in der Hypophysis älterer Frauen eigenartige Herde vor, welche neben Lymphozytenansammlungen und epithelioiden Zellen echte Riesenzellen aufweisen. Auch unabhängig von den Herden finden sich dabei Riesenzellen im intakten Drüsengewebe. 2. Die Herde zeigen zum Teil eine große Ähnlichkeit mit Miliartuberkeln, haben indes weder mit Tuberkulose noch mit Syphilis etwas zu tun, noch sind die großen Zellen als Fremdkörperriesenzellen zu deuten. 3. Es handelt sich um Bildungen sui generis, wahrscheinlich veranlaßt durch den Reiz von Sekretionsanomalien unbekannter Art innerhalb des Organs.Hierzu 10 Textfiguren.     

Functional self-efficacy,perceived gait ability and perceived exertion in walking performance of individuals with low back pain

The purpose of this study was to examine psychological and perceptual factors that influence walking in individuals with low back pain (LBP). In Study 1 59 subjects with LBP recruited from an orthopedic surgeon participated. Perceived gait ability was measured with the Distorted Ambulation subscale of Pain Behavior Checklist (DAS-PBCL). The psychological factor of functional self-efficacy (FSE) was assessed on the FSE scale. These scales were completed before performing a 50-foot speed walk (50 FT WALK) and a 5-minute distance walk (5 MIN WALK) tests. DAS-PBCL had stronger correlations with walking performance ( r = 0.11 to 0.58) than FSE ( r = 0.03 to 0.49). DAS-PBCL had a stronger relationship with 50 FT WALK ( r = 0.18 to 0.58) than 5 MIN WALK ( r = 0.11 to 0.50). In Study 2 48 healthy pain-free subjects and an independent sample of 40 subjects with LBP referred from an orthopedic surgeon participated. They completed the 5 MIN WALK followed by the modified Borg's rating of perceived exertion scale (CR10). Subjects with LBP walked a significantly shorter distance ( t = 4.69, p<.005) but perceived a similar amount of exertion (Mann-Whitney U = 861.5, p =. 40) compared with those without LBP. Perceived gait ability appears to account for more variability in walking performance than functional self-efficacy of walking in individuals with LBP. Perceived gait ability, in particular, accounted for more variance in walking speed than in walking endurance. Individuals with LBP also experience more exertion during walking than those without LBP. These results suggest that clinicians may need to consider patients' perceptions of gait ability and exertion when assessing walking performance in patients with LBP.