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1.
Circannual variation in lymphocyte subsets, revisited 总被引:2,自引:0,他引:2
BACKGROUND: Circadian and circannual variations in lymphocyte subsets, especially CD8+ T-lymphocytes, have been reported. This study focuses on CD4+ T-lymphocyte seasonal variation over a 6-year 8-month period. STUDY DESIGN AND METHODS: Lymphocyte subsets were quantitated monthly for four healthy individuals from 1986 through 1992 as part of a flow cytometry quality-control program. RESULTS: In general, there were no significant seasonal changes in the total number of white cells or in total lymphocyte counts. The absolute numbers of CD4+ T-lymphocytes were lowest in summer when the CD8+ T-lymphocytes were highest. Mean CD4+ T-lymphocyte counts were 846, 967, 618, and 695 per microL for Subjects 1 through 4, respectively, in winter and 432, 670, 355, and 766 per microL, respectively, in summer. Two healthy subjects had CD4+ T-lymphocyte counts lower than 300 per microL on one or more occasions during the study period. In three of the four subjects, the percentage of B-lymphocytes in winter was almost double that in summer. In one of the four subjects, no circannual rhythm was observed in these lymphocyte subpopulations. CONCLUSION: The seasonal variation in CD4+ T- lymphocyte counts demonstrated in three healthy individuals over almost 7 years is again of interest in light of renewed consideration of using surrogate tests, such as CD4+ T-lymphocyte counts, to screen for AIDS- like diseases that may be in the blood supply. 相似文献
2.
The family history in family practice: a questionnaire study 总被引:9,自引:7,他引:2
OBJECTIVES: Our aims were to investigate family medical history taking in
general practice, and to evaluate the value attached to the family medical
history as an aid to decision making in general practice. METHOD: A postal
questionnaire survey was conducted among all 291 GPs working within the
Calderdale and Kirklees Health Authority area. Each questionnaire was
followed by a reminder. The main outcome measures were answers to questions
on routine and opportunistic family history taking and a question about
transmitting knowledge about genetic risk to other members of the family.
Questions were also posed about the value attached to the family medical
history as an aid to decision making. RESULTS: A total of 193 GPs returned
the questionnaire (response rate 66.3%). On registration, 94.3% of GPs
indicated that enquiries were made about a family history of coronary heart
disease. Breast and colorectal cancer were specifically asked about by
48.4% and 30.7% of GPs, respectively. One-fifth of respondents indicated
that they asked a general question about family medical history. A little
over one-quarter of respondents indicated that they made opportunistic
enquiries about the family history or suggested that the patient should
inform other members of the family about possible risks. In the scenarios
highlighted in this study, the majority of respondents felt that the family
medical history had value as an aid to decision making. This was
particularly the case for checking a patient's cholesterol (92.1%) and for
initiating referrals in younger patients with possible cancer-related
symptoms (three-quarters of respondents). CONCLUSION: GPs value the family
medical history as an aid to decision making. Unfortunately, apart from
enquiries about coronary heart disease, routine or opportunistic family
history taking is not occurring in practice. Mechanisms need to be sought
to extract information from the family medical history so that it can be
more effectively used by GPs.
相似文献
3.
Bhalachandra?S?KodkanyEmail author Richard?J?Derman Narayan?V?Honnungar Naresh?K?Tyagi Shivaprasad?S?Goudar Shivanand?C?Mastiholi Janet?L?Moore Elizabeth?M?McClure Nancy?Sloan Robert?L?Goldenberg 《Reproductive health》2015,12(Z2):S3
Background
Pregnancy-related vital registration is important to inform policy to reduce maternal, fetal and newborn mortality, yet few systems for capturing accurate data are available in low-middle income countries where the majority of the mortality occurs. Furthermore, methods to effectively implement high-quality registration systems have not been described. The goal of creating the registry described in this paper was to inform public health policy makers about pregnancy outcomes in our district so that appropriate interventions to improve these outcomes could be undertaken and to position the district to be a leader in pregnancy-related public health research.Methods
We created a prospective maternal and newborn health registry in Belgaum, Karnataka State, India. To initiate this registry, we worked with the Ministry of Health to first establish estimated birth rates and define the catchment areas of the clusters, working within the existing health system and primary health centers. We also undertook household surveys to identify women likely to become pregnant. We then implemented monitoring measures to ensure high quality and completeness of the maternal newborn health registry. All pregnant women in the catchment area were identified, consented and enrolled during pregnancy, with follow-up visits to ascertain pregnancy outcomes and mother/infant status at 42-days postpartum.Results
From 2008 through 2014, we demonstrated continued improvements in both the coverage for enrollment and accuracy of reporting pregnancy outcomes within the defined catchment area in Belgaum, India. Nearly 100% of women enrolled had follow-up at birth and 99% had 42-day follow-up. Furthermore, we facilitated earlier enrollment of women during pregnancy while achieving more timely follow-up and decreased time of reporting from the date of the pregnancy event.Conclusions
We created a pregnancy-related registry which includes demographic data, risk factors, and outcomes allowing for high rates of ascertainment and follow-up while working within the existing health system. Understanding the elements of the system used to create the registry is important to improve the quality of the results. Tracking of pregnancies and their outcomes is an important step toward reducing maternal and perinatal mortality.4.
Omrana?PashaEmail author Shivaprasad?S?Goudar Archana?Patel Ana?Garces Fabian?Esamai Elwyn?Chomba Janet?L?Moore Bhalchandra?S?Kodkany Sarah?Saleem Richard?J?Derman Edward?A?Liechty Patricia?L?Hibberd K?Michael?Hambidge Nancy?F?Krebs Waldemar?A?Carlo Elizabeth?M?McClure Marion?Koso-Thomas Robert?L?Goldenberg 《Reproductive health》2015,12(Z2):S11
Background
During the post-partum period, most women wish to delay or prevent future pregnancies. Despite this, the unmet need for family planning up to a year after delivery is higher than at any other time. This study aims to assess fertility intention, contraceptive usage and unmet need for family planning amongst women who are six weeks postpartum, as well as to identify those at greatest risk of having an unmet need for family planning during this period.Methods
Using the NICHD Global Network for Women’s and Children’s Health Research’s multi-site, prospective, ongoing, active surveillance system to track pregnancies and births in 100 rural geographic clusters in 5 countries (India, Pakistan, Zambia, Kenya and Guatemala), we assessed fertility intention and contraceptive usage at day 42 post-partum.Results
We gathered data on 36,687 women in the post-partum period. Less than 5% of these women wished to have another pregnancy within the year. Despite this, rates of modern contraceptive usage varied widely and unmet need ranged from 25% to 96%. Even amongst users of modern contraceptives, the uptake of the most effective long-acting reversible contraceptives (intrauterine devices) was low. Women of age less than 20 years, parity of two or less, limited education and those who deliver at home were at highest risk for having unmet need.Conclusions
Six weeks postpartum, almost all women wish to delay or prevent a future pregnancy. Even in sites where early contraceptive adoption is common, there is substantial unmet need for family planning. This is consistently highest amongst women below the age of 20 years. Interventions aimed at increasing the adoption of effective contraceptive methods are urgently needed in the majority of sites in order to reduce unmet need and to improve both maternal and infant outcomes, especially amongst young women.Study registration
Clinicaltrials.gov (ID# NCT01073475)5.
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10.
Salah Uddin Khan LaShondra Berman Najmul Haider Nancy Gerloff Md Z. Rahman Bo Shu Mustafizur Rahman Tapan Kumar Dey Todd C. Davis Bidhan Chandra Das Amanda Balish Ausraful Islam Jens P. Teifke Nord Zeidner Steven Lindstrom Alexander Klimov Ruben O. Donis Stephen P. Luby H. L. Shivaprasad Andrea B. Mikolon 《Archives of virology》2014,159(3):509-518
We investigated unusual crow mortality in Bangladesh during January-February 2011 at two sites. Crows of two species, Corvus splendens and C. macrorhynchos, were found sick and dead during the outbreaks. In selected crow roosts, morbidity was ~1 % and mortality was ~4 % during the investigation. Highly pathogenic avian influenza virus H5N1 clade 2.3.2.1 was isolated from dead crows. All isolates were closely related to A/duck/India/02CA10/2011 (H5N1) with 99.8 % and A/crow/Bangladesh/11rs1984-15/2011 (H5N1) virus with 99 % nucleotide sequence identity in their HA genes. The phylogenetic cluster of Bangladesh viruses suggested a common ancestor with viruses found in poultry from India, Myanmar and Nepal. Histopathological changes and immunohistochemistry staining in brain, pancreas, liver, heart, kidney, bursa of Fabricius, rectum, and cloaca were consistent with influenza virus infection. Through our limited investigation in domesticated birds near the crow roosts, we did not identify any samples that tested positive for influenza virus A/H5N1. However, environmental samples collected from live-bird markets near an outbreak site during the month of the outbreaks tested very weakly positive for influenza virus A/H5N1 in clade 2.3.2.1-specific rRT-PCR. Continuation of surveillance in wild and domestic birds may identify evolution of new avian influenza virus and associated public-health risks. 相似文献