A Novel Variant of the Human Blood Group K1 Antigen

A discrepancy in duplicate anti-K1 typing in a parentage case led to the discovery of an unusual K1 blood group antigen. Red blood cells from the propositus (JC) express a rare variant of the K1 antigen that is detectable by only 8 of 72 sera containing anti-K1. Absorption and elution studies using reactive anti-K1 confirmed the presence of a K1 antigen. Nonreactive anti-K1 was not absorbed by or eluted from JC's red blood cells. Red cells from 3 of the propositus's siblings also had the variant K1 antigen. The variant antigen exhibited qualitative as well as quantitative differences as compared to normal K1, and we have named it K1var.     

Immunohematological reference ranges for adult Ethiopians

A cross-sectional survey was carried out with 485 healthy working adult Ethiopians who are participating in a cohort study on the progression of human immunodeficiency virus type 1 (HIV-1) infection to establish hematological reference ranges for adult HIV-negative Ethiopians. In addition, enumeration of absolute numbers and percentages of leukocyte subsets was performed for 142 randomly selected HIV-negative individuals. Immunological results were compared to those of 1,356 healthy HIV-negative Dutch blood donor controls. Immunohematological mean values, medians, and 95th percentile reference ranges were established. Mean values were as follows: leukocyte (WBC) counts, 6.1 x 10(9)/liter (both genders); erythrocyte counts, 5.1 x 10(12)/liter (males) and 4.5 x 10(12)/liter (females); hemoglobin, 16.1 (male) and 14.3 (female) g/dl; hematocrit, 48.3% (male) and 42.0% (female); platelets, 205 x 10(9)/liter (both genders); monocytes, 343/microl; granulocytes, 3, 057/microl; lymphocytes, 1,857/microl; CD4 T cells, 775/microl; CD8 T cells, 747/microl; CD4/CD8 T-cell ratio, 1.2; T cells, 1, 555/microl; B cells, 191/microl; and NK cells, 250/microl. The major conclusions follow. (i) The WBC and platelet values of healthy HIV-negative Ethiopians are lower than the adopted reference values of Ethiopia. (ii) The absolute CD4 T-cell counts of healthy HIV-negative Ethiopians are considerably lower than those of the Dutch controls, while the opposite is true for the absolute CD8 T-cell counts. This results in a significantly reduced CD4/CD8 T-cell ratio for healthy Ethiopians, compared to the ratio for Dutch controls.     

Indications of the Protective Role of Natural Killer Cells in Human Cutaneous Leishmaniasis in an Area of Endemicity

The role of natural versus acquired immunity to Leishmania aethiopica infection in humans is the focus of our studies. We found in previous studies that mononuclear cells from nonexposed healthy Swedish donors responded to Leishmania antigen stimulation by proliferation and gamma interferon production. The main cell type responding was CD3⁻ CD16/56⁺ natural killer (NK) cells. These findings led us to suggest that the potential to produce a rapid, nonacquired NK cell response may be a protective phenotype. In order to test this hypothesis, an area in Ethiopia where Leishmania is endemic was selected, and peripheral blood mononuclear cells were obtained from individuals who had lived in the area most of their lives but had no evidence of past or present leishmaniasis. Their responses were compared with those of confirmed leishmaniasis patients from the same region with active lesions or cured leishmaniasis lesions. Cells from these donors were stimulated in vitro with L. aethiopica antigen. Responses were measured by proliferation, cytokine production, and phenotype analysis by fluorescence-activated cell sorting. The association of NRAMP1 alleles with the studied phenotype and susceptibility to L. aethiopica-induced leishmaniasis was also evaluated. The results show that Leishmania antigens can induce NK cell and CD8⁺-T-cell responses in vitro. This is clearly seen in proliferating cells from the cured (immune) individuals and the apparently protected controls from the area of endemicity. It contrasted with the reactivity of the patients, where some NK proliferation was coupled with enhanced CD4⁺-T-cell proliferation. We conclude from these observations that NK cells and CD8⁺ cells proliferating in response to Leishmania stimulation are involved in protection from and healing of (Ethiopian) cutaneous leishmaniasis; however, such mechanisms appear to be unrelated to the NRAMP1 host resistance gene.     

37℃凝血温度下正常人和哮喘患者血清ECP水平的测定

室温（２０℃）是广泛接受的血清ＥＣＰ测定凝血温度，但存在一些问题。设想体温３７℃可能是血清ＥＣＰ测定的有效凝血温度。为此，对６８例急性发作的哮喘患者在３７℃凝血温度下血清ＥＣＰ水平进行分析，比较凝血温度分别为２０℃和３７℃时同一患者血样本的ＥＣＰ水平变化，结果发现３７℃下哮喘患者血清ＥＣＰ水平（５０．９±３．１８μｇ／Ｌ）显著高于正常对照（１７．２７±１．３６μｇ／Ｌ，Ｐ＜０．０１）。在６８例病人中，３７℃凝血下有２８人血清ＥＣＰ水平高于正常值，而２０℃凝血下只有１７人血清ＥＣＰ水平高于正常值，两者间存在显著差异（Ｐ＜０．０５）。３７℃凝血温度下血清ＥＣＰ水平与哮喘症状计分显著相关（ｒ＝０．７７，Ｐ＜０．０１）。此外，尚测定了３７℃凝血温度下１０１位１０～５０岁的健康人血清ＥＣＰ水平，结果显示３７℃下正常人血清ＥＣＰ水平的几何均数是１７．８１μｇ／Ｌ，血清ＥＣＰ水平的正常值为７０μｇ／Ｌ以下（９５％的可信限）。本研究表明，在血清ＥＣＰ的测定中设凝血温度为３７℃不仅是有效、简化的方法，而且还可减少哮喘患者血清ＥＣＰ水平的假阴性。     

北柴胡适生地分析及数值区划研究

采用生物适生地分析系统,对北柴胡的适宜产地进行数值区划,并与资源普查结果相比较,以探索药材产地适宜性区划的现代方法。结果发现以北京延庆为基点,以水热距为距离和分级指标,得出了北柴胡全国的783个适宜产地,主要分布在纬度27．5-54．2°,经度75．17-134．17°之间,其中1级适宜产地的分布范围为纬度35．22-44．47°,经度102．33-124．05°之间,主要在山西、陕西、河北的北部,内蒙的中南部及辽宁的西南部,该结果与我国北柴胡的自然分布产区非常相似。结果表明采用生物适生地分析系统,结合柴胡资源调查资料,可以较好地对北柴胡的适宜产地进行数值分级区划。     

Dorsolumbar parasitic twin associated with lipomyelomeningocele: a case report from a tertiary teaching hospital,Ethiopia, East Africa

A parasitic or heteropagus twin is a grossly defective fetus (or fetus part) attached externally, with or without internal connections and is dependent on the cardiovascular system of the other twin (autosite) for survival. The estimated incidence is approximately 1 per 1 million live births. To date according to the authors’ knowledge; there are a few case reports published in the literature. Here we present a case of dorsolumbar parasitic twin with associated lipomyelomeningocele.     

Evaluation and characterization of tumor lysis syndrome before and after chemotherapy among pediatric oncology patients in Tikur Anbessa specialized hospital,Addis Ababa,Ethiopia

Background

Tumor lysis syndrome (TLS) is a life-threatening emergency disorder, caused by an abrupt release of intracellular metabolites after tumor cell death. It is characterized by a series of metabolic manifestations, especially hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. The aim of this study was to evaluate and characterize the incidence of tumor lysis syndrome among pediatric oncology patients before and after treatment.

Methods

Hospital based prospective cohort study was conducted for 6 months on 61 newly diagnosed pediatric oncology patients. Socio-demographic data was collected by interview administered questionnaire. Patients were followed and the physical diagnosis, imaging and laboratory results were interpreted by senior physicians. Data was entered to and analyzed by SPSS version 23.

Results

Among 61 pediatric oncology patients 39(63.9%) were males. The mean (±SD) age of the pediatric patients was 6.39 (±?3.67) years ranging from 2 months to 14 years. 29.5% of patients were found to have TLS. There were 11.5% and 18.0% of laboratory TLS (LTLS) and clinical TLS (CTLS) cases respectively. There were72.2% spontaneous and 27.8% treatment induced TLS cases with 23% and 21.3% cases of hyperuricemia and 4.9% and 6.6% cases of hyperkalemia incidence before and after treatment respectively. Only two patients died, in the study period, due to TLS.

Conclusion

There was high incidence of TLS irrespective of socio-demographic variation among study participants, suggesting that children with cancer are at risk of developing TLS. As TLS is a life-threatening complication of malignancies, early identification of patients at risk and reducing morbidity and mortality is crucially important.

     

Prevalence and correlates of dyslipidemia in HIV positive and negative adults in Western Kenya: A cross-sectional study

There is increasing morbidity and mortality from cardiovascular diseases (CVD) in sub-Saharan Africa (SSA). Dyslipidemia is a well-known CVD risk factor which has been associated with human immunodeficiency virus (HIV) infection and its treatment in high-income countries. Studies in SSA that have examined the relationship between HIV and dyslipidemia have reported mixed results. In this study, we sought to determine the prevalence of dyslipidemia in HIV positive and negative adults (>=30 years old) and evaluate for association in Western Kenya with a higher prevalence expected among HIV positive individuals.HIV positive adults receiving antiretroviral therapy (ART) and HIV negative individuals seeking HIV testing and counseling services were recruited into a cross-sectional study. Demographic and behavioral data and fasting blood samples were collected. Dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III. Associations between baseline demographic and clinical variables and dyslipidemia were analyzed using logistic regression.A total of 598 participants, 300 HIV positive and 298 HIV negative adults were enrolled. Dyslipidemia data was available for 564 (94%) participants. In total, 267 (47%) had dyslipidemia. This was not significantly different between HIV positive and HIV negative individuals (46% vs 49%, P = .4). In a multivariate analysis including both HIV positive and negative individuals, adults 50 to 59 years of age had a 2-fold increased risk of dyslipidemia (Odds ratio [OR] 2.1, 95% confidence interval (1.2–3.5) when compared to 30 to 39-years-old participants. Abdominal obesity (OR 2.5), being overweight (OR 1.9), and low fruit and vegetable intake (OR 2.2) were significantly associated with dyslipidemia. Among HIV positive participants, time since HIV diagnosis, ART duration, use of (PI) protease inhibitor-based ART, viral load suppression, current cluster of differentiation (CD4) count and nadir CD4 did not have significant associations with dyslipidemia.The prevalence of dyslipidemia is high in Western Kenya, with nearly half of all participants with lipid abnormalities. Dyslipidemia was not significantly associated with HIV status, or with HIV-specific factors. Older age, being overweight, abdominal obesity, and low fruit and vegetable intake were associated with dyslipidemia and may be targets for public health interventions to lower the prevalence of dyslipidemia and CVD risk in sub-Saharan Africa.     

Risk factors for active trachoma and Chlamydia trachomatis infection in rural Ethiopia after mass treatment with azithromycin

Objectives To investigate risk factors for ocular Chlamydia trachomatis infection and active trachoma, comparing communities receiving or not receiving an intervention programme of community‐wide azithromycin treatment and health education. Methods In a 3‐year post‐intervention follow‐up survey, 1722 children aged 3–9 years, from randomly selected households in 37 communities, were examined for signs of active trachoma and had samples taken to test for ocular C. trachomatis by polymerase chain reaction. Multivariate random effects logistic regression analyses considered interventions at community level, adjusting for other independent risk factors as appropriate. Results Younger age, ocular discharge and flies on eyes were risk factors for active trachoma in communities with and without antibiotic treatment. After azithromycin treatment, odds of active trachoma were lower in children aged 6–9 years than in children aged 3–5 years (OR 0.48, 95% CI: 0.36–0.66) and higher for children with ocular discharge (OR 4.5, 95% CI: 2.6–7.7) or flies on their eyes (OR 2.5, 95% CI: 1.6–3.7). Odds of C. trachomatis infection were lower in children aged 6–9 years than in younger children (OR 0.47, 95% CI: 0.23–0.96); and in children who received 2 or 3 doses rather than 1 (OR 0.26, 95% CI: 0.08–0.88). Conclusions In communities that received or did not receive the mass antibiotic treatment, the same risk factors for C. trachomatis and active trachoma were identified. Education and environmental improvements need to supplement antibiotic campaigns in order to positively impact on these remaining child level risk factors.