Species variation in the extrinsic lymphatic drainage of the rodent testis: its role within the context of an immunologically privileged site.

Earlier work suggested that the immunologically privileged site of the rat testis was associated with anomalous testicular lymph drainage whereby some lymphatic trunks bypassed regional lymph nodes and opened directly into the systemic blood circulation via the cisterna chyli and thoracic duct. Because other workers also noted the privileged status of the testes in untreated mice and guinea pigs, we opted to examine the nature of the testicular extrinsic lymphatic system in these rodents using the rat model for comparison. Contrary to expectation, there were no direct lymphatic-venous communications draining the testes of either guinea pigs or mice. Instead, testicular lymphatics drained into at least one lymph node before reaching the blood circulation. This disparity from testicular lymphatic drainage of the rat suggests that the immunologic privilege, if any, in mice and guinea pigs has an alternative explanation (e.g., lymphatic effect of steroidal factors emanating from the testicles or adrenal gland and altering the response to foreign graft).     

Multi-Nutrient Fortified Dairy-Based Drink Reduces Anaemia without Observed Adverse Effects on Gut Microbiota in Anaemic Malnourished Nigerian Toddlers: A Randomised Dose–Response Study

Prevalence of anaemia among Nigerian toddlers is reported to be high, and may cause significant morbidity, affects brain development and function, and results in weakness and fatigue. Although, iron fortification can reduce anaemia, yet the effect on gut microbiota is unclear. This open-label randomised study in anaemic malnourished Nigerian toddlers aimed to decrease anaemia without affecting pathogenic gut bacteria using a multi-nutrient fortified dairy-based drink. The test product was provided daily in different amounts (200, 400 or 600 mL, supplying 2.24, 4.48 and 6.72 mg of elemental iron, respectively) for 6 months. Haemoglobin, ferritin, and C-reactive protein concentrations were measured to determine anaemia, iron deficiency (ID) and iron deficiency anaemia (IDA) prevalence. Faecal samples were collected to analyse gut microbiota composition. All three dosages reduced anaemia prevalence, to 47%, 27% and 18%, respectively. ID and IDA prevalence was low and did not significantly decrease over time. Regarding gut microbiota, Enterobacteriaceae decreased over time without differences between groups, whereas Bifidobacteriaceae and pathogenic E. coli were not affected. In conclusion, the multi-nutrient fortified dairy-based drink reduced anaemia in a dose-dependent way, without stimulating intestinal potential pathogenic bacteria, and thus appears to be safe and effective in treating anaemia in Nigerian toddlers.     

Long-term,prolonged-release tacrolimus-based immunosuppression in de novo kidney transplant recipients: 5-year prospective follow-up of the ADHERE study patients

The objectives of this study were to assess long-term graft survival, patient survival, renal function, and acute rejections in de novo kidney transplant recipients, treated with once-daily prolonged-release tacrolimus-based therapy. The study was a 5-year non-interventional prospective follow-up of patients from the ADHERE study, a Phase IV 12-month open-label assessment of patients randomized to receive prolonged-release tacrolimus in combination with mycophenolate mofetil (MMF) (Arm 1) or sirolimus (Arm 2). From 838 patients in the randomized study, 587 were included in the long-term follow-up, of whom 510 completed the study at year 5. At 1 year post-transplant, graft and patient survival rates were 93.0% and 97.8%, respectively, and at 5 years were 84.0% and 90.8%, respectively. Cox proportional hazards analysis showed no association between graft loss, initial randomized treatment arm, donor age, donor type, or sex. The 5-year acute rejection-free survival rate was 77.4%, and biopsy-confirmed acute rejection-free survival rate was 86.0%. Renal function remained stable over the follow-up period: mean ± SD eGFR 4-variable modification diet in renal disease formula (MDRD4) was 52.3 ± 21.6 ml/min/1.73 m² at 6 months and 52.5 ± 23.0 ml/min/1.73 m² at 5 years post-transplant. These findings support the role of long-term once-daily prolonged-release tacrolimus-based immunosuppression, in combination with sirolimus or MMF, for renal transplant recipients in routine clinical practice.     

Same Strategy Different Industry: Corporate Influence on Public Policy

In March 2013 a state judge invalidated New York City’s proposal to ban sales of sugar-sweetened beverages larger than 16 ounces; the case is under appeal. This setback was attributable in part to opposition from the beverage industry and racial/ethnic minority organizations they support. We provide lessons from similar tobacco industry efforts to block policies that reduced smoking prevalence. We offer recommendations that draw on the tobacco control movement’s success in thwarting industry influence and promoting public health policies that hold promise to improve population health.Tobacco control policies, including cigarette taxes and smoke-free air laws, are largely responsible for dramatic declines in smoking rates over the past several decades.1 Likewise, public policies that seek to influence the food and physical activity environment hold promise for reducing the prevalence of obesity.2 However, policies that aim to limit access to unhealthy foods or tobacco products are often met with opposition by industries concerned that new regulations may have a negative impact on product sales. Evidence from statewide tobacco control efforts has demonstrated that effective grassroots advocacy is an important strategy to counter this opposition and engage policymakers and legislators in efforts to implement policies to improve population health.3,4 As such, organizations that represent racial/ethnic minority groups have particularly important roles to play when one considers the disproportionately higher burden of preventable disease among these groups compared with that among Whites. For example, African Americans have obesity rates that are approximately 40% greater than rates among Whites.5Yet, during New York City’s (NYC’s) recent attempt to restrict sales of sugar-sweetened beverages (SSBs) as part of a strategy to reverse negative trends in obesity rates, it was leading minority organizations, such as the National Association for the Advancement of Colored People (NAACP), who sided with the beverage industry to strongly oppose the policy. In this article, we explore parallels between the tobacco industry’s strategies to prevent grassroots support for tobacco control policies, particularly among minority-led organizations, and recent actions taken by the beverage industry to impede the regulation of SSB sales. We offer recommendations, which draw on the success of the tobacco control movement, to minority organizations and the public health community for promoting obesity-related policy initiatives.     

Self-medication for infants with colic in Lagos, Nigeria

Background  

Infantile colic is a self-limiting condition that is distributed worldwide. It is often misdiagnosed as an organic disease for which an infant is admitted to the hospital. Many studies have described the aetiopathogenesis, pharmacologic and non-pharmacologic management of colic but none has evaluated self-medication for infants with colic. The aim of this study was therefore to determine the knowledge of Nigerian mothers about colic, their home-based management, extent of self-medication for the infants with colic and the types of medicines involved.     

Erectile dysfunction: prevalence and relationship to depression,alcohol abuse and panic disorder

We studied the prevalence of erectile dysfunction in a sample of 829 Nigerian men, using the International Index of Erectile Function questionnaire. These men were also screened for depression, alcohol abuse and panic disorder using the Patient Health Questionnaire. The prevalence of erectile dysfunction (ED) was 36% in men 30 years and below, 31% in those 31 to 40, 46% in those 41 to 50, and 58% in those 51 to 60. Among those men identified as having ED, 10% were depressed, 10.3% had alcohol abuse while 0.6% had panic disorder. Using a multiple linear regression model, age and depression were found to be good predictors of erectile dysfunction but not alcohol abuse and panic disorder. We suggest that ED may be much more common than is being reported. The use of simple questionnaires by doctors, especially those working in medical and surgical clinics and those in primary health care centers, could help in detecting more cases for whom the negative life impact of ED could be minimized.     

Psychiatric referrals during peace and wartimes: a Nigerian experience

Using a questionnaire administered by us, we sought to investigate the differences between patients referred to the psychiatric department of a Nigerian military general hospital during peacetime and those referred during the civil war in Liberia in which Nigerian soldiers were involved as peacekeepers. Referrals to psychiatry in peacetime were quite few but increased considerably during the period of combat in direct relation to the increase in the number of surgical wounded in action cases. Organic mental disorders and anxiety disorders were more frequently referred in peacetime than in war, whereas substance abuse disorders were more frequent during the combat period. Non-psychotic psychiatric conditions were less referred in the wartime group, partly because of nonrecognition at the mission areas and also because of recovery in front-line areas or consideration of their evacuation as a nonpriority. Mental health workers engaged at the mission areas require more training in the identification of such cases.