Field workers' records and a microcomputer: monitoring child health in Nepal

A district-level project for monitoring uptake of family planning,child health and immunization services was started in Sindhupalchok,Nepal, in 1983. The project entailed setting up skill-basedin-service training for health workers and their supervisors,and organizing collection of data from field workers' routinereports at quarterly intervals after training. A microcomputerand dBase II software were used to analyse the data, producingreports for different management purposes. Data from each fieldworker area were aggregated and then analysed with respect tothe number of occasions on which households were contacted successfully.Despite geographical variations in the availability of immunizationfacilities, the uptake of immunization was rapid in all areascovered. Family planning services were universally availablein the project area. However, the increase in the percentageof couples practising family planning was more gradual. Theseresults support the linkage between visible improvements inchild health services (including home visiting) and uptake offamily planning. Data on morbidity and nutritional status showedno overall improvements among any regularly-visited childrenwithin the first 2 years of the project. Although the trainingprovided in the project was effective, and the information systemwas felt to be appropriate and useful, the quality of supervisionof field workers in the government Mother and Child/Family PlanningDivision was not adequate to ensure follow-up and reportingin areas remote from the district centre. However the informationyielded through the project does reveal the potential benefitsof home visiting services for children's health in Nepal. Theinformation also permits the setting of targets for achievementsby field workers responsible for promoting child health in thehills of Nepal.     

THE PLACENTAL TRANSMISSION OF PETHIDINE

Pethidine given intravenously to a pregnant patient began toreach the foetus in measurable quantities within 2 minutes.The level of concentration in cord blood fell exponentially,parallel to, but always lower than, the level in maternal blood.Non-pregnant patients excreted pethidine (in urine) mainly asthe demethylated compound, norpethidine; pregnant patients andneonates preferentially excreted pethidine in the unchangedstate. Two neonates excreted, respectively, 25 per cent and40 per cent of a received dose of pethidine in 48 hours. Significantlymore pethidine reached the foetus after intravenous than afterintramuscular injection. Following intramuscular administrationof pethidine to a pregnant patient at term, slightly less than1 per cent of the dose reached the foetus during the subsequentfew hours. ^*Present address: Research Department of Anaesthetis Royal Collegeof Surgeons of England, London.     

Sexual lifestyles in injecting drug users in Italy: potential for HIV infection transmission

To better target efforts aimed at modifying sexual behaviour among injecting drug users (IDUs), we conducted a detailed analysis of sexual partners and practices reported by 1214 Italian heterosexual drug users during the period June 1985–June 1987. Females were more likely to have only drug-using partners (42.8% vs 17.1%), while males were more likely to have only non drug-using partners (50.5% vs 21.4%). Female drug users were more likely to report either one partner or >10 partners, while males were more likely to report 2–10 partners. Nearly 90% of women with only drug-using partners had only one partner. Overall, 29% of women with only non drug-using partners reported that they always used condoms. This proportion increased to 65% among women with >10 non drug-using partners. In Italy, male IDUs may play a greater role than female IDUs in sexual transmission of HIV infection to the heterosexual non drug-using partners.     

Influence of Chinoin-170, a Novel Antitussive,on the Mucociliary Activity in Respiratory Airways of Rats,Rabbits, Guinea-pigs and Man

Abstract— Chinoin-170 (Ch-170; 3,7-dihydro-1,3-dimethyl-7-[(5-methyl-1,2,4-oxadiazol-3-yl)methyl]1H-purine-2,6-dione) is a new antitussive with bronchodilating activity. Its effects on the ciliary beating frequency (CBF) and mucociliary clearance were studied. In tracheal explants of rats, Ch-170 dose-dependently at concentrations 2 and 5 mg mL^?1 depressed CBF by 24 and 33%, respectively. In human mucosal explants, however, no effects were seen at concentrations up to 5 mg mL^?1. In anaesthetized guinea-pigs, an intravenous 50 mg kg^?1 dose of Ch-170 caused no changes, and 100 mg kg^?1 increased the CBF by 15%. Intravenous Ch-170 dose-dependently increased by 93 (50 mg kg^?1), 179 (70 mg kg^?1) and 253% (100 mg kg^?1) the tracheobronchial mucociliary clearance in rabbits. The effect, studied using ^99mTc-labelled red blood cells as a marker, was of similar quantity to that brought about by administering 16, 25 and 40 mg kg^?1 doses of bromhexine. It is concluded that unlike many older antitussives, Ch-170 in-vitro only slightly decreases the CBF in rats and has no adverse effects on the CBF in human mucosal explants at concentrations up to 5 mg mL^?1. In-vivo, Ch-170 does not significantly alter the CBF in guinea-pigs, but dose-dependently increases the mucociliary clearance in rabbits. The increase is most probably a result of changes in the production and the properties of respiratory mucus.     

Increased platelet sensitivity and thromboxane B2 formation in type-II hyperlipoproteinaemic patients

Platelet aggregation induced by collagen, ADP and epinephrine, was monitored in 150 type-II patients (115 type IIA and 35 type IIB) and compared with a reference group of normolipidaemic controls; in addition, malondialydehyde formation and thromboxane B2 were examined in a subsample of the type-IIA patients. Threshold aggregatory concentrations were significantly lower in the whole group of type-II patients for all three aggregating agents; no difference in terms of aggregatory response was detected between platelets from type-IIA and -IIB patients. Only 56% of type-II patients, however, exceeded the 95th percentile of the threshold aggregatory concentrations in controls. The formation of malondialdehyde in platelet-rich plasma stimulated with thrombin and collagen, was significantly higher in platelets from type-IIA patients. The production of thromboxane B2 by platelets, from endogenous arachidonic acid in type-IIA patients, was significantly higher and exceeded the highest level found in controls.     

Theileria annulata sporozoite surface antigen (SPAG-1) contains neutralizing determinants in the C terminus

SPAG-1 is a surface antigen on Theileria annulata sporozoites that is a candidate both for inclusion in a subunit vaccine and as a ligand for host cell recognition. We have pinpointed major neutralizing epitopes to the C terminus. To facilitate this we expressed SPAG-1 as a series of defined fragments in the pGEX system. These constructs were validated by sequencing and by their spectrum of reactivity with monoclonal antibody (MoAb) BA4. This MoAb recognizes the elastin motif VGVAPG, that is predicted to occur three times in the N terminal half of SPAG-1. The recombinant proteins were then tested by Western blotting with a neutralizing MoAb (1A7) and two neutralizing bovine sera (10T and 34A). The results demonstrate that 1A7 and the bovine sera react with determinants unique to the C terminus. We mapped the neutralizing determinant recognized by MoAb 1A7 to a 16 residue sequence (residues 807–822) using synthetic peptides. Interestingly the bovine sera do not recognize the 1A7 epitope. The potential role of the C terminus as a ligand for host cell recognition and the implications for sub-unit vaccine production are discussed.     

Determinants of Left Ventricular Hypertrophy and Diastolic Dysfunction in an HIV Clinical Cohort

Objective

The aim of this work was to investigate determinants of structural myocardial abnormalities in persons living with human immunodeficiency virus (PLWH).