Detection of T suppressor cells in patients with organ allografts

Specific immunosuppression of host's immune response to donor HLA antigens has been a major goal to clinical transplantation. Recent evidence has been accumulating to show that a distinct population of T cells expressing the CD8(+) CD28(-) phenotype display suppressor function and inhibit Th activation and proliferation by modulating the APC function. To assess the presence of Ts in transplant recipient's circulation, we have developed a flow cytometry method that measures the expression of costimulatory molecules on donor APC exposed to recipient Th and Ts. Our results demonstrate that quantitation of the capacity of CD8(+) CD28(-) T cells from patient circulation to suppress the activation of costimulatory molecules (CD80, CD86) on donor APC offers a reliable tool for monitoring specific immunosuppression against the graft in solid organ transplantation.     

Surveillance of Scrub Typhus in the fringe areas around Pune : Potential for Transmission does exist

A field based epidemiological study was undertaken to assess the potential of transmission of scrub typhus in the sylvatic and transitional (fringe) areas at ten different locations around Pune. Parameters studied included rodent trapping and identification, entomological parameters, immunological studies on rodent sera, and rodent organ impression smears. The study revealed that Rattus r rufescence, Rattus meltada, Suncus murinus and Rattus blanfordi were the predominant sylvatic rodent species. All the species showed mild to moderate infestation with trombiculid mite larvae, with Rr rufescence and S murinus showing even higher levels of infestation. Pooled rodent sera showed mild rise of OX2 in 13.9%, OX19 in 5.6% and OXK in 9.8% of the pooled sera. The rise in titres was appreciable among rodents from Lonavala, Khadakvasla, Panchet, Singhgadh and Kondhwa areas. Based on the findings of the study, certain recommendations on prevention, surveillance and epidemic investigations of scrub typhus in the Armed Forces have been submitted.Key Words: Mite, Rodent, Scrub typhus, Weil-Felix     

Musculoskeletal Disorders: Epidemiology and Treatment Seeking Behavior of Secondary School Students in a Nigerian Community

Background:Epidemiological information paucity exists on musculoskeletal disorders (MSD) among secondary school students in Nigeria. We aimed to determine prevalence, pattern, and treatment seeking behaviors (TSB) of MSD in south-west Nigeria.Results:A total of 133 students had 204 MSD representing 3.0% prevalence among the 4,441students screened. Eighty-one (60.9%) students had congenital disorders and 52 (39.1%) were acquired. The lower limbs (93.1%) were most commonly affected and 87 (65.4%) students presented with knee deformity. Other abnormalities were limb length discrepancy 6.8%, scoliosis 4.4%, pes planus 3.9%, and poliomyelitis 2.9%. One hundred students (75.2%) had no form of treatment, 18.8% receive treatment in the hospital, 3.7% in traditional healing home and 2.3% in church. Age, family, and school type were significant factors (P < 0.05) in health seeking behavior. The factors affecting treatment outcome were the place of treatment, hospital specific treatment, and reasons for stopping treatment.Conclusion:Treatable cases constitute a large proportion of MSD among secondary school students, but TSB was generally poor. Parental socio-economic and health services factors were related to the health seeking behavior. Strengthening of school health services and improved linkage with orthopedic services, community education on MSD, and education of all cadres of health professionals are recommended.     

Community-based treatment of late life depression an expert panel-informed literature review

OBJECTIVES: To present findings from an expert panel-informed literature review on community-based treatment of late-life depression. METHODS: A systematic literature review was conducted to appraise publications on community-based interventions for depression in older adults. The search was conducted between March and October 2005. An expert panel of mental health, aging, health services, and epidemiology researchers guided the review and voted on quality and effectiveness of these interventions. RESULTS: A total of 3,543 articles were found with publication dates from 1967 to October 2005; of these, 116 were eligible for inclusion. Adequate data existed to determine effectiveness for the following interventions: depression care management, group and individual psychotherapy for depression, psychotherapy targeting mental health, psychotherapy for caregivers, education and skills training (to manage health problems besides depression; and for caregivers), geriatric health evaluation and management, exercise, and physical rehabilitation and occupational therapy. After reviewing the data, panelists rated the depression care management interventions as effective. Education and skills training, geriatric health evaluation and management, and physical rehabilitation and occupational therapy received ineffective ratings. Other interventions received mixed effectiveness ratings. Insufficient data availability and poor study quality prevented the panelists from rating several reviewed interventions. CONCLUSIONS: While several well-described interventions were found to treat depression effectively in community-dwelling older adults, significant gaps still exist. Interventions that did not target depression specifically may be of benefit to older adults, but they should not be presumed to treat depression by themselves. Treating depressed elders may require a multifaceted approach to ensure effectiveness. More research in this area is needed.