Prostaglandin el attenuates impairment of cellular immunity after cardiopulmonary bypass

OBJECTIVE: It is well documented that cardiopulmonary bypass (CPB) severely impairs cellular immunity. The objective of this study was to investigate the effect of prostaglandin E1 (PGE1) on cellular immunity after CPB. METHODS: Patients who underwent elective cardiac surgery were randomly divided into the PGE1 group (n=12) and the control group (n=12). In the PGE1 group, PGE1 was administered at 20 ng/kg/min from just after the induction of anesthesia to the end of surgery. Peripheral blood mononuclear cells (PBMCs) were taken before anesthesia and on postoperative days 1, 3 and 7 (POD 1, POD 3 and POD 7). Proliferation responses of T cells to phytohemagglutinin (PHA) and pure protein derivative (PPD) antigen were measured as indicators of cellular immunity. RESULTS: PGE1 significantly attenuated the impairment of both PHA and PPD response after cardiac surgery on POD 1 (PHA response, 30 +/- 21% vs. 53 +/- 32%, control vs. PGE, p=0.048; PPD response, 18 +/- 21% vs. 39 +/- 27%, control vs. PGE, p=0.046). The reduced glutathione content of PBMCs in the control group was significantly decreased on POD 1. CONCLUSION: PGE1 attenuated the impairment of cellular immunity after cardiac surgery with CPB by reducing oxidative stress on PBMCs.     

E1 Tor霍乱弧菌SM_6和江苏1d菌株

ＳＭ６是我国检测Ｅ１Ｔｏｒ霍乱弧菌是否带有溶源性噬菌体的指示菌株。江苏的６株Ｅ１Ｔｏｒ霍乱弧菌和ＳＭ６都属于噬菌体－生物分型的１ｄ型，而在噬菌体分型中ＳＭ６为１／２型，江苏的６株菌株则为１／２／３型；霍乱毒素（ＣＴ）基因测定也表明两者的不同，ＳＭ６不含ＣＴ基因，江苏的６株都含有ＣＴ基因，显示噬菌体分型可将噬菌体－生物分型的型别进一步划分，ＳＭ６的特性也为霍乱的进一步研究提供了资料。     

E1 Tor Vibio Cholerae Strain SM_6 and Jiangsu 1d Strain

Ｅ１ＴｏｒＶｉｂｉｏＣｈｏｌｅｒａｅＳｔｒａｉｎＳＭ_６ａｎｄＪｉａｎｇｓｕ１ｄＳｔｒａｉｎ￥ＪｉａｎｇＸｉａｏｗａｎ，ｅｔａｌ．ＡＣＴＡＡＣＡＤＥＭＩＡＥＭＥＤＩＣＩＮＡＥＮＡＮＪＩＮＧ，１９９４，１４（２）：１６３－１６４ＡｂｓｔｒａｃｔＥ１Ｔｏ?..     

Epileptic seizure of El mouse initiates at the parietal cortex: depth EEG observation in freely moving condition using buffer amplifier

The initiation site of seizure discharges and the relationship between behavioral manifestations and electroencephalography were investigated in the El mouse, a hereditary epilepsy model. The chronic depth electrodes were implanted stereotaxically into the frontal cortex, parietal cortex, temporal cortex, hippocampus, striatum, amygdaloid complex, non-specific nuclei of thalamus and substantia nigra. Electrical activities were recorded in freely moving condition with use of the buffer amplifier devised in the laboratory and behaviors were monitored simultaneously. Seizure spike discharges started in the parietal cortex and spread out into other brain areas. When the hippocampus was involved, the tonic convulsion occurred behaviorally. The paper describes the first direct evidence of the initiation and propagation of seizure discharges in the brain of El mouse.     

前列腺素E1对大鼠卵泡壁发育和分化影响的形态学观察

本文应用组织学方法和电镜对PGE1引起未成熟大鼠卵泡颗粒细胞和卵泡膜外层细胞的形态学变化作了研究。结果表明:外源性PGE1刺激了颗粒细胞的发育和黄体化,同时也促进了卵泡膜外层细胞的发育和从成纤维细胞向平滑肌细胞分化。文中对有关PGE1在排卵过程中的作用机制等问题进行了讨论。     

Routine childhood vaccination programme coverage,El Salvador, 2011—In search of timeliness

While assessing immunization programmes, not only vaccination coverage is important, but also timely receipt of vaccines. We estimated both vaccination coverage and timeliness, as well as reasons for non-vaccination, and identified predictors of delayed or missed vaccination, for vaccines of the first two years of age, in El Salvador.     

Exceptionally strong easterly wind burst stalling El Ni?o of 2014

Intraseasonal wind bursts in the tropical Pacific are believed to affect the evolution and diversity of El Niño events. In particular, the occurrence of two strong westerly wind bursts (WWBs) in early 2014 apparently pushed the ocean–atmosphere system toward a moderate to strong El Niño—potentially an extreme event according to some climate models. However, the event’s progression quickly stalled, and the warming remained very weak throughout the year. Here, we find that the occurrence of an unusually strong basin-wide easterly wind burst (EWB) in June was a key factor that impeded the El Niño development. It was shortly after this EWB that all major Niño indices fell rapidly to near-normal values; a modest growth resumed only later in the year. The easterly burst and the weakness of subsequent WWBs resulted in the persistence of two separate warming centers in the central and eastern equatorial Pacific, suppressing the positive Bjerknes feedback critical for El Niño. Experiments with a climate model with superimposed wind bursts support these conclusions, pointing to inherent limits in El Niño predictability. Furthermore, we show that the spatial structure of the easterly burst matches that of the observed decadal trend in wind stress in the tropical Pacific, suggesting potential links between intraseasonal wind bursts and decadal climate variations.El Niño, the warm phase of the El Niño–Southern Oscillation (ENSO), is characterized by anomalously warm water appearing in the central and eastern equatorial Pacific every 2–7 years, driven by tropical ocean–atmosphere interactions with far-reaching global impacts (recent reviews are in refs. 1–3). These interactions and El Niño development involve several important feedbacks, including the positive Bjerknes feedback [zonal wind relaxation leads to the reduction of the zonal sea surface temperature (SST) gradient and further wind relaxation] (4). Since the year 2000, there has been a shift in the observed properties of El Niño, including its magnitude, frequency, and spatial structure of temperature anomalies (5, 6). For example, El Niño events occurred more frequently than during the previous two decades, but all were weak, and none reached the extreme magnitude of the 1982 and 1997 events. Concurrently, the rise of global mean surface temperature has slowed down with the so-called global warming hiatus (7–9). The stalled development of the 2014 El Niño presents a showcase to explore the relevant connection and mechanisms of these changes.At the beginning of 2014, many in the scientific community anticipated that a moderate to strong El Niño could develop by the end of the year (10–14) (Fig. S1). In March, the National Oceanic and Atmospheric Administration (NOAA) Climate Prediction Center announced an “El Niño watch” based on predictions made by dynamical and statistical models (12), attracting attention of the general public. Admittedly, these predictions encompassed large uncertainties because of the stochastic nature of the tropical climate system (15–17). In May, the National Aeronautics and Space Administration (NASA) suggested that 2014 could potentially rival the strongest on-record event of 1997/19998 (Fig. 1B), while acknowledging the large existing uncertainty (14); their projection was supported by satellite observations of strong Kelvin waves evident in sea surface height (SSH) (Fig. 2C). The spread of spring forecast plumes from some climate models, for example that of the European Centre for Medium-Range Weather Forecasts (ECMWF), included the possibility of a failed El Niño (Fig. S1) but only as a low-probability outcome involving unusual instances of weather noise. The observed development fell near the limit of these forecast possibilities after June and July, and eventually, the 2014 warm event barely qualified as El Niño (Fig. 1A).Open in a separate windowFig. 1.El Niño development in (A and C) 2014 and (B and D) 1997. (A and B) Evolution of the Niño3, Niño4, and Niño3.4 indices; the first two indices describe SST anomalies (in degrees Celsius) in the eastern and central equatorial Pacific, respectively, whereas the last index covers the region in between. (C and D) Variation in the zonal wind stress indices. These indices are obtained by averaging wind stress anomalies (in 10⁻² newtons per meter²) in the equatorial Pacific zonally and between 5 °S and 5 °N and then selecting negative (blue; easterly anomalies), positive (red; westerly anomalies), or full values (black) (Materials and Methods). The spatial averaging is intended to take into account both the magnitude and the fetch of the wind bursts. During 2014, two early year WWBs were followed by an exceptional EWB in June (highlighted by pink and blue, respectively). This easterly burst apparently led to a rapid decrease of the Niño indices (A). In contrast, the 1997 El Niño exhibited persistent westerly wind activity throughout the year. The graphs start on January 1.Open in a separate windowFig. 2.Spatiotemporal evolution of the 2014 El Niño. (A–D) Hovmöller diagrams for anomalies in (A) SST, (B) zonal wind stress, (C) SSH, and (D) surface zonal currents in the equatorial Pacific. Time goes downward. The SSH and surface velocity plots highlight the eastward propagating downwelling Kelvin waves, especially pronounced early in the year, and a strong upwelling Kelvin wave midyear. (E and F) El Niño development in 2014 (black line) compared with several historical (E) EP and (F) CP events. The diagrams show the position of the Warm Pool Eastern Edge (degrees of longitude) vs. the Niño3 SST (degrees Celsius) for different months of the year. The Warm Pool Eastern Edge is defined as the position of the 29 °C isotherm at the equator. Numbers indicate monthly averages (1, January; 2, February, etc.). The light vertical line marks the Dateline. In 2014, both the warm pool displacement and Niño3 SST anomalies were exceptionally large during May (month 5), were similar to those in 1997 and 1982 (the strongest events of the 20th century), and then, rapidly decreased by August (month 8).Open in a separate windowFig. S1.The El Niño spring forecasts of the Niño3.4 index from the European Centre for Medium-Range Weather Forecasts (ECMWF). Red lines show 50 ensemble members of the forecast plume initiated in March of 2014; the black dotted line indicates the observed Niño3.4 index. The observed development fell outside the forecast plume in June and July and remained beyond the typical forecast spread after that. Adapted from ref. 13.The question then arises as to which dynamic factors controlled the temporal and spatial development in the tropical Pacific in 2014. This warm event began with a rapid growth, such that, in early June, all major Niño indices (Materials and Methods) along the equator were nearly identical to those during the same time of 1997 (Fig. 1 A and B). A substantial warming also developed along the Peruvian coast (Fig. 3A). Then, the event’s progression slowed down or even reversed. By year end, the equatorial warming barely exceeded 1 °C, but the SST anomaly stretched uncharacteristically across the entire equatorial Pacific almost uniformly (Figs. 1A and ​and2A).2A). Accordingly, the major goal of this study is to investigate this unusual development, identify the main factors that impeded this event, and explore its broad implications.Open in a separate windowFig. 3.The June of 2014 EWB in satellite-based data. (A) The spatial structure of anomalies in surface winds (vectors; in meters per second) and SST (colors; in degrees Celsius) on June 12, 2014, when the burst was strongest. (B) Daily vs. weekly mean values of the zonal wind stress index (10⁻² newtons per meter²) for the period 1988–2014. The blue cross marks the peak value of the June of 2014 EWB. The wind stress index is defined as anomalous zonal wind stress averaged in the equatorial Pacific zonally and between 5 °S and 5 °N (Materials and Methods). Black circles are for the year 2014, red circles are for all El Niño years before 2014, and gray circles are for all other years (La Niña or neutral). Note that the June of 2014 EWB appears strongest in the satellite record for not only daily data but also, weekly averaged values, which confirms that the observations are robust.     

Ice cores record significant 1940s Antarctic warmth related to tropical climate variability

Although the 20th Century warming of global climate is well known, climate change in the high-latitude Southern Hemisphere (SH), especially in the first half of the century, remains poorly documented. We present a composite of water stable isotope data from high-resolution ice cores from the West Antarctic Ice Sheet. This record, representative of West Antarctic surface temperature, shows extreme positive anomalies in the 1936–45 decade that are significant in the context of the background 20th Century warming trend. We interpret these anomalies—previously undocumented in the high-latitude SH—as indicative of strong teleconnections in part driven by the major 1939–42 El Niño. These anomalies are coherent with tropical sea-surface temperature, mean SH air temperature, and North Pacific sea-level pressure, underscoring the sensitivity of West Antarctica's climate, and potentially its ice sheet, to large-scale changes in the global climate.     

Challenges in diagnosis of motor neuron disease: A case series of ALS mimic syndromes

Amyotrophic lateral sclerosis (ALS) is most often a sporadic disorder that affects both upper and lower motor neurons. Because the prognosis of ALS is uniformly poor compared to other motor neuron disorders, defining the diagnosis can help guide appropriate clinical management and improve quality of life for patients. However, the diagnosis of ALS is often challenging and there may be overlapping clinical features with other rare diseases. We present four patients who were referred to our center because of the clinical suspicion of ALS, in whom more detailed assessments revealed an alternative diagnosis, and we discuss the limitations of the modified-El Escorial criteria.     

Experiences of coercion to sterilize and forced sterilization among women living with HIV in Latin America

Introduction

Forced and coerced sterilization is an internationally recognized human rights violation reported by women living with HIV (WLHIV) around the globe. Forced sterilization occurs when a person is sterilized without her knowledge or informed consent. Coerced sterilization occurs when misinformation, intimidation tactics, financial incentives or access to health services or employment are used to compel individuals to accept the procedure.

Methods

Drawing on community-based research with 285 WLHIV from four Latin American countries (El Salvador, Honduras, Mexico and Nicaragua), we conduct thematic qualitative analysis of reports of how and when healthcare providers pressured women to sterilize and multivariate logistic regression to assess whether social and economic characteristics and fertility history were associated with pressure to sterilize.

Results

A quarter (23%) of the participant WLHIV experienced pressure to sterilize post-diagnosis. WLHIV who had a pregnancy during which they (and their healthcare providers) knew their HIV diagnosis were almost six times more likely to experience coercive or forced sterilization than WLHIV who did not have a pregnancy with a known diagnosis (OR 5.66 CI 95% 2.35–13.58 p≤0.001). WLHIV reported that healthcare providers told them that living with HIV annulled their right to choose the number and spacing of their children and their contraceptive method, employed misinformation about the consequences of a subsequent pregnancy for women''s and children''s health, and denied medical services needed to prevent vertical (mother-to-child) HIV transmission to coerce women into accepting sterilization. Forced sterilization was practiced during caesarean delivery.

Conclusions

The experiences of WLHIV indicate that HIV-related stigma and discrimination by healthcare providers is a primary driver of coercive and forced sterilization. WLHIV are particularly vulnerable when seeking maternal health services. Health worker training on HIV and reproductive rights, improving counselling on HIV and sexual and reproductive health for WLHIV, providing State mechanisms to investigate and sanction coercive and forced sterilization, and strengthening civil society to increase WLHIV''s capacity to resist coercion to sterilize can contribute to preventing coercive and forced sterilization. Improved access to judicial and non-judicial mechanisms to procure justice for women who have experienced reproductive rights violations is also needed.