A case-control study was carried out at a community hospital in eastern Thailand in order to study the association between haemoglobin E and Plasmodium falciparum malaria; 271 P. falciparum cases and 271 controls were enrolled. After adjusting for age, sex, time since last malaria attack, history of mosquito net use, and history of fava bean consumption in the previous month, neither heterozygous nor homozygous haemoglobin E provided significant protection against P. falciparum infection, with odds ratios (OR) = 0.91 (95% confidence limits = 0.61, 1.36) and 0.78 (0.34, 1.82) respectively when compared to persons with haemoglobin A who were not consumers of fava beans. However, haemoglobin E carriers who ate fava beans were significantly protected against P. falciparum malaria with OR = 0.26 (0.09, 0.76) and OR = 0.001 (0.00, 1120.59) for subjects with heterozygous and homozygous haemoglobin E, respectively. The study suggests a possible synergistic protective effect of haemoglobin E on the risk of P. falciparum malaria in subjects who have consumed fava beans.

Adolescent↗

PubMedDate not supplied

Constrained cell recognition peptides engineered into streptavidin.

Streptavidin is widely used as an adaptor molecule in diagnostics, separations, and laboratory assay applications. We have here engineered cell adhesive peptides into the three-dimensional scaffolding of streptavidin to convert streptavidin into a functional protein. The mutations did not alter refolding or tetramer assembly and the slow biotin dissociation rate of wild-type streptavidin was retained. The peptide targets were hexapeptide sequences derived from osteopontin and fibronectin that contain the RGD cell adhesion sequence. Cell binding assays directly demonstrated that rat aortic endothelial cells and human melanoma cells adhered to surfaces coated with either of the two RGD streptavidin mutants in a dose-dependent fashion. Wild-type streptavidin displayed no significant cell binding activity. Inhibition studies with soluble RGD peptides confirmed that the cell adhesion was RGD mediated. Further inhibition studies with antibodies directed against alphavbeta3 demonstrated that the RGD-streptavidin interaction was primarily mediated by this integrin with melanoma cells. These results demonstrate that peptide recognition sequences can be engineered into accessible surface regions of streptavidin without disrupting biotin binding properties. This approach to introducing secondary functional activities into streptavidin may improve streptavidin's utility in existing applications or provide new technology opportunities.

Amino Acid Sequence↗

PubMedDate not supplied

Western immunoblot analysis of protein antigens of Penicillium marneffei.

Protein antigens of Penicillium marneffei prepared during the yeast and mould phases of in vitro growth were analyzed by gel electrophoresis and immunoblot assay. More than 20 yeast phase proteins were detected by Coomassie staining; among these, at least 10 reacted with IgG in the pooled sera of 28 AIDS patients with penicilliosis. Four immunogenic proteins of 200, 88, 54 and 50 kDa were produced in large quantity during the deceleration and early stationary phases of growth. When these proteins were reacted with individual sera derived from 33 AIDS patients with penicilliosis, reactivities to the 200, 88, 54 and 50 kDa protein were detected in 72.7, 93.9, 60.6 and 57.6%, respectively. The bands of 88, 54 and 50 kDa gave strong reactions with about a half of serum samples. In one serum derived from an AIDS patient, reactivities to the 54 and 50 kDa proteins could be strongly detected two months before the definite diagnosis by fungal culture. Protein components from the mould form were of lower yield and gave weaker signal in immunoblot analysis. These results indicate that at least two yeast-phase immunoreactive proteins (54 and 50 kDa) are relatively specific to the P. marneffei infection, thereby suggesting its potential for clinical application to the diagnosis of this emerging disease.

Animals↗

PubMedDate not supplied

The effect of light exercise upon blood flow velocity determined by laser-Doppler flowmetry.

PRIMARY OBJECTIVE: The dominant, 0.1 Hz frequency, Traube-Hering component of blood flow velocity, which is related to baroreflex activity, may be modulated through the established techniques of manipulative medicine. Light exercise programmes, appropriate for use by the elderly and collectively termed gymnastique douce, also are believed to impact the baroreflex in a positive manner. Our objective was to test the relationship between the Traube-Hering oscillation and light exercise. METHODS: Using laser-Doppler flowmetry to quantify the Traube-Hering and other components of the blood flow velocity oscillation, we compared flowmetry records of 10 subjects before and immediately following a light-exercise programme. RESULTS: The data show that the light exercise programme amplifies the 0.1 Hz component of the blood flowmetry record. CONCLUSIONS: The 0.1 Hz component of blood-flow velocity is physiologically linked to baroreflex activity. It is this component that is augmented by a light exercise programme.

Adult↗

PubMedDate not supplied

Processes of facilitating progress by language-delayed children in special language-centred school units.

Explore the source record for details and available documents.

Child↗

PubMedDate not supplied

Community-acquired purulent meningitis: a review of 1,316 cases during the antibiotic era, 1954-1976.

This review of 1,316 cases of purulent meningitis assessed changes in the etiology, clinical features, and fatality rate during the antibiotic era. Hemophilus influenzae was the most frequent cause of purulent meningitis (458 cases), Neisseria meningitidis the second most frequent (396 cases), and Streptococcus pneumoniae the third most frequent (178 cases). No bacterial etiology was found for 148 patients with purulent meningitis, the fourth major category of meningitis throughout the 23 years surveyed. Few patients had notable underlying diseases or predisposing conditions; 77.4% were less than 10 years old, but only 13 patients were less than one month old. Patients with meningitis caused by Staphylococcus aureus or various streptococci commonly had associated suppurative foci and the highest fatality rate. There were 103 deaths, of which 70.8% occurred during the first 48 hr of hospitalization. Antibiotics had been given to 54.6% of patients before admission to the hospital. Bacteriologic and cerebrospinal fluid (CSF) findings for patients who received antibiotics prior to admission ("pretreated") were compared with these findings for those who had not had antibiotics in 1,032 cases of meningitis caused by H. influenzae, N. meningitidis, or S. pneumoniae. No significant differences in white blood cell counts or in glucose or protein concentrations in CSF were noted among patients infected with any of the three organisms; positive cultures of blood and CSF were significantly less frequent in "pretreated" patients whose disease was caused by any of the three organisms, and particularly in those with meningitis due to N. meningitidis. Nasopharyngeal, throat, and rectal swabs and CSF specimens from 141 patients were cultured for virus. Enteroviruses were isolated from rectal swabs of two patients with bacterial meningitis and from the CSF of two patients (in mixed culture with Salmonella enteritidis in one case).

Adolescent↗

PubMedDate not supplied

Endocarditis due to nutritionally deficient streptococci: therapeutic dilemma.

Three cases of endocarditis due to nutritionally deficient (variant) streptococci are presented and the literature is reviewed. In all of the cases reviewed, the patient presented with an indolent subacute course. Prior heart disease was present in 90% of the patients, embolization occurred in 27%, relapse after therapy in 17%, and death in 17%. Bacteriologic failure occurred in 41% of cases, despite sensitivity of the organisms to the antibiotics used in two-thirds of these cases. Combination therapy with penicillin and an aminoglycoside has been recommended previously; however, in 38% of the cases reviewed, bacteriologic failures occurred and the patients required surgery. The results of in vitro antibiotic-sensitivity testing are difficult to interpret and to apply to the expected response to therapy. Further studies on these organisms are needed to reduce the high rates of failure, relapse, and fatality.

Adult↗

PubMedDate not supplied

Successful repair of a ventricular assist system percutaneous lead.

A patient with an implanted, electrically powered, ventricular assist device (Thermo Cardiosystems VE HeartMate) experienced a partial break of the percutaneous lead 5 months after implantation. The break (limited to the Silicone rubber tube) occurred at the junction of the lead with the Y-connector to the controller and vent, leaving approximately 5 cm of exposed lead from the skin exit site to the connector. Electronic and pumping functions of the pump continued, but the opening in the lead (which went more that half way around the circumference) prevented the use of pneumatic actuation as a back-up mode for pump operation, and placed the pump at risk for contamination. Repair of the lead without surgical intervention was desirable, with ease of repair and minimal risk to the patient being the top priorities. The use of multiple layers of heat-shrink tubing or external metal stents was ruled out in favor of a three stage repair procedure. The first stage involved the removal of the Dacron velour in-growth material from the lead to expose the underlying Silicone rubber tube. While the opening in the tube was held shut, a coating of medical grade Silicone rubber adhesive was applied to the tube, then wrapped with a woven Dacron mesh, followed by two layers of plastic wrapping material to protect the adhesive. This initial layer was secured by an external stent of tubing with cable ties. After several days to allow for complete curing of the adhesive, the adhesive coating with mesh was repeated. The final step involved a double layer wrap of a 1 mm thick Silicone rubber sheeting with mesh incorporation and adhesive secured in place with cable ties. After completion of the repair and verification of the ability to operate the device with pneumatic actuation, the patient was discharged with no recurrence of the problem after 8 months of weekly follow-up. This experience demonstrates the need to clinically anticipate component repair or replacement without total device replacement in future implantable blood pump systems.

Adhesives↗

PubMedDate not supplied

Epidemiologic risk factors for incident sexually transmitted diseases in young Thai men.

BACKGROUND AND OBJECTIVES: Prospective studies of incidental sexually transmitted diseases in developing countries rarely have been reported. As the human immunodeficiency virus epidemic widens, knowledge of the epidemiology of sexually transmitted diseases as co-factors for human immunodeficiency virus infection is viewed as vitally important. GOAL: To determine epidemiologic risk factors for incidental sexually transmitted diseases in young men in northern Thailand. STUDY DESIGN: A cohort of 2,417 men selected by lottery for military conscription was followed an average of 22 months, with epidemiologic risk factors and sexually transmitted disease histories assessed semiannually. Sexually transmitted diseases were determined by physician or symptom histories obtained by interview. RESULTS: Sexually transmitted disease incidence was 17.04 per 100 person-years. Gonorrhea and chancroid were commonly reported, whereas incident syphilis was rare. Sexually transmitted disease incidence declined significantly in the 2-year period. Most sexually transmitted diseases were acquired through commercial sex patronage. However, among men who did not report visiting a brothel, there was a significant increase in sexually transmitted diseases among men reporting sex with a girlfriend. Other risk factors included inconsistent condom use, drug use, and low educational level. Frequent alcohol use was associated with incident sexually transmitted diseases in bivariate analysis, but drinking at the time of last brothel visit was not associated with increased sexually transmitted diseases. CONCLUSIONS: Sexually transmitted disease control in Thailand is based on an integrated sexually transmitted disease clinic system. Many commercial sex workers are examined and treated routinely, but too infrequently to reduce sexually transmitted disease transmission between them and their male clients. Condom-use levels in commercial sex settings still may be too low to reduce sexually transmitted disease transmission. More consistent and effective sexually transmitted disease treatment of commercial sex workers and their clients and education of men on the effective and consistent use of condoms is required to reduce the risks of sexually transmitted disease transmission in this population.

Adult↗

PubMedDate not supplied

Human immunodeficiency virus infection and self-treatment for sexually transmitted diseases among northern Thai men.

BACKGROUND AND OBJECTIVES: Self-treatment for sexually transmitted diseases (STD) is common, but little studied, in Thailand, and its influence on human immunodeficiency virus (HIV) infection is unknown. GOALS: To assess STD self-treatment and self-prophylaxis behaviors as well as HIV risks and serostatus among northern Thai men. STUDY DESIGN: Cross-sectional report from a cohort of military conscripts (N = 869). HIV and STD seroprevalence and reported risk behaviors, including STD history and antibiotic self-treatment, were obtained. Associations between STDs and self-treatment or prophylaxis and HIV infection were analyzed using t-tests, odds ratios, and logistic regression. RESULTS: The prevalence rate for HIV was 12.3%, and for syphilis it was 2.2%. Men who were seropositive for HIV were more likely to report having sex with commercial sex workers (OR 9.1), to have had an STD (OR 5.96) and to report inconsistent condom use with commercial sex workers (OR 3.13). Of 282 men reporting any STD, 65.2% treated themselves with antibiotics, and 8.5% used them before commercial sex. Among those who frequented commercial sex workers, 98.7% took preventive steps after sex by increasing urine output (69.2%), washing the genital area (28.9%), and using antibiotics (0.9%). Men reporting STD self-treatment were less likely to be HIV infected (OR 0.53; 95% CI 0.31, 0.93). CONCLUSIONS: These men are attempting to prevent HIV and STDs. Self-treatment with antibiotics may lower HIV risks associated with bacterial STD in a high-prevalence population.

Adult↗