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Descending projections from the medullary dorsal reticular nucleus make synaptic contacts with spinal cord lamina I cells projecting to that nucleus: an electron microscopic tracer study in the rat.

An ultrastructural study is made of the synaptic contacts occurring between structures labelled anterogradely and retrogradely in the superficial dorsal horn following injections of cholera toxin subunit B or horseradish peroxidase in the dorsal reticular nucleus of the medulla oblongata of the rat. Both tracers revealed labelled axonal boutons in lamina I with round synaptic vesicles and a few large granular vesicles making asymmetrical synaptic contacts upon labelled somata and dendrites. After injections of Phaseolus vulgaris leucoagglutinin in the dorsal reticular nucleus, labelled boutons identical to those revealed by the two other tracers were presynaptic to unlabelled somata and dendrites. In addition, dorsoreticular neurons were labelled retrogradely following injections of cholera toxin subunit B into the superficial dorsal horn of the cervical enlargement. These observations show the occurrence of a reciprocal connection between dorsal reticular and lamina I neurons. Considering the putative excitatory nature of the axodendritic contacts in lamina I, a positive feedback circuit is suggested, whereby the nociceptive signals transmitted to the dorsal medullary reticular formation by marginal neurons are intensified.

Afferent Pathways↗

The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators.

A World Health Organization Working Group has developed a major international collaborative study with the objective of measuring over 10 years, and in many different populations, the trends in, and determinants of, cardiovascular disease. Specifically the programme focuses on trends in event rates for validated fatal and non-fatal coronary heart attacks and strokes, and on trends in cardiovascular risk factors (blood pressure, cigarette smoking and serum cholesterol) in men and women aged 25-64 in the same defined communities. By this means it is hoped both to measure changes in cardiovascular mortality and to see how far they are explained; on the one hand by changes in incidence mediated by risk factor levels; and on the other by changes in case-fatality rates, related to medical care. Population centres need to be large and numerous; to reliably establish 10-year trends in event rates within a centre 200 or more fatal events in men per year are needed, while for the collaborative study a multiplicity of internally homogeneous centres showing differing trends will provide the best test of the hypotheses. Forty-one MONICA Collaborating Centres, using a standardized protocol, are studying 118 Reporting Units (subpopulations) with a total population aged 25-64 (both sexes) of about 15 million.

Adult↗

Race/ethnicity misclassification of persons reported with AIDS. The AIDS Mortality Project Group and The Supplement to HIV/AIDS Surveillance Project Group.

OBJECTIVES: To examine differences in race/ethnicity classifications of persons with AIDS among three reporting sources and to estimate the effect of these differences on calculated AIDS rates. METHODS: We reviewed case reports from the national AIDS surveillance database, interview (self-reported) data from 11 state/local health departments, and death certificate information from 16 state/local health departments for agreement in race/ethnicity coding among persons reported with AIDS. RESULTS: Race/ethnicity coding inconsistencies with AIDS case reports were greatest for persons identified as American Indians/Alaska natives on death certificates (46% [47/102] disagreement) and by self-report (57% 8/14 disagreement). Agreement with AIDS case reports was highest either for persons identified as white from death certificates (4% [1314/31,070] disagreement) and white from self-reports (2% [26/1068] disagreement) or black from death certificates (3% [440/13,592] disagreement) and black from self-reports (3% [21/736] disagreement). For other racial/ethnic groups, disagreement with AIDS case reports was intermediate; for Asians/Pacific Islanders, 12% [45/377] disagreement with death certificates and 33% 4/12 disagreement with self-reports; and for Hispanics, 14% [1151/8527] disagreement with death certificates and 24% [59/249] disagreement with self-reports. CONCLUSION: For certain racial/ethnic groups, classification by race/ethnicity can differ substantially by surveillance data source. Because allocation of public health resources may be determined by estimates of disease impact on different population groups, periodic evaluations of the accuracy of race and ethnicity reporting are needed to assure appropriate distribution of these resources.

Acquired Immunodeficiency Syndrome↗