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PubMed2005

Complementary factors contributing to the rapid spread of HIV-I in sub-Saharan Africa: a review.

OBJECTIVE: To examine and establish complementary factors that contribute to the alarmingly high prevalence of HIV-1 in sub-Saharan Africa (SSA) in order to create awareness and suggest possible measures to avert the spread of the pandemic. DATA SOURCES: Review of literature via Medline, the Internet, articles in refereed journals, and un-refereed features from the East Africa media houses and personal communications. DATA SELECTION: Most published data from 1981 to September 2004 found to have revealed an impact on the spread of HIV-1 in SSA were included in the review. Therefore, all selected articles were read and critically evaluated. Where possible the number of citations articles which had been received were sought to established the degree of impact. DATA EXTRACTION: Abstracts of all articles identified were accessed, read and analysed to determined possible relevance to the spread of HIV-1. When relevance was established from the abstract the entire paper was read and important points were included in the review. DATA SYNTHESIS: A matrix was drawn to include all subtitles (e.g. polygamy, circumcision, poverty, etc). Below each subtitle all published works were included and prioritised. Published works that were found to have impact were included in the review. Finally a percent composite picture of all factors was drawn in an attempt to prioritise the factors, not withstanding the fact that most factors are interrelated and complementary. CONCLUSIONS: There are many reasons why the spread of HIV-1 in SSA has not been declining over the years. Main risk factors for HIV-1 infection and AIDS disease in SSA were found to include poverty, famine, low status of women in society, corruption, naive risk taking perception, resistance to sexual behaviour change, high prevalence of sexually transmitted infections (STI), internal conflicts and refugee status, antiquated beliefs, lack of recreational facilities, ignorance of individual's HIV status, child and adult prostitution, uncertainty of safety of blood intended for transfusion, widow inheritance, circumcision, illiteracy and female genital cutting and polygamy. It is suggested that control programmes both local and donor-driven seeking to mitigate the spread of HIV-1 in SSA should take into account the apparent multiplicity of sub-Saharan African cultures and beliefs, some of which augment the spread of HIV-1.

Africa South of the Sahara↗
PubMed1980

Strachan's syndrome 30 years after onset.

While a prisoner-of-war in Malaya from 1942-1945, a 29-year-old man developed a painful sensorimotor neuropathy, bilateral central scotomata and sensorineural deafness. Examination 34 years later, after a long period of adequate nutrition, revealed considerable residual deficit. Nerve conduction studies suggested axonal degeneration with prominent collateral reinnervation. This case of Strachan's syndrome is reported to draw attention to the limited functional recovery and to focus attention on this condition at a time when famine conditions are rife in Southeast Asia.

Aged↗
PubMed1976

[Rise in incidence of pulmonary embolism fatalities among surgical patients and disposing factors involved. Analysis for a 50 year period (author's transl)].

During the 50 year period from 1917 to 1966, 210078 patients were treated in the Surgical Clinic of the University of Jena. Autopsies were carried out on 10083 of the patients which had dies in the Clinic. The average incidence rate of lung embolism was 0.44%, the range of values lying between 0.04% (1917) and 1.02% (1965). In periods of famine or distress, lung embolism reached its lowest point, whereas in periods of relative prosperity a high peak was reached. On the whole, the incidence of pulmonary embolism seem to be the increased age of the patients population and the higher frequency of associated heart and circulatory diseases, obesity, and accidents, as well as the extended indications for surgery in the aged.

Adult↗
PubMed1999

DNA polymorphism-diet-cofactor-development hypothesis and the gene-teratogen model for schizophrenia and other developmental disorders.

Three problems in identifying genes causing schizophrenia and other developmental disorders may be locus heterogeneity, high disease allele frequency, and unknown mode of inheritance. The DNA polymorphism-diet-cofactor-development (DDCD) hypothesis addresses the first two. The gene-teratogen model addresses the third. The DDCD hypothesis is that schizophrenia results in part from brain abnormality in utero from the aggregate effect of multiple mutations of small effect of genes related to important cofactors (e.g., folate, cobalamin, or pyridoxine) potentiated by maternal dietary deficiency of these cofactors and by pregnancy. The effect results from insufficiency of the cofactors and from resulting effects such as impaired DNA synthesis, immune deficiency, effects on niacin and serotonin metabolism, and teratogens, e.g., hyperhomocysteinemia. The hypothesis addresses all of the unusual features of schizophrenia: e.g., decreased brain gray matter, birth-month effect, geographical differences, socioeconomic predilection, association with obstetrical abnormalities, decreased incidence of rheumatoid arthritis, and association with famine and viral epidemics. In the gene-teratogen model, a teratogenic effect in utero produces a developmental disorder through a teratogenic locus and a modifying or specificity locus, as well as through environmental factors. An example is the major intrauterine effect seen in offspring of phenylketonuric mothers. Thus, the mode of inheritance of genes acting prenatally may in some cases be fundamentally different from that of genes acting postnatally. The model is interesting because it is simple and because teratogenic loci will be difficult to locate by conventional linkage mapping techniques due to misspecification of the affection status of both mother and affected children. A new study design is suggested for identifying teratogenic loci.

Alleles↗
PubMed1999

Control of infectious diseases.

Deaths from infectious diseases have declined markedly in the United States during the 20th century. This decline contributed to a sharp drop in infant and child mortality and to the 29.2-year increase in life expectancy. In 1900, 30.4% of all deaths occurred among children aged <5 years; in 1997, that percentage was only 1.4%. In 1900, the three leading causes of death were pneumonia, tuberculosis (TB), and diarrhea and enteritis, which (together with diphtheria) caused one third of all deaths. Of these deaths, 40% were among children aged <5 years. In 1997, heart disease and cancers accounted for 54.7% of all deaths, with 4.5% attributable to pneumonia, influenza, and human immunodeficiency virus (HIV) infection. Despite this overall progress, one of the most devastating epidemics in human history occurred during the 20th century: the 1918 influenza pandemic that resulted in 20 million deaths, including 500,000 in the United States, in <1 year-more than have died in as short a time during any war or famine in the world. HIV infection, first recognized in 1981, has caused a pandemic that is still in progress, affecting 33 million people and causing an estimated 13.9 million deaths. These episodes illustrate the volatility of infectious disease death rates and the unpredictability of disease emergence.

Anti-Bacterial Agents↗
PubMed2000

Scurvy in an unrepentant carnivore.

For centuries, scurvy, or vitamin C deficiency, decimated crews of sailing ships on long sea voyages and populations deprived of fresh fruits and vegetables during times of war or famine. Today, scurvy is extremely rare in the United States, and its classic findings of perifollicular petechiae, edema and purpura of the lower extremities, corkscrew hairs, and hemorrhagic gingivitis may go unrecognized. We report the case of a man from rural Appalachia who developed typical signs and symptoms of scurvy on two separate occasions, approximately 2 years apart. Both times, the patient underwent an extensive work-up and was diagnosed with numerous other conditions before his vitamin C deficiency was recognized. We discuss the clinical presentation, pathophysiology, diagnosis, and treatment of scurvy, with attention to specific findings that should alert the clinician to this diagnosis.

Biopsy↗
PubMedDate not supplied

[Epidemic typhus in tropical Africa. A reemerging disease that is severe but curable].

In tropical regions of Africa, frequently subject to social and political upheavals, there is an ever-present threat of typhus epidemics, as shown by the recent typhus outbreak in Burundi in 1997. Epidemic typhus should be systematically suspected in certain epidemiological conditions: famine, war, high-density populations (refugee camps, prisons), the presence of body louse in the clothing, and in the presence of certain clinical findings: severe infectious syndrome (temperature above 38 C), severe pain and muscle weakness, with coughing and severe neurological signs. The rapid diagnosis and treatment of typhus are essential. The prognosis has improved, thanks to the specific antibiotics that are currently available, particularly doxycycline, prescribed as a single oral dose of 200 mg for adults or of 100 mg for children. However, the prognosis still depends to a large extent on the speed of diagnosis. Typhus epidemics could be effectively predicted and limited if the measures for control of the body louse recommended by the World Health Organization were applied in the areas with the most favorable epidemiological conditions.

Adult↗
PubMed2001

The future of chronic diseases.

Major chronic diseases continue to be the main health scourge of the most developed countries, have only recently been retreating in frequency in the fledgling market economies, and are becoming dominant in many populous areas of the developing world. The descriptive evidence from the developments of the near past strongly suggests that much of the control outcomes have already been achieved with the existent imperfect causative knowledge. The continuation of desirable trends in major chronic diseases in some places like Central & Eastern Europe, is uncertain within the intermediate time range without gaining more etiological clues, among which the role of medical care is worthy of reconsideration. Other factors can grow in importance, like obesity, which may be freed from the suppressive influence of cigarette smoking to trigger major mass pathologies, like type 2 diabetes mellitus, arterial hypertension, some cancers etc. The role of social underpriviledge seems recalcitrant, although the part played by social share of biological risk agents may diminish in response to educational persuasion. The remotest destinies of some chronic diseases may depend on the mixture of external and genetic influences ending as predispositions towards some ailments, antecedents of which might have protected their carriers from dangers of the past unfriendly environment, like obesity (or diabetes) against famine, or hypertension against inefficient defense reaction. The resulting medium-range prediction of well-being for inhabitants of more developed world may not be forbidding, since increasing life expectancy needs not be synonymous with disability, and attaining old age does not require excessive sacrifice, beyond reducing number smoked, or preserving decent respiratory volumes.

Chronic Disease↗
PubMed2000

Dentistry in ancient mesopotamia.

Sumer, an empire in ancient Mesopotamia (southern Iraq), is well known as the cradle of our modern civilization and the home of biblical Abraham. An analysis of skeletal remains from cemeteries at the ancient cities of Ur and Kish (circa 2000 B.C.), show a genetically homogeneous, diseased, and short-lived population. These ancient Mesopotamians suffered severe dental attrition (95 percent), periodontal disease (42 percent), and caries (2 percent). Many oral congenital and neoplastic lesions were noted. During this period, the "local dentists" knew only a few modern dental techniques. Skeletal (dental) evidence indicates that the population suffered from chronic malnutrition. Malnutrition was probably caused by famine, which is substantiated in historic cuneiform and biblical writings, geologic strata samples, and analysis of skeletal and forensic dental pathology. These people had modern dentition but relatively poor dental health. The population's lack of malocclusions, caries, and TMJ problems appear to be due to flat plane occlusion.

History of Dentistry↗
PubMed2001

Sustaining our rivers in crisis: setting the international agenda for action.

The history of streams and rivers is as much a social and technological history as it is a scientific one. Rivers are the lifeblood of nations and the control of their waters has been fundamental to the building of human civilisations. The control or regulation of rivers embodied the advancement of institutions, administration and co-ordination; it was a manifestation of military and economic power. Yet the history of human development is also characterised by the degradation of the basic resource--polluted water, increased flooding, and the loss of biological diversity. Many early civilisations collapsed in the face of environmental degradation, manifest by flood, drought, famine and plague. The Industrial Revolution upon which modern societies are founded was based upon a short-term vision that has left rivers in crisis, marked by a legacy of pollution, slums, a loss of confidence in civic life, and a loss of ownership of places and spaces--once seen to be at the heart of civilized society. Within this global or international context of water management, this paper examines the impacts and future of rivers and water within the United Kingdom, establishing some principles for such management in other settings.

Conservation of Natural Resources↗
PubMed2000

An integrative approach to the study of human behavior. (Poster accepted for the International Conference of Psychology "Psychology After The Year 2000" at the University of Haifa, Israel, June 12-14, 2000).

The human behavior is a fundamental phenomenon in contemporary sciences in the widest sense of the word. The wide range of world problems such as wars, criminality, social depravation, famine, different catastrophes as Tjernobyl up to the pandemic AIDS, etc. are transferable into one common denominator: the failure of man in his behavior. Adequate understanding of all behavioral mechanisms and their failures is condition sine qua non for the most important task-the prediction of actual behavior resulting from different bio-psycho-socio-cultural sources. The authors express presumption about the essential importance of three basic postulates (I-III) in every kind of behavioral research: (I) Human life is an indivisible continuum from its very beginning (especially vulnerable) over adulthood (inclusive reproduction) until death. The prenatal stages of life are integral and very sensitive periods of human ontogenesis. Every discontinuity in this development can lead to physical, mental and social disfunctions in both prenatal and postnatal life. (II) Motivation is a basic inner drive generating the actual human behavior. All its five components should be taken into consideration: 1. Qualitative (the kind of motivational state: alimentary, sexual, territorial, etc.) 2. Quantitative (the intensity of motivational state, "arousal"). 3. Inner structure of each motivational state (into partial motivational states with specific sensitivity to external stimulation). 4. Synthetic (causal and functional aspects of actual motivation). 5. Hierarchy of motivational states (self-preservation of the individual is probably on the top of such a hypothetical hierarchical structure). (III) Both previous postulates demand the integrative approach to the study of human behavior and refers to three basic sources of behavior: 1. Function of the CNS. 2. Function of the endocrine system. 3.Variability of external conditions (including all kinds of behavioral stimulation).

Journal Article↗
PubMed1999

[People's way to fight the epidemic diseases in the early Choson period].

Epidemic diseases in the early Choson period were big problems to the people and society. However, the weapons to the epidemic diseases were very limited at that time. There were few drugs and well-trained practitioners for people. Most people could only depend on religious means and simple folklore medicine including inhalation of specific flavor. People tried to overcome or prevent the epidemics by praying, sorcery, ornaments, runaway and isolation. In most cases, the epidemic diseases came with or broke out from the famine, severe labour (especially in civil engineering) imposed by the ruling class. The epidemics of that time are thought to be typhoid fever, epidemic typhus, or similar febrile diseases.

Communicable Disease Control↗
PubMedDate not supplied

[Historical necessity and human action in Morte e vida severina].

Using the essential elements of tragic action described in Aristotles Poetics, the text compares João Cabral de Melo Neto's Morte e vida severina to Sophocles Oedipus rex with the purpose of bringing to light the tension that exists between human necessity and human action. It is an eminently epidemiological fact that draws a link between these two works. In Morte e vida severina, the causa efficiens behind Severino's decision to migrate is a famine; in Oedipus rex, a plague afflicting the inhabitants of Thebes is the event that hastens discovery of king Laiuss true assassin. It is a reflection on the finalis and formalis causes behind Severino's and Oedipus's movements and on the essential elements of tragic action that allows a transitory falsification or, better put, a rejection of the hypothesis that Morte e vida severina is a tragedy, at least not in Aristotelian terms.

Brazil↗
PubMed1997

[Not Available].

At the beginning of the 20s, Russia was devastated by famine and plagues. This paper deals with the life and work of the Leipzig physician Paul Carly Seyfarth (1890-1950), who participated in the Red Cross relief expedition to Russia. In 1922/23, Seyfarth was appointed director of the German Alexander-Hospital in Petersburg, which he reorganized and modernized for the treatment of infectious diseases.

Communicable Diseases↗
PubMed1993

Giovanni Maria Lancisi: De bovilla peste and stamping out.

Giovanni Maria Lancisi (1654-1720) was a physician, archiater of the pope, well-known as an anatomist and epidemiologist, who made an important contribution to veterinary medicine of when rinderpest (cattle plague) affected Europe in the XVIIIth century. His times, his life and career and his main contributions to medicine are described. the main features of the great epidemic of rinderpest which started in 1711 are presented. His book De bovilla peste, published in 1715, illustrates the characteristics of cattle plague and, above all, the control measures is discussed. Of the control measures, the most relevant were the introduction of stamping out, with special instructions for the killing and burial of affected animals, the prohibition of animal movements, the adoption of special hygienic and political measures. The relationships between cattle plague and poverty and famine are described, together with the actions taken to deal with them. Lancisi points out the relationship between politics and history on the one hand and cattle plague on the other. He may be considered the modern co-inventor (along with Bates) of stamping out.

Animal Population Groups↗
PubMedDate not supplied

[Foetal programming of nutrition-related chronic diseases].

Intrauterine growth retardation, which reflects in large part maternal malnutrition in poorer communities, contributes to chronic disease risk through foetal programming, according to the early origins hypothesis of Barker. Foetal programming implies that during critical periods of prenatal growth, permanent changes in metabolism or structures result from adverse intrauterine conditions. Observational studies first showed an association between lower birth weights and higher rates of coronary disease in the 80s, in England and Scandinavia. The link between low birth weights, or other indicators of small birth size, and cardiovascular disease was later confirmed in many epidemiological studies, including in the USA and in India. Similarly, a reverse relationship of birth weight and systolic blood pressure was shown in men and women, in developed as well as developing countries, and in all age groups, although it was less consistent in adolescents. Insulin resistance and type-2 diabetes have also been found to be independently related to small size at birth in several studies around the world. Insulin resistance associated with small size at birth was frequently shown to be present at a young age. The association of small birth size with chronic disease tends to increase with catch-up growth and obesity, and usually persists after adjusting for confounding factors such as age, family history, and socio-economic status. Several, but not all, twin studies lend support to the hypothesis. There is a tendency for lighter members of twin pairs to have a higher blood pressure, and more diabetes. Observations in people exposed to the Dutch famine while in utero also tend to corroborate the hypothesis. Those who were exposed early in their intrauterine life did not have lower birth weights, but they were prone to becoming obese later on. In contrast, those exposed towards the end of gestation had lower birth weights, and showed a higher rate of impaired glucose tolerance, while having a lower risk of obesity. Dietary manipulations in animal models provide further support and mechanistic explanations, in particular protein deficiency in pregnant rats, which elevates blood pressure, impairs glucose tolerance, and increases the likelihood of obesity in the progeny. Although there are still controversial areas, there is at present sufficient scientific evidence for foetal programming to be regarded as an additional risk factor for chronic disease, in interaction with genetic and lifestyle risk factors. The fact that intrauterine growth retardation may predispose to nutrition-related chronic disease has serious implications for developing countries, particularly those undergoing rapid nutritional transition, as it may further increase the rates of obesity, cardiovascular disease and diabetes when diets and lifestyles are in themselves "atherogenic". The challenge is for programmes to simultaneously combat apparently opposite nutrition problems, malnutrition and "over-nutrition". Improving the nutrition of women is even more imperative when considering that it may contribute to preventing chronic diseases in the next generation, in addition to enhancing health and survival of mothers and children.

Birth Weight↗
PubMedDate not supplied

Female infanticide and child neglect as possible reasons for low sex ratio in the Punjab, 1881-1931.

"The social and cultural practices prevalent in various parts of [India] resulted in the neglect of the female child...[in general, and] probably more so in the Punjab. Moreover, female mortality significantly exceeded male mortality in years of epidemics and famines. This paper tries to examine the socio-cultural and economic factors, namely, the system of land holdings and inheritance strategies, structured customs in different parts of the province, and notions of honour and status which probably have been at the back of neglect of the girl child. Among certain caste groups even female infanticide might not have been uncommon."

Asia↗
PubMed2002

PHA storage from several substrates by different morphological types in an anoxic/aerobic SBR.

An activated sludge was cultivated on a mixture of several soluble substrates (acetate, ethanol, glucose, glutamic acid, peptone, Tween 80, starch, yeast extract) in an anoxic/aerobic SBR. Highly dynamic conditions in the SBR (feast famine regime) caused fast removal of most COD in the anoxic phase (in particular acetate, ethanol, glutamic acid and glucose were totally removed) and relevant contribution of storage. In spite of that, filament abundance was always high, as is typical of bulking sludges. Filaments which developed in the reactor were characterized on a morphological basis and on the basis of their ability to grow and to store polyhydroxyalkanoates (PHAs). Three main filaments prevailed in the biocenosis, whose relative abundance was varyng with time: Nostocoida limicola II, (two different morphological types), Haliscomenobacter hydrossis and an unidentified one. It was found that maximum growth rate was higher for flocformers than for filaments on each of the tested substrates. Epifluorescence showed that storage ability was more widespread among flocformers than in the filaments. Only one type of Nostocoida limicola II was able to store PHAs. The obtained data show that aerobic growth on the little residual fraction of COD from the anoxic phase was enough to support high abundance of filamentous microorganisms.

Bioreactors↗