Stage-dependent production and release of histidine-rich protein 2 by Plasmodium falciparum

Because of their sequestration in the microcirculation, the pathogenic late stages of Plasmodium falciparum are under-represented in peripheral blood samples from patients with falciparum malaria. Excreted products of the parasite might help to estimate this sequestered biomass. We quantified the stage-dependent production and release per parasite of P. falciparum histidine-rich protein 2 (PfHRP2) with the objective of measuring the sequestered biomass. A simple method to relate parasite stage to parasite age was developed to facilitate this. In four isolates of P. falciparum, the median (range) PfHRP2 content was 2.0fg (0.5-4.3fg) for a young ring stage infected erythrocyte, and 5.4fg (2.1-10.2fg) for the schizont stage. The amount of PfHRP2 in the parasitized erythrocyte increased most during development to the mature trophozoite stage. The median (range) amount of PfHRP2 secreted per parasite per entire erythrocytic cycle was 5.2fg (1.1-13.0fg). A median of 89% of the total PfHRP2 was excreted at the moment of schizont rupture. This assessment of the stage-dependent release of PfHRP2 is an essential prerequisite for future studies aimed at estimating the total patient parasite mass from the peripheral blood PfHRP2 concentration.     

Henoch-schonlein purpura associated with esophagus carcinoma and adenocarcinoma of the lung

Henoch-Sch?nlein purpura (HSP) is known to exist in association with a variety of malignant diseases including squamous and small cell lung cancer and hematological malignancies. We report the first cases of HSP associated with carcinoma of the esophagus and adenocarcinoma of the lung, respectively. We compare the main features of our patients with 23 previously published cases. We recommend that patients with HSP, especially men over 40 years of age, should undergo screening for occult neoplasia.     

The use of terrestrial and aquatic microcosms and mesocosms for the ecological risk assessment of veterinary medicinal products

In this paper, we investigate the applicability of experimental model ecosystems (microcosms and mesocosms) for the ecological risk assessment of veterinary medicinal products (VMPs). VMPs are used in large quantities, but the assessment of associated risks to the environment is limited, although they are continually infused into the environment via a number of routes. It is argued that the experience obtained by pesticide research largely can be used when evaluating VMPs, although there are several major differences between pesticides and pharmaceuticals (e.g., knowledge of their mechanisms of action on nontarget organisms). Also, because microorganisms are often the target organisms of VMPs, risk assessment should focus more on endpoints describing functional processes. This paper provides a review of the current risk assessment schemes of Europe and North America along with examples of experiments already performed with veterinary medicinal products in aquatic and terrestrial ecosystem models. We suggest that some of the approaches developed for pesticide risk assessment can be used for VMPs and offer suggestions for the development of a framework for ecological risk assessment of VMPs.     

Alcohol abuse and dependence criteria as predictors of a chronic course of alcohol use disorders in the general population

AIMS: To investigate whether DSM-IV abuse and dependence criteria and the ICD-10 criterion for craving differentially predict a chronic course of alcohol use disorders (AUD) in the general population. METHODS: Data were derived from the Netherlands Mental Health Survey and Incidence Study, a large representative sample of the general Dutch population with a baseline and a 1- and 3-year follow-up assessment. In the present study, a cohort of subjects with a DSM-IV AUD diagnosis at baseline was followed (n = 382). Diagnostic criteria of AUD according to DSM-IV and ICD-10 were assessed using the Composite International Diagnostic Interview (CIDI). RESULTS: In our cohort of subjects with an AUD diagnosis at baseline, the presence of all dependence criteria, except tolerance, significantly increased the risk for dependence at 1 and 3 years follow-up. Abuse criteria displayed much lower and often non-significant risks for dependence at follow-up, with the exception of the criterion 'legal problems'. The ICD-10 criterion 'craving' had the highest relative risk (RR) of all criteria for dependence at 1 year (RR = 12.4, 95% CI = 5.5-27.8) and 3 years follow-up (RR = 12.9, 95% CI = 4.4-37.7). CONCLUSION: With the exception of tolerance, all DSM-IV dependence criteria are useful in predicting the course of AUD in the general population.     

Gradient detection and contrast transfer by the human eye

Threshold measurements were performed with stimulus patterns involving gradual changes in luminance. The results of these measurements indicate that threshold data obtained using linear luminance gradients permit quantitative prediction of the dependence of the threshold modulation on the spatial frequency as well as on the number of cycles of sinusoidal gratings. It appears that for detection purposes, a sinusoidal grating can be considered as one linear gradient with the same width. This makes it possible to predict the spatial modulation transfer function of the eye from measurements with spatial luminance gradients.     

Intraoperative autotransfusion. Experience in 725 consecutive cases

Autologous intraoperative transfusion employing the Haemonetics Cell Saver is reported in 725 patients from a general hospital population, of which 75% were cardiovascular patients. The remaining cases included various orthopedic procedures, splenectomy, craniotomy, ectopic pregnancies, Caesarian sections, and exploratory laparotomy. On occasion, this method was utilized in trauma and in pediatric surgery. The product of washed red blood cells gave an average yield of 573 cc per case with an average hematocrit of 55 cc/dl available for autologous infusion. In 100 consecutive open heart procedures operated prior to the Cell Saver period, an average of 1.97 units of bank blood was utilized during operation, as compared with 0.75 units in 100 consecutive cases studied employing the Cell Saver (p less than 0.0001). Homologous blood utilization during cardiac surgery declined more than 50% with the use of the Cell Saver. Quality control was monitored scrupulously and included special precautions against air embolism, abnormal coagulation, and sepsis. The overall mortality rate was 2.8%, and in no instance was mortality or morbidity ascribable to the autologous transfusion. Numerous advantages offered by autotransfusion include prevention of sensitization of the recipient to various antigens in donor erythrocytes, leucocytes, platelets, and plasma, and avoidance of transfusion-transmitted diseases, especially viral hepatitis. Additionally, autologous blood, the only perfectly compatible product, provided immediate availability while conserving blood bank resources. In circumstances in which the intraoperative blood loss exceeded 1000 cc in the adult, its use was observed to be cost-effective. In the present study, autotransfusion proved safe, efficient, and in some instances life saving.     

Medical teaching facilities, Parowvallei]

The building complex which has been erected for training in the area of medicine is described in relation to the thinking which forms the background for these physical facilities. Provision is made for training of students in medicine, nursing and the paramedical services of physiotherapy and occupational therapy. The Faculty of Dentistry of the University of Stellenbosch is also on the site. Facilities exist for the training of a wide spectrum of medical technologists and technicians, and nursing colleges have been established for the training of both White and Coloured nurses. There are supporting services such as workshops, a laundry and animal facilities. A crèche for the children of working mothers, both White and Coloured, has been established, and a bank and a post office have also been built on the site. The Tygerberg Hospital provides a comprehensive service to patients and is planned to accommodate all ethnic groups under one roof with particular provision of facilities for the most specialised services. The emphasis is on the training of students in medicine, both undergraduate and postgraduate.