Tropical ulcers.

We present 87 cases of chronic leg ulcers. The ages and sexes of the patients, and the symptomatology and complications, are described. The term "tropical ulcer" is inappropriate for these cases--though the term may be appropriate for certain rare acute ulcers colonized by Vincent's bacilli. For most persistent leg ulcers in the tropics, however, a general term of chronic ulcer is better--because it stimulates one to look for the cause and to treat the patient accordingly.     

Expression of iNOS gene in macrophages stimulated with 17beta-estradiol is regulated by free intracellular Ca2+.

17Beta-estradiol has potent Ca2+ ionophore capability and its signaling in macrophages is mediated through binding to surface and genomic receptors, resulting in transient nitric oxide (NO) elaboration. We decided to examine if the transient release of NO is due to Ca2+ influx pattern or the quenching effect of superoxide (*O2-) through peroxynitrite formation. Differential chelation of intracellular Ca2+ ([Ca2+]i) showed that NO generation was favored by [Ca2+]i concentration of 237 nM. Application of an estrogen receptor antagonist ICI 182 780 resulted in attenuation of estradiol mediated NO release. Studies directed at identifying the possible role of *O2-; in the attenuation of NO showed no supportive evidence. Inhibition of extracellular Ca2+ channel or extracellular and intracellular Ca2+ channels showed data consistent with a case for optimum Ca2+ influx signal favoring iNOS gene expression, accompanied by an elevation in iNOS protein. These data show that Ca2+ influx pattern determines macrophage NO elaboration.     

Fluorescent carbon nanoparticles from Citrus sinensis as efficient sorbents for pollutant dyes

Here, we report a simple, green and economic process for the synthesis of highly fluorescent carbon nanoparticles (CPs) through low‐temperature carbonization of a fruit waste, Citrus sinensis peel. This approach allows the large‐scale production of aqueous CPs dispersions without any additives and post‐treatment processes. The as‐prepared CPs were of small particle size, exhibited bright blue fluorescence under UV irradiation (λ_max = 365 nm) with excellent colloidal stability in water. The chemical composition, structure and morphology of the as‐prepared CPs were analyzed using various spectroscopic techniques such as X‐ray diffraction, transmission electron microscopy and raman spectroscopy. The formed CPs were turbostratic in nature, with a large number of functional groups on the surface. We explored the adsorption characteristics of the formed CPs for wastewater treatment. Because of the negative surface of the CPs, as evident from the zeta value, it is possible to use them for selective adsorption of the cationic dye methylene blue from a mixture of dyes. The equilibrium adsorption isotherm revealed that the Langmuir model better describes the adsorption process than the Freundlich model. As‐prepared CPs rapidly adsorbed ~84% of the methylene blue within 1 min and can be regenerated and used repeatedly. Copyright © 2016 John Wiley & Sons, Ltd.     

Molecular Subtype-Specific Expression of MicroRNA-29c in Breast Cancer Is Associated with CpG Dinucleotide Methylation of the Promoter

Basal-like breast cancer is a molecularly distinct subtype of breast cancer that is highly aggressive and has a poor prognosis. MicroRNA-29c (miR-29c) has been shown to be significantly down-regulated in basal-like breast tumors and to be involved in cell invasion and sensitivity to chemotherapy. However, little is known about the genetic and regulatory factors contributing to the altered expression of miR-29c in basal-like breast cancer. We here report that epigenetic modifications at the miR-29c promoter, rather than copy number variation of the gene, may drive the lower expression of miR-29c in basal-like breast cancer. Bisulfite sequencing of CpG sites in the miR-29c promoter region showed higher methylation in basal-like breast cancer cell lines compared to luminal subtype cells with a significant inverse correlation between expression and methylation of miR-29c. Analysis of primary breast tumors using The Cancer Genome Atlas (TCGA) dataset confirmed significantly higher levels of methylation of the promoter in basal-like breast tumors compared to all other subtypes. Furthermore, inhibition of CpG methylation with 5-aza-CdR increases miR-29c expression in basal-like breast cancer cells. Flourescent In Situ Hybridization (FISH) revealed chromosomal abnormalities at miR-29c loci in breast cancer cell lines, but with no correlation between copy number variation and expression of miR-29c. Our data demonstrated that dysregulation of miR-29c in basal-like breast cancer cells may be in part driven by methylation at CpG sites. Epigenetic control of the miR-29c promoter by epigenetic modifiers may provide a potential therapeutic target to overcome the aggressive behavior of these cancers.     

Ankylosis of the mandible from cancrum oris.

We present 30 cases of ankylosis of the lower jaw following cancrum oris. The clinical and radiological findings, the anesthetic methods, and the surgical management are described. Adequate excision of limiting scar and any bony ankylosis, with immediate mucosal or skin coverage of any raw surfaces created, is the proper approach. Postoperative jaw exercises and the use of a bite block may be helpful.     

<Emphasis Type="Italic">Chlamydia pneumoniae</Emphasis> infected macrophages exhibit enhanced plasma membrane fluidity and show increased adherence to endothelial cells

Chlamydia pneumoniae, an intracellular prokaryote, is known to have requirement for some lipids which it is incapable of synthesizing, and these lipids have important fluidizing roles in plasma membrane. We decided to examine if the trafficking of these lipids to C. pneumoniae alters the physicochemical properties of macrophage plasma membrane, affects the expression of genes and proteins of enzymes associated with metabolism of some of these lipids and assess if Ca²⁺ signaling usually induced in macrophages infected with C. pneumoniae modulates the genes of these selected enzymes. Chlamydia pneumoniae induced the depletion of macrophage membrane cholesterol, phosphatidylinositol and cardiolipin but caused an increase in phosphotidylcholine resulting in a relative increase in total phospholipids. There was increased membrane fluidity, enhanced macrophage fragility and heightened adherence of macrophages to endothelial cells despite the application of inhibitor of adhesion molecules. Also, there was impairment of macrophage 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase gene and protein expression independent of Ca²⁺ signaling, while phospholipase C gene and protein were up-regulated in a manner minimally dependent on Ca²⁺ signaling. The implications of these findings are that macrophages infected with C. pneumoniae have altered membrane physicochemical characteristics which may render them atherogenic. (Mol Cell Biochem 269: 69–84, 2005)     

Implementing and Measuring the Level of Laboratory Service Integration in a Program Setting in Nigeria

Background

The surge of donor funds to fight HIV&AIDS epidemic inadvertently resulted in the setup of laboratories as parallel structures to rapidly respond to the identified need. However these parallel structures are a threat to the existing fragile laboratory systems. Laboratory service integration is critical to remedy this situation. This paper describes an approach to quantitatively measure and track integration of HIV-related laboratory services into the mainstream laboratory services and highlight some key intervention steps taken, to enhance service integration.

Method

A quantitative before-and-after study conducted in 122 Family Health International (FHI360) supported health facilities across Nigeria. A minimum service package was identified including management structure; trainings; equipment utilization and maintenance; information, commodity and quality management for laboratory integration. A check list was used to assess facilities at baseline and 3 months follow-up. Level of integration was assessed on an ordinal scale (0 = no integration, 1 = partial integration, 2 = full integration) for each service package. A composite score grading expressed as a percentage of total obtainable score of 14 was defined and used to classify facilities (≤80% FULL, 25% to 79% PARTIAL and <25% NO integration). Weaknesses were noted and addressed.

Results

We analyzed 9 (7.4%) primary, 104 (85.2%) secondary and 9 (7.4%) tertiary level facilities. There were statistically significant differences in integration levels between baseline and 3 months follow-up period (p<0.01). Baseline median total integration score was 4 (IQR 3 to 5) compared to 7 (IQR 4 to 9) at 3 months follow-up (p = 0.000). Partial and fully integrated laboratory systems were 64 (52.5%) and 0 (0.0%) at baseline, compared to 100 (82.0%) and 3 (2.4%) respectively at 3 months follow-up (p = 0.000).

Discussion

This project showcases our novel approach to measure the status of each laboratory on the integration continuum.     

The Pattern of Attrition from an Antiretroviral Treatment Program in Nigeria

Objective

To evaluate the rate and factors associated with attrition of patients receiving ART in tertiary and secondary hospitals in Nigeria.

Methods and Findings

We reviewed patient level data collected between 2007 and 2010 from 11 hospitals across Nigeria. Kaplan-Meier product-limit and Cox regression were used to determine probability of retention in care and risk factors for attrition respectively. Of 6,408 patients in the cohort, 3,839 (59.9%) were females, median age of study population was 33years (IQR: 27–40) and 4,415 (69%) were from secondary health facilities. The NRTI backbone was Stavudine (D4T) in 3708 (57.9%) and Zidovudine (ZDV) in 2613 (40.8%) of patients. Patients lost to follow up accounted for 62.7% of all attrition followed by treatment stops (25.3%) and deaths (12.0%). Attrition was 14.1 (N = 624) and 15.1% (N = 300) in secondary and tertiary hospitals respectively (p = 0.169) in the first 12 months on follow up. During the 13 to 24 months follow up period, attrition was 10.7% (N = 407) and 19.6% (N = 332) in secondary and tertiary facilities respectively (p<0.001). Median time to lost to follow up was 11.1 (IQR: 6.1 to 18.5) months in secondary compared with 13.6 (IQR: 9.9 to 17.0) months in tertiary sites (p = 0.002). At 24 months follow up, male gender [AHR 1.18, 95% CI: 1.01–1.37, P = 0.038]; WHO clinical stage III [AHR 1.30, 95%CI: 1.03–1.66, P = 0.03] and clinical stage IV [AHR 1.90, 95%CI: 1.20–3.02, p = 0.007] and care in a tertiary hospital [AHR 2.21, 95% CI: 1.83–2.67, p<0.001], were associated with attrition.

Conclusion

Attrition could potentially be reduced by decentralizing patients on ART after the first 12 months on therapy to lower level facilities, earlier initiation on treatment and strengthening adherence counseling amongst males.     

Prevalence of urogenital and intestinal schistosomiasis among school children in South-west Nigeria

BackgroundThe risk of co-infection with Schistosoma haematobium and S. mansoni and the potential harmful effect on morbidity and control is enhanced by the overlapping distribution of both species in sub-Saharan Africa. Despite the reported high endemicity of both species in Nigeria, studies on the spread and effect of their mixed infection are limited. Therefore, a cross-sectional survey was conducted among school children in two communities in South-west Nigeria to investigate the prevalence of mixed human schistosome infection, intensity, and possible ectopic egg elimination.MethodsUrine and stool samples were collected from consenting school children in Ilie and Ore communities of Osun State, Nigeria. Schistosoma haematobium eggs were detected in urine using the urine filtration technique, while S. mansoni eggs were detected in stool using the Kato–Katz thick smear technique.ResultsThe study enrolled 466 primary and secondary school children (211; 45.3% males vs. 255; 54.7% females; mean age 11.6 ± 3.16 years). The overall prevalence of schistosomiasis was 40% (185/466), with 19% (89/466) recording single S. haematobium infection while 9% (41/465) had a single S. mansoni infection. The geometric mean egg count for S. haematobium was 189.4 egg/10ml urine; 95% CI: range 115.9–262.9, while for S. mansoni, it was 115.7 epg; 95% CI: range 78.4–152.9. The prevalence of ectopic S mansoni (S. mansoni eggs in urine) was 4.7%, while no ectopic S. haematobium (S. haematobium eggs in stool) was recorded. Mixed infection of S. haematobium/S. mansoni had a prevalence of 9.5% (44/466). More females (54.5%) presented with S. haematobium/S. mansoni co-infection. For both parasites, males had higher infection intensity, with a significant difference observed with S. haematobium (p = 0.0004). Hematuria was significant in individuals with single S. haematobium infection (p = 0.002), mixed ectopic S. haematobium/S. mansoni (p = 0.009) and mixed S. haematobium/S. mansoni/ectopic S. mansoni (p = 0.0003).ConclusionsThese findings suggest the probability of interspecific interactions between S. haematobium and S. mansoni. Scaling up of mass administration of praziquantel and control measures in the study areas is highly desirable.     

Metabolic reserves associated with pupal diapause in the flesh fly, Sarcophaga crassipalpis

Larvae of Sarcophaga crassipalpis destined for pupal diapause (light:dark 12:12, 20°C) contain nearly twice as much lipid and twice the haemolymph protein concentration as larvae that will not enter diapause (light:dark 15:9, 20°C). This conspicuous difference in metabolic reserves provides the earliest indication of the developmental fate of the larva. Lipid reserves are utilized rapidly during the first half of diapause and then remain stable until adult eclosion. In contrast, residual dry weight changes very little early in diapause but drops sharply late in diapause, thus implying a transition from lipid utilization to protein or carbohydrate utilization in mid-diapause. We suggest that this metabolic transition marks the end of the “fixed latency period”: pupae readily respond to environmental or hormonal stimulation after this point. Diapause-destined larvae did not accumulate more glycogen than nondiapause-destined larvae, but an 80% decrease in glycogen at the onset of diapause and its elevation at the end of diapause suggests the utilization of glycerol or related compounds as cryoprotectants during diapause. Profiles of water content are very similar in short-day and long-day flies, thus suggesting that dehydration is not a mechanism exploited by the flesh fly to achieve cold hardiness. Adult flies that have experienced pupal diapause emerge from the puparium with lipid, glycogen, and water content nearly identical to flies that have not experienced diapause, but the residual dry weight is much lower. The severe depletion of protein may account for the reduced fecundity of flies that have experienced diapause.